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Objective: To examine injury and concussion rates, mechanisms, locations, and types of injury in Canadian high school male rugby. Design: Prospective cohort study. Setting: High school male rugby. Participants: A total of 429 high school players (2018: n = 225, 2019: n = 256) were recruited from 12 teams in 7 schools in Calgary, Canada. Interventions: None. Main Outcome Measures: Injury surveillance included baseline questionnaires, weekly exposure, and injury reports. Injuries included those requiring medical attention, resulted in time loss and/or inability to complete a session. Concussion was defined as per the fifth Consensus on Concussion in Sport, and all players with a suspected concussion were referred to a study sport medicine physician. Results: A total of 134 injuries were captured, leading to an injury incidence rate (IR) of 57.9/1000 hours [95% confidence intervals (CIs): 45.4-73.8]. Median time loss was 6 days (range: 0-90). Injuries to the head were the most common (40%), followed by shoulder (12%) and ankle (10%). The concussion IR was 22.0/1000 hours (95% CIs: 15.9-30.4), which was the most common injury type (38%), followed by sprain (20%) and strain (15%). Sixty-five percent of injuries occurred in the tackle (ball carrier 35%, tackler 30%) and 76% of concussions (ball carrier 41%, tackler 35%). Conclusions: The rate of injury and concussion in Canadian youth high school male rugby is high, with tackle-related injuries and concussions the most common. Given this, there is a critical need for implementation of prevention strategies, in particular targeting concussion and the tackle event (eg, neuromuscular, tackle training, and law changes). [ABSTRACT FROM AUTHOR]

Clinical Scenario: Current studies have identified body checking as the most common cause of sports-related concussion in ice hockey across all divisions and levels. As a result, many hockey organizations, particularly in youth sports, have implemented rules making body checking to the head, face, and/or neck illegal. Such a rule, in Canada, makes age 13 the first age in which individuals can engage in body checking. Despite these changes, effectiveness of their implementation on the incidence of concussion in Canadian male youth ice hockey players remains unclear. Clinical Question: What is the effect of body checking policy changes on concussion incidence in male youth ice hockey players? Summary of Key Findings: Of the 3 included studies, 2 studies reported a decrease in the incidence of concussion once a body checking policy change was implemented. The third study showed an increase; however, it is important to note that this may be due, in part, to increased awareness leading to better reporting of injuries. Clinical Bottom Line: Current evidence supports a relationship between body checking policy implementation and decreased concussion incidence; however, more research is needed to understand the long-term implications of policy change and the effects in other leagues. In addition, further data are needed to differentiate between increased concussion incidence resulting from concussion education efforts that may improve disclosure and increased concussion incidence as a direct result of policy changes. Strength of Recommendation: Grade B evidence exists that policy changes regarding body checking decrease concussion incidence in male youth ice hockey players. [ABSTRACT FROM AUTHOR]

Bats are found as fatalities at most wind energy facilities around the world, creating a challenge for wind developers to predict risk to bats in an area before building a new facility. Bat echolocation activity surveys are the standard method for assessing risk, but their effectiveness has not been demonstrated. Sites with relatively low pre-construction bat activity rates are predicted to yield relatively low post-construction fatality rates (i.e., low risk), and vice-versa. To test this hypothesis, we ran simple linear regressions on bat activity rates and fatality rates from 49 paired pre- and post-construction studies across the United States and Canada. Bat activity rates did not predict bat fatality rates at wind energy facilities by detector height, by call frequency category of bats, or by season (P > 0.10). One possible explanation for the lack of a predictive relationship is that bat activity patterns may change between the pre- and post-construction periods if bats are attracted to turbines. Indeed, we found support that bat activity rates increased across call frequency category and season at four wind facilities that had measured bat activity rates before (x̄ = 1.89 bat passes/detector-night) and after turbines were built (x̄ = 4.84 bat passes/detector-night). However, simple linear regressions of post-construction activity rates and fatality rates from 25 studies found no correlation between activity and fatality rates collected concurrently by detector height (ground, raised, nacelle) or by call frequency category (P > 0.05). We conclude that the current pre-construction survey methods of collecting bat activity rates at proposed wind energy facilities do not provide reliable information on how many bat fatalities there may be once the facility is built, and advocate exploring other methods for assessing risk to bats prior to wind development. [ABSTRACT FROM AUTHOR]

In contrast to earlier studies, several recent ones have claimed that stability rates among same-sex couples are similar to those of different-sex couples. This article reexamines these latest accounts and provides new evidence regarding stability rates using three large, nationally representative datasets from the United States and Canada. Confirming the earliest work, we find that same-sex couples are more likely to break up than different-sex couples. We find that the gap in stability is larger for couples with children, the very group for which concerns about stability are the most important. [ABSTRACT FROM AUTHOR]

Immigrants living in low hepatitis C (HCV) prevalence countries bear a disproportionate HCV burden, but there are limited HCV population-based studies focussed on this population. We estimated rates and trends of reported HCV diagnoses over a 20-year period in Quebec, Canada, to investigate subgroups with the highest rates and changes over time. A population-based cohort of all reported HCV diagnoses in Quebec (1998-2018) linked to health administrative and immigration databases. HCV rates, rate ratios (RR) and trends overall and stratified by immigrant status and country of birth were estimated using Poisson regression. Among 38,348 HCV diagnoses, 14% occurred in immigrants, a median of 7.5 years after arrival. The average annual HCV rate/100,000 decreased for immigrants and nonimmigrants, but the risk (RR) among immigrants increased over the study period [35.7 vs. 34.5 (RR = 1.03) and 18.4 vs. 12.7 (1.45) between 1998-2008 and 2009-2018]. Immigrants from middle-income Europe & Central Asia [55.8 (RR = 4.39)], sub-Saharan Africa [51.7 (RR = 4.06)] and South Asia [32.8 (RR = 2.58)] had the highest rates between 2009 and 2018. Annual HCV rates decreased more slowly among immigrants vs. nonimmigrants (-5.9% vs. -8.9%, p < 0.001), resulting in a 2.5-fold (9%-21%) increase in the proportion of HCV diagnoses among immigrants (1998-2018). The slower decline in HCV rates among immigrants over the study period highlights the need for targeted screening for this population, particularly those from sub-Saharan Africa, Asia and middle-income Europe. These data can inform micro-elimination efforts in Canada and other low-HCV-prevalence countries., (© 2023 The Authors. Journal of Viral Hepatitis published by John Wiley & Sons Ltd.)

Background: Immigrants originating from intermediate and high HCV prevalence countries may be at increased risk of exposure to hepatitis C infection (HCV) in their countries of origin, however they are not routinely screened after arrival in most low HCV prevalence host countries. We aimed to describe the epidemiology of HCV in immigrants compared to the Canadian born population.Methods: Using the reportable infectious disease database linked to the landed immigration database and several provincial administrative databases, we assembled a cohort of all reported cases of HCV in Quebec, Canada (1998-2008). Underlying co-morbidities were identified in the health services databases. Stratum specific rates of reported cases/100,000, rate ratios (RRs) and trends over the study period were estimated.Results: A total of 20,862 patients with HCV were identified, among whom 1922 (9.2%) were immigrants. Immigrants were older and diagnosed a mean of 9.8 ± 7 years after arrival. The Canadian born population was more likely to have behavior co-morbidities (problematic alcohol or drug use) and HIV co-infection. Immigrants from Sub-Saharan Africa, Asia and Eastern Europe had the highest HCV reported rates with RRs compared to non-immigrants ranging from 1.5 to 1.7. The age and sex adjusted rates decreased by 4.9% per year in non-immigrants but remained unchanged in immigrants. The proportion of HCV occurring in immigrants doubled over the study period from 5 to 11%.Conclusions: Immigrants from intermediate and high HCV prevalence countries are at increased risk for HCV and had a mean delay in diagnosis of almost 10 years after arrival suggesting that they may benefit from targeted HCV screening and earlier linkage to care. [ABSTRACT FROM AUTHOR]

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The article focuses on history of 'unreasonableness' in administrative law of Australia, Great Britain and Canada. Topics discussed include definition of unreasonableness as a decision that is found to be devoid of merit, the court case 'Election Importing Co Ply Ltd v Courtice' regarding a dispute for imposition of import duties, and another court case 'Parramatla City Council v Pestelf' regarding ability of the council to impose local rate on a land.

Purpose The Canadian Province of Alberta has no presumed consent for organ- donation, and has had chronically low deceased-donation rates. To address this, the government sponsored a public organ-donation registry, which was launched in 2013. Registration was encouraged by using a behavioural economic "nudge", of prompted choice to enrol at driver's license renewal. We determined the effect of this nudge policy on heart donation rates, and the relative production efficiency of heart transplants (HTx) in Alberta over 10 years, spanning this policy change. Methods Retrospective analysis of administrative and medical transplant databases was conducted from 01/2007 to 12/2016, using interrupted time-series measures of quarterly recipient listings, heart organ offers and transplants. The baseline period 2007-2013 served to reconstruct the counterfactual after the policy rollout. Heart offers were designated by source of origin. Time-related changes were assessed using linear regression, and HTx efficiency was plotted quarterly, using a simple production-frontier model. Results 451 unique individuals were listed for HTx, while 2661 donor heart offers were made from all sources, including 439 (16.5%) from within Alberta. HTx occurred following 306 offers, a conversion rate of 11.5%. Simultaneously, 68 listed patients (15.4%) died while awaiting HTx. A time related 41% increase in donor heart offers from 59.2 to 83.7 per quarter (p<0.01) from all sources occurred from 2007-16, but the population adjusted donor rate from within Alberta was unchanged, at a mean (95% CI) of 2.7 (2.3-3.1)/106 population prior to, versus 3.1 (2.6-3.6)/106 after the policy change (p= ns). No time related trend in efficiency of organ acceptance for cardiac transplantation could be identified. The HTx production frontier product (1/offer efficiency x 1/recipient efficiency) ranged from 0.22 to 0.9 over the 40 fiscal quarters analyzed indicating a more than fourfold variance attributable largely to technical Inefficiency. Conclusion Nudge policies to increase organ donation did not result in an early increase in the population adjusted heart organ donation rate within Alberta. Improved efficiency in the use of organs offered, rather than increased donor organ numbers may be present the greatest opportunity to improve HTx completion in Alberta. [ABSTRACT FROM AUTHOR]

Background: In most developed countries, governments are implementing policies encouraging older persons to work past 65 years to reduce the burden on societies related to disability benefits and pension payments. Despite this push to extend working lives, we know little about who already works past this age and any inequalities that may exist. Our study investigates the employment rates of those aged 65-75 years of age by educational level, health status and sex in Canada (CAN), Denmark (DK), Sweden (SE) and the United Kingdom (UK). Secondly, we aim to relate findings on employment rates to prevailing policies in the different countries, to increase the understanding on how to further extend working lives.Methods: We used nationally representative cross-sectional survey data from the 2012-2013 Canadian Community Health Survey, 2013/14 Survey of Health, Ageing and Retirement in Europe for Denmark and Sweden and the 2013 English Longitudinal Study of Ageing to examine employment rates for those aged 65-75 years by sex, educational level and health status (having limiting longstanding illness (LLI) or not).Results: Employment rates decline by age, but we see a linear decline in CAN and the UK compared to an initial decline then a plateau of employment rates from 66 to 68 years in DK and SE. Employment rates among persons aged 65-75 years were lower in the UK than in CAN, DK and SE. Among women, employment rates were highest in SE. Women with low education and a LLI had considerably lower employment rates than men with low education and a LLI (employment rates for men ranged from 27% to 12% compared with employment rates for women which ranged from 12% to 0%).Conclusions: Our results suggest that educational level, sex and health all play a role in extending working lives. The variation in employment rates between the four countries implies that policies do matter, but that social differentials show that policies cannot be 'one size fits all'. Policy-makers must consider different groups (i.e. low-educated women with a LLI) when designing policies to extend working lives. [ABSTRACT FROM AUTHOR]

Objective: To compare suicide rates and characteristics in East Asian and Western countries., Method: Data from five East Asian jurisdictions and five English-speaking Western countries were obtained from national offices responsible for collection of statistics. Data were graphed to demonstrate differences between East Asian and Western age patterns of suicide. Relevant literature was reviewed, including observations concerning suicide rates in various non-English-speaking European countries., Results: Age patterns and rates of suicide differ between East and West and across time, but with Japan's and the United States patterns progressively becoming more similar., Conclusions: Sociocultural factors affect suicide patterns and rates; choice of method and cohort effects affect rates. Strategies for prevention of suicide should give attention to culture-related precipitants of suicide., (Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.)

Antimicrobial resistance profiles were determined for Neisseria gonorrhoeae strains isolated in Canada during 2010-2014. The proportion of isolates with decreased susceptibility to cephalosporins declined significantly between 2011 and 2014, whereas azithromycin resistance increased significantly during that period. Continued surveillance of antimicrobial drug susceptibilities is imperative to inform treatment guidelines.