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While internationalization is among the top strategic priorities of universities and colleges globally, research into the expanse of internationalization in the kinesiology discipline is not well researched. Given this gap, critical consideration of the state and status of the phenomenon is needed. Knowing more about what is being done in the name of internationalization within kinesiology and reflecting on how those actions and outcomes are aligned, or not, with key theoretical guidance is necessary in order to plan for improvement accordingly. For these reasons, this paper first provides a primer on internationalization in higher education, including how the phenomenon has come to be defined as well as key contemporary critiques associated with it. In particular, we highlight Beck's (2012) theoretical concept of 'eduscape' to critically consider the influences of globalization on internationalization within higher education kinesiology as well as Khoo, Taylor, and Andreotti's (2016) principles of intelligibility, dissent, and solidarity to consider the ways kinesiology scholars engage critically with internationalization processes. Presented next is a review of the kinesiology literature that is explicitly focused on internationalization. Then, the results of a pilot survey into the views of National Association for Kinesiology in Higher Education (NAKHE) members and other Western kinesiology scholars on internationalization is reported next. The paper concludes with recommendations as to how NAKHE and the broader community of Western kinesiology scholars might best navigate internationalization moving forward. We recommend the complexity-informed and principle-driven approach of inclusive leadership as a means of pursuing cognitive justice in the 21st century.

In this paper, I discuss the process of redesigning and teaching a mandatory, academic skill building course for students on academic probation at Mount Saint Vincent University (MSVU) in Atlantic Canada. The rationale for redesigning the course was to offer an alternative curricular framework, including instructional approaches, to course instructors who taught a modular-based curriculum. The original course was designed to focus on improving students' individual self-efficacy and motivation for academic success; however, the social and relational nature of learning was not articulated as an underpinning theory in the curriculum. In the new curriculum, I draw on both Etienne Wenger's (1998) notion of communities of practice as sites for learning and Howe and Strauss' (2000; 2007) work on generational analysis as theoretical frameworks. Furthermore, I incorporate Wenger, McDermott, and Snyder's (2002) design principles for cultivating communities of practice as a framework for translating theory into practice. The initial information that I collected from students, instructors, and a thorough review of the original curriculum led to the main inquiry question: How can a curriculum, centred on building community in the classroom, help students to cultivate meaningful learning experiences that take learning beyond a "fake it 'til you make it" mentality? This question guided the curricular design process and also my experiences teaching the course at MSVU during the Fall semester of 2012.

Comparing group is one of the key uses of large-scale assessment results, which are used to gain insights to inform policy and practice and to examine the comparability of scores and score meaning. Such comparisons typically focus on examinees' final answers and responses to test questions, ignoring response process differences groups may engage in. This paper discusses and demonstrates the use of response process data in enhancing group comparison and fairness research methodologies. We propose two statistical approaches for identifying differential response processes which extend the differential item functioning (DIF) detection methods and demonstrate the complementary use of process data in comparing groups in two case studies. Our findings demonstrate the use of response process data in gaining insights about students' test-taking behaviors from different populations that go beyond what may be identified using response data only.

This paper is a conversation about growing an inclusive field of disability studies. The paper draws on data collected through an analysis of existing disability studies programmes in selected Canadian universities. The paper makes a case for including diverse perspectives, experiences, viewpoints, and voices in these programmes. In this work, I call for an interrogation of the normativity in the field of disability studies and for critical reflections and discussions about growing a diverse and inclusive field that pays attention to marginalised populations. There is a need to rethink the exclusionary nature of knowledge, space, bodies, and pedagogy in the field, which perpetuates Eurocentric culture, thoughts, and practices.

Learning as a central focus in the discourse on professional development is well grounded in the educational and professional development literature. Yet, despite this consensus, and significant research on how professionals learn, most professional development and continuing professional education (CPE) practices continue to focus on delivering content rather than enhancing learning. This paper provides an update and overview of adult education's ongoing critique of and contributions to debates about the aims, structure, and purposes of continuing professional development and CPE. The author profiles a long-standing and continuing effort by educational scholars to reclaim this vital area of study and practice, in order to bring their learning focus as well as their critical questions to bear on it.

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This article offers a sampling and critique of the history of education in North America, including Canada, the United States and Mexico. Being Black and Indigenous academics, respectively, the authors' scholarship centres on community relationships, considering activism around #BlackLivesMatter and Indigenous Peoples, especially with the news of thousands of unmarked graves at former Indian Residential Schools in Canada. Amidst increasing global calls for decolonisation, social justice and accountability, we ask: how should one consider the history of education in North America amidst social unrest, climate change, the SARS-CoV-2 pandemic, ongoing colonialisms, gender inequities, police violence against Black bodies and unmarked graves of Indigenous children? This paper traces histories of Indian Residential Schools, explores schooling structures and emerging settler states, and examines the growing focus on local histories to offer new directions in the history of education that challenge antiquated national narratives. [ABSTRACT FROM AUTHOR]

Background: Climate change is a defining issue and grand challenge for the health sector in North America. Synthesizing evidence on climate change impacts, climate-health adaptation, and climate-health mitigation is crucial for health practitioners and decision-makers to effectively understand, prepare for, and respond to climate change impacts on human health. This protocol paper outlines our process to systematically conduct a literature review to investigate the climate-health evidence base in North America. Methods: A search string will be used to search CINAHL®, Web of Science™, Scopus®, Embase® via Ovid, and MEDLINE® via Ovid aggregator databases. Articles will be screened using inclusion/exclusion criteria by two independent reviewers. First, the inclusion/exclusion criteria will be applied to article titles and abstracts, and then to the full articles. Included articles will be analyzed using quantitative and qualitative methods. Discussion: This protocol describes review methods that will be used to systematically and transparently create a database of articles published in academic journals that examine climate-health in North America. [ABSTRACT FROM AUTHOR]

Floating Catchment Area (FCA) methods are a popular tool to investigate accessibility to public facilities, in particular health care services. FCA approaches are attractive because, unlike other accessibility measures, they take into account the potential for congestion of facilities. This is done by 1) considering the population within the catchment area of a facility to calculate a variable that measures level of service, and then 2) aggregating the level of service by population centers subject to catchment area constraints. In this paper we discuss an effect of FCA approaches, an artifact that we term demand and level of service inflation. These artifacts are present in previous implementations of FCA methods. We argue that inflation makes interpretation of estimates of accessibility difficult, which has possible deleterious consequences for decision making. Next, we propose a simple and intuitive approach to proportionally allocate demandand and level of service in FCA calculations. The approach is based on a standardization of the impedance matrix, similar to approaches popular in the spatial statistics and econometrics literature. The result is a more intiuitive measure of accessibility that 1) provides a local version of the provider-to-population ratio; and 2) preserves the level of demand and the level of supply in a system. We illustrate the relevant issues with some examples, and then empirically by means of a case study of accessibility to family physicians in the Hamilton Census Metropolitan Area (CMA), in Ontario, Canada. Results indicate that demand and supply inflation/deflation affect the interpretation of accessibility analysis using existing FCA methods, and that the proposed adjustment can lead to more intuitive results. [ABSTRACT FROM AUTHOR]

Freely-available satellite data streams and the ability to process these data on cloud-computing platforms such as Google Earth Engine have made frequent, large-scale landcover mapping at high resolution a real possibility. In this paper we apply these technologies, along with machine learning, to the mapping of peatlands–a landcover class that is critical for preserving biodiversity, helping to address climate change impacts, and providing ecosystem services, e.g., carbon storage–in the Boreal Forest Natural Region of Alberta, Canada. We outline a data-driven, scientific framework that: compiles large amounts of Earth observation data sets (radar, optical, and LiDAR); examines the extracted variables for suitability in peatland modelling; optimizes model parameterization; and finally, predicts peatland occurrence across a large boreal area (397, 958 km2) of Alberta at 10 m spatial resolution (equalling 3.9 billion pixels across Alberta). The resulting peatland occurrence model shows an accuracy of 87% and a kappa statistic of 0.57 when compared to our validation data set. Differentiating peatlands from mineral wetlands achieved an accuracy of 69% and kappa statistic of 0.37. This data-driven approach is applicable at large geopolitical scales (e.g., provincial, national) for wetland and landcover inventories that support long-term, responsible resource management. [ABSTRACT FROM AUTHOR]

Background: This study reports on physicians’ experiences with chronic pain management. For over a decade prescription opioids have been a primary treatment for chronic pain in North America. However, the current opioid epidemic has complicated long-standing practices for chronic pain management which historically involved prescribing pain medication. Caring for patients with chronic pain occurs within a context in which a growing proportion of patients suffer from chronic rather than acute conditions alongside rising social inequities. Methods: Our team undertook an ethnographic approach known as institutional ethnography in the province of Ontario, Canada in order to explore the social organization of chronic pain management from the standpoint of primary care physicians. This paper reports on a subset of this study data, specifically interviews with 19 primary care clinicians and 8 nurses supplemented by 40 hours of observations. The clinicians in our sample were largely primary care physicians and nurses working in urban, rural and Northern settings. Findings: In their reflections on providing care for patients with chronic pain, many providers describe being most challenged by the work involved in helping patients who also struggled with poverty, mental health and addiction. These frustrations were often complicated by concerns that they could lose their license for inappropriate prescribing, thus shifting their work from providing treatment and care to policing their patients for malingering and opioid abuse. Interpretation: Our findings show that care providers find the treatment of patients with chronic pain–especially those patients also experiencing poverty–to be challenging at best, and at worst frustrating and overwhelming. In many instances, their narratives suggested experiences of depersonalization, loss of job satisfaction and emotional exhaustion in relation to providing care for these patients, key dimensions of burnout. In essence, the work that they performed in relation to their patients’ social rather than medical needs seems to contribute to these experiences. Their experiences were further exacerbated by the fact that restricting and reducing opioid dosing in patients with chronic pain has become a major focus of care provision. [ABSTRACT FROM AUTHOR]

This paper augments recently reported proposals to enhance the electric power transmission grid in North America. The augmentation suggested is to join Canada, the United States, and Mexico with a large scale, high voltage DC (HVDC) "backbone." The objectives of such an investment include enhancement of the capabilities of the underlying AC transmission, increasing the potential of renewable wind and solar generation resources, and facilitation of the integration of natural gas generation to the North American energy resource mix. A method of calculation of expected power flows is reported based on the Kirchhoff laws and Tellegen's theorem. That method does not replace detailed electric power flow studies, but it gives an estimation of the HVDC facilities requirements. Practicalities in long term mesoscale transmission planning and expansion are briefly discussed and the use of net present value to assess financial efficacy is suggested. It is noted that energy sales and purchases in North America form a main part of balance of payments for Canada, the United States, and Mexico. [ABSTRACT FROM AUTHOR]

In this study power generation and demand arematched through a least-costmix of renewable energy (RE) resources and storage technologies for North America by 2030. The study is performed using an hourly resolved model based on a linear optimization algorithm. The geographical, technical and economic potentials of different forms of RE resources enable the option of building a super grid between different North American regions. North America (including the U.S., Canada and Mexico in this paper), is divided into 20 sub-regions based on their population, demand, area and electricity grid structure. Four scenarios have been evaluated: region-wide, country-wide, area-wide and an integrated scenario. The levelised cost of electricity is found to be quite attractive in such a system, with the range from 63/MWhel in a decentralized case and 42/MWhel in a more centralized and integrated scenario. Electrical grid interconnections significantly reduce the storage requirement and overall cost of the energy system. Among all RE resources, wind and solar PV are found to be the least-cost options and hence the main contributors to fossil fuel substitution. The results clearly show that a 100% RE-based system is feasible and a real policy option at a modest cost. However, such a tremendous transition will not be possible in a short time if policy-makers, energy investors and other relevant organizations do not support the proposed system. [ABSTRACT FROM AUTHOR]

During April 2022, bryological inventories of arable lands in the Peterborough Ecodistrict of Ontario, Canada, resulted in the detection of a population of Ephemerum recurvifolium (Dickson) Boulay. Specimens were collected and confirmed, and vouchers were provided to the National Herbarium of Canada (CANM). This species of moss has not been reported previously in North America. Its detection raises the question whether it is native or adventive on the continent, finding an answer to which will require more extensive field inventories, studies of herbarium material and population genetics research. [ABSTRACT FROM AUTHOR]

Background: With the advent of competency-based medical education, as well as Canadian efforts to include clinical informatics within undergraduate medical education, competency frameworks in the United States have not emphasized the skills associated with clinical informatics pertinent to the broader practice of medicine. Objective: By examining the competency frameworks with which undergraduate medical education in clinical informatics has been developed in Canada and the United States, we hypothesized that there is a gap: the lack of a unified competency set and frame for clinical informatics education across North America. Methods: We performed directional competency mapping between Canadian and American graduate clinical informatics competencies and general graduate medical education competencies. Directional competency mapping was performed between Canadian roles and American common program requirements using keyword matching at the subcompetency and enabling competency levels. In addition, for general graduate medical education competencies, the Physician Competency Reference Set developed for the Liaison Committee on Medical Education was used as a direct means of computing the ontological overlap between competency frameworks. Results: Upon mapping Canadian roles to American competencies via both undergraduate and graduate medical education competency frameworks, the difference in focus between the 2 countries can be thematically described as a difference between the concepts of clinical and management reasoning. Conclusions: We suggest that the development or deployment of informatics competencies in undergraduate medical education should focus on 3 items: the teaching of diagnostic reasoning, such that the information tasks that comprise both clinical and management reasoning can be discussed; precision medical education, where informatics can provide for more fine-grained evaluation; and assessment methods to support traditional pedagogical efforts (both at the bedside and beyond). Assessment using cases or structured assessments (eg, Objective Structured Clinical Examinations) would help students draw parallels between clinical informatics and fundamental clinical subjects and would better emphasize the cognitive techniques taught through informatics. [ABSTRACT FROM AUTHOR]

If decolonization truly begins with land, then it can be said that landscape studies—as a field concerned with the study, design, and ordering of land—has at least some stake in on going processes of decolonization. Repeated contestations for Indigenous land rights in North America suggest that settler-colonial contexts present a distinct and pressing concern for decolonization. The landscapes of colonialism are also deeply racialized, converging on extractive capitalism and environmental racism. Historically, landscape has been used as a disciplinary tool to facilitate the control of land and to naturalise colonial hegemonies, including the cultural framing of landscape through art and architecture. Current approaches to the built environment (including development, conservation, and management) also routinely perpetuate colonizing logics. For landscape studies, the prospect of decolonization (and of a decolonizing landscape praxis) demands the critical reconciliation of underlying coloniality within the field and a complete reorientation towards anti-colonial subjectivities. [ABSTRACT FROM AUTHOR]

Why, after years of restrictive regulation of street vending, and food vending in particular, have cities across North America welcomed new food carts and trucks? In this article I draw on a case study of Vancouver, Canada, to demonstrate the important effect of ideas about food on the regulatory and policy changes that have allowed food carts and trucks to proliferate. In particular, new cultural discourses have imbued food with a multivalent goodness. This goodness is understood to have the capacity to do good in the city by bringing good urban places into being. While these discourses favour the tastes of the privileged, ideas about 'good' food expand beyond the 'gourmet' to embrace health, environment, economy, cultural diversity and creativity, as well as community building, local identity and visions of vibrant, shared public spaces. The proliferation of discourses about 'good food' has produced a potent set of cultural ideas that animates popular and policy discussions about street food in the city; in Vancouver, these ideas provided the impetus to push for regulatory change and generated consensus around new, less restrictive regulation of food vending on streets and sidewalks. [ABSTRACT FROM AUTHOR]

In North America, the psychiatric workforce while relatively large, remains insufficient for the population needs. Specialist training opportunities in psychiatry continues to grow, reflected in both increased recruitment and competitiveness. Furthermore, the iterative process of curriculum development and standardisation of training encourages greater educational consistency. There is an ongoing growth in subspecialty training opportunities, however access varies across centres and curriculum gaps remain. The diverse demographic characteristics and requirements of populations also play a role in educational needs, such as youth mental health, tele-psychiatry, cultural, rural and addictions psychiatry. Advances in science such as genetics, and the use of technologies and digital media also invite innovative approaches to knowledge acquisition. Overall, training needs to be matched by sufficient numbers of experienced and skilful trainers, mentorship and leadership in psychiatry with awareness of physician wellbeing and the risks of burnout. In the USA and Canada, the growing prospect of fellowships in leadership and administration lay important foundations for the growth of psychiatry, driven by high quality education for the mental health professionals and leaders of tomorrow. [ABSTRACT FROM AUTHOR]

With the advent of continuous antiretroviral therapy, HIV has become a complex chronic, rather than acute, condition. The Chronic Care Model (CCM) provides an integrated approach to the delivery of care for people with chronic conditions that could therefore be applied to the delivery of care for people living with HIV. Our objective was to assess the alignment of HIV care settings with the CCM. We conducted a mixed methods study to explore structures, organization and care processes of Canadian HIV care settings. The quantitative results of phase one are published elsewhere. For phase two, we conducted semi-structured interviews with key informants from 12 HIV care settings across Canada. Irrespective of composition of the care setting or its location, HIV care in Canada is well aligned with several components of the CCM, most prominently in the areas of linkage to community resources and delivery system design with inter-professional team-based care. We propose the need for improvements in the availability of electronic clinical information systems and self-management support services to support better care delivery and health outcomes among people living with HIV in Canada. [ABSTRACT FROM AUTHOR]

Introduction: La Maison Bleue is a community-based perinatal health and social centre in Montreal that provides services during pregnancy up to age five to families living in vulnerable contexts. The study aimed to describe: 1) the challenges and protective factors that affect the well-being of migrant families receiving care at La Maison Bleue; and 2) how La Maison Bleue strengthens resilience among these families. Methods: We conducted a focused ethnography. Immigrants, refugees, asylum seekers and undocumented migrants were invited to participate. We collected data from November to December 2017 via semi-structured interviews and participant observation during group activities at La Maison Bleue. Data were thematically analysed. Results: Twenty-four mothers participated (9 interviewed, 17 observed). Challenges to well-being included family separation, isolation, loss of support, the immigration process, an unfamiliar culture and environment, and language barriers. Key protective factors were women’s intrinsic drive to overcome difficulties, their positive outlook and ability to find meaning in their adversity, their faith, culture and traditions, and supportive relationships, both locally and transnationally. La Maison Bleue strengthened resilience by providing a safe space, offering holistic care that responded to both medical and psychosocial needs, and empowering women to achieve their full potential towards better health for themselves and their families. Conclusion: Migrant mothers have many strengths and centres like La Maison Bleue can offer a safe space and be an empowering community resource to assist mothers in overcoming the multiple challenges that they face while resettling and raising their young children in a new country. [ABSTRACT FROM AUTHOR]

Residential segregation into spatial neighborhoods and boroughs is a well-known spatial dynamic process that characterise complex urban environments. Existing models of segregation, including the pioneering Schelling ones, often do not consider all the factors that can contribute to this process. Segregation as well as aggregation emerges from local interactions among individuals, and is rooted in the complexity of social, economic and environmental interactions. The main objective of this study is to develop and implement a geospatial agent-based model to simulate the decision-making process of location of new household for incoming immigrant populations. Particularly this study aims to simulate and analyse the dynamics of the new immigrant populations arriving in the bilingual cities and boroughs of the island of Montreal. The model was implemented in NetLogo software, using real geospatial datasets. The obtained simulation results indicate realistic spatial patterns of spatial composition of the ethnographic fabric on the island of Montreal. The proposed model has the potential to be used as part of the city planning purposes. [ABSTRACT FROM AUTHOR]

Despite an overwhelming scientific consensus that climate change poses severe risks to human and natural systems, many young Canadian adults do not view it as a major issue. We analyzed secondary science curricula in each province for their coverage of climate change according to six core topics: physical climate mechanisms (“It’s climate”), observed increase in temperature (“It’s warming”), anthropogenic causes of warming (“It’s us”), scientific consensus (“Experts agree”), negative consequences associated with warming (“It’s bad”), and the possibility for avoiding the worst effects (“We can fix it”). We found that learning objectives tend to focus on knowledge of the first three elements, with little or no emphasis on scientific consensus, climate change impacts, or ways to address the issue. The provinces of Saskatchewan and Ontario provide the most comprehensive standards for climate change education, while Nova Scotia and New Brunswick provide the least. We conducted interviews with individuals responsible for curriculum design in six different provinces to understand how curriculum documents are developed and whether political controversies influence the writing process. Interviewees described a process relying on input from professionals, institutions, and members of the public where curriculum developers made decisions independent of political concerns. In some cases, efforts to provide balance may have led to a focus on social controversy, contrary to overwhelming scientific consensus. Curriculum documents are the basis for teacher instruction and textbook content; aligning these documents with the best possible evidence can improve student learning and engage the next generation of Canadians on the critical issue of climate change. [ABSTRACT FROM AUTHOR]

Non-consensual condom removal (NCCR) is the removal of a condom before or during sexual intercourse without one’s partner's consent. Despite considerable news and media attention devoted to the trend (as stealthing), little empirical research to date has examined people’s views of the practice. The present study aimed to contribute toward generating empirical evidence to guide the discussion surrounding NCCR. We asked participants about whether or not they felt NCCR is wrong, whether there should be consequences for its perpetration, and contextualized responses within legal context. A total of 592 undergraduate students took part in an online survey inquiring about their experiences with and views of NCCR. We used descriptive statistics to determine sample prevalence and outcomes of NCCR and qualitatively analyzed responses to open-ended questions asking about perceptions of NCCR. Of participants who had engaged in penetrative sexual intercourse with a male partner using an external condom, 18.7%, 95% CI [14.4, 22.7] reported that they had NCCR perpetrated against them. The majority of these participants reported that they experienced NCCR negatively and encountered related consequences; several reported contracting an STI, experiencing an unplanned pregnancy, or both. Nearly all participants expressed that NCCR is wrong, citing reasons that included the lack of consent, possibility of unplanned or unwanted outcomes, and a betrayal of trust. In this study, we found that there was agreement that NCCR is wrong, but variability in responses regarding the circumstances under which there should be consequences for the action. These perceptions reflect the current uncertainty in law. We recommend researchers refer to the phenomenon as NCCR (rather than stealthing) and discuss related issues to encourage future research to adopt consistent and accurate labels and definitions for NCCR. We hope that our findings will guide future research and spur public and legal discussion on NCCR. [ABSTRACT FROM AUTHOR]

Background: Attention to research and planning are increasingly being devoted to newcomer health, but the needs of newcomers with disabilities remain largely unknown. This information is difficult to determine since population-level data are rarely available on newcomers or on people with intellectual and developmental disabilities (IDD), although in Ontario, Canada these databases are accessible. This study compared the prevalence of IDD among first generation adult newcomers to adult non-newcomers in Ontario, and assessed how having IDD affected the health profile and health service use of newcomers. Methods: This population-based retrospective cohort study of adults aged 19–65 in 2010 used linked health and social services administrative data. Prevalence of IDD among newcomers (n = 1,649,633) and non-newcomers (n = 6,880,196) was compared. Among newcomers, those with IDD (n = 2,830) and without IDD (n = 1,646,803) were compared in terms of health conditions, and community and hospital service use. Results: Prevalence of IDD was lower in newcomers than non-newcomers (171.6 versus 898.3 per 100,000 adults, p<0.0001). Among newcomers, those with IDD were more likely than those without IDD to have comorbid physical health disorders, non-psychotic, psychotic and substance use disorders. Newcomers with IDD were also more likely to have psychiatry visits, and frequent emergency department visits and hospitalizations. Conclusion: First generation adult newcomers have lower rates of IDD than non-newcomers. How much of this difference is attributable to admission policies that exclude people expected to be high health service users versus how much is attributable to our methodological approach is unknown. Finding more medical and psychiatric comorbidity, and more health service use among newcomers with IDD compared to newcomers without IDD is consistent with patterns observed in adults with IDD more generally. To inform polices that support newcomers with IDD future research should investigate reasons for the prevalence finding, barriers and facilitators to timely health care access, and pathways to care. [ABSTRACT FROM AUTHOR]

We discuss strategies to promote the inclusion of people with developmental disabilities (DDs) in qualitative community-based research studies. Strategies were applied in three projects conducted between 2012 and 2017 that addressed issues of socioeconomic challenges, discrimination, and exclusion of children and young adults with developmental disabilities (YADD). Strategies included partnership with community organizations; inclusion of YADD, family caregivers (FCs), and service providers in advisory committees (ACs); and strategies to accommodate YADD. As part of our contribution, we discuss issues of invisibility and exclusion of individuals with DDs who have "low" functioning capacities. There is a need to review studies sampling inclusion criteria as they may constitute a barrier for participation. Preference for sampling "high" functioning individuals may reinforce exclusion in research, and replicate broader patterns of socioeconomic exclusion of individuals with disabilities. Our discussion of inclusive research is informed by critical disability studies and the underlying principle "nothing about us without us." [ABSTRACT FROM AUTHOR]

Background: Patients with chronic obstructive pulmonary disease (COPD) are more likely to be readmitted than patients with other chronic medical conditions, yet knowledge regarding such readmissions is limited. We aimed to determine factors associated with readmission within 30 days of a COPD hospitalization or death with an emphasis on examining aspects of socioeconomic status and specific comorbidities. Methods: A population-based cohort study was conducted using health administrative data from Ontario, Canada. All hospitalizations for COPD between 2004 and 2014 were considered. The primary exposures were socioeconomic status as measured by residential instability (an ecologic variable), and comorbidities such as cardiovascular disease and cancer. Other domains of socioeconomic status were considered as secondary exposures. Logistic regression with generalized estimating equations was used to examine the effect of exposures, adjusting for other patient factors, on 30-day readmission or death. Results: There were 126,013 patients contributing to 252,756 index COPD hospitalizations from 168 Ontario hospitals. Of these hospitalizations, 19.4% resulted in a readmission and 2.8% resulted in death within 30 days. After adjusting for other factors, readmissions or death were modestly more likely among people with the highest residential instability compared to the lowest (OR 1.05, 95% CI 1.01–1.09). Comorbidities such as cardiovascular disease and cancer, as well as other aspects of low socioeconomic status also increased readmission or death risk. Interpretation: Socioeconomic status, measured in various ways, and many comorbidities predict 30-day readmission or death in patients hospitalized for COPD. Strategies that address these factors may help reduce readmissions and death. [ABSTRACT FROM AUTHOR]

Background: Population trends of disease prevalence and incidence over time measure burden of disease and inform healthcare planning. Neuromuscular disorders (NMD) affect muscle and nerve function with varying degrees of severity and disease progression. Objective: Using health administrative databases we described trends in incidence, prevalence, and mortality of adults and children with NMD. We also explored place of death and use of palliative care. Methods: Population-based (Ontario, Canada) cohort study (2003 to 2014) of adults and children with NMD identified using International Classification of Disease and health insurance billing codes within administrative health databases. Results: Adult disease prevalence increased on average per year by 8% (95% confidence interval (CI) 6% to 10%, P <.001), with the largest increase in adults18-39 years. Childhood disease prevalence increased by 10% (95% CI 8% to 11%, P <.0001) per year, with the largest increase in children 0 to 5 years. Prevalence increased across all diagnoses except amyotrophic lateral sclerosis and spinal muscular atrophy for adults and all diagnoses for children. Adult incidence decreased by 3% (95% CI -4% to -2%, P <.0001) but incidence remained stable in children. Death occurred in 34,336 (18.5%) adults; 21,236 (61.8%) of whom received palliative care. Death occurred in 1,009 (5.6%) children; 507 (50.2%) of whom received palliative care. Mortality decreased over time in adults (odds ratio (OR) 0.86, 95% CI 0.86–0.87, P <.0001) and children (OR 0.79, 95% CI 0.76–0.82, P <.0001). Use of palliative care over time increased for adults (OR 1.18, 95% CI 1.09 to 1.28, P <.0001) and children (OR 1.22, 95% CI 1.20 to 1.23, P <.0001). Conclusions: In both adults and children, NMD prevalence is rising and mortality rates are declining. In adults incidence is decreasing while in children it remains stable. This confirms on a population-based level the increased survival of children and adults with NMD. [ABSTRACT FROM AUTHOR]

Tree cavities provide a critical resource for cavity-nesting animals, and high quality cavities can be difficult for animals to acquire in habitats where competition is high. We investigated the breeding performance of Lewis's Woodpeckers in three habitat types in British Columbia, Canada in 2013 and 2014. We also assessed whether the number of nest competitors and cavity availability influenced the habitat specific breeding performance of this threatened cavity nesting species. We found that daily nest survival rate was lower in burned habitat (0.15 ± 0.08 (0.05–0.37)) than in live pine (0.72 ± 0.10 (0.51–0.87)) or cottonwood (0.69 ± 0.09 (0.51–0.83)) habitats. However, hatching success (the proportion of eggs that hatch) was lower in live pine habitat (0.59 ± 0.09 95% CI) than burned (0.77 ± 0.19 95% CI) or cottonwood (0.80 ± 0.07 95% CI) habitat, and the fledging success of successful nests in live pine and burned habitat (1.86 ± 0.31 and 1.88 ± 0.59 95% CI, respectively) was slightly lower than in cottonwood habitat (2.61 ± 0.45 95% CI). Consequently, Lewis's Woodpeckers in cottonwood habitat produced more fledglings per nesting attempt (2.05 ± 0.49 95% CI) than in live pine (1.53 ± 0.35 95% CI) or burned (0.79 ± 0.49 95% CI) habitat. Habitats differed in the number of nesting competitors and the number of suitable cavities surrounding active Lewis's Woodpecker nests. Our results showed that cavity density best explained breeding performance differences although the mechanisms remain unclear. There was no evidence that the number of heterospecific nest competitors, including the invasive European Starling (Sturnus vulgaris), explained or influenced Lewis's Woodpecker breeding performance. Cavity density influenced the productivity of successful nests but did not explain habitat differences in hatching success or daily nest survival. Further work is required to understand the mechanistic basis for the habitat specific breeding performance of Lewis's Woodpeckers. Habitat differences in breeding performance in British Columbia are not consistent with those in other regions, highlighting the importance of regionally-specific demographic data for managing species at risk. [ABSTRACT FROM AUTHOR]

Background: Food insecurity is associated with a wide array of negative health outcomes and higher health care costs but there has been no population-based study of the association of food insecurity and mortality in high-income countries. Methods: We use cross-sectional population surveys linked to encoded health administrative data. The sample is 90,368 adults, living in Ontario and respondents in the Canadian Community Health Survey (CCHS). The outcome of interest is all-cause mortality at any time after the interview and within four years of the interview. The primary variable of interest is food insecurity status, with individuals classed as “food secure”, “marginally food insecure”, “moderately food insecure”, or “severely food insecure”. We use logistic regression models to determine the association of mortality with food insecurity status, adjusting for other social determinants of health. Results: Using a full set of covariates, in comparison to food secure individuals, the odds of death at any point after the interview are 1.28 (CI = 1.08, 1.52) for marginally food insecure individuals, 1.49 (CI = 1.29, 1.73) for moderately food insecure individuals, and 2.60 (CI = 2.17, 3.12) for severely food insecure individuals. When mortality within four years of the interview is considered, the odds are, respectively, 1.19 (CI = 0.95, 1.50), 1.65 (CI = 1.37, 1.98), and 2.31 (CI = 1.81, 2.93). Interpretation: These findings demonstrate that food insecurity is associated with higher mortality rates and these higher rates are especially large for the most severe food insecurity category. Efforts to reduce food insecurity should be incorporated into broader public health initiatives to reduce mortality. [ABSTRACT FROM AUTHOR]

Two new species ofGomphonemawith linear-lanceolate valves, narrow cells (width ≤6 µm), wide axial areas, short uniseriate striae, and one stigmoid per valve are described.Gomphonema caperatumsp. nov. has narrow, almost linear valves with short marginal striae, apically elongated slit-like areolae, and transapically oriented linear markings on the external valve surface, which are only observable under scanning electron microscopy. This is a common and often abundant species in rivers across Eastern North America, especially in the Appalachian region, but is also found on the West Coast.Gomphonema obstipumsp. nov. has lanceolate valves with bent apices, variously shaped apically elongated areolae, and shallow circular depressions on the external valve surface. This species has only been found in two Virginian rivers. We compare the new taxa with several species ofGomphonemafrom North American rivers that are morphologically similar, such asGomphonema amerhombicumReichardt,Gomphonema stoermeriKociolek & Kingston, and other species with linear-lanceolate valves and wide axial areas. In addition, we report here for the first time the occurrence ofGomphonema incognitumin North America. This study underscores the insufficiency of our knowledge of diatom diversity in North America and the need for more detailed taxonomic investigations. [ABSTRACT FROM PUBLISHER]

Insect outbreaks often occur synchronously across large spatial scales, but the long-term temporal stability of the phenomenon and the mechanisms behind it are not well understood. In this study, I use a widespread lepidopteran defoliator native to western North America—the western spruce budworm—as a case study to explore patterns of and potential causes for synchronous population fluctuations. Analyses of synchrony are typically severely limited by the short historical records available for many species. To overcome this limitation, I compiled multi-century dendrochronological reconstructions of western spruce budworm outbreaks from across much of the species’ range. This allowed me to analyze synchrony at a sub-continental spatial scale over the last three centuries. I found statistically significant synchrony among regional outbreak records up to 2,000 km apart and identified numerous outbreak periods that occurred synchronously across much of the species’ range. I quantified spatial and temporal associations between climate and synchronous outbreak periods using paleoclimate reconstructions. The spatial patterns of outbreak histories and climate records were remarkably similar, with higher similarity in outbreak histories apparent between regions with more similar climate conditions. Synchronous outbreaks typically occurred during periods of average or above average moisture availability preceded by periods of low moisture availability. My results suggest that climatic variability has played a key role in synchronizing western spruce budworm population fluctuations in disjunct forests across western North America for at least the last three centuries. Widespread synchrony appears to be a natural part of this species’ population dynamics, though synchronous outbreaks have occurred more frequently during the 20th century than during prior centuries. This study uses a novel combination of statistical methods and dendrochronological data to provide analyses of this species’ population dynamics with an unprecedented combination of spatial extent and temporal depth. [ABSTRACT FROM AUTHOR]

The recent emergence of West Nile virus (WNV) in North America highlights vulnerability to climate sensitive diseases and stresses the importance of preventive efforts to reduce their public health impact. Effective prevention involves reducing environmental risk of exposure and increasing adoption of preventive behaviours, both of which depend on knowledge and acceptance of such measures. When making operational decisions about disease prevention and control, public health must take into account a wide range of operational, environmental, social and economic considerations in addition to intervention effectiveness. The current study aimed to identify, assess and rank possible risk reduction measures taking into account a broad set of criteria and perspectives applicable to the management of WNV in Quebec under increasing transmission risk scenarios, some of which may be related to ongoing warming in higher-latitude regions. A participatory approach was used to collect information on categories of concern to relevant stakeholders with respect to WNV prevention and control. Multi-criteria decision analysis was applied to examine stakeholder perspectives and their effect on strategy rankings under increasing transmission risk scenarios. Twenty-three preventive interventions were retained for evaluation using eighteen criteria identified by stakeholders. Combined evaluations revealed that, at an individual-level, inspecting window screen integrity, wearing light colored, long clothing, eliminating peridomestic larval sites and reducing outdoor activities at peak times were top interventions under six WNV transmission scenarios. At a regional-level, the use of larvicides was a preferred strategy in five out of six scenarios, while use of adulticides and dissemination of sterile male mosquitoes were found to be among the least favoured interventions in almost all scenarios. Our findings suggest that continued public health efforts aimed at reinforcing individual-level preventive behaviours combined with the application of larvicides to manage the risk of WNV infection are the interventions most acceptable and effective at reaching current management objectives now and under future theoretical transmission risk. [ABSTRACT FROM AUTHOR]

Simple Summary: Studies of widely distributed species often are problematic as such research usually needs to engage a lot of time, a large team of field workers, and big financial support before good quality data will be collected. Citizen scientists allow to study different aspects of species biology and ecology with significantly reduced basic operational costs of such studies. Based on the data deposited in the iNaturalist database, we studied the ecology of the American flat bark beetle in the entire area of its species range. The results clearly show high value of citizen science, particularly in studies focused on habitat preferences and phenology in both recognized subspecies of this taxon. The American red flat bark beetle, Cucujus clavipes, is a wide distributed saproxylic species divided into two subspecies: ssp. clavipes restricted to eastern regions of North America and ssp. puniceus occurring only in western regions of this continent. Unique morphological features, including body shape and body coloration, make this species easy to recognize even for amateurs. Surprisingly, except some studies focused on physiological adaptations of the species, the ecology of C. clavipes was almost unstudied. Based on over 500 records collected by citizen scientists and deposited in the iNaturalist data base, we studied phenological activity of adult beetles, habitat preferences and impact of future climate change for both subspecies separately. The results clearly show that spp. clavipes and ssp. puniceus can be characterized by differences in phenology and macrohabitat preferences, and their ranges do not overlap at any point. Spp. clavipes is found as more opportunistic taxon occurring in different forests as well as in urban and agricultural areas with tree vegetation always in elevations below 500 m, while elevational distribution of ssp. puniceus covers areas up to 2300 m, and the beetle was observed mainly in forested areas. Moreover, we expect that climate warming will have negative influence on both subspecies with the possible loss of proper niches at level even up to 47–70% of their actual ranges during next few decades. As the species is actually recognized as unthreatened and always co-occurs with many other species, we suggest, because of its expected future habitat loss, to pay more attention to conservationists for possible negative changes in saproxylic insects and/or forest fauna in North America. In addition, as our results clearly show that both subspecies of C. clavipes differ ecologically, which strongly supports earlier significant morphological and physiological differences noted between them, we suggest that their taxonomical status should be verified by molecular data, because very probably they represent separate species. [ABSTRACT FROM AUTHOR]