Search

The Canadian boreal forest biome has been subjected to a long history of management for wood production. Here, we examined the cumulative impacts of logging on older forests in terms of area, distribution and patch configuration in the managed forest zones of the Eastern Canadian provinces of Ontario and Quebec. We also examined the consequences of these cumulative impacts on a once widely distributed and now threatened species, the woodland caribou (Rangifer tarandus caribou). The cumulative area of recently logged forest (since ~1976) was 14,024,619 ha, with 8,210,617 ha in Quebec and 5,814,002 ha in Ontario. The total area of older forests was 21,249,341 ha, with 11,840,474 ha in Quebec and 9,408,867 ha in Ontario. Patch statistics revealed that there were 1,085,822 older forests with core patches < 0.25 ha and an additional 603,052 < 1.0 ha. There were 52 > 10,00–50,000 ha and 8 < 50,000 ha. Older forest patches (critical caribou habitat) in the 21 local population ranges totalled 6,103,534 ha, distributed among ~387,102 patches with 362,933 < 10 ha and 14 > 50,000 ha. The median percentage of local population ranges that was disturbed was 53.5%, with Charlevoix having the maximum (90.3%) and Basse Côte-Nord the least (34.9%). Woodland caribou local population ranges with disturbed suitable habitats >35% are considered unable to support self-sustaining populations. We found that for the 21 caribou local population ranges examined, 3 were at very high risk (>75% area disturbed), 16 at high risk (>45 ≤ 75% area disturbed), and 2 at low risk (≤35% area disturbed). Major changes are needed in boreal forest management in Ontario and Quebec for it to be ecologically sustainable, including a greater emphasis on protection and restoration for older forests, and to lower the risks for caribou populations. [ABSTRACT FROM AUTHOR]

Background: Cannabis poisonings among children are of public health concern. Existing evidence from the US and from four provinces in Canada (Quebec, Ontario, Alberta, British Columbia) indicate an increase in pediatric cannabis-related poisonings since the legalization of cannabis. This study evaluates trends in cannabis-related poisoning pediatric emergency department (ED) visits and hospitalizations in Canada and addresses a gap in literature by describing trends and context around cannabis edible-related poisoning cases using data from a Canadian sentinel surveillance system. Methods: Mixed-methods using data from two administrative data sources and one injury/poisoning sentinel surveillance system to estimate age-specific rates of cannabis-related poisonings ED visits (Ontario and Alberta), edible-related events (sentinel surveillance Canada), and hospitalizations (Canada with the exception of Quebec) among children between the ages of 0 to 11 from 2015/2016 to 2021. Annual absolute changes were calculated to quantify the magnitude of change between each age-specific rate. Joinpoint regression was used for trend analysis. A thematic analysis was completed to gain a better understanding of cannabis edible-related poisoning cases in the ED. Results: The pediatric age-specific rates for cannabis-related poisoning ED visits (average annual percent change (AAPC) Ontario: 98.2%, 95% CI: 79.1, 119.2; AAPC Alberta: 57.4%, 95% CI: 36.7, 81.2), hospitalizations (AAPC: 63.4%, 95% CI: 42.0, 87.9) and cannabis edible-related events (AAPC: 122.8%, 95% CI: 64.0, 202.6) increased significantly from 2015 to 2021. Almost half of all pediatric edible-related events involved gummy edible products (48.8%, n = 143). Based on the thematic analysis, 88% cannabis edible-related events were attributed to inadvertent ingestion due to access to such products or lack of safe storage practices. Conclusion: Age-specific rates of cannabis-related poisoning ED visits (Ontario and Alberta) and hospitalizations (Canada with the exception of Quebec) have increased since cannabis legalization, with the largest increase in rates occurring from 2019 to 2020. A similar increase in the rate of cannabis edible-related cases from sentinel surveillance data underscores the importance of monitoring this outcome. Public health messaging and national public health promotion strategies targeted towards raising awareness on the risks associated with consuming illegal cannabis and safe storage of cannabis could help mitigate cannabis poisonings among children. [ABSTRACT FROM AUTHOR]

Infections with antimicrobial resistant pathogens are a major threat to human and animal health worldwide. Further, reduction of livestock-associated antimicrobial use (AMU) is often identified as an area of focus. Selective dry cow therapy (DCT) warrants consideration as an important way to decrease AMU on Canadian dairy farms. In addition, teat sealants (TS) are a nonantimicrobial alternative for prevention of intramammary infection during the dry period. Therefore, objectives of this study were to determine how antimicrobials and TS are used at dry-off on Canadian dairy farms to determine selective DCT uptake and enacted selection protocols. It was expected that these data will provide a baseline understanding of DCT practices and highlight areas for future intervention to further reduce AMU. An observational study was conducted utilizing 2 in-person questionnaires conducted between July 2019 and September 2021 on 144 participating dairy farms in 5 Canadian provinces (British Columbia = 30, Alberta = 30, Ontario = 31, Québec = 29, and Nova Scotia = 24). Overall, 45 farms (31%) reported adopting selective DCT, 95 (66%) enacted blanket DCT, and 4 (3%) did not provide antimicrobial DCT. Farms enacting selective DCT had approximately 50% less intramammary antimicrobials used at dry-off compared with blanket DCT farms. Cow somatic cell count history was the most common criterion for selective DCT decision-making, followed by previous clinical mastitis history, bacteriological culture, and milk production. A slight majority of farms (56%) applied TS to all cows at dry-off, whereas 17 farms (12%) used TS selectively, and 46 farms (32%) did not use TS. Larger herds more often used TS, and farms with an automatic milking system more often used TS selectively than applied to all cows. Results highlighted the variability in antimicrobial treatment and TS use protocols at dry-off on Canadian dairy farms, and the potential for further antimicrobial reduction with increased adoption of selective DCT. [ABSTRACT FROM AUTHOR]

Genetic counseling is a fast-growing profession worldwide, with genetic counselors taking on increasingly comprehensive and autonomous roles in the healthcare sector. However, the absence of appropriate legal frameworks could potentially create risks of harm to the public. Legal recognition serves to protect the public from risk of harm by regulating the safe and competent practice of healthcare professionals. Genetic counseling is not legally recognized in most world jurisdictions. Examination of the legal status of genetic counseling in different jurisdictions and whether existing legal mechanisms are adequate to address potential risks of harm is therefore timely. This paper examines the different roles of genetic counselors in the Canadian province of Quebec and the state of Qatar, the authors’ respective jurisdictions. It considers the types of harms that may be created where appropriate legal mechanisms are lacking, considering the socio-political and legal differences between the two jurisdictions. Moreover, it examines the legal status of genetic counseling in Quebec and Qatar to determine whether these statuses appropriately address the identified risks of harm. The authors argue that existing legal frameworks are inadequate to address these risks and recommend that additional regulatory mechanisms be implemented to properly protect the public from risks of harm. [ABSTRACT FROM AUTHOR]

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

Objective: In 2018, the sale of non-medical cannabis was authorized in the province of Quebec in Canada, within a public monopoly under the Société Québécoise du Cannabis (SQDC). The objective of this study was to offer a description of the cannabis-using population regarding the sources of cannabis supply and to explore whether at-risk individuals are purchasing cannabis at SQDC. Method: We used data from a cross-sectional, representative population survey (age >18 years, n = 1799), the Enquête Québécoise sur le Cannabis, which was completed between February and June 2019. Analyses involved adjusted binary logistic regressions, incorporating population weights, to assess 7 potential indicators of harm. Results: The vulnerability profiles of SQDC consumers (47.8%) and those acquiring their cannabis elsewhere (52.2%) were similar in terms of frequency of cannabis use (adjusted odds ratio [aOR] = 0.46; 95% confidence interval [CI] = 0.12-1.67), motivation to use (aOR = 0.62; 95% CI = 0.16-2.46), concomitant consumption of other substances (aOR = 0.80; 95% CI = 0.14-4.75), cannabis-impaired driving behaviours (aOR = 0.93; 95% CI = 0.26-3.36), psychological distress (aOR = 0.99; 95% CI = 0.26-3.79), and problematic cannabis use (aOR = 0.46; 95% CI = 0.13-1.64). However, SQDC consumers were more likely to be aware of the cannabinoid content of the product purchased compared to those who acquired their cannabis from other sources (aOR = 4.12; 95% CI = 1.10-15.40). Conclusions: No association was detected between the source of cannabis supply and potential vulnerability indicators of cannabis-related harms, but SQDC consumers were more aware of the cannabinoid content of the products purchased. These results suggest that the regulated government supply in Quebec is reaching a substantial portion of those with potential high vulnerability to harm. Whether this knowledge translates into a reduction in the negative consequences related to consumption is still to be determined. [ABSTRACT FROM AUTHOR]

From the very beginning, the Cowboys Fringants, among the greatest exponents of Quebec folk- rock of the last twenty years, have composed songs that reflect their social and geographical environment. Particularly prolific in their musical production, the band appears to be very tied to its community of origin, as evidenced by the numerous topics dealt with relating to Quebec, its territories, and its language. The abundant corpus of songs composed over the years therefore allows for exploration of the contribution of the band to both social representations of the Franco-Quebec community and co-construction of the sense of belonging to the latter. After a presentation of the historical and sociolinguistic context of the sole province in Canada with a majority francophone population, followed by brief methodological notes relating to the treatment of the corpus - which includes all the albums published until 2021 - the study will focus on the places and the protagonists described by the group. The sociocultural snapshot created therein will therefore allow investigation and reflection on the collective identity thus (self) represented, to understand how this narrative allows the band to actively participate in the co-construction of the social representations of Quebecers. [ABSTRACT FROM AUTHOR]

Introduction: Youth initiation may drive differences in smoking prevalence across Canadian provinces. Provincial differences in initiation relate to tobacco control strategies and public health funding, but have also been attributed to population characteristics. We test this hypothesis by examining the extent to which seven characteristics—immigration, language, family structure, education, income, home ownership and at-school status—explain differences in initiation across provinces. Methods: We used data from 16 897 youth aged 12 to 17 years in the Canadian Community Health Survey collected from 2015 to 2018. To examine the proportion of provincial differences explained by population characteristics, we compared average marginal effects (AMEs) from partially and fully adjusted models regressing “having ever initiated” on province and other characteristics. We also tested interactions to examine differences in the association between population characteristics and initiation across provinces. Results: Initiation varied from 4% in British Columbia to 10% in Quebec. Being born in Canada, speaking French, not living in a two-parent household, being in the lowest household income quintile, having parents without postsecondary education, living in rented accommodation and not being in school were each associated with initiation. Taking these results into consideration, the AME of residing in another province compared with Quebec was attenuated by between 3% and 9%. Family structure and household income were more strongly associated with initiation in the Atlantic region and Manitoba, but not in Quebec. Conclusion: Differences in initiation between Quebec and other provinces are unlikely to be substantially explained by their demographic or socioeconomic composition. Reprioritizing tobacco control and public health funding are likely key in attaining the “tobacco endgame” across provinces. [ABSTRACT FROM AUTHOR]

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

It is well known that many consumers believe local foods are more expensive than comparative products coming from other markets. The aim of this study was to measure the price competitiveness of products certified by the Aliments du Québec program, a well-known program in the Canadian province of Quebec. Using machine-learning, artificial intelligence and targeted data mining, the report identifies local products and comparator products, to consider whether locally certified products are more expensive than comparative products coming from outside Quebec. Uncertified products used as comparative products come from anywhere around the world, outside of the province of Quebec. For this study, a total of more than 350,000 discrete price data points were analyzed in the Winter 2022. Local product prices were examined relative to the prices of comparator products. In total, there were 48 subcategories considered. In 70.83% of the subcategories, the local product was either as expensive (similar price) or less expensive than the comparator product. Results challenge the popular belief that local food products are often more expensive. This study also provides limitation and future research paths. [ABSTRACT FROM AUTHOR]

Environmental short amplicon sequencing, or metabarcoding, is commonly used to characterize the bacterial and fungal microbiota of cheese. Comparisons between different metabarcoding studies are complicated by the use of different gene markers. Here, we systematically compare different metabarcoding molecular targets using V3–V4 and V6–V8 regions of the bacterial 16S rDNA and fungal ITS1 and ITS2 regions. Taxonomic profiles varied depending on the molecular markers used. Based on data quality and detection capacity of the markers toward microorganisms usually associated with the dairy environment, the ribosomal regions V3–V4 and ITS2 were selected and further used to evaluate variability in the microbial ecosystem of terroir cheeses from the province of Quebec in Canada. Both fungal and bacterial ecosystem profiles were described for 32 different ready-to-eat bloomy-, washed- and natural-rind specialty cheese varieties. Among them, 15 were studied over two different production years. Using the Bray–Curtis dissimilarity index as an indicator of microbial shifts, we found that most variations could be explained by either a voluntary change in starter or ripening culture composition, or by changes in the cheesemaking technology. Overall, our results suggest the persistence of the microbiota between the two years studied—these data aid understanding of cheese microbiota composition and persistence during cheese ripening. [ABSTRACT FROM AUTHOR]

The present research aims at the comparative analysis of the conditions that support the manifestation of the principle of autonomy in public administration in the administrative-territorial units, with particularization at the commune of Mérignac in France, Quebec province in Canada and Tudora commune in Romania. Through the approach, we found that, in support of local autonomy, the French territorial communities are communes, departments, regions, communities with special status, overseas communities; the Canadian territory is divided into provinces and territories, the province of Quebec being divided by municipalities, cities, parishes, villages, cantons, united cantons; the Romanian national community is divided into local communities formed into counties, municipalities, cities and communes. At the level of the three administrative-territorial units analyzed, human, material and financial public resources were identified, which together provide support for the applicability of the principle of autonomy. In addition, the consistency of local autonomy is also conferred by the recognition of the full competence of the local public administration authorities to manage the affairs of the administrative-territorial units. The fact that the acts of the local public administration authorities in the three territorial divisions are subject to control does not express a restriction on the principle of autonomy. [ABSTRACT FROM AUTHOR]

Background: In 2016, Quebec, a Canadian province, implemented a program to improve access to specialized health services (Accès priorisé aux services spécialisés (APSS)), which includes single regional access points for processing requests to such services via primary care (Centre de répartition des demandes de services (CRDS)). Family physicians fill out and submit requests for initial consultations with specialists using a standardized form with predefined prioritization levels according to listed reasons for consultations, which is then sent to the centralized referral system (the CRDS) where consultations with specialists are assigned. We 1) described the APSS-CRDS program in three Quebec regions using logic models; 2) compared similarities and differences in the components and processes of the APSS-CRDS models; and 3) explored contextual factors influencing the models' similarities and differences.Methods: We relied on a qualitative study to develop logic models of the implemented APSS-CRDS program in three regions. Semi-structured interviews with health administrators (n = 9) were conducted. The interviews were analysed using a framework analysis approach according to the APSS-CRDS's components included in the initially designed program, Mitchell and Lewis (2003)'s logic model framework, and Chaudoir and colleagues (2013)'s framework on contextual factors' influence on an innovation's implementation.Results: Findings show the APSS-CRDS program's regional variability in the implementation of its components, including its structure (centralized/decentralized), human resources involved in implementation and operation, processes to obtain specialists' availability and assess/relay requests, as well as monitoring methods. Variability may be explained by contextual factors' influence, like ministerial and medical associations' involvement, collaborations, the context's implementation readiness, physician practice characteristics, and the program's adaptability.Interpretation: Findings are useful to inform decision-makers on the design of programs like the APSS-CRDS, which aim to improve access to specialists, the essential components for the design of these types of interventions, and how contextual factors may influence program implementation. Variability in program design is important to consider as it may influence anticipated effects, a next step for the research team. Results may also inform stakeholders should they wish to implement similar programs to increase access to specialized health services via primary care. [ABSTRACT FROM AUTHOR]

Background: Québec was the Canadian province most impacted by COVID-19, with 401,462 cases as of September 24th, 2021, and 11,347 deaths due mostly to a very severe first pandemic wave. In April 2020, we assembled the Coronavirus Sequencing in Québec (CoVSeQ) consortium to sequence SARS-CoV-2 genomes in Québec to track viral introduction events and transmission within the province. Methods: Using genomic epidemiology, we investigated the arrival of SARS-CoV-2 to Québec. We report 2921 high-quality SARS-CoV-2 genomes in the context of > 12,000 publicly available genomes sampled globally over the first pandemic wave (up to June 1st, 2020). By combining phylogenetic and phylodynamic analyses with epidemiological data, we quantify the number of introduction events into Québec, identify their origins, and characterize the spatiotemporal spread of the virus. Results: Conservatively, we estimated approximately 600 independent introduction events, the majority of which happened from spring break until 2 weeks after the Canadian border closed for non-essential travel. Subsequent mass repatriations did not generate large transmission lineages (> 50 sequenced cases), likely due to mandatory quarantine measures in place at the time. Consistent with common spring break and "snowbird" destinations, most of the introductions were inferred to have originated from Europe via the Americas. Once introduced into Québec, viral lineage sizes were overdispersed, with a few lineages giving rise to most infections. Consistent with founder effects, the earliest lineages to arrive tended to spread most successfully. Fewer than 100 viral introductions arrived during spring break, of which 7–12 led to the largest transmission lineages of the first wave (accounting for 52–75% of all sequenced infections). These successful transmission lineages dispersed widely across the province. Transmission lineage size was greatly reduced after March 11th, when a quarantine order for returning travellers was enacted. While this suggests the effectiveness of early public health measures, the biggest transmission lineages had already been ignited prior to this order. Conclusions: Combined, our results reinforce how, in the absence of tight travel restrictions or quarantine measures, fewer than 100 viral introductions in a week can ensure the establishment of extended transmission chains. [ABSTRACT FROM AUTHOR]

Background: Patient safety is a worldwide problem, and the patient contribution to mitigate the risk of patient harm is now recognized as a cornerstone to its solution. In order to understand the nature of integrating patients into patient safety and healthcare organizations and to monitor their integration, a Canadian survey tool has been co-constructed by patients, researchers and the Canadian Patient Safety Institute (CPSI). This questionnaire has been adapted from the French version of the patient engagement (PE) in patient safety (PS) questionnaire created for the province of Quebec, Canada.Methodology: The pan-Canadian PE in PS survey tool was developed in a five-step process: (1) a literature review and revision of the initial tool developed in the province of Quebec; (2) translation of the French questionnaire into an English version tool; (3) creation of a Canadian expert advisory group; (4) adaptation of the English version tool based on feedback from the expert advisory group (assessment and development of the construct's dimensions, wording assessment and adaptation for pan-Canadian use, technical testing of the online platform for the survey); and (5) pilot testing and pre-validation of the tool before pan-Canadian use.Results and Conclusion: Eight pan-Canadian PE in PS surveys were completed from five Canadian provinces by the expert advisory group and six surveys were completed during the pilot project by participants from different provinces in Canada. This survey tool comprises 5 sections: (1) demographic identification of the participants (Q1 to Q5); (2) general questions (Q6 to Q17); (3) the patient engagement process (experience level of participants and organizational incentives for PE in general) (Q18 to Q33); (4) PE in PS processes, such as current activities, strategies, structures, resources and factors (Q34 to Q67); and (5) the context and impact of PE in PS initiatives in Canadian healthcare organizations (CHOs) (Q68 to Q75), including outcome identification, improvement mechanisms and strategies, evaluation mechanisms, and indicators. [ABSTRACT FROM AUTHOR]

Agriculture produces food, fiber and biofuels for the world's growing population, however, agriculture can be a major contributor of nitrogen (N) losses including emissions of ammonia (NH 3), nitrous oxide (N 2 O) and nitrate (NO 3 −) leaching and runoff. A Canadian Agricultural Nitrogen Budget for Reactive N (CANBNr) model was developed to estimate the soil N balance in 3487 soil landscape of Canada polygons from 1981 to 2016. The CANBNr model integrates NH 3 emission from fertilizers, manure from housing, storage and field, as well as direct/indirect N 2 O emissions from fertilizers, manures, crop residues and soil organic matter. The NO 3 − leaching is estimated based on the residual soil N (RSN) at harvest and drainage derived with the DeNitrification-DeComposition (DNDC) model. From 1981 to 2016, the N input from fertilizer and N fixation increased at a greater rate than N removal in harvested crops in all provinces of Canada, resulting in an increase in the RSN and N losses. In 2016, the Prairie provinces had lower N losses (11.7 kg N ha−1) from N 2 O, NH 3 and NO 3 − compared with 43.2 kg N ha−1 in central Canada, and 76.5 kg N ha−1 in Atlantic Canada. However, the Prairie provinces had 84.3% of the total Canadian farmland (74.3% of the total Canadian N input), while central Canada had 12.9% of Canadian farmland (21.7% of the total Canadian N input). In the Prairie provinces, the total N 2 O loss from fertilizer N ranged 4.4–8.6 Gg N whereas NH 3 loss ranged from 17.1 to 44.6 Gg N and these values were influenced by both emission intensity and total land area. Total N 2 O losses from manure were highest in Alberta, Ontario and Quebec resulting in 4.8, 4.4, and 3.4 Gg N and NH 3 losses from manure were also highest in these 3 provinces at 61.1, 45.2 and 40.4 Gg N, respectively. Nitrate leaching was impacted by drainage volumes, soil type and N inputs. In the non-growing season, NO 3 − leaching losses (36-yr average) were 63.3 Gg in Ontario and 57.5 Gg N in Quebec compared with 20.8 Gg N for Ontario and 35.5 Gg N for Quebec in the growing season. In contrast, the Prairie provinces showed higher NO 3 − leaching in the growing season (23.1–37.4 Gg N) than in the non-growing season (10.4–13.7 Gg N). In summary, total fertilizer N increased the most over the 36 years in the Prairies which resulted in increased RSN and N leaching losses that will require further intervention. [Display omitted] • Canadian Agricultural Nitrogen Budget for Reactive N (CANBNr) model was developed. • The N budget were simulated at 3487 soil landscape of Canada polygons from 1981 to 2016. • RSN and N losses increased due to the greater increase in N input from fertilizer and N fixation than N removal by crop. • The Prairie provinces had lower N 2 O, NH 3 and NO 3 − leaching losses per hectare farmland than other provinces. [ABSTRACT FROM AUTHOR]

Context: Recently, updated Canadian surgical and medical abortion practice guidelines were released, mifepristone was approved by Health Canada for first trimester medical abortion (FTMA) as a regular prescription, and nurse practitioners (NPs) began to independently provide abortion care. These changes enabled a shift for abortion provision into primary care. Objective: (1) Describe the abortion care workforce, (2) Evaluate the reported clinical abortion practice compared to current clinical practice guidelines, and (3) Assess stigma and harassment experienced by providers. Study Design: Cross-sectional, self-administered, anonymized survey available in French and English. Setting: National survey of abortion providers in Canada. Population studied: Physicians and NPs providing abortion care in 2019 were contacted through national professional health care organizations. Outcome measures: Respondent demographics, characteristics of first and second trimester surgical and first, second and third trimester medical abortion (STTMA) practices, and stigma and resilience experienced by providers. Results: Between July and December 2020, 435 physicians and 30 NPs were recruited, representing every province and territory in Canada. The highest proportions were from the most populated provinces: Ontario (31.8%) and Quebec (23.6%). Most physicians were family physicians (n=246) or obstetrician-gynaecologists (n=185). Among 358 FTMA respondents, 61.3% reported having less than five years experience and 99.4 % used a mifepristone misoprostol regimen. Of 115 STTMA respondents, 58.5% used an off-label but guideline supported mifepristone misoprostol regimen. Respondents included 222 first and second trimester surgical abortion providers. Only 4.6% of 109 second trimester surgical abortion provider respondents used mifepristone for preoperative cervical ripening. Twelve percent of respondents experienced harassment or violence in 2019, most commonly as picketing or confrontations at their workplace. Conclusion: Introduction of mifepristone and changes in abortion guidelines, regulations and licensing changed the abortion workforce and care in Canada. Respondents reported overall provision of FTMA in line with current guideline. Guideline supported second trimester use of mifepristone has not been fully adopted yet. The results of this study will inform knowledge translation activities directed at health system, policy, and service leaders. [ABSTRACT FROM AUTHOR]

The objective of this text is to present a reflection on the link between local initiatives to combat food insecurity and actions adapting to climate change. To this end, two case studies of ongoing experiments in the Canadian province of Quebec will be presented and compared. While these two cases are very different in terms of location, production and people involved, they share the objective of bringing fresh and healthy food, produced locally, to the population of their territory and of rethinking the relationship of the community to nature through food production. Despite their significant differences, each of these two cases features actions for responding to problems that have a common cause: an agro-industrial food system that, by decoupling the locations of production and consumption, in order to maximize the economic profitability of the capital invested, has compromised both the health of citizens and the ecological balance. [ABSTRACT FROM AUTHOR]