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Repeat photography offers distinctive insights into ecological change, with ground‐based oblique photographs often predating early aerial images by decades. However, the oblique angle of the photographs presents challenges for extracting and analyzing ecological information using traditional remote sensing approaches. Several innovative methods have been developed for analyzing repeat photographs, but none offer a comprehensive end‐to‐end workflow incorporating image classification and georeferencing to produce quantifiable landcover data. In this paper, we provide an overview of two new tools, an automated deep learning classifier and intuitive georeferencing tool, and describe how they are used to derive landcover data from 19 images associated with the Mountain Legacy Project, a research team that works with the world's largest collection of systematic high‐resolution historic mountain photographs. We then combined these data to produce a contemporary landcover map for a study area in Jasper National Park, Canada. We assessed georeferencing accuracy by calculating the root‐mean‐square error and mean displacement for a subset of the images, which was 4.6 and 3.7 m, respectively. Overall classification accuracy of the landcover map produced from oblique images was 68%, which was comparable to landcover data produced from aerial imagery using a conventional classification method. The new workflow advances the use of repeat photographs for yielding quantitative landcover data. It has several advantages over existing methods including the ability to produce quick and consistent image classifications with little human input, and accurately georeference and combine these data to generate landcover maps for large areas. [ABSTRACT FROM AUTHOR]

This paper uses panel data for Canada from 1976 to 2018, across 10 provinces, to reassess the relationship between mortality rates and economic fluctuations. The key contribution of our paper lies in examining the extent to which this relationship is driven by the employment rate (extensive margin) versus average hours worked (intensive margin). We find evidence of procyclical mortality for females at the aggregate level; aggregate male mortality remains largely unaffected by economic fluctuations. Our findings also reveal temporal heterogeneity, as the extensive margin becomes the driving force for female mortality rates during the more recent period (1990 onwards). These findings remain robust when accounting for personal income and pollution. Finally, we find some support for a procyclical relationship for individuals in the working age groups, while mortality exhibits a countercyclical pattern for children (age 0 to 14) and the elderly (age 65 and above). [ABSTRACT FROM AUTHOR]

Social scientists, geographers, criminologists, and health scientists are often tasked with finding data to best capture the impact of "community context" on individual outcomes, including residential services, physical resources, and social institutions. One outlet for such data in Canada is Digital Map Technologies Inc. (DMTI) Spatial, which offers a national repository of over one million businesses and recreational points of interest. The database is generated through CanMap Streetfiles, which includes geocodes of each point's precise location. These data are available to researchers from their university data library and Esri Canada, but primarily available to private sector and government markets. That said, the goal of the current paper is to encourage researchers to access this rich yet under‐utilized data source. Each service, business, or resource in the DMTI Spatial database is assigned to a respective category using Standard Industrial Classification codes and North American Industrial Classification System codes. It is not clear, however, which is the more reliable coding criteria. We provide an overview of our review of DMTI Spatial data and take‐away suggestions for using this valuable resource for future research on meso‐level residential markers. Key messages: The goal of this paper is to outline existing data source(s) and measures from DMTI Spatial that might help capture meso‐level residential institutions.We recommend "best practices" for using DMTI Spatial data in researchers' own work to capture neighbourhood resources/amenities, or the social infrastructure of the community using either Standard Industrial Classification codes or North American Industrial Classification System codes.We conclude that Standard Industrial Classification codes in DMTI Spatial enhanced points of interest data are more complete—and more accurate—than North American Industrial Classification System codes. [ABSTRACT FROM AUTHOR]

Territorial inequalities have long been a subject of study and concern in Canada. In the face of large structural changes such as industrial shifts and the decarbonization of our economies, there is an urgency to understand such inequalities and design effective policy interventions for those places facing persistent economic decline. This paper shares a novel composite index that measures economic disparity across Canadian Census Subdivisions (CSDs) using Census data from 2001 through 2016 and the 2011 National Household Survey. Named the "Index of Economic Disparity," it is comprised of an equally weighted average of four sub‐indices that assign percentile rankings for all CSDs based on whether they experience persistent and substantial decline in key economic areas: population, labour force outcomes, working‐age share of population, and industrial diversity. The variation of outcomes across geographies—urban and rural—highlights the importance of place‐based policies. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Economics is the property of Wiley-Blackwell 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.)

Copyright of Canadian Journal of Economics is the property of Wiley-Blackwell 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.)

Copyright of Canadian Journal of Economics is the property of Wiley-Blackwell 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.)

Benthic invertebrates are important trophic links in food webs and useful bioindicators of environmental conditions, but long‐term benthic organism abundance data across broad geographic areas are rare and historic datasets are often not readily accessible. This dataset provides densities of benthic macroinvertebrates collected from 1930 to 2019 during surveys in Lake Erie, a Laurentian Great Lake. The surveys were funded by the governments of the United States and Canada to investigate the status and changes in the benthic community. From the total of 21 lake‐wide and basin‐wide benthic surveys conducted in Lake Erie from 1929 to 2019, we were able to acquire data for 17 surveys, including species‐level data for 10 surveys and data by higher taxonomic groups for seven surveys. Our amassed Lake Erie dataset includes data from 11 surveys (including five with species‐level data) conducted in the western basin in 1930–2019, seven surveys (six with species‐level data) in the central basin, and eight surveys (seven with species‐level data) in the eastern basin (1973–2019). This Lake Erie dataset represents the most extensive temporal dataset of benthic invertebrates available for any of the Laurentian Great Lakes. Benthic samples were collected using Ponar or Shipek bottom dredges and taxa densities were calculated as individuals per square meter using the area of the dredge. Density data are provided for taxa in the Annelida, Arthropoda, Mollusca, Cnidaria, Nemertea, and Platyhelminthes phyla. Current taxonomy was used for most groups but, in a few cases, older taxonomic names were used for consistency with historical data. Analysis of this dataset indicates that eutrophication, water quality improvement, and dreissenid introduction were the major drivers of changes in the benthic community in the western basin, while hypoxia was a major factor in the central basin, and dreissenid introduction was the most important driver in the eastern basin. Considering the rarity of high taxonomic resolution long‐term benthic data for lake ecosystems, this dataset could be useful to explore broader aspects of ecological theory, including effects of eutrophication, hypoxia, invasive species, and other factors on community organization, phylogenetic and functional diversity, and spatial and temporal scales of variation in community structure. In addition, the dataset could be useful for studies on individual species, including abundance and distribution, species co‐occurrence, and how the patterns of dominance and rarity change over space and time. Use of this dataset for academic or educational purposes is encouraged as long as this data paper is properly cited. [ABSTRACT FROM AUTHOR]

Introduction: Social prescribing offers a formal pathway of connecting patients in the health system with sources of support within the community to help improve their health and well‐being. Since its launch in March 2022, the Canadian Institute for Social Prescribing has acted as a collective impact network to identify, connect and build upon established social prescribing initiatives using a co‐design methodology. The institute received input from a participant advisory council, co‐design partners and several communities of interest groups. This study aimed to describe the perceptions of the Canadian Institute for Social Prescribing's role in advancing social prescribing using a co‐design approach and the barriers and facilitators to implementing social prescribing in Canada. Methods: We used a qualitative descriptive study design, document analysis, participant observation and semi‐structured individual interviews (n = 7) with members of the Canadian Institute for Social Prescribing co‐design group and the institute's leadership. We also analysed documents, field notes and transcripts using codebook thematic analysis. Results: Four themes were developed representing the facilitators of implementing the Canadian Institute for Social Prescribing to support social prescribing: Creating relational mechanisms (i.e., partnerships and connections), Bringing awareness to social prescribing and contributing to the evidence (i.e., values and beliefs), Addressing systemic conditions (i.e., having a common language for social prescribing and organizing the community health sector) and Enabling funding and policy to drive social prescribing initiatives (i.e., shifting evidence into policy and securing sustainable funding). Conclusion: Participants' reflections on the co‐design process demonstrated that the Canadian Institute for Social Prescribing development provided networking opportunities and shared resources relevant to social prescribing. Co‐design efforts also fostered relational and informational support, which laid the necessary groundwork in Canada to overcome the complex interplay between the macro‐ and micro‐level settings in which social prescribing is practiced. Patient or Public Contribution: The interviews and observations involved participants with lived experience of delivering, receiving or advocating for social prescribing. [ABSTRACT FROM AUTHOR]

Wildfires have long been regarded as one chief culprit in regional air pollution, and pose great impacts on climate change. Although climate forcing of wildfire smoke has been widely investigated, its influence on synoptic systems remains unclear. Based on measurement and modeling analysis, the impact of wildfire smoke on the development of a mid‐latitude cyclone was revealed for Canadian wildfires in early June of 2023. The radiative forcing induced by smoke at surface and in the atmosphere reached up to −150 and 100 W m−2, posing opposite tendencies of atmospheric stratification over the land and ocean. Such perturbations contributed to the enhancement and stagnation of the cyclone, which favored the transport of smoke from the fire‐intensive region, indicated by nearly 40% increment of PM2.5 mass flux. With escalating wildfire risk in the future, the inclusion of smoke aerosols' impacts on meteorology in weather forecast models is of great importance. Plain Language Summary: Wildfires are uncontrolled fires that burn in the wildland vegetation, posing great challenges to regional air quality and global climate. Wildfire smoke has been known to exert great climate forcing via aerosol‐radiation interaction yet its impact on synoptic scales needs further investigation. Here, based on comprehensive observations and modeling analysis for the extreme Canadian wildfires in early June of 2023, smoke aerosol is revealed to induce significant radiative forcing and yield opposite modifications of temperature stratification over the land and ocean, resulting in intensified and stagnant mid‐latitude cyclone. Such perturbations favored the transport of smoke from fire‐intensive region to downwind cities in Canada and United States, and the subsequent long‐range transport dominated by the cyclone. Key Points: Smoke from intensive Canadian wildfires in early June of 2023 degraded the air quality of cities in eastern Canada and United StatesThe wildfire smoke enhanced the development of the mid‐latitude cyclone via smoke aerosol‐radiation interactionThe intensification and stagnation of the cyclone facilitated the transport of smoke to downwind cities in northeastern United States [ABSTRACT FROM AUTHOR]

Background/Objectives: Transitions to and from Emergency Departments (EDs) can be detrimental to long‐term care (LTC) residents and burden the healthcare system. While reducing avoidable transfers is imperative, various terms are used interchangeably including inappropriate, preventable, or unnecessary transitions. Our study objectives were to develop a conceptual definition of avoidable LTC‐ED transitions and to verify the level of stakeholder agreement with this definition. Methods: The EXamining Aged Care Transitions study adopted an exploratory sequential mixed‐method design. The study was conducted in 2015–2016 in 16 LTC facilities, 1 ED, and 1 Emergency Medical Service (EMS) in a major urban center in western Canada. Phase 1 included 80 participants, (healthcare aides, licensed practical nurses, registered nurses, LTC managers, family members of residents, and EMS staff). We conducted semistructured interviews (n = 25) and focus groups (n = 19). In Phase 2, 327 ED staff, EMS staff, LTC staff, and medical directors responded to a survey based on the qualitative findings. Results: Avoidable transitions were attributed to limited resources in LTC, insufficient preventive care, and resident or family wishes. The definition generated was: A transition of an LTC resident to the ED is considered avoidable if: (a) Diagnostic testing, medical assessment, and treatment can be accessed in a timely manner by other means; (b) the reasons for a transfer are unclear and the transition would increase the disorientation, pain, or discomfort of a resident, outweighing a clear benefit of a transfer; and (c) the transition is against the wishes expressed by the resident over time, including through informal and undocumented conversations. There was a high level of agreement with the definition across the four participant groups. Conclusions and Implications: To effectively reduce LTC resident avoidable transitions, stakeholders must share a common definition. Our conceptual definition may significantly contribute to improved care for LTC residents. Key points: Important dimensions in assessing transition avoidability include timely diagnostic testing availability, in‐facility assessment and treatment options, clear transfer purpose, risk/benefit analysis for resident well‐being, and recognition of advanced care goals and informal care preferences.Our findings highlighted essential differences between perceptions of unnecessary and avoidable transitions.Avoidable transitions were attributed to limited resources in long‐term care, insufficient preventive care, and resident or family wishes. [ABSTRACT FROM AUTHOR]

Societal Impact Statement: Cultural use berries are prized foods and medicines across the United States and Canada, with almost 200 different species used by Indigenous Peoples. Berries are increasingly being impacted by environmental and land‐use change. Berry habitats, how and when berry plants reproduce, and the volume of berries available for harvest each year are shifting widely. These changes are impacting access to, availability of, and consumption of berries. Biocultural stewardship practices, like low‐intensity fire, transplanting, and thinning, can be used in response to these stressors to support berry plant health and productivity as well as a sustained relationship with this important food. Summary: Almost 200 different species of berries are used for food and medicine by Indigenous Peoples, with unparalleled nutritional and cultural significance among plant foods. Environmental and land‐use change is increasingly compromising access to, availability of, and consumption of berries. In this review, I consider (a) how climate and land‐use change are impacting cultural use berries across species and places, as documented by Indigenous Peoples and in the scientific literature, and (b) how stewardship practices are being applied to promote resilience and sustainability in berrying landscapes experiencing stress. Climate impacts on Arctic and subarctic berry species include earlier ripening, changes in taste, or increased variability in abundance. These same regions are experiencing a proliferation of shrubs, while forests throughout the lower 48 and Canada are suffering from suffocating fuel loads and stand densities that are not conducive to berry habitat for many species. In the Pacific West, berries are influenced by prolonged droughts and increasing spring and summer temperatures. Climate change impacts are amplified by shifts in land use for forestry and agriculture. Biocultural stewardship practices, like low‐intensity fire, thinning, transplanting, and cultural care, can be used to mitigate these impacts and promote berry microclimate habitats. There is opportunity for intertribal networking and knowledge sharing around berry stewardship practices that will support local and regional climate change responses. [ABSTRACT FROM AUTHOR]

Aim: The rapidly changing Arctic is ideal for investigating uncertainties in climate projections. Despite the challenges of collecting data in this region, an unprecedented large‐scale survey of shorebirds has been conducted over the last 30 years. Our study aimed to (1) develop probabilistic estimates for the change in suitable habitat for 10 Arctic shorebird species in Canada by 2075 and (2) assess the contribution of modelling decisions to the uncertainty in these estimates. Location: Arctic Canada. Methods: To evaluate uncertainty, we considered six classes of modelling decisions, yielding 216 unique projections for each species. We tested three decisions that are less commonly explored − the pool of candidate variables, a method for selecting variables, and the maximum distance of tree line dispersal, as well as the modelling algorithm, carbon emissions scenario, and global circulation model. We used a bootstrapping approach, creating a probability distribution for the proportional change in suitable habitat for each species. Results: Our findings indicated a substantial risk for 8/10 species to lose over half of their suitable breeding habitat, but this projection is much less certain than has been described previously. While much uncertainty is unexplained, we were surprised that the largest source of uncertainty among our modelling decisions was from our choice of methods for variable selection, that the other modelling decisions were relatively small sources of uncertainty, overshadowing other modelling decisions. Main Conclusions: While most scenarios predict a northward shift and significant habitat loss for Arctic‐breeding shorebirds, the Arctic Archipelago of Canada will remain an important refuge because in many other Arctic regions, there is no land farther north for these species to shift into. A comprehensive understanding of uncertainty is important for deciding if future projections can or should be used when planning climate‐resilient protected area networks. [ABSTRACT FROM AUTHOR]

Context: Best practice guidelines for the recovery and return to work (RTW) of people with mental disorders recommend access to the services of an interdisciplinary team combining pharmacological, psychological and work rehabilitation interventions. In the Canadian context, primary healthcare services are responsible for providing these services for people with common mental disorders, such as depressive or anxiety disorders. However, not everyone has easy access to these recommended primary healthcare services, and previous studies suggest that multiple personal, practice‐related and organizational factors can influence the patient's journey. Moreover, previous studies documented that family physicians often work in silos and lack the knowledge and time needed to effectively manage by themselves patients' occupational health. Thus, the care and service trajectories of these patients are often suboptimal and can have important consequences on the person's recovery and RTW. Objective and Population Studied: Our study aimed to gain a better understanding of the patient journeys and the factors influencing their access to and experience with primary healthcare services while they were on sick leave due to a common mental disorder. Methods: A descriptive qualitative research design was used to understand and describe these factors. Conventional content analysis was used to analyze the verbatim. Results: Five themes describe the main factors that influenced the patient's journey of the 14 participants of this study: (1) the fragmented interventions provided by family physicians; (2) patients' autonomy in managing their own care; (3) the attitude and case management provided by the insurer, (4) the employer's openness and understanding and (5) the match between the person's needs and their access to psychosocial and rehabilitation services. Conclusions: Our findings highlight important gaps in the collaborative practices surrounding the management of mental health‐related sick leave, the coordination of primary healthcare services and the access to work rehabilitation services. Occupational therapists and other professionals can support family physicians in managing sick leaves, strengthen interprofessional and intersectoral collaboration and ensure that patients receive needed services in a timelier manner no matter their insurance coverage or financial needs. Patients of Public Contribution: This study aimed at looking into the perspective of people who have lived or are currently experiencing a sick leave related to a mental health disorder to highlight the factors which they feel hindered their recovery and RTW. Additionally, two patient partners were involved in this study and are now engaged in the dissemination of the research results and the pursuit of our team research programme to improve services delivered to this population. [ABSTRACT FROM AUTHOR]

Context: Engaging with peers is gaining increasing interest from healthcare systems in numerous countries. Peers are people who offer support by drawing on lived experiences of significant challenges or 'insider' knowledge of communities. Growing evidence suggests that peers can serve as a bridge between underserved communities and care providers across sectors, through their ability to build trust and relationships. Peer support is thus seen as an innovative way to address core issues of formal healthcare, particularly fragmentation of care and health inequalities. The wide body of approaches, goals and models of peer support speaks volumes of such interest. Navigating the various labels used to name peers, however, can be daunting. Similar terms often hide critical differences. Objectives/Background: This article seeks to disentangle the conceptual multiplicity of peer support, presenting a conceptual map based on a 3‐year knowledge synthesis project involving peers and programme stakeholders in Canada, and international scientific and grey literature. Synthesis/Main Results: The map introduces six key questions to navigate and situate peer support approaches according to peers' roles, pathways and settings of practice, regardless of the terms used to label them. As a tool, it offers a broad overview of the different ways peers contribute to integrating health and community care. Discussion: We conclude by discussing the map's potential and limitations to establish a common language and bridge models, in support of knowledge exchange among practitioners, policymakers and researchers. Patient or Public Contribution: Our team includes one experienced peer support worker. She contributed to the design of the conceptual map and the production of the manuscript. More than 10 peers working across Canada were also involved during research meetings to validate and refine the conceptual map. [ABSTRACT FROM AUTHOR]

Although sucrose is widely administered to hospitalized infants for single painful procedures, total sucrose volume during the entire neonatal intensive care unit (NICU) stay and associated adverse events are unknown. In a longitudinal observation study, we aimed to quantify and contextualize sucrose administration during the NICU stay. Specifically, we investigated the frequency, nature, and severity of painful procedures; proportion of procedures where neonates received sucrose; total volume of sucrose administered for painful procedures; and incidence and type of adverse events. Neonates <32 weeks gestational age at birth and <10 days of life were recruited from four Canadian tertiary NICUs. Daily chart reviews of documented painful procedures, sucrose administration, and any associated adverse events were undertaken. One hundred sixty‐eight neonates underwent a total of 9093 skin‐breaking procedures (mean 54.1 [±65.2] procedures/neonate or 1.1 [±0.9] procedures/day/neonate) during an average NICU stay of 45.9 (±31.4) days. Pain severity was recorded for 5399/9093 (59.4%) of the painful procedures; the majority (5051 [93.5%]) were heel lances of moderate pain intensity. Sucrose was administered for 7839/9093 (86.2%) of painful procedures. The total average sucrose volume was 5.5 (±5.4) mL/neonate or 0.11 (±0.08) mL/neonate/day. Infants experienced an average of 7.9 (±12.7) minor adverse events associated with pain and/or sucrose administration that resolved without intervention. The total number of painful procedures, sucrose volume, and incidence of adverse events throughout the NICU stay were described addressing an important knowledge gap in neonatal pain. These data provide a baseline for examining the association between total sucrose volume during NICU stay and research on longer‐term behavioral and neurodevelopmental outcomes. [ABSTRACT FROM AUTHOR]

Introduction: There is a growing role for patients, family members and caregivers as consultants, collaborators and partners in health system settings in Canada. However, compensation for this role is not systematized. When offered, it varies in both type (e.g., one‐time honorarium, salary) and amount. Further, broad‐based views of patient partners on compensation are still unknown. We aimed to describe the types and frequency of compensation patient partners have been offered and their attitudes towards compensation. Methods: This study uses data from the Canadian Patient Partner Study (CPPS) survey. The survey gathered the experiences and perspectives of those who self‐identified as patient partners working across the Canadian health system. Three questions were about compensation, asking what types of compensation participants had been offered, if they had ever refused compensation, and whether they felt adequately compensated. The latter two questions included open‐text comments in addition to menu‐based and scaled response options. Basic frequencies were performed for all questions and open‐text comments were analyzed through inductive qualitative content analysis. Results: A total of 603 individuals participated in the CPPS survey. Most respondents were never or rarely offered salary (81%), honorarium (64%), gift cards (80%) or material gifts (93%) while half were offered conference registration and expenses at least sometimes. A total of 129 (26%) of 499 respondents reported refusing compensation. Of 511 respondents, half felt adequately compensated always or often, and half only sometimes, rarely or never. Open‐text comments revealed positive, ambivalent and negative attitudes towards compensation. Attitudes were framed by perceptions about their role, sentiments of giving back to the health system, feelings of acknowledgement, practical considerations, values of fairness and equity and accountability relationships. Conclusions: Our findings confirm that compensation is not standardized in Canada. Half of survey respondents routinely feel inadequately compensated. Patient partners have diverse views of what constitutes adequate compensation inclusive of personal considerations such as a preference for volunteering, and broader concerns such as promoting equity in patient partnership. Organizations should attempt to ensure that compensation practices are clear, transparent and attentive to patient partners' unique contexts. Patient Contribution: Two patient partners are members of the CPPS research team and have been fully engaged in all study phases from project conception to knowledge translation. They are co‐authors of this manuscript. The survey was co‐designed and pilot tested with patient partners and survey participants were patient partners. [ABSTRACT FROM AUTHOR]

Background: Patient and public involvement (PPI) is a critical priority in research, policy, academia and advocacy organizations. PPI in dementia research is gaining momentum. However, these efforts are missing in international projects aimed at those living with advanced dementia in long‐term care (LTC) homes. Additional complexities can arise in enacting PPI within the context of integration of a palliative approach to care and experiences around end‐of‐life in (EOL) dementia. The mySupport study involved implementing the Family Carer Decision Support (FCDS) intervention for care partners of those living with advanced dementia in LTC in six countries. Research Design and Objective: An interpretive description study was conducted to explore the perspectives of international researchers from six countries on engaging people with lived experiences of dementia and EOL care in research processes. The findings from this study informed the development of a PPI strategy and a subsequent toolkit for the FCDS intervention. Findings: Thirty‐eight interviews were completed with project researchers: 12 from the United Kingdom, 8 from Canada, 7 from Ireland, 4 each from Italy and The Netherlands and 3 from the Czech Republic. Four broad themes describe international researchers' perspectives on advancing methods of engagement for people with lived experiences of dementia and EOL in international PPI activities: (1) Groundwork to engage in research; (2) planning for research activities is key; (3) focus on meaningful engagement and (4) having foresight for practical issues shaping PPI. Discussion and Implications: International projects that involve PPI can present many sources of challenges. The findings in this study highlight important considerations for foundational work for incorporating PPI in international projects. Learning from world leaders and those with lived experiences in various regions can be insightful and help share tools and resources. Patient or Public Contribution: PPI was envisioned as a critical part of conducting the mySupport study. The findings from this study informed the development of a PPI strategy and an international Strategic Guiding Council that included family carers of those living with advanced dementia in LTC homes in six countries. This manuscript focused on the perspectives of researchers on their engagement with people with lived experiences of dementia and EOL. The perspectives of persons with lived experiences on engaging in the mySupport research study will be reported in a forthcoming manuscript. [ABSTRACT FROM AUTHOR]

Introduction: Creating safer care is a high priority across healthcare systems. Despite this, most systems tend to focus on mitigating past harm, not creating proactive solutions. Managers and staff identify safety threats often with little input from patients and their caregivers during their health encounters. Methods: This is a qualitative descriptive study utilizing focus groups and one‐to‐one interviews with patients and caregivers who were currently using (or had previously used) services in health systems across Canada. Data were analysed via inductive thematic analysis to understand existing and desired strategies to promote safer and better quality care from the perspectives of patients and caregivers. Findings: In our analysis, we identified three key themes (safety strategies) from patients' and caregivers' perspectives and experiences: Using Tools and Approaches for Engaging Patients and Caregivers in their Care; Having Accountability Processes and Mechanisms for Safe Care; and Enabling Patients and Caregivers Access to Information. Conclusions: Safety is more than the absence of harm. Our findings outline a number of suggestions from patients and caregivers on how to make care safer, ranging from being valued on teams, participating as members of quality improvement tables, having access to health information, having access to an advocate to help make sense of information and having processes in place for disclosure and closure. Future work can further refine, implement and evaluate these strategies in practice. Patient or Public Contributions: An advisory group guided the research and was co‐chaired by a patient partner. Members of the advisory group spanned patient and caregiver organizations and health sectors across Canada and included three patient partners and leaders who work closely with patients and caregivers in their day‐to‐day work. In the research itself, we engaged 28 patients and caregivers from across Canada to learn about their safety experiences and learn what safer care looks like from their perspectives. [ABSTRACT FROM AUTHOR]

Background: Indiscriminate use of laboratory blood testing in hospitals contributes to patient discomfort and healthcare waste. Patient engagement in low‐value healthcare can help reduce overuse. Understanding patient experience is necessary to identify opportunities to improve patient engagement with in‐hospital laboratory testing. Objectives: To understand patient experience with the process of in‐hospital laboratory blood testing. Methods: We used a qualitative study design via semistructured interviews conducted online or over the phone. Participants were adult patients or family members/caregivers (≥18 years of age) with a recent (within 12 months of interview) experience of hospitalization in Alberta or British Columbia, Canada. We identified participants through convenience sampling and conducted interviews between May 2021 and June 2022. We analysed transcripts using thematic content analysis. Recruitment was continued until code saturation was reached. Results: We interviewed 16 participants (13 patients, 1 family member and 2 caregivers). We identified four themes from patients' experiences of in‐hospital laboratory blood testing: (i) patients need information from healthcare teams about expected blood testing processes, (ii) blood draw processes should consider patient comfort and preferences, (iii) patients want information from their healthcare teams about the rationale and frequency of blood testing and (iv) patients need information on how their testing results affect their medical care. Conclusion: Current laboratory testing processes in hospitals do not facilitate shared decision‐making and patient engagement. Patient engagement with laboratory testing in hospitals requires an empathetic healthcare team that provides clear communication regarding testing procedures, rationale and results, while considering patient preferences and offering opportunities for involvement. Patient or Public Contribution: We interviewed 16 patients and/or family members/caregivers regarding their in‐hospital laboratory blood testing experiences. Our findings show correlations between patient needs and patient recommendations to make testing processes more patient‐centred. To bring a lived‐experience lens to this study, we formed a Patient Advisory Council with 9–11 patient research partners. Our patient research partners informed the research design, co‐developed participant recruitment strategies, co‐conducted data collection and informed the data analysis. Some of our patient research partners are co‐authors of this manuscript. [ABSTRACT FROM AUTHOR]

Introduction: Caring for children and youth with special health care needs (CYSHCN) is a significant undertaking for families. While respite care is intended to address this burden, demand continues to exceed supply. Exploring the perspectives of respite service providers (SPs) and stakeholders (SKs) provides unique insight into families' needs and respite care systems. Methods: We conducted semistructured interviews with 41 respite care SPs and SKs across four Canadian provinces to ascertain perspectives on current and ideal respite care for families of CYSHCN. The analysis included delineating units of meaning from the data, clustering units of meaning to form thematic statements and extracting themes. The second‐level analysis involved applying themes and subthemes to cross‐functional process maps. Findings: Participants noted the critical, but sometimes absent role of Community Service Workers, who have the ability to support families accessing and navigating respite care systems. SPs and SKs identified current respite systems as operating in crisis mode. New findings suggest an ideal respite care system would incorporate advocacy for families, empower families and value CYSHCN, their families and respite workers. Conclusion: The evidence of unmet respite care needs of families of CYSHCN across Canada has long been available. Our findings identifying respite system challenges and solutions can be used by funders and policymakers for planning and enhancing resources, and by healthcare professionals, respite care providers and SKs to understand barriers and take action to improve respite outcomes to meet the respite needs of all families and CYSHCN. Patient or Public Contribution: The research team is composed of patients, researchers, clinicians and decision‐makers along with our Family Advisory Committee (FAC) composed of members of families of CYSHNC. The FAC was formed and met regularly with research team members, knowledge users and collaborators throughout the study to provide input on design, review themes and ensure findings are translated and disseminated in a meaningful way. [ABSTRACT FROM AUTHOR]

Algal bioindicators, such as diatoms, often show subdued responses to eutrophication in Arctic lakes because climate‐related changes (e.g., ice cover) tend to be the overriding factors influencing assemblage composition. Here, we examined how sub‐Arctic ponds historically receiving high nutrient inputs from nesting seabirds have responded to recent climate change. We present diatom data obtained from 12 sediment cores in seaduck‐affected ponds located on islands through Hudson Strait, Canada. All study cores show consistently elevated values of sedimentary ẟ15N, an established proxy for tracking marine‐derived nutrients, indicating seabirds have been present on these islands for at least the duration of the sediment records (~100 to 400 years). We document diverse epiphytic diatom assemblages to the base of all sediment cores, which is in marked contrast to seabird‐free Arctic ponds—these oligotrophic sites typically record epilithic diatom flora prior to recent warming. Diatoms are likely responding indirectly to seabird nutrients via habitat as nutrients promote the growth of mosses supporting epiphytic diatom communities. This masks the typical diatom response to increased warming in the Arctic, which also results in habitat changes and the growth of mosses around the pond edges. Changes in sedimentary chlorophyll a were not consistently synchronous with large changes in ẟ15N values, suggesting that primary production in ponds is not responding linearly to changes in seabird‐derived nitrogen. Across all ponds, we recorded shifts in diatom epiphytic assemblages (e.g., increases in % relative abundance of many Nitzschia species) that often align with increases in chlorophyll a. The changes in diatoms and chlorophyll a, although variable, are most likely driven by climate change as they are generally consistent with longer ice‐free conditions and growing seasons. Together, our results show that to effectively use diatoms in animal population reconstructions across the sub‐Arctic and Arctic, a strong understanding of eutrophication and climate change, based on supplementary proxies, is also required. [ABSTRACT FROM AUTHOR]

Our aim was to examine temporal change in alpha and beta diversity of freshwater fish communities in rivers that have urbanized over the same period to understand the influence of changes in land use and river connectivity on community change. We used biological (2001–2018), land use (2000–2015), and connectivity data (1987–2017) from Toronto, Ontario, Canada. We used linear mixed effects models to determine the strength of upstream land use, connectivity, and their changes over time to explain temporal change in alpha and beta diversity indices. We examined beta diversity using the temporal beta diversity index (TBI) to assess site‐specific community change. The TBI was partitioned into gains and losses, and species‐specific changes in abundance were assessed using paired t‐tests. There were more gains than losses across the study sites as measured by TBI. We found little to no significant differences in species‐specific abundances at aggregated spatial scales (study region, watershed, stream order). We found different relationships between landscape and connectivity variables with the biodiversity indices tested; however, almost all estimated confidence intervals overlapped with zero and had low goodness‐of‐fit. More fish biodiversity gains than losses were found across the study region, as measured by TBI. We found TBI to be a useful indicator of change as it identifies key sites to further investigate. We found two high value TBI sites gained non‐native species, and one site shifted from a cool‐water to warm‐water species dominated community, both of which have management implications. Upstream catchment land use and connectivity had poor explanatory power for change in the measured biodiversity indices. Ultimately, such spatial–temporal datasets are invaluable and can reveal trends in biodiversity useful for environmental management when considering competing interests involved with urban sprawl in the ongoing "Decade on Restoration." [ABSTRACT FROM AUTHOR]

Background: The need for new therapies to improve survival and outcomes in pediatric oncology along with the lack of approval and accessible clinical trials has led to "out‐of‐trial" use of innovative therapies. We conducted a retrospective analysis of requests for innovative anticancer therapy in Canadian pediatric oncology tertiary centers for patients less than 30 years old between 2013 and 2020. Methods: Innovative therapies were defined as cancer‐directed drugs used (a) off‐label, (b) unlicensed drugs being used outside the context of a clinical trial, or (c) approved drugs with limited evidence in pediatrics. We excluded cytotoxic chemotherapy, cellular products, and cytokines. Results: We retrieved data on 352 innovative therapy drug requests. Underlying diagnosis was primary CNS tumor 31%; extracranial solid tumor 37%, leukemia/lymphoma 22%, LCH 2%, and plexiform neurofibroma 6%. RAS/MAP kinase pathway inhibitors were the most frequently requested innovative therapies in 28% of all requests followed by multi‐targeted tyrosine kinase inhibitors (17%), inhibitors of the PIK3CA‐mTOR‐AKT pathway (8%), immune checkpoints inhibitors (8%), and antibody drug conjugates (8%). In 112 out of 352 requests, innovative therapies were used in combination with another anticancer agent. 48% of requests were motivated by the presence of an actionable molecular target. Compassionate access accounted for 52% of all requests while public insurance was used in 27%. Mechanisms of funding varied between provinces. Conclusion: This real‐world data collection illustrates an increasing use of "out‐of‐trial" innovative therapies in pediatric oncology. This new field of practice warrants further studies to understand the impact on patient trajectory and equity in access to innovative therapies. [ABSTRACT FROM AUTHOR]

Objective: To collate and critically review international evidence on the direct health system costs of children and adolescents and young adults (AYA) with cancer. Methods: We conducted searches in PubMed, MEDLINE, CINAHL, and Scopus. Articles were limited to studies involving people aged 0–39 years at cancer diagnosis and published from 2012 to 2022. Two reviewers screened the articles and evaluated the studies using the Consolidated Health Economic Evaluation Reporting Standards checklist. The reviewers synthesized the findings using a narrative approach and presented the costs in 2022 US dollars for comparability. Results: Overall, the mean healthcare costs for all cancers in the 5 years post diagnosis ranged from US$36,670 among children in Korea to US$127,946 among AYA in the USA. During the first year, the mean costs among children 0–14 years ranged from US$34,953 in Chile to over US$130,000 in Canada. These were higher than the costs for AYA, estimated at US$61,855 in Canada. At the end of life, the mean costs were estimated at over US$300,000 among children and US$235,265 among adolescents in Canada. Leukemia was the most expensive cancer type, estimated at US$50,133 in Chile, to US$152,533 among children in Canada. Overall, more than a third of the total cost is related to hospitalizations. All the included studies were of good quality. Conclusions: Healthcare costs associated with cancer are substantial among children, and AYA. More research is needed on the cost of cancer in low‐ and middle‐income countries and harmonization of costs across countries. [ABSTRACT FROM AUTHOR]

Rapid warming and human exploitation threaten boreal forests. Understanding links among vegetation, climate, and people in this vast biome requires highly resolved long‐term records that integrate regional inputs. We developed an 850‐year pollen‐based record of supraregional vegetation change using a southern Greenland ice core and atmospheric modeling that identified the boreal and mixed‐conifer forests of eastern Canada as the dominant pollen source regions. Conifer pollen increased ∼1400 CE at the onset of the cooler and drier Little Ice Age. A subsequent decline began ∼1650 CE and a statistically significant pollen change after 1760 CE suggests ecological consequences of the Little Ice Age cooling and initial human exploitation that persisted until recent decades. These supraregional changes are broadly consistent with local records and demonstrate intensification of human impacts on northern forests, suggesting a shift from a climate‐modulated to an increasingly human‐controlled system during recent centuries. Plain Language Summary: Understanding the consequences of climate warming and human exploitation for northern forests requires long‐term regional records of this sparsely populated region. We present a first 850‐year vegetation record from a low‐elevation ice core in Southern Greenland. The ice core integrates pollen from Eastern Canadian forests and other boreal forests, providing temporal precision and regional coverage not available from previous paleoecological investigations. We show that climate change drove changes in the abundances of coniferous species during the Little Ice Age. Subsequent warming coincided with the onset of timber exploitation that brought a shift from a climate‐controlled to an increasingly human‐controlled system. Current warming trends likely will further alter vegetation distribution, productivity, and disturbance regimes of northern forests, but they will be moderated by the legacy of human impacts. Key Points: Atmospheric model FLEXPART identifies boreal and mixed‐conifer forests in Canada as pollen source area for Southern Greenland ice corePollen in Greenland ice track conifer pollen increases ∼1400 CE at the onset of the cooler and drier Little Ice AgeConifer pollen declines ∼1650 CE coincident with cold LIA climate and initial commercial forest exploitation [ABSTRACT FROM AUTHOR]

Objective: To investigate gastrointestinal (GI)‐related physician visits and drug dispensations in the 5 years preceding a first recorded demyelinating event or multiple sclerosis (MS) onset. Methods: Using linked administrative and clinical data from British Columbia (1996–2013), Canada, we identified an administrative cohort via a validated algorithm (n = 6863), a clinical cohort diagnosed at a MS clinic (n = 966), and matched controls (administrative cohort: n = 31,865; clinical cohort: n = 4534). In each cohort, the 5 years before a first demyelinating event or MS symptom onset (i.e., index date) were examined. We compared rates of GI‐related physician visits and risk of ≥1 GI‐related dispensation between MS cases and controls using negative binomial and robust Poisson models. Sex differences were tested using interaction terms. Results: The administrative cohort MS cases had higher rates of physician visits related to gastritis and duodenitis (adjusted rate/risk ratio (aRR):1.42, 95% CI: 1.10–1.83) and diseases of the esophagus (aRR: 1.46, 95% CI: 1.06–2.02) prior to the index date. MS cases also had greater risk of at least one dispensation for several drug classes, including constipation‐related (aRR: 1.82, 95% CI: 1.50–2.22), antiemetics/antinauseants (aRR: 1.64, 95% CI: 1.43–1.89), and propulsives (promotility drugs; aRR: 1.62, 95% CI: 1.47–1.79). Men had a disproportionally higher relative risk for propulsives than women (aRR: men = 2.32, 95% CI: 1.79–3.00; women = 1.54, 95% CI: 1.36–1.72). Several findings were similar in the smaller clinical cohort though none reached statistical significance. Interpretation: GI‐related physician visits and drug dispensations were more common in the 5 years before the first demyelinating event versus matched controls. GI symptoms are a measurable feature of the prodromal or early phase of MS, with a sex difference evident. [ABSTRACT FROM AUTHOR]

Effectors encoded by avirulence genes (Avr) interact with the Phytophthora sojae resistance gene (Rps) products to generate incompatible interactions. The virulence profile of P. sojae is rapidly evolving as a result of the large‐scale deployment of Rps genes in soybean. For a successful exploitation of Rps genes, it is recommended that soybean growers use cultivars containing the Rps genes corresponding to Avr genes present in P. sojae populations present in their fields. Determination of the virulence profile of P. sojae isolates is critical for the selection of soybean cultivars. High‐resolution melting curve (HRM) analysis is a powerful tool, first applied in medicine, for detecting mutations with potential applications in different biological fields. Here, we report the development of an HRM protocol, as an original approach to discriminate effectors, to differentiate P. sojae haplotypes for six Avr genes. An HRM assay was performed on 24 P. sojae isolates with different haplotypes collected from soybean fields across Canada. The results clearly confirmed that the HRM assay discriminated different virulence genotypes. Moreover, the HRM assay was able to differentiate multiple haplotypes representing small allelic variations. HRM‐based prediction was validated by phenotyping assays. This HRM assay provides a unique, cost‐effective and efficient tool to predict virulence pathotypes associated with six different Avr (1b, 1c, 1d, 1k, 3a and 6) genes from P. sojae, which can be applied in the deployment of appropriate Rps genes in soybean fields. [ABSTRACT FROM AUTHOR]