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Introduction: Wildfires impact large populations worldwide with increasing frequency and severity. In Canada, the fire season has affected more areas this year with potential implications for individuals' well-being and quality of life (QoL). Objective: This study aimed to explore data related to the well-being and QoL of individuals living in areas impacted by wildfires in two Canadian provinces. Methodology: A cross-sectional survey was used to collect data from the residents in the two provinces who subscribed to the Text4Hope mental health support service. Descriptive and inferential statistics were applied using World Health Organization Well-Being Index (WHO-5). Results: Out of 1802 Text4Hope subscribers, 298 responded to the baseline surveys, yielding a response rate of (16.5%). The mean score of QoL was (40.8/100 ± 20.7). Most respondents were from Alberta (84.2%), 40 years old or below (28.3%), females (85.2%), Caucasian (83.5%), in a relationship (56.4%), employed (63.6%), received diagnoses of depression (56.6%), and anxiety (52.9%).The overall prevalence of low QoL was (67.3%; 95% CI: 61.2–73.1%) that was mostly reported among subscribers who were from Nova Scotia (70.5%), 40 years old or younger (71.2%), other gender (83.3%), Black/Hispanic and other ethnicity (85.7% each), having high-school or less education (70.3%), not in a relationship (74.1%), and unemployed (73.6%). In terms of clinical factors, low QoL was most prevalent among those who received the diagnoses of depression (74%) and anxiety (74.3%), and those who have been receiving antidepressants (71.8%) or benzodiazepines (93.3%). Regarding wildfire-related factors, the highest prevalence of low QoL was reported among those living in a region that has recently been impacted by the wildfires (74.7%) and those who have been less frequently watching television images about the devastation caused by the recent wildfires (72.6%). The multivariate logistic regression analysis model predicting the low QoL including the various variables was statistically significant; Χ2 (df = 19; n = 254) = 31.69, p = 0.03. It was found that living in a region impacted by wildfires (37.9%) was the only significant predictor of low QoL (adjusted OR: 1.96; 95% CI: 1.05–3.65). Conclusions: The impact of wildfire on the QoL and well-being among people living in impacted regions is significant. It is empirical for the health authorities to support those who are disadvantaged by wildfire via running of screening programs to early identify mental health symptoms and addressing the living conditions of the survivors, along with the provision of innovative means of mental health support. This necessitates enhanced planning of the governments and health authorities to overcome such adverse psychological consequences of these events. [ABSTRACT FROM AUTHOR]

Background: Examining support for substance use policies, including those for harm reduction, among the general public and policy influencers is a fundamental step to map the current policy landscape and leverage policy opportunities. Yet, this is a knowledge gap in Canada. Our paper identifies the level of support for substance use policies in two provinces in Canada and describes how the level of support is associated with intrusiveness and sociodemographic variables., Methods: Data came from the 2019 Chronic Disease Prevention Survey. The representative sample included members of the general public (Alberta n = 1648, Manitoba n = 1770) as well as policy influencers (Alberta n = 204, Manitoba n = 98). We measured the level of support for 22 public policies concerning substance use through a 4-point Likert-scale. The Nuffield Council on Bioethics Intervention Ladder framework was applied to assess intrusiveness. We used cumulative link models to run ordinal regressions for identification of explanatory sociodemographic variables., Results: Overall, there was generally strong support for the policies assessed. The general public in Manitoba was significantly more supportive of policies than its Alberta counterpart. Some differences were found between provinces and samples. For certain substance use policies, there was stronger support among women than men and among those with higher education than those with less education., Conclusions: The results highlight areas where efforts are needed to increase support from both policy influencers and general public for adoption, implementation, and scaling of substance use policies. Socio-demographic variables related to support for substance use policies may be useful in informing strategies such as knowledge mobilization to advance the policy landscape in Western Canada., (© 2024. The Author(s).)

Background: Advance care planning (ACP) is a process which enables patients to communicate wishes, values, fears, and preferences for future medical care. Despite patient interest in ACP, the frequency of discussions remains low. Barriers to ACP may be mitigated by involving non-physician clinic staff, preparing patients ahead of visits, and using tools to structure visits. An ACP care pathway incorporating these principles was implemented in longitudinal generalist outpatient care, including primary care/family medicine and general internal medicine, in two Canadian provinces. This study aims to understand clinician experiences implementing the pathway., Methods: The pathway was implemented in one family practice in Alberta, two family practices in British Columbia (BC), and one BC internal medicine outpatient clinic. Physicians and allied health professionals delivered structured pathway visits based on the Serious Illness Conversation Guide. Twelve physicians and one social worker participated in interviews or focus groups at the end of the study period. Qualitative data were coded inductively using an iterative approach, with regular meetings between coders., Results: Clinicians described experiences with the ACP care pathway, impact at the clinician level, and impact at the patient level. Within each domain, clinicians described barriers and facilitators experienced during implementation. Clinicians also reflected candidly about potential for future implementation and the sustainability of the pathway., Conclusions: While the pathway was implemented slightly differently between provinces, core experiences were that implementation of the pathway, and integration with current practice, were feasible. Across settings, similar themes recurred regarding usefulness of the pathway structure and its tools, impact on clinician confidence and interactions with patients, teamwork and task delegation, compatibility with existing workflow, and patient preparation and readiness. Clinicians were supportive of ACP and of the pathway., Trial Registration: The study was prospectively registered with clinicaltrials.gov (NCT03508557). Registered April 25, 2018. https://classic., Clinicaltrials: gov/ct2/show/NCT03508557 ., (© 2024. The Author(s).)

This study investigated the diagnostic capacity for Fetal Alcohol Spectrum Disorder (FASD) in multidisciplinary clinics across several provincial and one territorial jurisdictions of Canada: Alberta, British Columbia, Manitoba, Ontario and Northwest Territories. The data were collected directly from clinics capable of providing diagnoses of FASD and examined annual capacity for the assessment and diagnosis of FASD per year from 2015 to 2019. In total, 58 FASD diagnostic clinics were identified and 33 clinics participated in this survey. The study identified inadequate FASD diagnostic capacity in all participating jurisdictions. Based on the findings and the current population sizes, it is estimated that 98% of individuals with FASD are undiagnosed or misdiagnosed in Canada. Wait times for FASD diagnosis ranged from 1 month to 4.5 years across participating jurisdictions. The annual FASD diagnostic capacity in the select provinces and territories require at least a 67-fold increase per year., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Popova et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Despite the association between cannabis use and higher prevalence of suicidal ideation and attempt, the effect of cannabis legalization and regulation in Canada on intentional self-harm has not been determined., Methods: We used an interrupted time series of population-based rates of emergency department (ED) visits and hospitalizations for intentional self-harm per 100 000 in Ontario and Alberta from January/April 2010 to February 2020. Aggregate monthly counts of ED visits and hospitalizations for intentional self-harm (ICD-10 codes X60-X84, R45.8) were obtained from the National Ambulatory Care Reporting System and Discharge Abstract Database, respectively., Results: The legalization and regulation of cannabis in Canada was not significantly associated with a change in rates of ED visits for intentional self-harm in Ontario (level = 0.58, 95% CI: -1.14 to 2.31; trend = -0.17, 95% CI: -0.35 to 0.01) or Alberta (level = -0.06, 95% CI: -2.25 to 2.12; trend = -0.07, 95% CI: -0.27 to 0.13). Hospitalizations for intentional self-harm also remained unchanged in Ontario (level = -0.14, 95% CI: -0.48 to 0.20; trend = 0.01, 95% CI: -0.03 to 0.04) and Alberta (level = -0.41, 95% CI: -1.03 to 0.21; trend = -0.03, 95% CI: -0.08 to 0.03)., Conclusion: Legalization and regulation of cannabis in Canada has not increased rates of ED visits or hospitalizations for intentional self-harm in Ontario and Alberta. Individual-level analyses that account for demographic characteristics and include other provinces and territories are needed., Competing Interests: MDC is a practising neurosurgeon who treats patients who sustained head injuries or trauma that may have been a result of substance use and intoxication, including due to cannabis. MDC had financial support from the Public Health Agency of Canada for the submitted work. MDC also received a grant from the Canadian Institutes of Health Research for a similar study, which might have an interest in the submitted work (RM and OS were listed as co-applicants). MDC and MW received a research grant from the Toronto Cannabis and Cannabinoid Research Consortium, which might have an interest in the submitted work. MC reports no financial interests, activities, relationships or affiliations that could appear to have influenced the submitted work. Each author confirms that this study has not been previously published in any form and is not currently under consideration by any other journal.

This paper provides an empirical estimation of the effects of provincial corporate tax rates on economic growth using annual panel data from Canadian provinces over the period 1981-2016. Our empirical approach enables us to investigate the long-run relationship between provincial tax rates and economic growth by allowing short-run dynamics to vary across provinces. We find that a reduction in the provincial CIT rate has a statistically significant positive effect on economic growth rate. Based on our preferred specification of the econometric model, a one percentage-point reduction in a provincial government's statutory CIT rate increases the growth rate by 0.12 percentage points four years after the initial CIT rate cut and increases real per capita GDP by 1.2 per cent in the long run. The results are robust to various sensitivity checks. These results are consistent with the empirical estimates in our previous study of Ferede and Dahlby (2012), who used a different econometric methodology and sample period. They are also broadly consistent with the findings of recent empirical studies of the impact of corporate income taxes on the economic performance of U.S. states. In a companion communiqué, we use the econometric results to estimate the increase in Alberta's growth rate from the Alberta government's announced reduction in the provincial CIT rate from 12 per cent in 2018 to eight per cent in 2022. [ABSTRACT FROM AUTHOR]

This review paper investigates the landscape of wildfire-related studies with a focus on infrastructure and evacuations across Canadian provinces, revealing a predominant focus on Alberta, particularly after the 2016 Fort McMurray wildfire. The aftermath of this event has heightened attention to the unique challenges faced during evacuations, emphasizing the urgent need for heightened awareness and preparedness, especially in the vulnerable northern communities of Alberta. Studies beyond Alberta contribute to understanding Canadian wildfire dynamics. However, a noticeable research gap in British Columbia raises concerns about research prioritization and resource allocation despite heightened wildfire activity. The fact that some provinces are contributing less than 4.2%, such as Quebec, Saskatchewan, Ontario, Northwest Territories, Yukon, and the Prairies, might be attributed to regional variations influenced by historical wildfire frequency and population density. Thematic analysis categorizing studies into "community support/resilience", "evacuation efficiency", and "infrastructure protection/raising awareness" provides nuanced insights. The dominance of the "community support/resilience" category, comprising over 40% of studies, signifies a societal shift towards proactive community engagement. Balanced representation in the "evacuation efficiency" and "infrastructure protection/raising awareness" categories, each contributing over 29%, reflects a collective effort to glean lessons from past evacuations and enhance community preparedness. Temporal trends and thematic analyses spotlight a commitment to continuous improvement, adaptability to emerging challenges, and a growing recognition of the multifaceted aspects of wildfire management. The evolving emphasis on community involvement, responsiveness to changing evacuation dynamics, and heightened awareness of infrastructure protection underscores the proactive stance of the research community, providing insights for shaping future research priorities, policy frameworks, and community resilience strategies in the face of evolving wildfire threats in Canada. [ABSTRACT FROM AUTHOR]

Background A comprehensive evaluation of progress in cancer survival for all cancer types combined in Canada has recently been accomplished. An analogous evaluation across Canadian provinces has yet to be conducted. Data and methods Data from 1992 to 2017 are from the population-based Canadian Cancer Registry death-linked analytic file. Provincial cancer survival index (CSI) estimates were calculated as the weighted sum of the sex- and cancer-specific age-standardized provincial net survival estimates. Provincial sex-specific CSI estimates were calculated separately using sex-specific cancer type weights. Data availability (Quebec) and sufficiency (Prince Edward Island and the territories) issues precluded CSI calculations for all jurisdictions. Results For the most recent period, 2013 to 2017, the five-year CSI was highest in Ontario (64.1%) and Alberta (63.3%), and lowest in Nova Scotia (60.8%). Significant progress in the five-year CSI since the period from 1992 to 1996 was observed in each province; the largest increases occurred in Alberta (8.7 percentage points) and Ontario (8.6 percentage points). Alberta's increase improved its relative provincial ranking from eighth to second. The influence of prostate cancer on provincial changes in the CSI since the period from 2003 to 2007 varied considerably from strongly counterproductive in New Brunswick, Saskatchewan and Nova Scotia because of decreasing prostate cancer survival, to strongly productive in Manitoba. Interpretation Significant progress has been made in five-year cancer survival for all cancers combined since the early 1990s in each Canadian province studied. However, the magnitude of the progress has not been uniform across the provinces, and the cancer and sex combinations that have most influenced it have varied by province and period. [ABSTRACT FROM AUTHOR]

Introduction: Improving health services integration through primary health care (PHC) teams for patients with chronic conditions is essential to address their complex health needs and facilitate better health outcomes. The objective of this study was to explore if and how patients, family members, and caregivers were engaged or wanted to be engaged in developing, implementing and evaluating health policies related to PHC teams. This patient‐oriented research was carried out in three provinces across Canada: British Columbia, Alberta and Ontario. Methods: A total of 29 semi‐structured interviews with patients were conducted across the three provinces and data were analysed using thematic analysis. Results: Three key themes were identified: motivation for policy engagement, experiences with policy engagement and barriers to engagement in policy. The majority of participants in the study wanted to be engaged in policy processes and advocate for integrated care through PHC teams. Barriers to patient engagement in policy, such as lack of opportunities for engagement, power imbalances, tokenism, lack of accessibility of engagement opportunities and experiences of racism and discrimination were also identified. Conclusion: This study increases the understanding of patient, family member, and caregiver engagement in policy related to PHC team integration and the barriers that currently exist in this engagement process. This information can be used to guide decision‐makers on how to improve the delivery of integrated health services through PHC teams and enhance patient, family member, and caregiver engagement in PHC policy. Patient or Public Contribution: We would like to acknowledge the contributions of our patient partners, Brenda Jagroop and Judy Birdsell, who assisted with developing and pilot testing the interview guide. Judy Birdsell also assisted with the preparation of this manuscript. This study also engaged patients, family members, and caregivers to share their experiences with engagement in PHC policy. [ABSTRACT FROM AUTHOR]

Background Small observational studies have suggested that statin users have a lower risk of dying with COVID-19. We tested this hypothesis in a large, population-based cohort of adults in 2 of Canada's most populous provinces: Ontario and Alberta. Methods and Results We examined reverse transcriptase-polymerase chain reaction swab positivity rates for SARS-CoV-2 in adults using statins compared with nonusers. In patients with SARS-CoV-2 infection, we compared 30-day risk of all-cause emergency department visit, hospitalization, intensive care unit admission, or death in statin users versus nonusers, adjusting for baseline differences in demographics, clinical comorbidities, and prior health care use, as well as propensity for statin use. Between January and June 2020, 2.4% of 226 142 tested individuals aged 18 to 65 years, 2.7% of 88 387 people aged 66 to 75 years, and 4.1% of 154 950 people older than 75 years had a positive reverse transcriptase-polymerase chain reaction swab for SARS-CoV-2. Compared with 353 878 nonusers, the 115 871 statin users were more likely to test positive for SARS-CoV-2 (3.6% versus 2.8%, P <0.001), but this difference was not significant after adjustment for baseline differences and propensity for statin use in each age stratum (adjusted odds ratio 1.00 [95% CI, 0.88-1.14], 1.00 [0.91-1.09], and 1.06 [0.82-1.38], respectively). In individuals younger than 75 years with SARS-CoV-2 infection, statin users were more likely to visit an emergency department, be hospitalized, be admitted to the intensive care unit, or to die of any cause within 30 days of their positive swab result than nonusers, but none of these associations were significant after multivariable adjustment. In individuals older than 75 years with SARS-CoV-2, statin users were more likely to visit an emergency department (28.2% versus 17.9%, adjusted odds ratio 1.41 [1.23-1.61]) or be hospitalized (32.7% versus 21.9%, adjusted odds ratio 1.19 [1.05-1.36]), but were less likely to die (26.9% versus 31.3%, adjusted odds ratio 0.76 [0.67-0.86]) of any cause within 30 days of their positive swab result than nonusers. Conclusions Compared with statin nonusers, patients taking statins exhibit the same risk of testing positive for SARS-CoV-2 and those younger than 75 years exhibit similar outcomes within 30 days of a positive test. Patients older than 75 years with a positive SARS-CoV-2 test and who were taking statins had more emergency department visits and hospitalizations, but exhibited lower 30-day all-cause mortality risk.

Background: Autosomal dominant (AD) spinocerebellar ataxias (SCAs) encompass a large group of rare disorders, which occurs in individuals of different ethnic backgrounds. To date, demographics, and clinical descriptions of AD SCA in Canada are lacking. Methods: A retrospective chart review of patients with a genetically confirmed diagnosis of AD SCAs was performed at five tertiary centers across Canada in the provinces of Quebec, Alberta, and Ontario. Demographic, genetic, and clinical information were collected and analyzed. Results: A total of 203 patients with AD SCA were identified. Weighted estimated prevalence of AD SCA in three large Canadian provinces was calculated (2.25 cases per 100.000) which is in keeping with the figures documented worldwide. We found that the distribution of the most common SCA differed when comparing provinces. The most prevalent SCA diagnosis in Ontario was SCA3 (49%), while the most prevalent SCA diagnosis in Alberta and Quebec was SCA2 in 26% and 47%, respectively. SCA6 was the third most prevalent SCA subtype in Quebec (14%), which was not seen as commonly in other provinces. SCA1 was uncommonly seen in both Alberta and Quebec, despite being common in Ontario. Conclusions: In this largest Canadian study, we describe the prevalence, distribution, and clinical characteristics of AD SCA. We found that the distribution of the most common SCA differed in the three provinces studied. This finding reflects the heterogenous nature of the Canadian population. [ABSTRACT FROM AUTHOR]

Background: The development of a successful COVID-19 control strategy requires a thorough understanding of the trends in geographic and demographic distributions of disease burden. In terms of the estimation of the population prevalence, this includes the crucial process of unravelling the number of patients who remain undiagnosed., Objective: This study estimates the period prevalence of COVID-19 between March 1, 2020, and November 30, 2020, and the proportion of the infected population that remained undiagnosed in the Canadian provinces of Quebec, Ontario, Alberta, and British Columbia., Methods: A model-based mathematical framework based on a disease progression and transmission model was developed to estimate the historical prevalence of COVID-19 using provincial-level statistics reporting seroprevalence, diagnoses, and deaths resulting from COVID-19. The framework was applied to three different age cohorts (< 30; 30-69; and ≥70 years) in each of the provinces studied., Results: The estimates of COVID-19 period prevalence between March 1, 2020, and November 30, 2020, were 4.73% (95% CI 4.42%-4.99%) for Quebec, 2.88% (95% CI 2.75%-3.02%) for Ontario, 3.27% (95% CI 2.72%-3.70%) for Alberta, and 2.95% (95% CI 2.77%-3.15%) for British Columbia. Among the cohorts considered in this study, the estimated total number of infections ranged from 2-fold the number of diagnoses (among Quebecers, aged ≥70 years: 26,476/53,549, 49.44%) to 6-fold the number of diagnoses (among British Columbians aged ≥70 years: 3108/18,147, 17.12%)., Conclusions: Our estimates indicate that a high proportion of the population infected between March 1 and November 30, 2020, remained undiagnosed. Knowledge of COVID-19 period prevalence and the undiagnosed population can provide vital evidence that policy makers can consider when planning COVID-19 control interventions and vaccination programs., (©Abdullah Hamadeh, Zeny Feng, Jessmyn Niergarth, William WL Wong. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 09.09.2021.)

Introduction: The use of osimertinib in the first-line (1L) setting is an effective treatment option for sensitizing EGFR-mutations (EGFRm+) and has significantly altered the standard of care practice for EGFRm+ disease in Canada. Unfortunately, acquired resistance to osimertinib is almost universal, and outcomes are disparate. Post-progression treatment patterns and the outcome of real-world Canadian EGFRm+ patients receiving 1L osimertinib were the focus of this retrospective review. Methods: The Glans-Look Lung Cancer Research database was used to identify and collect demographic, clinical, treatment, and outcome data on EGFRm+ patients who received 1L osimertinib in the Canadian province of Alberta between 2018 and 2022. Results: A total of 150 patients receiving 1L osimertinib were identified. In total, 86 developed progressive disease, with 56 (65%) continuing systemic therapy, 73% continuing osimertinib, and 27% switching to second-line (2L) systemic therapy. Patients were similar both in clinical characteristics at 1L osimertinib initiation and patterns of treatment failure at progression; those continuing 1L osimertinib post-progression had a longer time to progression (13.5 vs. 8.8 months, p = 0.05) and subsequent post-osimertinib initiation survival (34.7 vs. 22.8 months, p = 0.11). Conclusions: The continuation of osimertinib post-progression is an effective disease management strategy for select real-world EGFRm+ patients, providing continued clinical benefit, potentially due to different underlying disease pathogenesis. [ABSTRACT FROM AUTHOR]

Objective: To assess and compare the favourability of healthy public policy options to promote healthy eating from the perspective of members of the general public and policy influencers in two Canadian provinces.Design: The Chronic Disease Prevention Survey, administered in 2016, required participants to rank their level of support for different evidence-based policy options to promote healthy eating at the population level. Pearson's χ 2 significance testing was used to compare support between groups for each policy option and results were interpreted using the Nuffield Council on Bioethics' intervention ladder framework.Setting: Alberta and Québec, Canada.ParticipantsMembers of the general public (n 2400) and policy influencers (n 302) in Alberta and Québec.Results: General public and policy influencer survey respondents were more supportive of healthy eating policies if they were less intrusive on individual autonomy. However, in comparing levels of support between groups, we found policy influencers indicated significantly stronger support overall for healthy eating policy options. We also found that policy influencers in Québec tended to show more support for more restrictive policy options than their counterparts from Alberta.Conclusions: These results suggest that additional knowledge brokering may be required to increase support for more intrusive yet impactful evidence-based policy interventions; and that the overall lower levels of support among members of the public may impede policy influencers from taking action on policies to promote healthy eating. [ABSTRACT FROM AUTHOR]

Pregnancy-associated cancer-that is diagnosed in pregnancy or within 365 days after delivery-is increasingly common as cancer therapy evolves and survivorship increases. This study assessed the incidence and temporal trends of pregnancy-associated cancer in Alberta and Ontario-together accounting for 50% of Canada's entire population. Linked data from the two provincial cancer registries and health administrative data were used to ascertain new diagnoses of cancer, livebirths, stillbirths and induced abortions among women aged 18-50 years, from 2003 to 2015. The annual crude incidence rate (IR) was calculated as the number of women with a pregnancy-associated cancer per 100,000 deliveries. A nonparametric test for trend assessed for any temporal trends. In Alberta, the crude IR of pregnancy-associated cancer was 156.2 per 100,000 deliveries (95% CI 145.8-166.7), and in Ontario, the IR was 149.4 per 100,000 deliveries (95% CI 143.3-155.4). While no statistically significant temporal trend in the IR of pregnancy-associated cancer was seen in Alberta, there was a rise in Ontario ( p = 0.01). Pregnancy-associated cancer is common enough to warrant more detailed research on maternal, pregnancy and child outcomes, especially as cancer therapies continue to evolve.

The Canadian Prairie Provinces (Alberta, Saskatchewan and Manitoba) are home to species from 29 of the 45 spider families currently found in Canada. Here we provide a beginner-friendly dichotomous key to the spider families of the Canadian Prairies. The key includes numerous photos, line drawings, and simplified definitions of anatomical characters necessary for family-level identification. For each family we include an illustrated summary of important character states, a whole-body photo of an exemplar of the family, and number of species of the family currently reported from the Prairie Provinces. [ABSTRACT FROM AUTHOR]

Background: Directly-funded home care (DF) provides government funds to people who need assistance with the activities of daily living, allowing them to arrange their own services. As programs expand globally, many allow DF clients to hire home care agencies to organize their services rather than finding their own workers. In Canada, half of the DF home care programs allow users to purchase agency services. The goal of this research is to describe the role of agency providers in DF home care in Canada and consider potential equity implications for service access from the perspectives of clients and families. Methods: Framed with intersectionality, the study included online focus groups with families and clients (n = 56) in the two Canadian provinces of Alberta and Manitoba between June 2021-April 2022. All transcripts underwent qualitative thematic analysis using open and axial coding techniques. Each transcript was analyzed by two of three possible independent coders using Dedoose qualitative analysis software. Results: The article presents five thematic findings. First, the focus groups document high rates of satisfaction with the care regardless of whether the client uses agency providers. Second, agency providers mediate some of the administrative barriers and emotional strain of using DF home care, and this is especially important for family caregivers who are working or have additional care responsibilities. Third, there are out-of-pocket expenses reported by most participants, with agency clients describing administrative fees despite lower pay for the frontline care workers. Fourth, agencies are not generally effective for linguistic and/or cultural matching between workers and families. Finally, we find that DF care programs cannot compensate for a limited informal support network. Conclusions: Clients and families often intentionally choose DF home care after negative experiences with other public service options, yet the results suggest that in some Canadian contexts, DF home care is a privilege only afforded to some. Given the growing inequalities that exist in Canadian society, all public home care options must be open to all who need it, irrespective of ability to pay, degree of social support, or competence in the English language. [ABSTRACT FROM AUTHOR]

Introduction: Screen time, a proxy for sedentary behaviours, has emerged as a critical health determinant among youth in contemporary societies, where most aspects of youth life involve access to screen-time devices. An understudied approach to reducing screen time among youth is bullying reduction. This study aims to understand the association between bullying perpetration, victimization, youth perception of the school environment and multiple screen-time behaviours., Methods: A total of 44,861 youth aged between 13 and 18 years in two Canadian provinces completed a validated questionnaire that collected student data on health behaviours and outcomes, including multiple screen-time behaviours, bullying perpetration and victimization, and school connectedness. The outcome variables were total screen time, time spent watching television, playing video games, internet surfing, and communication- based screen-time behaviours. Using a random intercept, the final models were built using PROC MIXED in SAS 9.4. These models were adjusted for age, ethnicity, weekly disposable income, daylight hours, and weather variables., Results: Compared to youth who reported non-involvement in bullying, youth who were bullies, victims, or both bullies and victims spent on average more minutes per day in front of screens across all screen time categories. Youth who felt happy and safe at school, and who perceived their teachers as being fair, reported lower levels of multiple screen-time behaviours., Conclusion: With non-involvement in bullying showing a strong negative association with multiple screen-time behaviours, school policies to address bullying and screen time through school connectedness could offer a novel approach in minimizing these harmful behaviours., Competing Interests: Apart from Dr. Leatherdale being the CIHR-PHAC Chair in Applied Public Health Research, and an Associate Scientific Editor with Health Promotion and Chronic Disease Prevention in Canada: Research, Policy and Practice, we declare that no other conflicts of interest exist.

Background: Primary care in Canada is the first point of entry for patients needing specialized services, the fundamental source of care for those living with chronic illness, and the main supplier of preventive services. Increased pressures on the system lead to changes such as an increased reliance on interdisciplinary teams, which are advocated to have numerous advantages. The functioning of teams largely depends on inter-professional relationships that can be supported or strained by the financial arrangements within teams. We assess which types of financial environments perpetuate and which reduce the challenge of medical dominance., Methods: Using qualitative interview data from 19 interdisciplinary teams/networks in three Canadian provinces, as well as related policy documents, we develop a typology of financial environments along two dimensions, financial hierarchy and multiplicity of funding sources. A financial hierarchy is created when the incomes of some providers are a function of the incomes of other providers. A multiplicity of funding sources is created when team funding is provided by several funders and a team faces multiple lines of accountability., Results: We argue that medical dominance is perpetuated with higher degrees of financial hierarchy and higher degrees of multiplicity. We show that the financial environments created in the three provinces have not supported a reduction in medical dominance. The longstanding Community Health Centre model, however, displays the least financial hierarchy and the least multiplicity-an environment least fertile for medical dominance., Conclusions: The functioning of interdisciplinary primary care teams can be negatively affected by the unique positioning of the medical profession. The financial environment created for teams is an important consideration in policy development, as it plays an important role in establishing inter-professional relationships. Policies that reduce financial hierarchies and funding multiplicities are optimal in this regard.

Background: Substance use is common among people who visit emergency departments (EDs) frequently. We aimed to characterize subgroups within this cohort to better understand care needs/gaps, and generalizability of characteristics in three Canadian provinces.Methods: This was a retrospective cohort study (April 1st, 2013 to March 31st, 2016) of ED patients in Ontario, Alberta, and British Columbia (B.C.) We included patients ≥ 18 years with substance use-related healthcare contact during the study period and frequent ED visits, defined as those in the top 10% of ED utilization when all patients were ordered by annual ED visit number. We used linked administrative databases including ED visits and hospitalizations (all provinces); mental heath-related hospitalizations (Ontario and Alberta); and prescriptions, physician services, and mortality (B.C.). We compared to cohorts of people with (1) frequent ED visits and no substance use, and (2) non-frequent ED visits and substance use. We employed cluster analysis to identify subgroups with distinct visit patterns and clinical characteristics during index year, April 1st, 2014 to March 31st, 2015.Results: In 2014/15, we identified 19,604, 7,706, and 9,404 people with frequent ED visits and substance use in Ontario, Alberta, and B.C (median 37-43 years; 60.9-63.0% male), whose ED visits and hospitalizations were higher than comparison groups. In all provinces, cluster analyses identified subgroups with "extreme" and "moderate" frequent visits (median 13-19 versus 4-6 visits/year). "Extreme" versus "moderate" subgroups had more hospitalizations, mental health-related ED visits, general practitioner visits but less continuity with one provider, more commonly left against medical advice, and had higher 365-day mortality in B.C. (9.3% versus 6.6%; versus 10.4% among people with frequent ED visits and no substance use, and 4.3% among people with non-frequent ED visits and substance use). The most common ED diagnosis was acute alcohol intoxication in all subgroups.Conclusions: Subgroups of people with "extreme" (13-19 visits/year) and "moderate" (4-6 visits/year) frequent ED visits and substance use had similar utilization patterns and characteristics in Ontario, Alberta, and B.C., and the "extreme" subgroup had high mortality. Our findings suggest a need for improved evidence-based substance use disorder management, and strengthened continuity with primary and mental healthcare. [ABSTRACT FROM AUTHOR]

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Objective: To estimate the degree to which fine particulate (PM2.5) air pollution is associated with systemic autoimmune rheumatic diseases (SARDs)., Methods: We used population-based administrative data from Alberta (1993-2007) and Quebec (1989-2011). SARD algorithms included ≥2 physician billing codes, or ≥1 rheumatology billing code, or ≥1 hospitalization diagnostic code (for systemic lupus, Sjogren's Syndrome, scleroderma, polymyositis, dermatomyositis, or undifferentiated connective tissue disease). Bayesian hierarchical latent class regression models estimated the probability that any given resident was a SARD case, based on the algorithms. Mean 2001-2006 residential ambient PM2.5 levels were assigned using satellite-derived data for dissemination area regions in Alberta and CLSC regions in Quebec. The sum of individual level probabilities provided the estimated total cases per region in each province, according to age, sex, urban-versus-rural residence, income, and PM2.5 levels. In Alberta, we ran separate models for First-Nations (FN) and non-First Nations subgroups. Bayesian logistic regression modeling generated odds ratio (OR) estimates for being a SARD case, accounting concurrently for demographics, as well as an interaction term between age and sex., Results: Our data suggested that the probability of being a SARD case was higher among females versus males and for residents aged >45 versus younger, with the highest ORs for older females. Independently, the odds of being a SARDs case increased with PM2.5 levels in both provinces., Conclusion: Our data suggest that PM2.5 exposure may be associated with an increased risk of SARDs., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Crossfield is located in the province of Alberta in Canada and is one of the most well-known reservoirs of hydrocarbons. Since the 1950s, there has been continuous exploitation of more than 10 formations such as Cardium, Viking, Ellerslie, Elkton, Shunda, and Wabamun. Because of its location near the Foothills, the southwestern part of the Western Canada Sedimentary Basin, the Crossfield area has a complex geology and relatively deeper reservoirs, therefore requiring an in-depth examination of each formation. In this study, geological, technical, and economic analyses were performed on each formation within the 10 sections of the study lands in the Crossfield area. As the result of the study, there was potential for drilling 48 horizontal wells in the Cardium A zone and the Viking formation. In addition, it turned out to be economically feasible even at the WTI price of 60 dollars per barrel considering Alberta's Royalty Framework, which is determined by the production rate and the price of oil, and the Horizontal Oil New Well Royalty Rate feature. A further study is required to investigate the exploitation potential of the Cardium B zone, the Ellerslie, and the Elkton formations in this area. [ABSTRACT FROM AUTHOR]

Albertans4HealthResearch, supported by the Alberta Strategy for Patient-Oriented Research Patient Engagement Team, hosted a virtual round table discussion to develop a list of considerations for successful partnerships in patient-oriented research. The group, which consists of active patient partners across the Canadian province of Alberta and some research staff engaged in patient-oriented research, considered advice for academic researchers on how to best partner with patients and community members on health research projects. The group identified four main themes, aligned with the national strategy for patient-oriented research (SPOR) patient engagement framework, highlighting important considerations for researchers from the patient perspective, providing practical ways to implement SPOR's key principles: inclusiveness, support, mutual respect, and co-building. This commentary considers the process behind this engagement exercise and offers advice directly from active patient research partners on how to fulfill the operational patient engagement mandate. Academic research teams can use this guidance when considering how to work together with patient partners and community members. Plain English summary: Albertans4HealthResearch, supported by the Alberta Strategy for Patient-Oriented Research (AbSPORU) Patient Engagement Team, hosted a virtual round table discussion to develop a list of considerations for successful partnerships in patient-oriented research. The group, which consists of active patient partners across the Canadian province of Alberta and some research staff engaged in patient-oriented research, considered advice for academic researchers on how to best partner with patients and community members on health research projects. The group identified four main themes, aligned with the national Strategy for Patient-Oriented Research (SPOR) Patient Engagement Framework, highlighting important considerations for researchers from the patient perspective, providing practical ways to implement SPOR's key principles: inclusiveness, support, mutual respect, and co-building. This commentary considers the process behind this engagement exercise and offers advice directly from active patient research partners on how to fulfill the operational patient engagement mandate. Academic research teams can use this guidance when considering how to work together with patient partners and community members. [ABSTRACT FROM AUTHOR]

Simple Summary: Infectious laryngotracheitis virus is an economically important acute upper respiratory tract disease in chickens. To control the disease, there are two types of vaccines commercially available, the recombinant viral vector and the live attenuated vaccines. The live attenuated vaccines are effective in disease control, but because of their residual virulence, they can replicate, cause disease, and revert to their original virulent form. Strains of the virus can be categorized as vaccine-related or wild type related. Information is scarce on the type of strains that are circulating in Canada. This study aims to discriminate between wild type and vaccine strains associated with infectious laryngotracheitis cases in the provinces of Alberta and British Columbia between the years 2009–2018. To accomplish this objective, the sequencing of two specific partial genes was performed. As a result, 27 samples from Alberta, and 5 samples from British Columbia were successfully sequenced. From the total samples, ~85% were related to vaccine strains and the rest categorized as wild type. These results reinforce the concern on current practices surrounding vaccination and the need to implement better biosecurity measures. Infectious laryngotracheitis virus (ILTV) causes an acute upper respiratory disease in chickens called infectious laryngotracheitis (ILT). Live attenuated vaccines are effective in disease control; however, they have residual virulence, which makes them able to replicate, cause disease and revert to the original virulent form. Information is scarce on the molecular nature of ILTV that is linked to ILT in Canada. This study aims to determine whether isolates originating from ILT cases in Western Canada are a wild type or vaccine origin. Samples submitted for the diagnosis of ILT between 2009–2018 were obtained from Alberta (AB, n = 46) and British Columbia (BC, n = 9). For genotyping, a Sanger sequencing of open reading frame (ORF) a and b was used. A total of 27 from AB, and 5 from BC samples yielded a fragment of 1751 base pairs (bp). Three of the BC samples classified as group IV (CEO vaccine strains) and 2 as group V (CEO revertant). Of the AB samples, 22 samples clustered with group V, 3 with group VI (wild type), and 2 with group VII, VIII, and IX (wild type). Overall, 17 non-synonymous single nucleotide polymorphisms (SNPs) were detected. Further studies are underway to ascertain the virulence and transmission potential of these isolates. [ABSTRACT FROM AUTHOR]

In 2018, using in-depth, semi-structured, collaborative dialogues, I asked 11 child and youth care practitioners working in various Canadian provinces, including British Columbia, Alberta, and Ontario, "How do you understand, name, reproduce, contest, and struggle with White settler privilege?" The intent was to name and challenge the dominant Whitestream norms in child and youth care. This project was inspired by the significant work of Indigenous and racialized activist- scholars to address the ongoing overrepresentation of Indigenous families across colonial systems in which child and youth care practitioners work, such as the child welfare and justice systems, and the underrepresentation in others, such as educational systems. Participants named colonial violence and systemic racism as entrenched in child and youth care practice while recognizing the difficulty of challenging dominant White norms and conventions in the classroom and field. I explore how this key finding unsettles child and youth care pedagogy and practice. In closing, I propose two practical ethical pathways towards unsettling White settler privilege in child and youth care. [ABSTRACT FROM AUTHOR]

Continuous urban expansion transforms the natural land cover into impervious surfaces across the world. It increases the city's thermal intensity that impacts the local climate, thus, warming the urban environment. Surface urban heat island (SUHI) is an indicator of quantifying such local urban warming. In this study, we quantified SUHI for the two most populated cities in Alberta, Canada, i.e., the city of Calgary and the city of Edmonton. We used the moderate resolution imaging spectroradiometer (MODIS) acquired land surface temperature (LST) to estimate the day and nighttime SUHI and its trends during 2001–2020. We also performed a correlation analysis between SUHI and selected seven influencing factors, such as urban expansion, population, precipitation, and four large-scale atmospheric oscillations, i.e., Sea Surface Temperature (SST), Pacific North America (PNA), Pacific Decadal Oscillation (PDO), and Arctic Oscillation (AO). Our results indicated a continuous increase in the annual day and nighttime SUHI values from 2001 to 2020 in both cities, with a higher magnitude found for Calgary. Moreover, the highest value of daytime SUHI was observed in July for both cities. While significant warming trends of SUHI were noticed in the annual daytime for the cities, only Calgary showed it in the annual nighttime. The monthly significant warming trends of SUHI showed an increasing pattern during daytime in June, July, August, and September in Calgary, and March and September in Edmonton. Here, only Calgary showed the nighttime significant warming trends in March, May, and August. Further, our correlation analysis indicated that population and built-up expansion were the main factors that influenced the SUHI in the cities during the study period. Moreover, SST indicated an acceptable relationship with SUHI in Edmonton only, while PDO, PNA, and AO did not show any relation in either of the two cities. We conclude that population, built-up size, and landscape pattern could better explain the variations of the SUHI intensity and trends. These findings may help to develop the adaptation and mitigating strategies in fighting the impact of SUHI and ensure a sustainable city environment. [ABSTRACT FROM AUTHOR]

Background: Implementation scientists and practitioners, alike, recognize the importance of sustaining practice change, however post-implementation studies of interventions are rare. This is a protocol for the Sustainment, Sustainability and Spread Study (SSaSSy). The purpose of this study is to contribute to knowledge on the sustainment (sustained use), sustainability (sustained benefits), and spread of evidence-based practice innovations in health care. Specifically, this is a post-implementation study of an evidence-informed, Care Aide-led, facilitation-based quality-improvement intervention called SCOPE (Safer Care for Older Persons (in long-term care) Environments). SCOPE has been implemented in nursing homes in the Canadian Provinces of Manitoba (MB), Alberta (AB) and British Columbia (BC). Our study has three aims: (i) to determine the role that adaptation/contextualization plays in sustainment, sustainability and spread of the SCOPE intervention; (ii) to study the relative effects on sustainment, sustainability and intra-organizational spread of high-intensity and low-intensity post-implementation "boosters", and a "no booster" condition, and (iii) to compare the relative costs and impacts of each booster condition.Methods/design: SSaSSy is a two-phase mixed methods study. The overarching design is convergent, with qualitative and quantitative data collected over a similar timeframe in each of the two phases, analyzed independently, then merged for analysis and interpretation. Phase 1 is a pilot involving up to 7 units in 7 MB nursing homes in which SCOPE was piloted in 2016 to 2017, in preparation for phase 2. Phase 2 will comprise a quasi-experiment with two treatment groups of low- and high-intensity post-implementation "boosters", and an untreated control group (no booster), using pretests and post-tests of the dependent variables relating to sustained care and management practices, and resident outcomes. Phase 2 will involve 31 trial sites in BC (17 units) and AB (14 units) nursing homes, where the SCOPE trial concluded in May 2019.Discussion: This project stands to advance understanding of the factors that influence the sustainment of practice changes introduced through evidence-informed practice change interventions, and their associated sustainability. Findings will inform our understanding of the nature of the relationship of fidelity and adaptation to sustainment and sustainability, and afford insights into factors that influence the intra-organizational spread of practice changes introduced through complex interventions. [ABSTRACT FROM AUTHOR]

Metastatic breast cancer (MBC) patient outcomes may vary according to distinct health care payers and different countries. We compared 291 Alberta (AB), Canada and 9429 US patients < 65 with de novo MBC diagnosed from 2010 through 2014. Data were extracted from the provincial Breast Data Mart and from the National Cancer Institute's SEER program. US patients were divided by insurance status (US privately insured, US Medicaid or US uninsured). Kaplan-Meier and log-rank analyses were used to assess differences in OS and hazard ratios (HR) were estimated using Cox models. Multivariate models were adjusted for age, surgical status, and biomarker profile. No difference in OS was noted between AB and US patients (HR = 0.92 (0.77–1.10), p = 0.365). Median OS was not reached for the US privately insured and AB groups, and was 11 months and 8 months for the US Medicaid and US uninsured groups, respectively. The 3-year OS rates were comparable between US privately insured and AB groups (53.28% (51.95–54.59) and 55.54% (49.49–61.16), respectively). Both groups had improved survival (p < 0.001) relative to the US Medicaid and US uninsured groups [39.32% (37.25–41.37) and 40.53% (36.20–44.81)]. Our study suggests that a universal health care system is not inferior to a private insurance-based model for de novo MBC. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Veterinary Research / Revue Canadienne de Recherche Vétérinaire is the property of Canadian Veterinary Medical Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To quantify associations of the dietary share of ultra-processed foods (UPF) with the overall diet quality of First Nations peoples.Design: A cross-sectional analysis of data from the First Nations Food, Nutrition and Environment Study, designed to contribute to knowledge gaps regarding the diet of First Nations peoples living on-reserve, south of the 60th parallel. A multistage sampling of communities was conducted. All foods from 24 h dietary recalls were categorized into NOVA categories and analyses were performed to evaluate the impact of UPF on diet quality.Setting: Western and Central Canada.Subjects: First Nations participants aged 19 years or older.Results: The sample consisted of 3700 participants. UPF contributed 53·9 % of energy. Compared with the non-UPF fraction of the diet, the UPF fraction had 3·5 times less vitamin A, 2·4 times less K, 2·2 times less protein, 2·3 times more free sugars and 1·8 times more Na. As the contribution of UPF to energy increased so did the overall intakes of energy, carbohydrate, free sugar, saturated fat, Na, Ca and vitamin C, and Na:K; while protein, fibre, K, Fe and vitamin A decreased. Diets of individuals who ate traditional First Nations food (e.g. wild plants and game animals) on the day of the recall were lower in UPF.Conclusions: UPF were prevalent in First Nations diets. Efforts to curb UPF consumption and increase intake of traditional First Nations foods and other fresh or minimally processed foods would improve diet quality and health in First Nations peoples. [ABSTRACT FROM AUTHOR]

Introduction: Clinical mastitis (CM) treatment decision-making is a multifaceted process that remains relatively understudied, despite CM being one of the most prevalent diseases on dairy farms worldwide, contributing greatly to the use of antimicrobials in the dairy industry. This study aimed to gain insights into decision-making mechanisms employed by dairy farmers in British Columbia and Alberta, Canada, when dealing with CM. Methods: Interviews were held with 15 dairy farmers in the Canadian provinces of British Columbia and Alberta and analyzed using reflexive thematic analysis to develop both the decision-pathway and overarching themes influencing the CM decisions by farmers in this region. Results and discussion: The analysis generated a decision-making process that begins with identification and classification of CM, guided by visual characteristics of milk and the udder, available milk production and quality data, presence of systemic signs, and additional diagnostics. Subsequently, CM cases are assessed based on the likelihood of cure, value of the cow, and herd goals to decide whether antimicrobial treatment is desired. Next, a treatment choice is made by evaluating severity and urgency of the case, availability of drugs and timing of the case. Finally, definition of treatment success and progression over time following the treatment decision guides the termination of treatment. Three overarching themes were generated that shape the decision-making process: 'Personal attributes', including personal approach and experiential knowledge; 'Inter-actor dynamics', such as shared decision-making and dynamics among producers, veterinarians, and milkers; and 'Moving beyond protocols', which highlights the dynamic nature of mastitis decision-making. These insights have the potential to inform the development of effective interventions to improve CM antimicrobial use that align with the reality of farming operations within Western Canada, and potentially beyond. [ABSTRACT FROM AUTHOR]

Background: Effective communication among interdisciplinary healthcare teams is essential for quality healthcare, especially in nursing homes (NHs). Care aides provide most direct care in NHs, yet are rarely included in formal communications about resident care (e.g., change of shift reports, family conferences). Audit and feedback is a potentially effective improvement intervention. This study compares the effect of simple and two higher intensity levels of feedback based on goal-setting theory on improving formal staff communication in NHs.Methods: This pragmatic three-arm parallel cluster-randomized controlled trial included NHs participating in TREC (translating research in elder care) across the Canadian provinces of Alberta and British Columbia. Facilities with at least one care unit with 10 or more care aide responses on the TREC baseline survey were eligible. At baseline, 4641 care aides and 1693 nurses cared for 8766 residents in 67 eligible NHs. NHs were randomly allocated to a simple (control) group (22 homes, 60 care units) or one of two higher intensity feedback intervention groups (based on goal-setting theory): basic assisted feedback (22 homes, 69 care units) and enhanced assisted feedback 2 (23 homes, 72 care units). Our primary outcome was the amount of formal communication about resident care that involved care aides, measured by the Alberta Context Tool and presented as adjusted mean differences [95% confidence interval] between study arms at 12-month follow-up.Results: Baseline and follow-up data were available for 20 homes (57 care units, 751 care aides, 2428 residents) in the control group, 19 homes (61 care units, 836 care aides, 2387 residents) in the basic group, and 14 homes (45 care units, 615 care aides, 1584 residents) in the enhanced group. Compared to simple feedback, care aide involvement in formal communications at follow-up was 0.17 points higher in both the basic ([0.03; 0.32], p = 0.021) and enhanced groups ([0.01; 0.33], p = 0.035). We found no difference in this outcome between the two higher intensity groups.Conclusions: Theoretically informed feedback was superior to simple feedback in improving care aides' involvement in formal communications about resident care. This underlines that prior estimates for efficacy of audit and feedback may be constrained by the type of feedback intervention tested.Trial Registration: ClinicalTrials.gov ( NCT02695836 ), registered on March 1, 2016. [ABSTRACT FROM AUTHOR]

Contemporary forest-health initiatives require technologies and workflows that can monitor forest degradation and recovery simply and efficiently over large areas. Spectral recovery analysis—the examination of spectral trajectories in satellite time series—can help democratize this process, particularly when performed with cloud computing and open-access satellite archives. We used the Landsat archive and Google Earth Engine (GEE) to track spectral recovery across more than 57,000 forest harvest areas in the Canadian province of Alberta. We analyzed changes in the normalized burn ratio (NBR) to document a variety of recovery metrics, including year of harvest, percent recovery after five years, number of years required to achieve 80% of pre-disturbance NBR, and % recovery the end of our monitoring window (2018). We found harvest areas in Alberta to recover an average of 59.9% of their pre-harvest NBR after five years. The mean number of years required to achieve 80% recovery in the province was 8.7 years. We observed significant variability in pre- and post-harvest spectral recovery both regionally and locally, demonstrating the importance of climate, elevation, and complex local factors on rates of spectral recovery. These findings are comparable to those reported in other studies and demonstrate the potential for our workflow to support broad-scale management and research objectives in a manner that is complimentary to existing information sources. Measures of spectral recovery for all 57,979 harvest areas in our analysis are freely available and browseable via a custom GEE visualization tool, further demonstrating the accessibility of this information to stakeholders and interested members of the public. [ABSTRACT FROM AUTHOR]

Background: Vertebral subluxation theories are controversial in chiropractic. Divisions are evident in the chiropractic community among those who align their practices to subluxation theories and those who do not. This study investigated how many clinics offering chiropractic in the Canadian province of Alberta promote a theory of subluxation, which health ailments or improvements were linked to subluxation, and whether the subluxation discourse was used to promote chiropractic for particular demographics. Methods: Using the search engine on the Canadian Chiropractic Associations' website, we made a list of all clinics in Alberta. We then used Google searches to obtain a URL for each clinic with a website, totalling 324 URLs for 369 clinics. We then searched on each website for "subluxation" and performed content analysis on the related content. Results: One hundred twenty-one clinics' websites (33%) presented a theory of vertebral subluxation. The health ailments and improvements discussed in relation to subluxation were wide-ranging. An observed trend was the marketing of chiropractic for children, which was observed on 29 clinic websites (8%). Conclusions: Based on the controversy surrounding vertebral subluxation, the substantial number of clinic websites aligning their practice with vertebral subluxation should cause concern for regulatory bodies. [ABSTRACT FROM AUTHOR]

Introduction: The age of diagnosis is crucial for optimal health outcomes; however, some individuals with Autism Spectrum Disorder (ASD) may not be diagnosed until adulthood. Limited information is available about the lived experience of receiving a diagnosis during adulthood. Thus, we aimed to investigate stakeholders' experiences about the ASD diagnosis during adulthood. Method: We interviewed 18 individuals including 13 adults with ASD who had received a late diagnosis during adulthood and 5 parents of individuals with ASD from various Canadian provinces. Results: Using a thematic analysis, three main themes emerged: (a) noticing differences and similarities, (b) hindering elements to diagnosis, and (c) emotional response to diagnostic odyssey. Conclusion: This study adds to the literature about experiences of receiving ASD diagnosis in adulthood. Given the impact of diagnosis on individuals, it is important to minimize the barriers to ensure individuals who require ASD-related supports can access them in a timely and effective manner. This study highlights the importance of receiving an ASD diagnosis and facilitates positive health outcomes. The findings from the current study can be used to guide adult diagnostic processes and practices to help make ASD diagnosis more accessible. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Veterinary Journal / Revue Vétérinaire Canadienne is the property of Canadian Veterinary Medical Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Staphylococcus aureus is one of the prevalent etiological agents of contagious bovine mastitis, causing a significant economic burden on the global dairy industry. Given the emergence of antibiotic resistance (ABR) and possible zoonotic spillovers, S aureus from mastitic cattle pose threat to both veterinary and public health. Therefore, assessment of their ABR status and pathogenic translation in human infection models is crucial. Results: In this study, 43 S. aureus isolates associated with bovine mastitis obtained from four different Canadian provinces (Alberta, Ontario, Quebec, and Atlantic provinces) were tested for ABR and virulence through phenotypic and genotypic profiling. All 43 isolates exhibited crucial virulence characteristics such as hemolysis, and biofilm formation, and six isolates from ST151, ST352, and ST8 categories showed ABR. Genes associated with ABR (tetK, tetM, aac6', norA, norB, lmrS, blaR, blaZ, etc.), toxin production (hla, hlab, lukD, etc.), adherence (fmbA, fnbB, clfA, clfB, icaABCD, etc.), and host immune invasion (spa, sbi, cap, adsA, etc.) were identified by analyzing whole-genome sequences. Although none of the isolates possessed human adaptation genes, both groups of ABR and antibiotic-susceptible isolates demonstrated intracellular invasion, colonization, infection, and death of human intestinal epithelial cells (Caco-2), and Caenorhabditis elegans. Notably, the susceptibilities of S. aureus towards antibiotics such as streptomycin, kanamycin, and ampicillin were altered when the bacteria were internalized in Caco-2 cells and C. elegans. Meanwhile, tetracycline, chloramphenicol, and ceftiofur were comparatively more effective with ≤ 2.5 log10 reductions of intracellular S. aureus. Conclusions: This study demonstrated the potential of S. aureus isolated from mastitis cows to possess virulence characteristics enabling invasion of intestinal cells thus calling for developing therapeutics capable of targeting drug-resistant intracellular pathogens for effective disease management. [ABSTRACT FROM AUTHOR]

Background: Adolescence and young adulthood is an important period for substance use initiation and related harms. In the context of the ongoing opioid crisis, the risks for youth (ages 16–29) who use opioids are particularly heightened. Despite recommendations to adopt a developmentally appropriate and comprehensive approach to reduce opioid-related harms among youth, data continue to show that youth are not adequately engaged in opioid treatments and encounter many barriers. The aim of this study is to identify youth-centered opportunities for improving opioid treatment services. Methods: This paper reports multi-site qualitative findings from youth participating in the 'Improving Treatment Together' project, a community-based participatory project being conducted in British Columbia and Alberta, two western Canadian provinces that have been dramatically impacted by the opioid crisis. Qualitative data were collected during three workshops with youth who used opioids and accessed opioid treatment services in the prior 12 months. These workshops were conducted in three communities following the core elements of human-centered co-design. A multi-site qualitative analysis was conducted to identify within- and between-site themes surrounding youths' needs for improving opioid treatment service experiences and outcomes. Results: Three overarching needs themes were identified from across the communities. The first reflected youths' difficulties finding and staying connected to opioid treatment services, with the overarching need theme suggesting opportunities to reduce organizational and systems-related barriers to care, such as waiting times and wider information about service availability. The second area of need was rooted in youths' feelings of judgment when accessing services. Consequently, opportunities to increase respectful and empathic interactions were the overarching need. The final theme was more nuanced across communities and reflected opportunities for an individualized approach to opioid treatment services that consider youths' unique basic safety, social, and health needs. Conclusions: This study identifies fundamental directions for the operationalization and implementation of youth-centered opioid treatment services. These directions are contextualized in youths' lived experiences accessing services in their local communities, with overarching themes from across sites strengthening their transferability to other settings. [ABSTRACT FROM AUTHOR]

Echinococcus multilocularis (Em) is a zoonotic parasite considered a global emergent pathogen. Recent findings indicate that the parasite is expanding its range in North America and that European-type haplotypes are circulating in western Canada. However, genetic analyses are usually conducted only on a few parasites out of thousands of individuals within each definitive host, likely underestimating the prevalence of less common haplotypes. Moreover, mixed infections with several mtDNA haplotypes in the same host have been reported, but their relative abundance within the host was never estimated. We aimed to 1) estimate the frequency of co-infections of different Em haplotypes in coyotes (Canis latrans) and red foxes (Vulpes vulpes) from western Canada and their relative abundance within the definitive hosts, 2) detect less prevalent haplotypes by sampling a larger proportion of the parasite subpopulation per host, and 3) investigate differences in the distribution of Em haplotypes in these main definitive hosts; foxes and coyotes. We extracted DNA from ~10% of the worm subpopulation per host (20 foxes and 47 coyotes) and used deep amplicon sequencing (NGS technology) on four loci, targeting the most polymorphic regions from the mitochondrial genes cox1 (814 bp), nad1 (344 bp), and cob (387 bp). We detected the presence of mixed infections with multiple Em haplotypes and with different Echinococcus species including Em and E. granulosus s.l. genotypes G8/G10, low intraspecific diversity of Em, and a higher abundance of the European-type haplotypes in both hosts. Our results suggest a population expansion of the European over the North American strain in Alberta and a limited distribution of some European-type haplotypes. Our findings indicate that deep amplicon sequencing represents a valuable tool to characterize Em in multiple hosts, to assess the current distribution and possible origins of the European strain in North America. The potential use of next-generation sequencing technologies is particularly important to understand the patterns of geographic expansion of this parasite. Author summary: Echinococcus multilocularis is a tiny tapeworm whose adults live in the intestines of wild and domestic canids and shed their eggs with the host feces. If accidentally ingested by people, eggs can cause human alveolar echinococcosis (AE), a highly lethal parasitic disease. Despite Em being common in North America, only two locally acquired AE human cases were reported in North America until 2013. However, in the last 6 years, 14 new cases have been detected in Alberta, Canada, and recent findings showed that the European strain of this parasite is now common in wildlife in this province, which could potentially increase the risk of infection in humans and domestic animals. In this study, we genetically characterized Em in coyotes and red foxes to assess the extent of the European-type strain distribution in three Canadian provinces. We used deep amplicon sequencing, an innovative approach that allows us to detect co-infections and the presence of less prevalent genetic variants by sampling a larger proportion of the parasite subpopulation per host. Our study showed an overwhelming prevalence of the European strain over the native North American strain in both hosts, and a limited geographical distribution of some European genetic variants, likely due to multiple introduction events of this invasive strain. [ABSTRACT FROM AUTHOR]

Objective: To assess general public and policy influencer support for population-level tobacco control policies in two Canadian provinces. Methods: We implemented the Chronic Disease Prevention Survey in 2016 to a census sample of policy influencers (n = 302) and a random sample of members of the public (n = 2400) in Alberta and Quebec, Canada. Survey respondents ranked their support for tobacco control policy options using a Likert-style scale, with aggregate responses presented as net favourable percentages. Levels of support were further analyzed by coding each policy option using the Nuffield Council on Bioethics intervention ladder framework, to assess its level of intrusiveness on personal autonomy. Results: Policy influencers and the public considered the vast majority of tobacco control policy options as "extremely" or "very" favourable, although policy influencers in Alberta and Quebec differed on over half the policies, with stronger support in Quebec. Policy influencers and the public strongly supported more intrusive tobacco control policy options, despite anticipated effects on personal autonomy (i.e. for policies targeting children/youth and emerging tobacco products like electronic cigarettes). They indicated less support for fiscally based tobacco control policies (i.e. taxation), despite these policies being highly effective. Conclusion: Overall, policy influencers and the general public strongly supported more restrictive tobacco control policies. This study further highlights policies where support among both population groups was unanimous (potential "quick wins" for health advocates). It also highlights areas where additional advocacy work is required to communicate the population-health benefit of tobacco control policies. [ABSTRACT FROM AUTHOR]

Objectives Sickle cell disease (SCD) is an inherited multisystem disorder with complications starting in the first year of life. Newborn screening (NBS) can identify infants with SCD and is associated with decreased morbidity and mortality. Variation in availability of NBS in Canada, and lack of standardized screening for immigrant children, may lead to delayed diagnosis. Methods This was a retrospective cohort study of 126 children aged 0–18 years with SCD registered with the SCD clinic at the Alberta Children's Hospital between January 2003 and January 2018, prior to province-wide universal NBS for SCD. Patient demographic information, circumstances of diagnosis, and other contextual information were collected from patient health records. Descriptive statistics were used to summarize data, with Mood's median test used to compare medians between groups. Results Forty-three (35%) patients were born in Alberta. Patients were mostly (95.3%) of African descent. Of patients born in Alberta, 63% (26/43) were diagnosed at >12 months of age, with a median age at diagnosis of 18 months (IQR = 4–39). This was significantly older (P < 0.001) than children born in the USA or in Canadian provinces with SCD NBS programs, where the median age at diagnosis was zero months (N = 36). Of the 42% of patients born outside North America, 64% were diagnosed following an acute complication. Conclusions This study highlights the importance of NBS for early detection and management of SCD, and the importance of screening at-risk immigrants who may not have received NBS for SCD. [ABSTRACT FROM AUTHOR]

Translocation of captive-bred animals is a widely used conservation strategy to support the recovery of imperiled wild populations. Identifying which factors enhance or limit survival after release can be important in adapting translocation strategies, particularly for species with low survival rates after release from captivity. Many translocation programs track post-translocation survival, but few complete spatial-statistical assessments of mortality risk associated with release environments. Typically, few animals are released from captive breeding programs, limiting the sample size available for analyses. We aimed to create a workflow that used limited datasets to evaluate the influence of spatial conditions and other factors on mortality risk. Greater sage-grouse (Centrocercus urophasianus) are endangered in Canada and of conservation concern throughout their range in the United States. After the species declined precipitously in Canada, a captive breeding program was initiated with subsequent releases in Alberta and Saskatchewan. Despite success in captive breeding, mortality rates of released sage-grouse were high. We used GPS- and VHF-based locations of released sage-grouse to determine how spatial features influence mortality risk of sage-grouse after release from captivity. We implemented a multistep approach to quantify and map risk relative to the environmental features associated with mortality. We also assessed whether the movement behaviors of sage-grouse correspond with environmental risk factors by using a combination of survival models and integrated step-selection functions. Mortality of sage-grouse in Alberta was hastened in areas close to anthropogenic disturbance. Although birds in Alberta avoided areas of higher mortality risk, those in Saskatchewan did not, perhaps due to environmental and selection constraints. This multistep approach allowed us to utilize small sample sizes to assess key risk factors in the landscape. This process supports the adaptive modification of translocation plans and can similarly support other data-limited scientists and managers in assessing environmental mortality risk and defining conservation actions for endangered species. [ABSTRACT FROM AUTHOR]

Objectives: Canada's ongoing drug poisoning crisis has contributed to unprecedented rates of morbidity and mortality. Health Canada has funded safer supply pilot programs to help connect people who use drugs to pharmaceutical grade medications that reduce their reliance on a toxic drug supply. However, most provinces, including Alberta and Saskatchewan, have not endorsed these initiatives. We explored public support for safer supply programs in these two Canadian provinces and identified predictors of support for this policy option., Methods: Cross-sectional data were examined from an online panel survey that included measures assessing views on policy responses to substance use and addiction. A total of 1602 adults were recruited during March 2021. We used descriptive statistics to characterize support for safer supply programs in Alberta and Saskatchewan and multinominal logistic regression analysis to examine predictors of public support for safer supply., Results: The majority of respondents (AB: 63.5% and SK: 56.3%) supported safer supply programs that replace illegal street drugs with pharmaceutical alternatives for those unable to stop using. Predicted probabilities show a greater probability of support for safer supply among those with higher education and those leaning left on the political spectrum., Conclusion: A majority of Canadians from Alberta and Saskatchewan supported provincial government efforts to expand safer supply, suggesting a lack of public support is not the main barrier to implementation. Efforts at mobilizing this public opinion are needed to scale up and facilitate evaluation of this drug poisoning response., (© 2023. The Author(s) under exclusive license to The Canadian Public Health Association.)

Background: Administrative health data are increasingly used for research and surveillance to inform decision-making because of its large sample sizes, geographic coverage, comprehensivity, and possibility for longitudinal follow-up. Within Canadian provinces, individuals are assigned unique personal health numbers that allow for linkage of administrative health records in that jurisdiction. It is therefore necessary to ensure that these data are of high quality, and that chart information is accurately coded to meet this end. Our objective is to explore the potential barriers that exist for high quality data coding through qualitative inquiry into the roles and responsibilities of medical chart coders.Methods: We conducted semi-structured interviews with 28 medical chart coders from Alberta, Canada. We used thematic analysis and open-coded each transcript to understand the process of administrative health data generation and identify barriers to its quality.Results: The process of generating administrative health data is highly complex and involves a diverse workforce. As such, there are multiple points in this process that introduce challenges for high quality data. For coders, the main barriers to data quality occurred around chart documentation, variability in the interpretation of chart information, and high quota expectations.Conclusions: This study illustrates the complex nature of barriers to high quality coding, in the context of administrative data generation. The findings from this study may be of use to data users, researchers, and decision-makers who wish to better understand the limitations of their data or pursue interventions to improve data quality. [ABSTRACT FROM AUTHOR]

Background: Wildfires have become increasingly prevalent in various regions, resulting in substantial environmental and psychological consequences that have garnered increasing attention. Objective: This study aims to examine the prevalence of likely Generalized Anxiety Disorder (GAD) and explore the determinants of likely GAD during the wildfires in Alberta and Nova Scotia. Methods: Data were collected online through a cross-sectional survey from 14 May–23 June 2023. Alberta and Nova Scotia participants self-subscribed to the program by texting 'HopeAB' or 'HopeNS' to a short code, respectively. The GAD-7–validated tool was used to collect information on likely GAD. Results: This study included 298 respondents while one hundred and twelve respondents lived in a region of Alberta/Nova Scotia affected by the wildfires (37.7%). The prevalence of likely GAD among the respondents was 41.9%. Respondents who lived in a region of Alberta/Nova Scotia recently impacted by the wildfires were twice as likely to experience GAD symptoms (OR = 2.4; 95% C.I. 1.3–4.3). Conclusions: The study's identification of a statistically significant relationship between residing in a wildfire-impacted region and likely GAD shows the association between environmental and psychological well-being. However, the relatively small sample size and self-reported assessment of GAD symptoms may limit the generalizability of the findings. Further research involving a larger sample size delving into potential predictors could facilitate strategies for mitigating the mental health consequences of natural disasters. [ABSTRACT FROM AUTHOR]

Background: Family violence, which includes intimate partner abuse, child abuse, and elder abuse, is a serious public health concern. Primary healthcare (PHC) offers a vital opportunity to identify and address family violence, yet barriers prevent the effective implementation of family violence interventions in PHC settings. The purpose of this study is to improve family violence identification and response in Alberta's PHC settings by exploring readiness factors. Methods: An integrated knowledge translation approach, combining implementation science and participatory action research, was employed to develop a readiness assessment tool for addressing family violence within PHC settings in Alberta. The research involved three phases: phase 1 involved a rapid evidence assessment, phase 2 engaged a panel of healthcare and family violence experts to explore readiness components in the Alberta context, and phase 3 utilized a 3-round Delphi consensus-building process to refine readiness indicators. Results: Phase 1 findings from a rapid evidence assessment highlighted five main models/tools for assessing readiness to implement family violence interventions in PHC settings. In phase 2, additional concepts were identified through exploration with healthcare and family violence expert panel members, resulting in a total of 16 concepts for assessing family violence readiness within the Alberta PHC context. The 3-round Delphi consensus-building process in Phase 3 involved nine panelists, who collectively agreed on the inclusion of all concepts and indicators, yielding a total of 60 items for the proposed readiness assessment tool for addressing family violence in PHC within Alberta. Conclusion: The current study lays the groundwork for future family violence intervention programs, offering insights into key components that promote readiness for implementing comprehensive programs and supporting PHC organizations in effectively addressing family violence. [ABSTRACT FROM AUTHOR]