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

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Background: This study involved a scoping review to explore factors influencing dental hygienist demand and supply in high-income countries. Methods: A six-stage scoping review was conducted with separate search strategies tailored to four databases (MEDLINE, CINAHL, Google Scholar, and Google) plus a targeted scan of dental hygienist organization websites. This yielded 2,117 unique citations, leading to 148 articles included in the review. Results: Nearly half of the articles (47%) focused on the United States, with 11% on Canada. Most articles (91%) were in English, alongside 13 in Korean and one in French. Journal articles comprised 62% of the publications, followed by reports/working papers (11%) and websites (11%). Other types included conference abstracts, policy briefs, and presentation slides. Content-wise, 47% were original research, with analysis articles (14%), commentaries (11%), and reviews (8%) also present. The articles were coded into three main categories: workforce characteristics/projections, factor-specific analyses, and workforce opportunities. The articles on workforce characteristics covered demographic, geographic, and employment aspects of dental hygienists, along with projections for supply and demand using simulation modelling and geospatial analyses. Factor-specific articles investigated the (1) working environment, (2) policy/regulatory/training environment, (3) job/career satisfaction and related human resource issues, and (4) scope of practice. The third key category of articles highlighted opportunities for expanding the workforce through alternative models in different sectors/settings (e.g., public health, primary care, long-term care, hospitals, mobile outreach, and non-clinical roles including research, education and leadership) and for a range of vulnerable or underserved populations (e.g., geriatric and pediatric populations, persons with disabilities, those living in rural/remote areas, Indigenous peoples, and incarcerated people). Conclusions: This review provides a comprehensive documentation of the current state of the dental hygienist workforce, compiling factors affecting demand and supply, and highlighting opportunities for the dental hygienist workforce in Canada and other high-income countries. The findings offer a foundation for future research, highlighting the need for more focused and rigorous reviews and underscoring the necessity of high-quality studies to verify the effectiveness of various interventions and policies. This is crucial to address dental hygienist workforce challenges and ensure the sustainability and effectiveness of oral health care delivery. [ABSTRACT FROM AUTHOR]

Purpose: This research aims to assess variations of motivations when studying international location decisions. In particular, this study aims to assess the influence of diverse motivations – seeking technology, seeking brand assets, seeking markets, seeking resources and escaping institutional constraints – as determinants of the international location choice of emerging market multinational enterprises (EM MNEs) entering least developed, emerging, and developed countries. Design/methodology/approach: The authors develop a set of hypotheses based on the ownership–location–internalization framework and complement it with an institutional perspective. The conceptual model posits that the different internationalization motivations (seeking technology, seeking brand assets, seeking markets, seeking resources and escaping institutional constraints) will impact the location choice of EM MNEs in developed economies, emerging markets or least developed countries. This study uses the 2013 survey data collected by the China Council for the Promotion of International Trade and the Asia Pacific Foundation of Canada. The final sample of analysis of this research includes 693 observations. Findings: After controlling for several variables, two-stage Heckman regressions show there is a variation of motivations when EM MNEs enter least developed countries, emerging markets and developed economies. EM MNEs are motivated to enter least developed countries to seek markets and resources. Conversely, those firms enter developed countries in their search for technological assets and to escape institutional constraints at home. While the present study findings show a clear difference in the motivations that lead to location choice in least developed vs developed countries, the results are not as clear for location in other emerging countries. Research limitations/implications: The paper offers empirical support for the importance of motivations as crucial determinants of location choice. Originality/value: This paper provides a detailed quantitative study on the internationalization location choice of EM MNEs based on their motivations. Though theoretical models underscore the importance of motivations, we know very little about how, in practice, motivations drive location choice. This study contributes to the international location choice literature a deeper understanding of how diverse motivations drive choices of expansion into developed economies, emerging markets or least developed countries. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to perform a bibliometric analysis centered on recent advancements in injury prevention for female athletes. Methods: The study employed Excel, VOSviewer, and the bibliometric R-package tools to analyze and evaluate relevant records obtained from the Web of Science (WOS) database, using a reliable search methodology. Results: From the WOS database, a collection of 10 560 scientific records was acquired using specific keywords, covering the period between 2010 and 2023. These records were subjected to content analysis, revealing the prevalent themes in this research area. Noteworthy topics included risk, risk factors, prevention, women, exercise, physical activity, epidemiology, injuries, performance, injury, strength, and health. The investigation also indicated that the journals "American journal of sports medicine" and "journal of athletic training" demonstrated the highest level of activity in this field. Regarding research productivity, developed countries, such as the United States and Canada stood out as the most prolific contributors. Moreover, the study recognized Gregory D Myer as the most active author in this area. Conclusion: The convergence of injury prevention in female athletes continues to be a subject of significant research attention. This study highlights that the bulk of the literature on this subject originates from researchers in developed countries. However, it is crucial to recognize that a substantial segment of the global population, particularly in developing nations, lacks sufficient representation in research related to early life psychology concerning exercise and physical activity. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has left no area of human life unaffected and the food system in its global, regional, or micro manifestations is not an exception. The images of empty store shelves caused by lockdowns stirred a lot of anxiety among consumers in the so-called First World. At the same time, thousands of miles away, in the developing and underdeveloped countries, where having a meal is never taken for granted, people suffered the harshest consequences of any pandemic-related instability in the food system. Both these realities deserve intellectual reflection, with the former being far more intricate than its media portrayals and therefore will be explored further in this work. This paper aims to study the COVID-19 impact on food systems in developed countries such as the United States and Canada, as well as the challenges to the food security they face during the pandemic. It offers a top-down approach, starting with the definition of food security, and highlighting some crucial aspects of food access and food availability, which has been compromised by the spread of coronavirus in the two countries. Detailed analysis of responses to the pandemic-related food security problems in both countries will be offered as well. The right to food is presented here as a human right, and the links between that right and the concept of food security are brought out. The pandemic wreaked havoc on food security in many parts of the world, including the affluent, but at the same time revealed its fragility and the need for continuous monitoring, re-assessment, and improvement through more effective food programs. The emerging sliver of hope for a more just postpandemic food system should not be ignored. [ABSTRACT FROM AUTHOR]

Biotherapeutics dominate the pipelines of pharmaceutical companies across the world today with products ranging from hormones, immune-modulators, monoclonal antibodies (mAbs), blood coagulation factors, enzymes and vaccines. However, they are considerably more expensive than their small molecule counterparts (pharmaceuticals) and as a result their contribution to the already unacceptably high healthcare costs in the developed economies (Europe, United States, Japan, Canada and South Korea) has been in the limelight in the last decade. This has resulted in the rise of biosimilars, seen as the affordable versions of innovator biotherapeutics. As the developed economies form the majority of the global sales of biotherapeutics, they are an attractive market for the biosimilars as well. Regulatory considerations for approval of biosimilars in these jurisdictions is likely to have a major impact on the adoption of biosimilars. In this paper, we offer a perspective on this topic while focusing on the developed markets. This article summarizes the main regulatory requirements for approval of biosimilars in Europe, United States, Japan, Canada, and South Korea. An overview on current biosimilars status and market in the aforesaid countries has also been included., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Health systems must identify preventable adverse outcomes to improve surgical safety. We conducted a systematic review to determine national rates of postoperative complications associated with two common pediatric surgery operations in High-Income Countries (HICs)., Methods: National database studies of complication rates associated with pediatric appendectomies and cholecystectomies (2000-2016) in Canada, the US, and the UK were included. Outcomes included mortality, length of hospital stay (LOS), and other surgical complications. Outcome data were extracted and comparisons made between countries and databases., Results: Thirty-three papers met inclusion criteria (1 Canadian, 1 UK, and 4 US Databases). Mean LOS was 3.00 (±1.42) days and 3.44 (±1.55) days for appendectomy and cholecystectomy, respectively. Mortality was 0.06% after appendectomy and 0.24% after cholecystectomy. Readmission and reoperation rates were 6.79% and 0.32% for appendectomy, and 1.37% and 0.71% for cholecystectomy. For appendectomies, LOS was shorter in Canadian and UK studies compared to US studies, and mortality and readmission rates were lower (OR 0.46 95%CI 0.23 to 0.93, OR 3.63 to 3.77 95%CI) in UK studies compared to US studies., Conclusions: Outcomes after pediatric appendectomy and cholecystectomy are good but vary between HICs. Understanding national outcomes and intercountry differences is essential in developing health system approaches to pediatric surgical safety., Level of Evidence: II., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Using regional level panel data of three developed countries, comprising Australia, Canada, and New Zealand, the study investigates the response of consumption smoothing to housing capital gains. The consumption smoothing model first revisits the theory of perfect risk sharing. After rejecting a full consumption smoothing hypothesis, the results strongly indicate that the appreciation of house values smooths consumption further. For the sake of comparison, analysing three developed economies reveals the diversification in the response of consumption to long-run output shocks. Canadian residents appear to be more sensitive to permanent domestic output shocks while Australian's consumption pattern remains unchanged. [ABSTRACT FROM AUTHOR]

An environmental health professional performs numerous job functions that have an impact on everyone's health and lifestyle. Their work is to prevent death and illness from environmentally related disease and injury. Moreover, the quality and safety of their air, food, water, and the infrastructure that supports vital environmental health services are one of the indicators separated many developed countries from undeveloped countries. This paper, environmental health professional in developed countries including the United State of America, United Kingdom, Canada, and Australia were discussed. It was revealed that the Registration of Environmental Health Specialist/Sanitarians is a process that certifies the applicant has been found by the certifying body of each state/country to meet the qualifications to protect environmental health. The result of these reviews indicates that competencies of Environmental Health Officers (EHOs) of all selected developed countries are focused on facility and system inspections and compliance and enforcement of environmental health laws. Moreover, risk assessment and management, investigation, monitor and control, and promoting environmental and public health awareness are appeared in some countries. Thus, the experiences in selected developed countries for certification of Environmental Health Specialist or sanitarian could be used as a guideline for environmental health professional development in other countries. [ABSTRACT FROM AUTHOR]

In an era which marks an exceptional phase of growth in science and technology, the acute disparities in access to healthcare still persist. So where on one hand scientific advancement in medicine aims at increasing life expectancy, on the other hand there are millions who are denied access to existing medicines. Patents on medicines also pose a significant barrier to access new drugs, especially in low and middle income countries which already suffer from poor health financing mechanisms. The patent laws were built on the assumption of incentivizing the innovators by rewarding them with the exclusive right to produce, sell or market the innovation. The basic premise for granting patents was based on the thought that it would increase investment in research and development promoting dynamic gains through newer innovations. However, evidence found to support this justification is meager. So in a situation where the drug gap still persists and we aim to achieve sustainable development goals by 2030, this paper attempts to focus on understanding how compulsory licensing has been used in selected cases to alleviate the major legal and political barriers to access medicines. The methodology comprises of cross-country comparison of patent framework and compulsory licensing cases. The sample selected for study includes both developed as well as developing countries. The aim is to evaluate the policy approaches used by selected countries to grant compulsory licenses and to identify the best practices for evidence-based policy making on international issues related to pharmaceutical patents. In each case, a driving factor has been the international extension of patent laws through trade agreements; first bilaterally (US-Canada) and subsequently internationally (1995 Uruguay round, under which low- and middle-income countries were granted a grace period until 2005 to comply). [ABSTRACT FROM AUTHOR]

In a number of ways, implementing monetary policy in Canada stands apart from monetary policy in most other industrial countries. Commercial banks and other participants to the main clearinghouse – the large-value transfer system (LVTS) – hold no reserves at the central bank. Clearing and settlement is both in real time and net, while only settlement occurs on the books of the central bank. The Bank of Canada does not conduct open-market operations and rarely intervenes in the repo market; and despite this, the collateralized overnight rate always remains within 2 or 3 basis points of the target interest rate. The paper explains why this is so by describing the setup of the Canadian clearing and settlement system, including the rules that have been put forward in case a bank defaults on its due payments before settlement occurs. Some puzzles that arose through the years are also discussed, as well as the unlikely prospect of introducing blockchain technology in the Canadian clearing and settlement system. [ABSTRACT FROM AUTHOR]

International service learning, a form of service learning where students travel to developing countries to provide community services of varying types, has come to be common practice at universities throughout the Global North. This paper reports and discusses a case study focused on the ethical questions arising from current practice at one Canadian university. The study follows the path students take from their home university to their final placement. In the context of the political economy of North-South relations in a period of neoliberalism, the analysis considers the ethics of power differentials, reciprocity, accountability, student preparedness and qualifications in relation to host communities. The article concludes with a critique of post-secondary institutional involvement with and promotion of international service learning. [ABSTRACT FROM AUTHOR]

Exploitation of fossil fuel sources in the power generation and transportation sector has been a major source of carbon dioxide emissions that contributes to global warming. Replacement of hydrocarbon-based fuel sources with cleaner fuels is imperative for environmental preservation at the global level. In this regard, hydrogen can be used as an effective non-carbonaceous fuel option as well as an energy carrier. Canada is currently one of the economically advanced countries in the world and aims at achieving a net-zero economy by 2050. However, fossil fuels are still largely utilized for both transportation and power generation purposes. Slightly less than a quarter of the total grid power in Canada is supplied through fossil fuel combustion including natural gas, coal, and petroleum. As a matter of fact, Canada, as one of the top ten global producers of hydrogen, exhibits a great potential of achieving the goal of sustainable development. Thus, this paper discusses the current status, challenges, and opportunities offered by the hydrogen sector and its development in the near- and long-term future in Canada. The potential methods of hydrogen production in Canada are described by categorizing them according to the energy and feedstock sources required for their realization. In addition, the status of hydrogen storage and distribution in Canada is also discussed. Various sectors consuming hydrogen as the end-users in Canada are categorized based on hydrogen use as a fuel, a heating source, and an industrial feedstock and are comprehensively discussed. Several challenges and the necessary line-of-actions to establish a hydrogen economy in Canada in the long-term future are also discussed, and a road map for accomplishing the net-zero economy by 2050 is further explained based on achieving certain near-term, mid-term, and long-term goals. Moreover, the job creation opportunities in Canada are discussed by considering numerous critical sectors. [Display omitted] • Overview of Canada's global position with regards to hydrogen production. • Overview of Canada's natural resources and infrastructural potential. • Comprehensive discussion on hydrogen production pathways and end-use in Canada. • Identification of several key challenges to achieve net-zero economy by 2050. [ABSTRACT FROM AUTHOR]

The importation of rescue dogs has become an increasingly common occurrence in recent years, often involving industrialized countries as the ultimate destination. However, international dog rescue activities have attracted considerable criticism from the veterinary community and the public due to the associated zoonotic disease and public health risks, as well as the potential poor behaviour of international rescue dogs. The Government of Canada has also recently placed a temporary suspension on all commercial dog imports from non-rabies free countries due to the growing concerns of the zoonotic disease risks. To understand the perspectives and experiences of stakeholders involved in dog import activities in Canada, we interviewed nine members in leadership positions of Canadian-based international dog rescue organizations. Thematic analysis of interview dialogue yielded three themes: 1) Motive, which described the reason behind participants' involvement in international dog rescue; 2) Challenge, which described the major difficulties faced in participants' dog rescue work; 3) Duty, which described participants' beliefs on responsible dog rescue practices. Members of international dog rescue organizations described being driven by strong desires to provide animal and humanitarian aid. However, local dog rescue efforts were constrained by logistical and societal barriers unique to the Canadian context. Additionally, the current study revealed both similarities and differences in occupational experiences between international dog rescue organizations and other animal care professions. Specifically, difficulties with the emotional burden associated with caregiving professions was also present within dog rescue work. However, international dog rescue members also experienced additional challenges due to the stigma surrounding international dog rescue operations. Further research on attitudes held by other stakeholders involved in dog import activities, as well as members of Canadian communities needing dog rescue aid may provide meaningful inputs on how to better support and facilitate local and international dog rescue efforts. [ABSTRACT FROM AUTHOR]

Background: Racism in the healthcare system has become a burgeoning focus in health policy-making and research. Existing research has shown both interpersonal and structural forms of racism limiting access to quality healthcare for racialised healthcare users. Nevertheless, little is known about the specifics of racism in the inpatient sector, specifically hospitals and rehabilitation facilities. The aim of this scoping review is therefore to map the evidence on racial discrimination experienced by people receiving treatment in inpatient settings (hospitals and rehabilitation facilities) or their caregivers in high-income countries, focusing specifically on whether intersectional axes of discrimination have been taken into account when describing these experiences. Methods: Based on the conceptual framework developed by Arksey and O'Malley, this scoping review surveyed existing research on racism and racial discrimination in inpatient care in high-income countries published between 2013 and 2023. The software Rayyan was used to support the screening process while MAXQDA was used for thematic coding. Results: Forty-seven articles were included in this review. Specifics of the inpatient sector included different hospitalisation, admission and referral rates within and across hospitals; the threat of racial discrimination from other healthcare users; and the spatial segregation of healthcare users according to ethnic, religious or racialised criteria. While most articles described some interactions between race and other social categories in the sample composition, the framework of intersectionality was rarely considered explicitly during analysis. Discussion: While the USA continue to predominate in discussions, other high-income countries including Canada, Australia and the UK also examine racism in their own healthcare systems. Absent from the literature are studies from a wider range of European countries as well as of racialised and disadvantaged groups other than refugees or recent immigrants. Research in this area would also benefit from an engagement with approaches to intersectionality in public health to produce a more nuanced understanding of the interactions of racism with other axes of discrimination. As inpatient care exhibits a range of specific structures, future research and policy-making ought to consider these specifics to develop targeted interventions, including training for non-clinical staff and robust, transparent and accessible complaint procedures. [ABSTRACT FROM AUTHOR]

Objectives: Community health workers (CHWs) have been deployed to provide health-related services to their fellow community members and to guide them through often complex health systems. They help address concerns about how marginalized populations in many countries experience health inequities that are due, in part, to lack of appropriate primary health care services, possibly resulting in inappropriate use of higher-cost health services or facilities. This paper reviews studies on CHW interventions in a number of high-income countries, including Canada, to identify research gaps on CHW roles., Methods: A scoping review using 68 sources of interventions involving CHWs was undertaken. The five-step Arksey and O'Malley model guided this review with the aim of summarizing research findings and identifying research gaps in the existing literature on CHWs in Canada (23 sources). A standardized extraction tool was employed to synthesize the literature., Synthesis: We found that CHWs provide a wide range of health-related services but in a manner that, in Canada, is unrecognized and unregulated. In highincome countries, CHW interventions have contributed to health-related issues in communities and demonstrated potential to both reduce health inequity in marginalized populations and reduce the cost of medical services., Conclusion: CHWs are an under-recognized, and therefore underutilized, public health workforce, which has a promising capacity to reduce health inequities in marginalized populations in Canada. There is growing support to suggest that CHW roles need to be better integrated within the broader health and social services systems to enable their full potential to be realized.

Background: Drowning is a significant public health issue, with females accounting for one third of global drowning deaths. The rate of female drowning has not decreased within high-income countries and presentations to hospital have increased. This scoping review aimed to explore adult female unintentional drowning, including risk factors, clinical treatment and outcomes of females hospitalised for drowning.Methods: A systematic search of the literature following the PRISMA-ScR framework was undertaken. The databases OVID MEDLINE, Embase, CINAHL, OVID Emcare, Web of Science, Informit and Scopus were accessed. Study locations of focus were Australia, Canada, New Zealand, the United Kingdom, and the United States. Studies from January 2003 to April 2019 were included. The quality of evidence of included studies was assessed using GRADE guidelines.Results: The final search results included 14 studies from Australia (n = 4), Canada (n = 1), New Zealand (n = 1), United States (n = 6), United Kingdom (n = 1), and one study reporting data from both Australia and United States. Nine studies reported risk factors for female drowning including age, with the proportion of female drowning incidence increasing with age. Although females are now engaging in risk-taking behaviours associated with drowning that are similar to males, such as consuming alcohol and swimming in unsafe locations, their exposure to risky situations and ways they assess risk, differ. Females are more likely to drown from accidental entry into water, such as in a vehicle during a flood or fall into water. This review found no evidence on the clinical treatment provided to females in hospital after a drowning incident, and only a small number of studies reported the clinical outcomes of females, with inconsistent results (some studies reported better and some no difference in clinical outcomes among females).Conclusion: Adult females are a group vulnerable to drowning, that have lacked attention. There was no single study found which focused solely on female drowning. There is a need for further research to explore female risk factors, the clinical treatment and outcomes of females hospitalised for drowning. This will not only save the lives of females, but also contribute to an overall reduction in drowning. [ABSTRACT FROM AUTHOR]

Objective: Despite low patient numbers, rural emergency departments have a similar diversity of case presentations as urban tertiary hospitals, with the need to manage high‐acuity cases with limited resources. There are no consistent descriptions of the resources available to rural emergency departments internationally, limiting the capacity to compare clinical protocols and standards of care across similarly resourced units. This review aimed to describe the range of human, physical and specialist resources described in rural emergency departments in developed countries and propose a typology for use internationally. Design and setting: A systematic literature search was performed for journal articles between 2000 and 2019 describing the staffing, access to radiology and laboratory investigations, and hospital inpatient specialists. Results: Considerable diversity in defining rurality and in resource access was found within and between Australia, New Zealand, Canada and USA. Discussion: A typology was developed to account for (a) emergency department staff on‐floor, (b) emergency department staff on‐call, (c) physical resources and (d) access to a specialist surgical service. This provides a valuable tool for relevant stakeholders to effectively communicate rural emergency department resources within a country and internationally. Conclusion: The proposed five‐tiered typology draws together international literature regarding rural emergency department services. Although further research is required to test this tool, the formation of this common language allows a base for effective communication between governments, training providers and policy‐makers who are seeking to improve health systems and health outcomes. [ABSTRACT FROM AUTHOR]

The public–private partnership (PPP) paradigm emerged as a form of global health governance in the mid-1990s to overcome state and market failures constraining access to essential medicines among populations with limited purchasing power in low- and middle-income countries. PPPs are now ubiquitous across the development spectrum. Yet while the narrative that the private sector must be engaged if complex health challenges are to be overcome is now dominant in development discourse, it does not yet appear to be shaping government approaches to addressing health inequalities within high-income welfare states such as Canada. This is significant as both the actions and inactions of firms factor heavily into why low-income Canadians face a disproportionate risk of developing diet-associated chronic diseases, such as type II diabetes. In the same ways PPPs have been an effective policy tool for strengthening public health in poor countries, this paper illuminates how the PPP model may have utility for mitigating poverty-associated food insecurity giving rise to diet-associated non-communicable diseases within the context of wealthy states. [ABSTRACT FROM PUBLISHER]

Since reports about CIA-funded LSD studies came out in the 1970s, psychedelic drugs have invoked images of unethical experimentation and "mad scientists" in the public imagination. Even now, as the stigma surrounding psychedelics diminishes in the 21st century, the figure of the "mad scientist" continues to occupy a space in what Ido Hartogsohn calls the "collective set and setting," the larger framework of cultural understandings that shape how individuals experience psychedelic drugs. Scientists and humanities scholars who study these drugs have responded to this issue by drawing boundaries between those who used psychedelics carefully and those who used them ignorantly. Yet these boundaries were not always so clear in the past. Drawing on historical examples of LSD's use as a correctional tool in Canada, I show how enthusiasm about the drug's potential led several experienced and knowledgeable psychedelic therapists to use it on vulnerable populations in diverse institutional settings, such as correctional facilities. These examples reveal how the institutional context of modern industrial societies shaped the application of psychedelic therapy in the past and suggest that today's therapists need to carefully consider how this broader context impacts their work. [ABSTRACT FROM AUTHOR]

Introduction: Health systems in developed nations are striving to improve care experiences and quality. A common care quality issue is delayed hospital discharge, known in Canada as Alternate Level of Care (ALC). An ALC designation is given when a patient's treatment is complete but his/her next point of care (e.g. long-term care, assisted living, care at home) is unavailable. While ALC patients occupy hospital beds, care and activation usually decreases or even ceases, exacerbating their already heightened risk of functional decline, falls, and hospital-related adverse events. ALC is also a systems issue: hospital beds are unavailable to incoming patients, causing emergency service backlogs, cancelled surgeries and delays. ALC also impacts patients and their family caregivers who fill these care gaps; however, little is known about personal care experiences, particularly among family caregivers. Methods: Interviews were conducted with 30 caregivers across three health regions in Ontario, Canada with varying geographies, community resources and population characteristics. Interviews focused on caregivers' experiences of caring for loved ones who were designated ALC. Qualitative descriptive analysis was used to identify core themes. Results: Core themes included: patient over person (patients no longer had medical needs but still required personal care); uncertain, confusing processes (steps in care were unclear); inconsistent quality of care delivery (between providers); caregivers addressing gaps in the system (caregivers provided support to patients while in hospital); and personalization of long-term care (caregivers wanted patients to be in a place that felt homelike, stimulating and in close proximity to them). Discussion: Caregivers' roles continue while patients are hospitalized. ALC patients' physical and social needs are often neglected by the hospital, putting patients and caregivers at risk of additional decline. Caregivers strive to fill care gaps but factors related to geographic location, understanding of the health system and comfort in advocating shape their ability to do so. Conclusion (w/key findings): Caregivers play a critical, and often overlooked, role in meeting the care needs of patients during care transitions. An ALC designation creates additional uncertainty during an already vulnerable time. Ironically, patient and caregiver needs are ongoing but care within the hospital is considered 'complete'. The caregiver experience provides insight on health care system gaps, the importance of caregiver involvement within care teams and a need for tailored caregiver engagement strategies. Lessons learned: ALC is an issue that requires a collective response from health and social care systems (including acute and intermediate care hospitals, long-term care, homecare and primary care) with better engagement of caregivers, who oversee patient care within and beyond the hospital walls. Limitations: This paper shares caregiver perspectives only. An analysis of the experiences of other stakeholders, including patients, providers, managers and decision-makers is required in order to act on the identified needs of caregivers. Suggestions for future research: Future research by this team will engage patients and caregivers to co-design strategies to address delayed hospital discharge. The team will explore the experiences of providers and decision-makers and collect input on the implementation barriers and facilitators of such co-designed strategies. [ABSTRACT FROM AUTHOR]

Background: Perceived financial security impacts physical, mental, and social health and overall wellbeing at community and population levels. Public health action on this dynamic is even more critical now that the COVID-19 pandemic has exacerbated financial strain and reduced financial wellbeing. Yet, public health literature on this topic is limited. Initiatives targeting financial strain and financial wellbeing and their deterministic effects on equity in health and living conditions are missing. Our research-practice collaborative project addresses this gap in knowledge and intervention through an action-oriented public health framework for initiatives targeting financial strain and wellbeing. Methods: The Framework was developed using a multi-step methodology that involved review of theoretical and empirical evidence alongside input from a panel of experts from Australia and Canada. In an integrated knowledge translation approach, academics (n = 14) and a diverse group of experts from government and non-profit sectors (n = 22) were engaged throughout the project via workshops, one-on-one dialogues, and questionnaires. Results: The validated Framework provides organizations and governments with guidance for the design, implementation, and assessment of diverse financial wellbeing- and financial strain-related initiatives. It presents 17 priority actionable areas (i.e., entry points for action) likely to have long-lasting, positive effects on people's financial circumstances, contributing to improved financial wellbeing and health. The 17 entry points relate to five domains: Government (All Levels), Organizational & Political Culture, Socioeconomic & Political Context, Social & Cultural Circumstances, and Life Circumstances. Conclusions: The Framework reveals the intersectionality of root causes and consequences of financial strain and poor financial wellbeing, while also reinforcing the need for tailored actions to promote socioeconomic and health equity for all people. The dynamic, systemic interplay of the entry points illustrated in the Framework suggest opportunities for multi-sectoral, collaborative action across government and organizations towards systems change and the prevention of unintended negative impacts of initiatives. [ABSTRACT FROM AUTHOR]

Background and Purpose: Consistent measurement of respectful maternity care (RMC) is lacking. This Delphi study assessed consensus about indicators of RMC. Methods: A multidisciplinary panel assessed items (n = 201) drawn from global literature. Over two rounds, the panel rated importance, relevance, and clarity, and ranked priority within 17 domains including communication, autonomy, support, stigma, discrimination, and mistreatment. Qualitative feedback supported the analysis. Results: In Round One, 191 indicators exceeded a content validation index of 0.80. In Round Two, Kendall's W ranged from 0.081 (p =.209) to 0.425 (p <.001) across domains. Fourteen indicators received strong support. Changes in indicator assessment between rounds prevented agreement stability assessment. Conclusion: The indicators comprise a registry of items for use in perinatal care research. [ABSTRACT FROM AUTHOR]

With limited residency positions, the majority of international medical graduates living in Canada and other developed countries cannot work as physicians. The educational experience and career development of unmatched international medical graduates (those who are not matched to a residency position) residing in Canada have never been studied. Through an innovative collaboration of provincial international medical graduate organizations, we launched an online survey targeting the career development of unmatched international medical graduates, with 356 survey responses entering data analysis. Respondents reported that at the early career planning stage, close to a third had not had adequate knowledge of their career prospects in Canada. Although official resources are available, most respondents found that the information did not match well with reality. After arriving in Canada, educational resources for unmatched international medical graduates are scarce. The majority of them work in healthcare-related fields but reported significant difficulties finding these positions, and there were limited career training opportunities. Among respondents who were no longer pursuing residency positions and had moved on to alternate career paths, we found, unexpectedly, that 69% of them reported previous residency application experience did not contribute to their current occupation, and most were not satisfied with their current career status and continuing education opportunities. In conclusion, the unmatched international medical graduates could serve as a vital reservoir of skilled medical professionals to serve the community, especially during public health crises. Continuing education and career support of unmatched international medical graduates are crucial for their career development and should be an area of priority for policymakers. Career support, especially for alternative career paths, can be built on the current services that exist in most provinces in Canada. In addition, novel online and social media tools can be utilized to increase the outreach of these programs. [ABSTRACT FROM AUTHOR]

In the last decade, Sci-Hub has become prevalent among academic information users across the world. Providing thousands of users with millions of uncopyrighted electronic academic resources, this information pirate website has become a significant threat to copyrights in cyberspace. Information scholars have examined the unequal distribution of IP addresses of Sci-Hub users' nationality and emphasized the high proportion taken by users from the developed countries. This study finds new evidence from Google Scholar. Searching "Sci-Hub.tw" in the academic search engine, the author finds 531 results containing the keyword. Considering the result, the author argues that academic users in South American countries may use Sci-Hub more frequently than their counterparts in the rest of the world. Moreover, users in the Global North also rely on Sci-Hub to complete their research as well. The new evidence on Google Scholar proves the universal use of Sci-Hub across the world. [ABSTRACT FROM AUTHOR]

Accelerating the pace of energy technological innovation is essential to curb global climate change and build a clean energy system. Based on this idea, from the perspective of renewable energy technology gaps across countries, this study presents a thorough empirical analysis of the convergence of energy technology research, development, and demonstration (RD&D) budgets across OECD countries over 1985–2017. In doing so, we apply two-regimes threshold autoregressive approach to account for heterogeneity, nonlinearity, and transition path in energy technology RD&D convergence. One observation is that only a small number of advanced countries namely Canada, Japan, and the U.S. follow a nonlinear process and exhibit partial convergence in energy technology RD&D budgets with Japan as a transition country. Interestingly, our results also provide clear support for the global convergence of energy technology RD&D budgets once accounting for the two regimes jointly. These trends in national energy innovation policies could arguably help Canada, Japan, and the U.S. to drive up their energy RD&D trajectory into the future, suggesting that these countries would be able to achieve a more sustainable energy innovation supply system. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has produced massive procedural backlogs in many parts of the developed world, with a disproportionate impact on the elderly. Whereas it is well-known that such a backlog would cause undue morbidity and mortality in thousands of patients, it is still unclear how jurisdictions plan on catching up on their missed surgeries and screening tests. In this comparative review therefore, we examine existing literature to quantify the backlog and thereafter summarize the solutions that have been proposed to clear it. Searches were performed on Google, Google Scholar, PubMed, Ovid MEDLINE®, and Ovid Embase® to identify literature from Canada, the United Kingdom, and the United States of America. We report our findings with a focus on three representative types of procedures including cataract surgery, colorectal screening, and hip and knee replacement surgery. Common themes of potential solutions included leveraging more advanced technology, ensuring preventative care, training an appropriate allied health workforce, and innovating in the operating room to improve efficiency and surgical capacity. Although no single solution emerges to be universally applicable, a combination of proposed solutions can be considered after an individualized assessment of the hospital or clinic context, the type of surgery required, and the availability of equipment, facility, and staff. [ABSTRACT FROM AUTHOR]

Background: A woman and girl centred, rights-based approach to health care is critical to achieving sexual and reproductive health. However, women with female genital mutilation in high-income countries have been found to receive sub-optimal care. This study examined documents guiding clinicians in health and community service settings in English-speaking high-income countries to identify approaches to ensure quality women and girl-centred care for those with or at risk of female genital mutilation. Method: We undertook a scoping review using the integrative model of patient-centredness to identify principles, enablers, and activities to facilitate woman and girl-centred care interactions. We developed an inclusion criterion to identify documents such as guidance statements and tools and technical guidelines, procedural documents and clinical practice guidelines. We searched the databases and websites of health professional associations, ministries of health, hospitals, national, state and local government and non-government organisations working in female genital mutilation in the United Kingdom, Ireland, Canada, The United States, New Zealand, and Australia. The Appraisal of Guidelines for Research and Evaluation tool was used to appraise screened documents. Findings: One-hundred and twenty-four documents were included in this scoping review; 88 were developed in the United Kingdom, 20 in Australia, nine in the United States, three in Canada, two in New Zealand and two in Ireland. The focus of documents from the United Kingdom on multi-professional safeguarding (62), while those retrieved from Australia, Canada, Ireland, New Zealand and the US focused on clinical practice. Twelve percent of the included documents contained references to all principles of patient-centred care, and only one document spoke to all principles, enablers and activities. Conclusion: This study demonstrates the need to improve the female genital mutilation-related guidance provided to professionals to care for and protect women and girls. Professionals need to involve women and girls with or at risk of female genital mutilation in the co-design of guidelines and tools and evaluation of them and the co-production of health care. Plain Language Summary: High-quality health care for women and girls should be provided by health workers who are respectful and caring. Health workers should also work with others as a team and help women and girls make their own decisions about their health care. This approach is called patient-centred care. Female genital mutilation (FGM) is a cultural practice associated with poor health outcomes. Women who have experienced FGM have not always received quality health care. We studied the guidance and tools to help health workers provide care to women and girls with or at risk of FGM. This study aimed to understand how health workers are supported to provide woman and girl-centred health care in these documents. We searched for these documents on the websites of health professional associations, government health departments and organisations working in FGM in the United Kingdom, Ireland, Canada, The United States, New Zealand, and Australia. The documents were analysed using a tool that described all the important areas needed to provide patient-centred health care. Of the 124 documents, we found that only 12% contained information about all aspects of patient-centred care. Only one document had details about all the areas that are part of patient-centred care. This study shows that we need to improve the FGM-related guidance provided to health workers to care for and protect women and girls. There is a need for health workers to involve women and girls with or at risk of FGM in designing guidelines and tools and evaluating them to these documents best fit their needs. [ABSTRACT FROM AUTHOR]

Herpes zoster (HZ) is a neurocutaneous disease that causes significant morbidity worldwide. The disease is caused by the reactivation of the varicella-zoster virus (VZV), which leads to the development of a painful, vesicular rash and can cause complications such as post-herpetic neuralgia and vision loss. Globally, the incidence of HZ is increasing, and it incurs billions in cost annually to the healthcare system and to society through loss of productivity. With the advent of effective vaccines such as the live attenuated vaccine, Zostavax®, in 2006, and more recently the adjuvant recombinant subunit vaccine, Shingrix®, in 2017, HZ has become a preventable disease. However, access to the vaccines remains mostly limited to countries with developed economies, such as the United States and Canada. Even among countries with developed economies that license the vaccine, few have implemented HZ vaccination into their national immunization schedules due to cost-effectiveness considerations. In this review, we discuss the currently available HZ vaccines, landscape of HZ vaccine guidelines, and economic burden of disease in countries with developed and developing economies, as well as barriers and considerations in HZ vaccine access on a global scale. [ABSTRACT FROM AUTHOR]

Health tourism is a booming billion-dollar business, which has attracted the attention of academia and industry. Most of the research conducted on health tourism has been conceptual or has mainly focused on health tourism activities from developed to developing countries. This study investigates the impact of tourism demand on health-related tourism spending in a developed country (Canada) with a dominant tourism market (United States (U.S.)). The study considers both volume and price effects of health tourism during the period of 1986–2016, by applying time-series analysis, including unit root and cointegration testing and application of autoregressive distribution lag modelling. The results show a positive long-term effect of U.S. tourism demand on overall health-related tourism spending in Canada, but varying results when considering the volume and price dimensions. The findings provide further insights for managing the niche business of health tourism in Canada. [ABSTRACT FROM AUTHOR]

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Pharmaceutical products are believed to enhance the safety of living to cure or prevent diseases. This Pharmaceutical products, however it can cause serious disruptive impacts on living organisms, when they are dispersed throughout the environment by a different path. In the past few years, the difficult tasks for the pharmaceutical industries is adapting to the effect of pharmaceutical products on earth. Such natural wellbeing and protection issues made ready in building up a rightful regulatory regime for Environment Risk Assessment (ERA) of pharmaceutical products. The majority of regulatory improvements have been made in ERA for pharmaceutical products in developed countries such as the US, EU, Canada. Countries around the world and organizations such as OECD have developed procedures for ERA to achieve the main goal. Currently, there is an absence of specified guidance for ERA of pharmaceutical products in other countries around the world. However, in the future, they are supposed to have stringent guidelines and legislative specifications. This study seeks to acknowledge, compare, and contrast ERA embraced by developed countries such as Europe and the US. In this study, we have given an outline of the awareness of pharmaceuticals products on ERA and its environmental impacts. Hence, it is important to develop an Eco Pharmaco-Vigilance (EPV) framework for monitoring and collecting information, which will eliminate the possibility of medicinal products that reach the earth. Within this review article we compared about the ERA that developed countries like Europe and the US have adopted. [ABSTRACT FROM AUTHOR]

Background: Esophageal cancer can be subdivided into two main histological subtypes with significant variability in their etiology and epidemiology. The incidence of esophageal adenocarcinoma (AC) is increasing across the developed countries, whereas the incidence of esophageal squamous cell carcinoma (SCC) is declining. Several risk factors have been identified in the pathogenesis of each subtype, however, their epidemiologic characteristics and distribution throughout Canada remain poorly understood. Methods: We performed a retrospective analysis of demographic data across Canada from 1992 to 2010 using two independent population‐based cancer registries. The incidence of esophageal cancer, for each subtype, was examined at the levels of provinces/territories, cities, and postal codes. Results: A total of 19 790 patients were diagnosed with esophageal cancer in Canada between 1992 and 2010; 74% were males. The average national incidence rate was 33.5 cases per million individuals per year. Incidence of esophageal AC increased over time, with notable high‐incidence rates on the Vancouver Island, the coasts of the Great Lakes, and the coasts of the Northumberland Strait in the Maritimes. The overall incidence of esophageal SCC has decreased. However, high incidence of esophageal SCC was detected in the Vancouver city, rural eastern Québec, and in the Maritimes. We also report clustering for each subtype using postal codes, which sheds light onto new avenues of research for potential environmental etiologies. Conclusions: This study, for the first time, provides a detailed analysis on the burden of esophageal cancer in Canada, revealing important geographic clustering trends. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to analyze the Austrian health care system using the ecology of care model. Our secondary aim was to compare data from Austria with those available from other countries. Design: 3508 interviews employing a 30-item questionnaire related to the utilization of the health care system including demographic factors were conducted. Participants were chosen by a Random Digital Dialing procedure. Further, a literature review of studies of other countries use of the ecology of care model was conducted. Main outcome measures: Austria has one of the highest utilization of health care services in any of the assessed categories. The comparison with the literature review shows that Austria has the highest utilization of specialists working in the outpatient sector as well as the highest hospitalization rates. Taiwan and Korea have comparable utilization patterns. Canada, Sweden, and Norway are countries with lower utilization patterns, and the U.S. and Japan are intermediate. Conclusion: In Austria and similarly organized countries, high utilization of all health care services can be observed, in particular, the utilization of specialists and hospitalizations. The over-utilization of all levels of health care in Austria may be due to the lack of a clear demarcation line between the primary and secondary levels of care, and the presence of universal health coverage, which also allows for unrestricted and undirected access to all levels of care. Previous studies have shown that comparable countries lack the health benefits of a strong primary care system with its coordination function. In Austria and similarly organized countries, there appears to be high utilization of health care in general, as well as with particular utilization of specialists and hospitalizations. The high utilization of all levels of care in Austria may be the result of competition, lack of a clear demarcation line between the primary and secondary level of care, and the presence of universal health coverage. Pathways between primary and secondary care should be strengthened as previous studies have shown that comparable countries lack the health benefits of strong primary care and its function for health care coordination. [ABSTRACT FROM AUTHOR]

The welfare state literature on developing nations is concerned with how governmental illegitimacy and incompetency are the sources of inequality, exploitation, exclusion, and domination of significant proportions of their citizenry. These dimensions clearly contribute to the problematic health outcomes in these nations. In contrast, developed nations are assumed to grapple with less contentious issues of stratification, decommodification, and the relative role of the state, market, and family in providing economic and social security, also important pathways to health. There is an explicit assumption that governing authorities in developed nations are legitimate and competent such that their citizens are not systematically subjected to inequality, exploitation, exclusion, and domination by elites. In this article, we argue that these concepts should also be the focus of welfare state analysis in developed liberal welfare states such as Canada. Such an analysis would expose how public policy is increasingly being made in the service of powerful economic elites rather than the majority, thereby threatening health. It would also serve to identify means of responding to these developments. [ABSTRACT FROM AUTHOR]

Objective: Concerns about differences in registration practices across countries have limited the use of routine data for international very preterm birth (VPT) rate comparisons.Design: Population-based study.Setting: Twenty-seven European countries, the United States, Canada and Japan in 2010.Population: A total of 9 376 252 singleton births.Method: We requested aggregated gestational age data on live births, stillbirths and terminations of pregnancy (TOP) before 32 weeks of gestation, and information on registration practices for these births. We compared VPT rates and assessed the impact of births at 22-23 weeks of gestation, and different criteria for inclusion of stillbirths and TOP on country rates and rankings.Main Outcome Measures: Singleton very preterm birth rate, defined as singleton stillbirths and live births before 32 completed weeks of gestation per 1000 total births, excluding TOP if identifiable in the data source.Results: Rates varied from 5.7 to 15.7 per 1000 total births and 4.0 to 11.9 per 1000 live births. Country registration practices were related to percentage of births at 22-23 weeks of gestation (between 1% and 23% of very preterm births) and stillbirths (between 6% and 40% of very preterm births). After excluding births at 22-23 weeks, rate variations remained high and with a few exceptions, country rankings were unchanged.Conclusions: International comparisons of very preterm birth rates using routine data should exclude births at 22-23 weeks of gestation and terminations of pregnancy. The persistent large rate variations after these exclusions warrant continued surveillance of VPT rates at 24 weeks and over in high-income countries.Tweetable Abstract: International comparisons of VPT rates should exclude births at 22-23 weeks of gestation and terminations of pregnancy. [ABSTRACT FROM AUTHOR]

International migrant women of childbearing age represent a large proportion of immigrants to high-income countries, yet research focusing on their postpartum health is limited. We investigated predictive factors for breast and non-breast pain 1 week post-birth in migrant and non-migrant women in Canada. Among migrant women, difficulty accessing health services; being from a middle-or high-income country; poor functionality in English and French; living with the father of their infant; and having no regular care provider were predictive of breast pain. Among non-migrant women, difficulties accessing health services, multiparity and prenatal education were predictive of breast pain, while receiving an epidural and having no regular care provider were predictive of non-breast pain. Among both groups, difficulties accessing health services and having no regular care provider were predictive of breast pain, while second degree or higher perineal tearing was predictive of non-breast pain. Migration-specific indicators should be considered in postpartum care planning. [ABSTRACT FROM AUTHOR]

Using the latest wave of the Canadian Ethnic Diversity Survey, I investigate whether religious identity and religious intensity associate with the degree to which people trust others, controlling for a wide range of characteristics. The analysis shows that Canadian Roman Catholics are appreciably less trusting than mainline Protestants, and religious nones are situated in between these two groups. With regard to religious intensity, I find that higher commitment negatively correlates with trust in unknown others for Roman Catholics. The reverse is true for Protestants. Results also show stark cross-denominational variations within Protestantism, as two highly committed denominations of Mennonite and Pentecostal are found to be the most and the least trusting religious groups in Canada. No non-Christian religious minority is found statistically significantly less trusting than Canadian Roman Catholics. Considering particularized trust in one's neighbours and co-workers yields comparable conclusions. [ABSTRACT FROM AUTHOR]

Societies exhibiting higher levels of economic inequality experience poorer health outcomes, and the proposed pathways used to explain these patterns are also relevant to oral health. This study therefore examines the relationship between the level of income inequality and the oral health and dental care services utilization of residents from eleven Canadian metropolitan areas. We calculated Pearson correlation coefficients (r) between each metropolitan area's Gini coefficient (used as a proxy for income inequality, calculated from 2006 Canadian census data) and each area's experience of dental pain, self-reported oral health, and use of dental care services (provided by data from the 2003 Canadian Community Health Survey). Greater levels of income inequality in the selected metropolitan areas were related to an increased likelihood of residents self-reporting their oral health as poor/fair and reporting a prolonged absence from visiting a dentist. There was, however, no relationship between the level of income inequality and the likelihood of respondents reporting a recent toothache, tooth sensitivity, or jaw pain. Policies designed to improve the oral health of the population, and Canadians' access to dental care generally, may therefore work best when supported by policies that promote greater economic equality within Canada. [ABSTRACT FROM AUTHOR]

Beginning in 2000, in economically advanced countries, a remarkable bifurcation in fertility levels has emerged, with one group in the moderate range of period total fertility rates, about 1.9, and the other at 1.3. The upper branch consists of countries in Northern and Western Europe, Oceania and the United States; the lower branch includes Central, Southern, and Eastern Europe, and East and Southeast Asia. A review of the major theories for low-fertility countries reveals that none of them would have predicted this specific bifurcation. We argue that those countries with fertility levels close to replacement level have institutional arrangements, and related policies, that make it easier, not easy, for women to combine the worker and mother roles. The institutional details are quite different across countries, suggesting that multiple combinations of institutional arrangements and policies can lead to the same country-level fertility outcome. Canada, the only exception to this bifurcation, illustrates the importance of the different institutional structures in Québec compared to the rest of Canada. [ABSTRACT FROM AUTHOR]

Objective: To assess the mean package size and manufacturer-recommended serving size of sweet beverages available in four high-income countries: Australia, Canada, the Netherlands and New Zealand.Design: Cross-sectional surveys.Setting: The two largest supermarket chains of each country in 2012/2013.Subjects: Individual pack size (IPS) drinks (n 891) and bulk pack size (BPS) drinks (n 1904).Results: For all IPS drinks, the mean package size was larger than the mean serving size (mean (sd)=412 (157) ml and 359 (159) ml, respectively). The mean (sd) package size of IPS drinks was significantly different for all countries (range: Australia=370 (149) ml to New Zealand=484 (191) ml; P<0·01). The mean (sd) package size of Dutch BPS drinks (1313 (323) ml) was significantly smaller compared with the other countries (New Zealand=1481 (595) ml, Australia=1542 (595) ml, Canada=1550 (434) ml; P<0·01). The mean (sd) serving size of BPS drinks was significantly different across all countries (range: Netherlands=216 (30) ml to Canada=248 (31) ml; P<0·00). New Zealand had the largest package and serving sizes of the countries assessed. In all countries, a large number of different serving sizes were used to provide information on the amount appropriate to consume in one sitting.Conclusions: At this point there is substantial inconsistency in package sizes and manufacturer-recommended serving sizes of sweet beverages within and between four high-income countries, especially for IPS drinks. As consumers do factor serving size into their judgements of healthiness of a product, serving size regulations, preferably set by governments and global health organisations, would provide consistency and assist individuals in making healthier food choices. [ABSTRACT FROM AUTHOR]

Importance: Differences in utilization and costs of end-of-life care among developed countries are of considerable policy interest.Objective: To compare site of death, health care utilization, and hospital expenditures in 7 countries: Belgium, Canada, England, Germany, the Netherlands, Norway, and the United States.Design, Setting, and Participants: Retrospective cohort study using administrative and registry data from 2010. Participants were decedents older than 65 years who died with cancer. Secondary analyses included decedents of any age, decedents older than 65 years with lung cancer, and decedents older than 65 years in the United States and Germany from 2012.Main Outcomes and Measures: Deaths in acute care hospitals, 3 inpatient measures (hospitalizations in acute care hospitals, admissions to intensive care units, and emergency department visits), 1 outpatient measure (chemotherapy episodes), and hospital expenditures paid by insurers (commercial or governmental) during the 180-day and 30-day periods before death. Expenditures were derived from country-specific methods for costing inpatient services.Results: The United States (cohort of decedents aged >65 years, N = 211,816) and the Netherlands (N = 7216) had the lowest proportion of decedents die in acute care hospitals (22.2.% and 29.4%, respectively). A higher proportion of decedents died in acute care hospitals in Belgium (N = 21,054; 51.2%), Canada (N = 20,818; 52.1%), England (N = 97,099; 41.7%), Germany (N = 24,434; 38.3%), and Norway (N = 6636; 44.7%). In the last 180 days of life, 40.3% of US decedents had an intensive care unit admission compared with less than 18% in other reporting nations. In the last 180 days of life, mean per capita hospital expenditures were higher in Canada (US $21,840), Norway (US $19,783), and the United States (US $18,500), intermediate in Germany (US $16,221) and Belgium (US $15,699), and lower in the Netherlands (US $10,936) and England (US $9342). Secondary analyses showed similar results.Conclusions and Relevance: Among patients older than 65 years who died with cancer in 7 developed countries in 2010, end-of-life care was more hospital-centric in Belgium, Canada, England, Germany, and Norway than in the Netherlands or the United States. Hospital expenditures near the end of life were higher in the United States, Norway, and Canada, intermediate in Germany and Belgium, and lower in the Netherlands and England. However, intensive care unit admissions were more than twice as common in the United States as in other countries. [ABSTRACT FROM AUTHOR]

BACKGROUND: Grief following child loss is profoundly destabilizing with serious long-term repercussions for bereaved parents. Employed parents may need time away from work to deal with this loss.OBJECTIVE: The purpose of this study was to reflect upon the ways labour policies and practices respond to parental bereavement.METHODS: Critical discourse analysis was used to examine labour policies and practices related to employment leave for bereaved parents in Canada. Results were compared to international labour standards.RESULTS: Universally, employment policies provide only for the practical issues of bereavement. Commonly, leave is three days, unpaid, and meant to enable ceremonial obligations. Policies do not acknowledge the long-term suffering caused by grief or the variable intensity of different kinds of loss. Managerial, moral, normative and neoliberal values embedded in these policies efface the intensely personal experience of grief, thereby leaving employees at risk for serious health and workplace safety issues.CONCLUSIONS: Bereavement leave currently understands grief as a generic, time-limited state with instrumental tasks and ceremonial obligations. In contrast, research characterizes responses to child loss as intense, highly personal experiences for which healing and recovery can take years. This disconnect is especially problematic when viewed through the lens of employee wellbeing, reintegration and workplace productivity. [ABSTRACT FROM AUTHOR]

Drug shortages in developed countries pose a serious public health problem and have far-reaching implications for healthcare providers and their patients. Given the current state of the market, with the limited number of manufacturers and the array of manufacturing quality issues, drug shortages have become a global concern, forcing regulatory authorities to explore and implement strategies to prevent and mitigate drug shortages. [ABSTRACT FROM AUTHOR]

Background The UK Child Health Programme ( CHP) aims to ensure that children attain their development and health potential. It comprises a series of proactive child health reviews incorporating growth and development surveillance and health promotion; routine immunizations; and certain screening tests, and is offered to all children. The evidence underpinning different elements of the CHP varies from robust to sparse, and consequently there is uncertainty about optimal programme design. This study aimed to compare the CHP currently recommended in the UK with that recommended in selected other high-income countries in order to inform ongoing CHP policy development. Methods The CHP recommended for preschool children in the UK was compared with that in Australia; Canada; the USA; and Sweden using a combination of literature review, focused website searches, and consultation with experts in the countries studied. Delivery, content, and uptake of child health reviews, immunizations, and screening were considered. Results All the countries studied recommend CHP services including child health reviews, immunizations, and screening to their preschool populations. Despite this superficial uniformity, considerable variation exists between countries in the detail of CHP delivery and content. The UK programme is relatively narrow in scope, offering the fewest child health reviews, a relatively restricted immunization programme (although some expansion is planned), and limited newborn bloodspot screening. Internationally comparable data on the uptake/coverage of CHP services are patchy: the available information suggests substantial variation between and within countries in the uptake of child health reviews. Conclusions In the absence of uncontested evidence on the 'ideal' CHP for preschool children, demonstrating variation between countries in recommended programmes provides valuable contextual information for policy makers. Further work looking at relationships between CHP services and children's outcomes would add further value. [ABSTRACT FROM AUTHOR]

Objective: To identify and compare factors influencing the use of standardized outcome measures by neurological physical therapists working in representative developed (Canada) and developing (India) countries. Methods: A self‐administered web‐based questionnaire on facilitators and barriers to using neurological outcome measures was sent by email to neurological physical therapists in Canada and India. Frequencies of responses to each question were computed. Differences between countries were assessed using two‐proportion z test. Results: Of 317 respondents, the use of standardized outcome measures was higher for Indian (96.7%) compared with Canadian physical therapists (89.2%). Among the most highly reported facilitators, three were common for both countries (known validity and reliability, outcome measures learned in professional training, and recommended in clinical practice guidelines). Three highly reported barriers were also common for India and Canada (lack of time, relying on judgement for clinical decisions, and unavailability of the assessment tools). Nevertheless, there were differences in the percentages of barriers and facilitators between countries. Conclusion: Understanding the factors influencing the uptake of outcome measures among neurological physical therapists working in a developed (Canada) and a developing country (India) can help identify whether strategies should or should not be modified to facilitate knowledge translation in different geographical, professional, or social contexts. [ABSTRACT FROM AUTHOR]