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Background: Every year, people in Canada are evacuated due to wildland fires to avoid death, injury, and illness from fire and smoke events. Aims: In this paper, we provide an overview of evacuations recorded in the Canadian Wildland Fire Evacuation Database between 1980 and 2021. Methods: Our analysis covers evacuations in Canada from 1980 to 2021. We provide summary statistics including number of evacuations and evacuees, evacuation duration, seasonality, evacuation causes, community types, structure losses, and fatalities. We also investigate temporal and spatial patterns. Key results: Between 1980 and 2021, there were 1393 wildland fire evacuation events with 576,747 people evacuated. During this period, there was an overall increase in frequency of evacuations, number of evacuees, and duration of events. Structure loss occurred during 194 evacuation events, with 4105 homes burned. We estimate wildland fire evacuations cost at least CAD3.7 billion (excluding structural losses), jumping to CAD4.6 billion if we include productivity losses. Indigenous peoples are disproportionately impacted in wildfire evacuations compared to the general Canadian population. Conclusions: Wildland fire evacuations continue to occur across Canada and are increasing. Implications: The findings from this study give us a better understanding of the characteristics of wildland fire evacuations, which can help guide emergency management. This paper summarises data on wildland fire evacuations in Canada between 1980 and 2021. There were 1393 wildland fire evacuation events with 576,747 people evacuated, costing approximately CAD4.6 billion CDN including productivity losses. [ABSTRACT FROM AUTHOR]

Background: Media wildfire coverage can shape public knowledge on fire-related issues, and potentially influence management decisions, so understanding the content of its coverage is important. Previous research examining media wildfire coverage has primarily focused on either a single fire or issue, and provides little insight about the range of wildfire-related topics discussed in the media. Aims: We aimed to assess wildfire topics covered in print media between 1986 and 2016 across the USA, Canada and Australia. Methods: Machine learning-based automated content analyses were conducted to identify primary topics within news articles and to map relationships between topics. Key results: News articles related to wildfire were clustered into four topic areas: Fire Response, Management, Environmental Conditions and Property Preparedness. Notable between-country differences emerge: the US media coverage focuses most on firefighting; Canadian coverage, climate change; and Australian coverage, preparedness. Conclusions: Our results reveal that: (1) wildfire media coverage has increased over the past 30 years; (2) coverage is more varied than the common perspective, i.e. media continues to portray fires in a negative light; and (3) topic coverage varies significantly between countries. Implications: These findings can help identify gaps in media coverage, and provide insights into critical topics, or relationships between topics, that may need additional emphasis in conversations about how to better learn to live with fire. This paper presents the results of a large-scale analysis of news media coverage of wildfires across 30 years and three countries: the USA, Canada and Australia. It describes the wildfire-relevant topics that are most common and the interrelationships between them in each of these three contexts. [ABSTRACT FROM AUTHOR]

Background: Cultural competency is often promoted as a strategy to address health inequities; however, there is little evidence linking cultural competency with improved patient outcomes. This article describes the characteristics of recent educational interventions designed to improve cultural competency in healthcare workers for First Nations peoples of Australia, New Zealand, Canada and the USA. Methods: In total, 13 electronic databases and 14 websites for the period from January 2015 to May 2021 were searched. Information on the characteristics and methodological quality of included studies was extracted using standardised assessment tools. Results: Thirteen published evaluations were identified; 10 for Australian Aboriginal and Torres Strait Islander peoples. The main positive outcomes reported were improvements in health professionals' attitudes and knowledge, and improved confidence in working with First Nations patients. The methodological quality of evaluations and the reporting of methodological criteria were moderate. Conclusions: Cultural competency education programs can improve knowledge, attitudes and confidence of healthcare workers to improve the health of First Nations peoples. Providing culturally safe health care should be routine practice, particularly in places where there are concentrations of First Nations peoples, yet there is relatively little research in this area. There remains limited evidence of the effectiveness of cultural education programs alone on community or patient outcomes. Cultural competency is often promoted as a strategy to address health inequities, although evidence linking cultural competency to patient outcomes is scarce. We conducted a narrative review of the recent literature on cultural education programs and found 13 published evaluations, mainly reporting improvements in health professionals' attitudes and knowledge, and improved confidence in working with First Nations patients. Although cultural education has a positive short-term impact, none of the studies included measured improved patient health outcomes. [ABSTRACT FROM AUTHOR]

Introduction. The global prevalence of diabetes is a pressing public health concern. Over 400 million individuals live with the effects of the disease, predominantly in low- and middleincome countries. In Aotearoa New Zealand (NZ), over 300 000 people have diabetes, resulting in a population rate of 43.1 per 1000. Enabling nurses to prescribe diabetes medications enhances accessibility and improves health outcomes for large sections of the population. Aim. This rapid review was undertaken to investigate the influence of nurse prescribing on health care delivery for individuals with diabetes in NZ, Australia, the United Kingdom, and Canada, countries sharing comparable health care systems and multicultural backgrounds. Methods. The review protocol was published on PROSPERO. In November 2022, a search was conducted across multiple databases to locate relevant literature and resources constrained to the last decade (from January 2012 to November 2022). Utilising the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, data extraction was systematically structured, while rigorous appraisal processes upheld selection quality. Results. Fifteen publications were identified as meeting predefined inclusion and exclusion criteria. The review of these articles revealed four main themes: the impact of nurse prescribing on clinical outcomes, levels of patient satisfaction, implications for health care service provisions, and identification of barriers and facilitators associated with nurse prescribing. Discussion. This report identifies outcomes of nurse prescribing, concluding it provides a potential avenue for enhancing access to and alleviating the burden on health care systems. [ABSTRACT FROM AUTHOR]

Background. Crown fires are an ecologically necessary but hazardous process in conifer forests. Prediction of their behaviour in Canada has largely depended on the Canadian Forest Fire Behaviour Prediction System, in which fire weather indices drive primarily fixed fuel type models. The Crown Fire Initiation and Spread (CFIS) system presents a more flexible approach to predicting crown fire occurrence than fixed fuel type models. Aims. Using a multi-decadal database of experimental fires carried out in conifer plots (1960–2019, n = 113), our aim was to develop updated models based on the CFIS system approach, fitting crown fire occurrence models to fire environment variables using logistic regression. Methods. We tested alternative fuel moisture estimates and compared various model forms using repeated cross-validation. In two-storeyed stands, crown fire occurrence was defined as the involvement of lower canopy stratum fuels. Key results. Final models based on wind speed, fuel strata gap, litter moisture and surface fuel consumption predicted crowning events correctly in up to 92% of cases in training data (89% in cross-validation). Conclusions and implications. These new models offer improved accuracy and flexibility that will help users assess how competing environmental factors interact under different fuel treatments and wildfire scenarios. [ABSTRACT FROM AUTHOR]

Background. There has been little quantification of the extent and duration of micrometeorological changes within a forest after airtanker drops of water-based suppressant. It has been speculated that a period of prolonged relative humidity - referred to as a 'relative humidity (RH) bubble' - temporarily exists in the canopy understorey post-drop. Aims. We quantify the RH bubble from the drops of five airtankers commonly used by wildland fire management organisations in Canada. Methods. We measured airtankers dropping water, foam concentrates, and gel enhancers in a mature jack pine stand. We examined the duration of change in RH and temperature using Generalised Additive Models, and the consequence of these changes on fine fuel moisture. Key results. The average maximum RH increased and temperature decreased, indicating that the effects of the 'RH bubble' in-stand lasted from 25 to 76 min, depending upon the airtanker type and load configuration. Conclusion. Airtanker drops cause an in-stand increase in RH and decrease in temperature, but this ambient change has a limited effect on potential fire behaviour. Implications. The direct effect of water wetting the fuel is the most impactful effect of an airtanker drop. The 'RH bubble' created, though observable, does not change fine fuel moisture enough to impact fire behaviour. [ABSTRACT FROM AUTHOR]

Background. Our objective was to understand what gay, bisexual, and queer men (GBQM) who had experience using pre-exposure prophylaxis (PrEP) thought about the 'Undetectable equals Untransmittable' (U=U) message and how it informed their sexual decision-making over time. Methods. We conducted annual longitudinal qualitative interviews (2020-22) with 17 current or former PrEP users as part of a mixed-methods implementation science study examining barriers and facilitators to PrEP awareness, access, and adherence. Over 3 years, 47 interviews were conducted with GBQM in Ontario, Canada. Interviews were transcribed verbatim and coded in NVivo following reflexive thematic analysis. Results. Participants' sexual health decision-making was informed by their confidence in biomedical HIV prevention and the person taking medication (i.e. themselves using PrEP versus a real/imagined person living with HIV (PLHIV)). Longitudinal narratives of U=U clustered around four overarching themes: (1) U=U confidence (i.e. increasing trust in U=U irrespective of their PrEP use); (2) PrEP confidence (i.e. accounts of self-reliance and PrEP as sufficient HIV protection); (3) combination confidence (i.e. trusting U=U and PrEP as a package); and (4) partner confidence (i.e. potential 'distrust' of U=U due to uncertainties about partners' medication adherence). Overall, men described increased sex with PLHIV over time, including some participants who, during earlier interviews, said they would 'never be comfortable' with serodifferent sexual partners. Conclusions. GBQM's use of PrEP shaped how they thought about U=U and sex with PLHIV. Although many GBQM embraced treatment as prevention/U=U as significant to their sexual lives, longitudinal analysis revealed its varied and uneven adoption across participants and time. [ABSTRACT FROM AUTHOR]

Wildland fire is a common occurrence in western Canada, with record-setting area burned recorded in British Columbia (BC) in the past decade. Here, we used the unsupervised machine learning algorithm HDBSCAN to identify high-density clusters of both human- and lightning-caused wildfire ignitions in BC using data from 2006 to 2020. We found that human-caused ignition clusters tended to occur around population centres, First Nations communities, roads and valleys, and were more common in the southern half of the province, which is more populated. Lightning-ignition clusters were generally fewer in number and larger in size than human-caused fires for most hyperparameter settings. There were significant differences (X 2 = 1884.8, d.f. = 7, P -value <2.2 × 10−16) in fuels associated with lightning- versus human-caused ignition clusters, with human-ignition cluster fires being more often found within leafless aspen (D1) and ponderosas pine and Douglas fir (C7) fuel types. These high-density clusters highlight regions where the greatest densities of both lightning- and human-caused fires have occurred in the province, thereby identifying regions of potential interest to wildland fire managers, researchers and various communities and industries. We used the unsupervised machine learning clustering algorithm HDBSCAN to identify high-density human- and lightning-caused wildland fire ignition clusters in British Columbia, Canada. Generally, human-ignition clusters occurred close to population centres and roads, while large lightning-ignition clusters seemed related to ecozones. Significant differences in fuel types were associated with both. [ABSTRACT FROM AUTHOR]

Objective. Examine the use of priority and provisional approval pathways by the Australian Therapeutic Goods Administration (TGA) for evaluating new medicines. Methods. This observational study assessed all new medicines approved by the TGA between 1 January 2018 and 18 October 2021. It examined how frequently priority and provisional approval pathways are being used, the conditions which the medicines are being approved to treat, how long medicines are spending in the approval pathways, the additional therapeutic value of the medicines being approved through these pathways and how the use of the pathways compares with similar regulatory pathways used by Health Canada. Results. The TGA approved 138 new medicines in the time period under study, of which 33 were approved through either the priority or provisional approval pathways. Sixteen were approved to treat cancer. It took the TGA a mean of 130 (95% CI 118, 143) and 144 (95% 101, 188) working days for priority and provisional pathways, respectively. Therapeutic evaluations were available for 16 of these medicines and 11 offered little to no therapeutic gain over existing medicines. There was moderate agreement between the TGA and Health Canada in their use of these pathways (Kappa = 0.5458, 95% CI 0.3900, 0.7016). Conclusions. The priority and provisional approval pathways are now being used by the TGA for about one-third of all new medicine approvals. Although the medicines approved in these ways are moving through the review process more quickly than those approved through the standard approval pathway, the majority of these medicines, for which an evaluation of therapeutic value is available, do not offer any substantial additional therapeutic value over existing medicines. [ABSTRACT FROM AUTHOR]

Background: Relationships between primary care providers (PCP) and trans patients remain important, necessitating discussions about gender identity, health and their intersections.Methods: Using an online survey, we explored socio-demographic and psycho-social factors associated with: (1) disclosing gender identity; (2) discussing gender identity-related health issues; and (3) comfort sharing gender identity with PCPs, among trans people (n =112) over 16years of age, sampled in Waterloo, Ontario, Canada. Bivariate and multivariate methods using modified Poisson regression generated effect estimates.Results: Age, birth presumed gender, employment status, family support, and transphobia were significantly associated with disclosing gender identity, discussing gender identity-related health issues, and comfortability sharing gender identity with PCPs.Conclusion: Increasing PCPs' knowledge of trans-related health issues is stressed to improve access and quality for trans patients. [ABSTRACT FROM AUTHOR]

Wildfire decision support systems combine fuel maps with other fire environment variables to predict fire behaviour and guide management actions. Until recently, financial and technological constraints have limited provincial fuel maps to relatively coarse spatial resolutions. Airborne Laser Scanning (ALS), a remote sensing technology that uses LiDAR (Light Detection and Ranging), is becoming an increasingly affordable and pragmatic tool for mapping fuels across localised and broad areas. Few studies have used ALS in boreal forest regions to describe structural attributes such as fuel load at a fine resolution (i.e.,100m² cell resolution). We usedALS to predict five forest attributes relevant to fire behaviour in black spruce (Picea mariana) stands inAlberta, Canada: canopy bulk density, canopy fuel load, stem density, canopy height and canopy base height. Least absolute shrinkage and selection operator (lasso) regression models indicated statistically significant relationships betweenALS data and the forest metrics of interest (R²≥ 0.81 for all metrics except canopy base height which had a R² value of 0.63). Performance of the regression models was acceptable and consistent with prior studies when applied to test datasets; however, regression models presented in this study mapped stand attributes at a much finer resolution (40 m²). [ABSTRACT FROM AUTHOR]

Understanding climate as a driver of low- to moderate-severity fires in the Montane Cordillera Ecozone of Canada is a priority given predicted and observed increases in frequency and severity of large fires due to climate change. We characterised historical fire-climate associations using 14 crossdated fire-scar records and tree-ring proxy reconstructions of summer drought and annual precipitation from the region. We compared fire-climate associations among years when fires burned in multiple study areas. From 1746 to 1945, there were 32 years with moderate fire synchrony in which four to six study areas recorded fire. During four high fire synchrony years, 7 to 10 study areas recorded fire. Below-average annual precipitation and summer drought synchronised fires, whereas infrequent years of high fire synchrony were preceded by a wet summer. After 1945, decreased fire occurrence and synchrony reflects fire exclusion, suppression and climatic variation. Global climate change manifests as blocking high-pressure ridges that superimpose on longer fire-seasons and increased droughts. Combined, they make dry forests increasingly susceptible to synchronous fires, which are difficult to suppress as observed during the record-breaking 2017, 2018 and 2021 fire seasons in British Columbia. From 1746 to 1945, fires commonly burned in dry forests of the Montane Cordillera Ecozone, Canada, synchronised by regional drought. Moderate-to-highly synchronous fires recurred once per 5.5 years. Post-1945 fire suppression, fuel accumulation and climate change enhanced the size and intensity of synchronous fires in 2017, 2018 and 2021 in British Columbia. [ABSTRACT FROM AUTHOR]

The article presents the discussion on outbreak of severe acute respiratory syndrome taking protective actions and most importantly communicating with confidence and transparency.