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Introduction: Wildfires impact large populations worldwide with increasing frequency and severity. In Canada, the fire season has affected more areas this year with potential implications for individuals' well-being and quality of life (QoL). Objective: This study aimed to explore data related to the well-being and QoL of individuals living in areas impacted by wildfires in two Canadian provinces. Methodology: A cross-sectional survey was used to collect data from the residents in the two provinces who subscribed to the Text4Hope mental health support service. Descriptive and inferential statistics were applied using World Health Organization Well-Being Index (WHO-5). Results: Out of 1802 Text4Hope subscribers, 298 responded to the baseline surveys, yielding a response rate of (16.5%). The mean score of QoL was (40.8/100 ± 20.7). Most respondents were from Alberta (84.2%), 40 years old or below (28.3%), females (85.2%), Caucasian (83.5%), in a relationship (56.4%), employed (63.6%), received diagnoses of depression (56.6%), and anxiety (52.9%).The overall prevalence of low QoL was (67.3%; 95% CI: 61.2–73.1%) that was mostly reported among subscribers who were from Nova Scotia (70.5%), 40 years old or younger (71.2%), other gender (83.3%), Black/Hispanic and other ethnicity (85.7% each), having high-school or less education (70.3%), not in a relationship (74.1%), and unemployed (73.6%). In terms of clinical factors, low QoL was most prevalent among those who received the diagnoses of depression (74%) and anxiety (74.3%), and those who have been receiving antidepressants (71.8%) or benzodiazepines (93.3%). Regarding wildfire-related factors, the highest prevalence of low QoL was reported among those living in a region that has recently been impacted by the wildfires (74.7%) and those who have been less frequently watching television images about the devastation caused by the recent wildfires (72.6%). The multivariate logistic regression analysis model predicting the low QoL including the various variables was statistically significant; Χ2 (df = 19; n = 254) = 31.69, p = 0.03. It was found that living in a region impacted by wildfires (37.9%) was the only significant predictor of low QoL (adjusted OR: 1.96; 95% CI: 1.05–3.65). Conclusions: The impact of wildfire on the QoL and well-being among people living in impacted regions is significant. It is empirical for the health authorities to support those who are disadvantaged by wildfire via running of screening programs to early identify mental health symptoms and addressing the living conditions of the survivors, along with the provision of innovative means of mental health support. This necessitates enhanced planning of the governments and health authorities to overcome such adverse psychological consequences of these events. [ABSTRACT FROM AUTHOR]

Background: Examining support for substance use policies, including those for harm reduction, among the general public and policy influencers is a fundamental step to map the current policy landscape and leverage policy opportunities. Yet, this is a knowledge gap in Canada. Our paper identifies the level of support for substance use policies in two provinces in Canada and describes how the level of support is associated with intrusiveness and sociodemographic variables., Methods: Data came from the 2019 Chronic Disease Prevention Survey. The representative sample included members of the general public (Alberta n = 1648, Manitoba n = 1770) as well as policy influencers (Alberta n = 204, Manitoba n = 98). We measured the level of support for 22 public policies concerning substance use through a 4-point Likert-scale. The Nuffield Council on Bioethics Intervention Ladder framework was applied to assess intrusiveness. We used cumulative link models to run ordinal regressions for identification of explanatory sociodemographic variables., Results: Overall, there was generally strong support for the policies assessed. The general public in Manitoba was significantly more supportive of policies than its Alberta counterpart. Some differences were found between provinces and samples. For certain substance use policies, there was stronger support among women than men and among those with higher education than those with less education., Conclusions: The results highlight areas where efforts are needed to increase support from both policy influencers and general public for adoption, implementation, and scaling of substance use policies. Socio-demographic variables related to support for substance use policies may be useful in informing strategies such as knowledge mobilization to advance the policy landscape in Western Canada., (© 2024. The Author(s).)

Background: Advance care planning (ACP) is a process which enables patients to communicate wishes, values, fears, and preferences for future medical care. Despite patient interest in ACP, the frequency of discussions remains low. Barriers to ACP may be mitigated by involving non-physician clinic staff, preparing patients ahead of visits, and using tools to structure visits. An ACP care pathway incorporating these principles was implemented in longitudinal generalist outpatient care, including primary care/family medicine and general internal medicine, in two Canadian provinces. This study aims to understand clinician experiences implementing the pathway., Methods: The pathway was implemented in one family practice in Alberta, two family practices in British Columbia (BC), and one BC internal medicine outpatient clinic. Physicians and allied health professionals delivered structured pathway visits based on the Serious Illness Conversation Guide. Twelve physicians and one social worker participated in interviews or focus groups at the end of the study period. Qualitative data were coded inductively using an iterative approach, with regular meetings between coders., Results: Clinicians described experiences with the ACP care pathway, impact at the clinician level, and impact at the patient level. Within each domain, clinicians described barriers and facilitators experienced during implementation. Clinicians also reflected candidly about potential for future implementation and the sustainability of the pathway., Conclusions: While the pathway was implemented slightly differently between provinces, core experiences were that implementation of the pathway, and integration with current practice, were feasible. Across settings, similar themes recurred regarding usefulness of the pathway structure and its tools, impact on clinician confidence and interactions with patients, teamwork and task delegation, compatibility with existing workflow, and patient preparation and readiness. Clinicians were supportive of ACP and of the pathway., Trial Registration: The study was prospectively registered with clinicaltrials.gov (NCT03508557). Registered April 25, 2018. https://classic., Clinicaltrials: gov/ct2/show/NCT03508557 ., (© 2024. The Author(s).)

This study investigated the diagnostic capacity for Fetal Alcohol Spectrum Disorder (FASD) in multidisciplinary clinics across several provincial and one territorial jurisdictions of Canada: Alberta, British Columbia, Manitoba, Ontario and Northwest Territories. The data were collected directly from clinics capable of providing diagnoses of FASD and examined annual capacity for the assessment and diagnosis of FASD per year from 2015 to 2019. In total, 58 FASD diagnostic clinics were identified and 33 clinics participated in this survey. The study identified inadequate FASD diagnostic capacity in all participating jurisdictions. Based on the findings and the current population sizes, it is estimated that 98% of individuals with FASD are undiagnosed or misdiagnosed in Canada. Wait times for FASD diagnosis ranged from 1 month to 4.5 years across participating jurisdictions. The annual FASD diagnostic capacity in the select provinces and territories require at least a 67-fold increase per year., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Popova et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This review paper investigates the landscape of wildfire-related studies with a focus on infrastructure and evacuations across Canadian provinces, revealing a predominant focus on Alberta, particularly after the 2016 Fort McMurray wildfire. The aftermath of this event has heightened attention to the unique challenges faced during evacuations, emphasizing the urgent need for heightened awareness and preparedness, especially in the vulnerable northern communities of Alberta. Studies beyond Alberta contribute to understanding Canadian wildfire dynamics. However, a noticeable research gap in British Columbia raises concerns about research prioritization and resource allocation despite heightened wildfire activity. The fact that some provinces are contributing less than 4.2%, such as Quebec, Saskatchewan, Ontario, Northwest Territories, Yukon, and the Prairies, might be attributed to regional variations influenced by historical wildfire frequency and population density. Thematic analysis categorizing studies into "community support/resilience", "evacuation efficiency", and "infrastructure protection/raising awareness" provides nuanced insights. The dominance of the "community support/resilience" category, comprising over 40% of studies, signifies a societal shift towards proactive community engagement. Balanced representation in the "evacuation efficiency" and "infrastructure protection/raising awareness" categories, each contributing over 29%, reflects a collective effort to glean lessons from past evacuations and enhance community preparedness. Temporal trends and thematic analyses spotlight a commitment to continuous improvement, adaptability to emerging challenges, and a growing recognition of the multifaceted aspects of wildfire management. The evolving emphasis on community involvement, responsiveness to changing evacuation dynamics, and heightened awareness of infrastructure protection underscores the proactive stance of the research community, providing insights for shaping future research priorities, policy frameworks, and community resilience strategies in the face of evolving wildfire threats in Canada. [ABSTRACT FROM AUTHOR]

Introduction: The use of osimertinib in the first-line (1L) setting is an effective treatment option for sensitizing EGFR-mutations (EGFRm+) and has significantly altered the standard of care practice for EGFRm+ disease in Canada. Unfortunately, acquired resistance to osimertinib is almost universal, and outcomes are disparate. Post-progression treatment patterns and the outcome of real-world Canadian EGFRm+ patients receiving 1L osimertinib were the focus of this retrospective review. Methods: The Glans-Look Lung Cancer Research database was used to identify and collect demographic, clinical, treatment, and outcome data on EGFRm+ patients who received 1L osimertinib in the Canadian province of Alberta between 2018 and 2022. Results: A total of 150 patients receiving 1L osimertinib were identified. In total, 86 developed progressive disease, with 56 (65%) continuing systemic therapy, 73% continuing osimertinib, and 27% switching to second-line (2L) systemic therapy. Patients were similar both in clinical characteristics at 1L osimertinib initiation and patterns of treatment failure at progression; those continuing 1L osimertinib post-progression had a longer time to progression (13.5 vs. 8.8 months, p = 0.05) and subsequent post-osimertinib initiation survival (34.7 vs. 22.8 months, p = 0.11). Conclusions: The continuation of osimertinib post-progression is an effective disease management strategy for select real-world EGFRm+ patients, providing continued clinical benefit, potentially due to different underlying disease pathogenesis. [ABSTRACT FROM AUTHOR]

Introduction: Clinical mastitis (CM) treatment decision-making is a multifaceted process that remains relatively understudied, despite CM being one of the most prevalent diseases on dairy farms worldwide, contributing greatly to the use of antimicrobials in the dairy industry. This study aimed to gain insights into decision-making mechanisms employed by dairy farmers in British Columbia and Alberta, Canada, when dealing with CM. Methods: Interviews were held with 15 dairy farmers in the Canadian provinces of British Columbia and Alberta and analyzed using reflexive thematic analysis to develop both the decision-pathway and overarching themes influencing the CM decisions by farmers in this region. Results and discussion: The analysis generated a decision-making process that begins with identification and classification of CM, guided by visual characteristics of milk and the udder, available milk production and quality data, presence of systemic signs, and additional diagnostics. Subsequently, CM cases are assessed based on the likelihood of cure, value of the cow, and herd goals to decide whether antimicrobial treatment is desired. Next, a treatment choice is made by evaluating severity and urgency of the case, availability of drugs and timing of the case. Finally, definition of treatment success and progression over time following the treatment decision guides the termination of treatment. Three overarching themes were generated that shape the decision-making process: 'Personal attributes', including personal approach and experiential knowledge; 'Inter-actor dynamics', such as shared decision-making and dynamics among producers, veterinarians, and milkers; and 'Moving beyond protocols', which highlights the dynamic nature of mastitis decision-making. These insights have the potential to inform the development of effective interventions to improve CM antimicrobial use that align with the reality of farming operations within Western Canada, and potentially beyond. [ABSTRACT FROM AUTHOR]

Permaculture, short-hand for "permanent agriculture," is an ethical system and set of engineering and design principles, aimed at growing food locally while building community. Many adherents believe that it carries the potential to transform and re-localize our economic system. To explore these views, we interviewed 56 permaculturists in the western Canadian provinces of Alberta and British Columbia. Findings demonstrate that participants view the non-hierarchical, self-reliance, and exchange-based aspects of permaculture as potentially liberating. At the same time, they feel stuck and embedded within existing capitalist market relations, exemplified by land ownership, costs of implementing permaculture landscapes, and the need for employment-based income. Many tensions likewise emerge from their own class positions and the privileges associated with, and benefits accruing from, current capitalist modes of exchange and ongoing settler colonialism. We conclude by discussing implications for theory and empirical research in environmental sociology and cognate areas. [ABSTRACT FROM AUTHOR]

Most minimum wage studies are identified on small, plentiful, mostly expected wage changes, spread out over time. A recent set of changes have instead been large, rapid, and unexpected, following the "Fight for $15" movement. Alberta is the first North American province, state, or territory to have this $15 minimum wage, with an unexpectedly large increase (47%) occurring over a short time horizon (3 years). The employment effects of this policy are estimated using a synthetic control approach on Labour Force Survey data. Similar to the existing literature, workers moved up the wage distribution, increment by increment, but with a higher distributional reach. Employment losses occurred at similar elasticities, but with large level changes, mostly among younger workers. Newer to the literature, regional employment losses were found in four of the five non-urban economic regions, but not in Alberta's two main cities, showing the significance and nuance of regional heterogeneity. [ABSTRACT FROM AUTHOR]

Translocation of captive-bred animals is a widely used conservation strategy to support the recovery of imperiled wild populations. Identifying which factors enhance or limit survival after release can be important in adapting translocation strategies, particularly for species with low survival rates after release from captivity. Many translocation programs track post-translocation survival, but few complete spatial-statistical assessments of mortality risk associated with release environments. Typically, few animals are released from captive breeding programs, limiting the sample size available for analyses. We aimed to create a workflow that used limited datasets to evaluate the influence of spatial conditions and other factors on mortality risk. Greater sage-grouse (Centrocercus urophasianus) are endangered in Canada and of conservation concern throughout their range in the United States. After the species declined precipitously in Canada, a captive breeding program was initiated with subsequent releases in Alberta and Saskatchewan. Despite success in captive breeding, mortality rates of released sage-grouse were high. We used GPS- and VHF-based locations of released sage-grouse to determine how spatial features influence mortality risk of sage-grouse after release from captivity. We implemented a multistep approach to quantify and map risk relative to the environmental features associated with mortality. We also assessed whether the movement behaviors of sage-grouse correspond with environmental risk factors by using a combination of survival models and integrated step-selection functions. Mortality of sage-grouse in Alberta was hastened in areas close to anthropogenic disturbance. Although birds in Alberta avoided areas of higher mortality risk, those in Saskatchewan did not, perhaps due to environmental and selection constraints. This multistep approach allowed us to utilize small sample sizes to assess key risk factors in the landscape. This process supports the adaptive modification of translocation plans and can similarly support other data-limited scientists and managers in assessing environmental mortality risk and defining conservation actions for endangered species. [ABSTRACT FROM AUTHOR]

Background: Wildfires have become increasingly prevalent in various regions, resulting in substantial environmental and psychological consequences that have garnered increasing attention. Objective: This study aims to examine the prevalence of likely Generalized Anxiety Disorder (GAD) and explore the determinants of likely GAD during the wildfires in Alberta and Nova Scotia. Methods: Data were collected online through a cross-sectional survey from 14 May–23 June 2023. Alberta and Nova Scotia participants self-subscribed to the program by texting 'HopeAB' or 'HopeNS' to a short code, respectively. The GAD-7–validated tool was used to collect information on likely GAD. Results: This study included 298 respondents while one hundred and twelve respondents lived in a region of Alberta/Nova Scotia affected by the wildfires (37.7%). The prevalence of likely GAD among the respondents was 41.9%. Respondents who lived in a region of Alberta/Nova Scotia recently impacted by the wildfires were twice as likely to experience GAD symptoms (OR = 2.4; 95% C.I. 1.3–4.3). Conclusions: The study's identification of a statistically significant relationship between residing in a wildfire-impacted region and likely GAD shows the association between environmental and psychological well-being. However, the relatively small sample size and self-reported assessment of GAD symptoms may limit the generalizability of the findings. Further research involving a larger sample size delving into potential predictors could facilitate strategies for mitigating the mental health consequences of natural disasters. [ABSTRACT FROM AUTHOR]

This study examined opportunities and barriers for implementing evidence-based Social and Emotional Learning (SEL) programs in Prairie Canadian Schools. Educators from Manitoba, Saskatchewan and Alberta completed an online survey on SEL feasibility and reported on five feasibility domains: (1) attitudes about SEL, (2) knowledge about SEL, (3) job stress, (4) resources for implementing SEL, and (5) SEL practices. Results indicated that positive attitudes toward SEL significantly predicted increased perceived feasibility for evidence-based SEL implementation. Additionally, both knowledge and access to resources predicted increased SEL practice by Prairie Canadian educators. Analyses for open-ended responses paralleled quantitative results. Specifically, Canadian educators had positive views about SEL programing, but like previous research conducted in other countries, indicated that they require better access to SEL training, and resources (e.g., more time to plan and teach SEL, funding and program materials). A unique Canadian context-related finding from this study was that some Prairie Canadian educators indicated a paucity of French materials for SEL programs, which impeded implementation. In order to effectively implement evidence-based SEL in Prairie Canadian schools, policy makers must address the indicated barriers for Canadian educators, such as increased SEL training and resources, and easy access to appropriate French materials. [ABSTRACT FROM AUTHOR]

This paper considers small businesses as an effective sector that solves current problems in the structure of the economy. The study aims to develop a set of measures (tools) for involving small businesses in stabilizing Alberta's economy. The methodology includes the monitoring of the economy within Alberta's regional borders over time; statistical analysis of the small business sector before and during the pandemic in the structure of the economy; as well as grouping and converting quantitative measurements into a qualitative summary of the main economic principles. These steps are aimed at developing a set of measures (tools) for involving small businesses in the economy of the province and the country as a whole. The growth of small enterprises ensures a practice focused on productivity, innovation, and society, which is confirmed by the dominant share of small businesses in the gross domestic product created by the dominant share of small businesses in the gross domestic product created by the private sector of the province. Thus, focusing on the economic principles of small businesses, a complex of measures is proposed for mobilization to maximize the economic result at the provincial level in the context of strengthening the national economy. In practice, the findings will help the local government to determine a set of beneficial policies, contributing to the utilization of the advantages of the local economy in the sphere of business production. Entrepreneurs are provided with an opportunity to qualitatively utilize economic opportunities, recognizing the risks of the external environment. [ABSTRACT FROM AUTHOR]

Alberta has the highest proportion of preterm births in Canada, which is associated with increased health service utilization and costs. The aim was to evaluate the effect of Alberta Family Integrated Care (Alberta FICare™) on health care costs compared to standard care. Data from a pragmatic cluster randomized controlled trial (cRCT) of Alberta FICare in Level II neonatal intensive care units (NICUs) were linked to administrative data on hospital admissions and emergency department (ED) visits to assess costs associated with birth admission and readmissions and ED visits within two months post-discharge -- the total cost -- per infant per group. Descriptive statistics were used to describe characteristics of the sample and unadjusted total costs. Predictive modeling compared the mean total costs between the groups, while accounting for potential confounding and stratification. A total of 718 infants from 10 NICUs were included. The mean (standard deviation) unadjusted total cost per infant was $39,649 ($19,741) and $42,195 ($20,955) in the Alberta FICare and standard care groups, respectively. Accounting for site geographic area and infant risk factors, the adjusted mean total cost per infant was lower in the Alberta FICare group ($39,434) compared to the standard care group ($41,740). The cRCT potentially lacked statistical power for this analysis, resulting in the non-statistically significant difference between the groups. Alberta FICare showed its potential to reduce the public health care system's costs. A pan-Canadian study would offer better insights in the intervention's effects on costs. [ABSTRACT FROM AUTHOR]

Background: Family violence, which includes intimate partner abuse, child abuse, and elder abuse, is a serious public health concern. Primary healthcare (PHC) offers a vital opportunity to identify and address family violence, yet barriers prevent the effective implementation of family violence interventions in PHC settings. The purpose of this study is to improve family violence identification and response in Alberta's PHC settings by exploring readiness factors. Methods: An integrated knowledge translation approach, combining implementation science and participatory action research, was employed to develop a readiness assessment tool for addressing family violence within PHC settings in Alberta. The research involved three phases: phase 1 involved a rapid evidence assessment, phase 2 engaged a panel of healthcare and family violence experts to explore readiness components in the Alberta context, and phase 3 utilized a 3-round Delphi consensus-building process to refine readiness indicators. Results: Phase 1 findings from a rapid evidence assessment highlighted five main models/tools for assessing readiness to implement family violence interventions in PHC settings. In phase 2, additional concepts were identified through exploration with healthcare and family violence expert panel members, resulting in a total of 16 concepts for assessing family violence readiness within the Alberta PHC context. The 3-round Delphi consensus-building process in Phase 3 involved nine panelists, who collectively agreed on the inclusion of all concepts and indicators, yielding a total of 60 items for the proposed readiness assessment tool for addressing family violence in PHC within Alberta. Conclusion: The current study lays the groundwork for future family violence intervention programs, offering insights into key components that promote readiness for implementing comprehensive programs and supporting PHC organizations in effectively addressing family violence. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 (C19) pandemic shocked primary care systems around the world. Those systems responded by supporting patients in the community, and acute care facilities in crisis. In Canada, the Patient Medical Home (PMH) is a widely adopted care model that aims to operationalize the tenets and principles of Primary Health Care (PHC) as developed since the Alma-Ata Declaration. This paper describes how personnel working in and with Primary Care Networks (PCNs) in Alberta, Canada deployed the PMH model and its underlying PHC principles to frame and respond to the C19 shock. Methods: Using purposive and snowball sampling techniques, we interviewed 57 participants who worked in public health and primary care, including community-based family physicians. We used interpretive description to analyze the interviews. Results: PCN staff and physicians described how the PMH model was foundational to normal operations, and how C19 responses were framed by the patient-centric, team-delivered, and continuous care principles the model shares with PHC. Specifically, participants described ensuring access to care, addressing the social determinants of health, being patient centered, and redeploying and expanding PHC teams to accomplish these goals. Discussion: Delivering PHC through the PMH allowed physicians and allied health staff to deliver patient-centered, team-based, holistic bio-medical services to Albertans. In tailoring services to meet the specific social and health needs of the populations served by each PCN, healthcare providers were able to ensure relevant support remained available and accessible. [ABSTRACT FROM AUTHOR]

Background: We applied a longitudinal network analysis approach to assess the formation of knowledge sharing and collaboration networks among care aide-led quality improvement (QI) teams in Canadian nursing homes participating in the Safer Care for Older Persons (in residential) Environments (SCOPE) trial which aimed to support unregulated front-line staff to lead unit-based quality improvement (QI) teams in nursing homes. We hypothesized that SCOPE's communicative and participatory nature would provide opportunities for peer support, knowledge sharing, and collaboration building among teams. Methods: Fourteen QI teams in Alberta (AB) and seventeen QI teams in British Columbia (BC) participated in the study. Communications across nursing homes occurred through a series of 4 collaborative Learning Congresses (training sessions) over a 1-year period. The senior leaders of QI teams participated in two online network surveys about the communication/collaboration between teams in their province, 1 month after the first, and 6 months later, after the fourth Learning Congress. We developed communication and collaboration network maps pertaining to three time points: before SCOPE, at 2 months, and at 9 months. Results: Over time, teams made significantly more new connections and strengthened existing ones, within and across regions. Geographic proximity and co-membership in organizational chains were important predictors of connectivity before and during SCOPE. Teams whose members were well connected at baseline disproportionately improved connectivity over time. On the other hand, teams that did not have prior opportunities to connect appeared to use SCOPE to build new ties. Conclusions: Our findings suggest the importance of network-altering activities to the formation of collaboration networks among QI teams across nursing homes. Active strategies could be used to better connect less connected teams and facilitate collaboration among geographically proximate teams. These findings may inform the development of interventions to leverage existing networks and provide new networking opportunities to develop and sustain organizational improvements. [ABSTRACT FROM AUTHOR]

Human alveolar echinococcosis is increasingly documented in Alberta, Canada. Its causative agent, Echinococcus multilocularis (Em), can be transmitted to humans by infected dogs. We assessed the prevalence and associated risk factors for Em infections in domestic dogs in Calgary, Alberta, Canada. In this cross-sectional study that coupled collection and assessment of dog feces with a survey on potential risk factors, 13 of 696 (Bayesian true prevalence, 2.4%; 95% CrI: 1.3–4.0%) individual dogs' feces collected during August and September 2012 were qPCR positive for Em. Sequencing two of these cases indicated that both were from the same Em European strain responsible for human infections in Alberta. Likelihood of intestinal Em was 5.6-times higher in hounds than other breeds, 4.6-times higher in dogs leashed at dog parks than those allowed off-leash, 3.1-times higher in dogs often kept in the backyard during spring and summer months than those rarely in the yard, and 3.3-times higher in dogs living in neighbourhoods bordering Bowmont park than those in other areas of Calgary. This situation warrants surveillance of dog infections as a preventative measure to reduce infections in North America. [ABSTRACT FROM AUTHOR]

Background: Since March 2023, hundreds of fires have burned from coast to coast throughout the country, placing Canada on track to have the worst wildfire season ever recorded. From East to West, provinces such as Quebec, Ontario, Nova Scotia, Alberta, and British Columbia have been particularly affected by large and uncontrollable wildfires. Objectives: The objective of this study was to determine the prevalence of depression symptoms and predictors among residents living in extreme climate conditions during the Canadian wildfires of 2023 in Alberta and Nova Scotia and to update the literature with data related to those wildfires. Methods: A cross-sectional quantitative survey was conducted in this study. REDCap was used to administer an online survey between 14 May and 23 June 2023. Through the Text4Hope program, participants subscribe to receive supportive SMS messages daily. As part of the initial welcome message, participants were invited to complete an online questionnaire, containing demographic information, wildfire-related information, and responses to the Patient Health Questionnaire-9 (PHQ-9) for depression assessment. SPSS version 25 was used to analyze the data. Descriptive, univariate, and multivariate regression analyses were employed. Results: A total of 298 respondents completed the survey out of 1802 who self-subscribed to the Text4Hope program in Alberta and Nova Scotia and received a link to the online survey, producing a response rate of 16.54%. Most of the respondents were females (85.2%, 253), below 40 years of age (28.3%, 84), employed (63.6%, 189), and in a relationship (56.4%, 167). A historical depression diagnosis (OR = 3.15; 95% CI: 1.39–7.14) was a significant predictor of moderate to severe MDD in our study. The unemployed individuals were two times more likely to report moderate to severe symptoms of MDD than employed individuals (OR = 2.46; 95% CI: 1.06–5.67). Among the total sample population, the moderate to severe MDD prevalence was 50.4%, whereas it was 56.1% among those living in areas affected by wildfires. Conclusion: Based on our study findings, unemployment and a history of depression diagnosis were independently significant risk factors associated with the developing moderate to severe MDD symptoms during wildfire disasters. Further research is required to identify robust predictors of mental health disorders in disaster survivors and provide appropriate interventions to the most vulnerable communities and individuals. [ABSTRACT FROM AUTHOR]

Over half of all new cancer cases in Alberta are diagnosed among people aged 65+ years, a group that encompasses vast variation. Patient-reported experience measures are routinely collected within Cancer Care Alberta; however, the specific consideration of the needs and concerns of older Albertans with cancer is lacking. In 2021, 2204 adults who had received treatment at a cancer centre in Alberta completed the Ambulatory Oncology Patient Satisfaction Survey (AOPSS). In this study, we explored the age differences in satisfaction across six dimensions of person-centred care and in the proportions of unmet needs across eight types of issues, with specific attention to older adults. Using three age groups (18–39, 40–64, 65+), only the physical comfort dimension showed significantly lower satisfaction among those aged 65+ years. Using five age groups (18–39, 40–64, 65–74, 75–84, 85+), significantly lower levels of satisfaction were found related to 'physical comfort' for those aged 65–74 and 75–84, 'coordination and continuity of care' for those aged 75–84 and 85+, and 'information, communication, and education' for those aged 85+. Therefore, grouping together all older adults aged 65+ years obscured lower levels of satisfaction with some dimensions of person-centred care among those aged 75–84 and 85+ years. Unmet needs generally increased with age for all types of issues, with significant differences across age groups for emotional, financial, social/family, and sexual health issues. The lower levels of satisfaction and higher proportions of unmet needs call for tailored interventions to promote optimal care experiences and outcomes among older adults receiving cancer care in Alberta and their families. [ABSTRACT FROM AUTHOR]

Introduction: Zoonoses associated with urban wildlife are increasingly concerning for human health and include the recent emergence of alveolar echinococcosis (AE) in North America. AE develops following infection with the tapeworm Echinococcus multilocularis. In Alberta, up to 65% of urban coyotes (Canis latrans) are infected with E. multilocularis, and infected scats contain eggs that can be accidentally ingested by people. Our goal was to determine the predictors of infection prevalence and intensity in coyote scats in Edmonton, Canada, and to identify the predictors of coyote scat deposition and content, especially as related to anthropogenic food sources and infrastructure. Methods: To study infection prevalence and intensity, volunteers collected 269 scats, which were tested for E. multilocularis using polymerase chain reaction. We compared infection prevalence and shedding intensity by habitat and scat content. To determine predictors of scat presence and content, we used snow tracking to identify 1263 scats. We compared landscape characteristics at scats and available points, and among scats with different contents. We used negative binomial regression to predict scat abundance in city-delineated green spaces. Results: 26.0% of tested scats were positive for E. multilocularis (n = 70), and infection was twice as common as expected near compost and 1.3x more common than expected when scats contained anthropogenic food. Scats were more common than expected near other scats (80% within 1mof scats, 27% at 11.5 m), buildings (19% at buildings, 16% at 80 m), and the camps of people experiencing homelessness (24% at camps, 20% at 60 m). Scats frequently contained fruit (52.9%), anthropogenic material (36.7%), and birdseed (16.0%), and scats containing anthropogenic material often occurred near human infrastructure, supporting a relationship between anthropogenic attractants and scat accumulation. Discussion: These results suggest that abundant food sources and anthropogenic food increase coyote aggregation, increasing both scat abundance and infection rates, which in turn increases risk of exposure to zoonotic parasites for humans. Risk to humans might be reduced by preventing coyote access to anthropogenic and aggregated food sources and educating people who are likely to encounter infected soil or vegetation, including gardeners, park users, and people experiencing homelessness. [ABSTRACT FROM AUTHOR]

Most of the globe has experienced significant warming trends that have been attributed to anthropogenic climate change. However, these rates of warming are also influenced by short-term climate fluctuations driven by atmospheric circulation dynamics, resulting in inconsistent trend magnitudes in both time and space. This research evaluated winter (December-February) temperature trends over 1950-2020 at 91 climate stations across British Columbia (BC), Alberta (AB), and Saskatchewan (SK), Canada, and determined the components attributed to thermodynamic and dynamic (atmospheric circulation) factors. A synoptic climatological approach was used to classify atmospheric circulation patterns in the midtroposphere, relate those patterns to surface temperature, and evaluate changes in frequency. Moderate to high temperature increases over 71 years were found for most of the region, averaging 3.18C in southern SK to 4.1℃ in central-northern AB, and a maximum of 5.8℃ in northern BC. Low to moderate increases were found for southern BC, averaging 1.2℃. Changes in atmospheric circulation accounted for 29% and 31% of observed temperature changes in central-northern BC and AB, respectively. Dynamic factors were a moderate driver in southern AB (18%) and central-northern SK (13%), and low in southern SK (5%). Negative dynamic contributions in southern BC (-6%), suggest that atmospheric circulation changes counteracted thermodynamically driven temperature changes. Results were consistent with trend analyses, indicating this method is well suited for trend detection and identification of thermodynamic and dynamic drivers. Results of this research improve our understanding of the magnitude of winter temperature changes critical for informing adaptation and climate-related policy decisions. [ABSTRACT FROM AUTHOR]

Objective: The goal of this study is to understand the attitudes and beliefs towards mandatory vaccination policies in Alberta, Canada in September 2021, during the fourth wave of COVID-19. Methods: 9400 posts between 1st September and 30th September 2021 were collected from the subreddit r/Alberta with Pushshift.io. Posts and comments were manually screened to determine their relevance to research objectives, and then coded using inductive coding and iterative qualitative analysis methods. Results: Inductive coding methods yielded five key themes: 1) opinions related to autonomy and consent, 2) concerns about COVID-19 vaccine passport enforcement, 3) concerns about government, 4) concerns about the logistics of passports, and 5) opinions relating to the necessity of passports to prevent lockdowns. Conclusion: Overall, the data presented favorable opinions towards an Albertan vaccine passport within r/Alberta. Anti-vaccine and anti-mandate opinions were often less extreme than those present in the literature, although this may be due to r/Alberta subreddit moderators removing those more extreme comments. Most reservations were due to issues of bodily autonomy, though concerns about the government and logistics also played a meaningful role. [ABSTRACT FROM AUTHOR]

Increasing amounts of screen time among young children has become a growing concern. Childcare centres maybe one important setting to intervene. This study aimed to examine the prevalence of screen time and screen time policies within childcare centres as well as the association between these policies and screen time among toddlers (19–35 months) and preschoolers (36–60 months). Directors (n = 238) of childcare centres in Alberta, Canada completed a brief questionnaire. The median weekly screen time for toddlers and preschoolers was 0 min/week. However, many centres were still providing screen time (Toddlers: 22%; Preschoolers: 47%). About a third of centres did not have a written screen time policy in place. Centres with a written screen time policy and more policy topics had a lower likelihood of providing no screen time compared to centres without a policy or less policy topics. In the future, targeted interventions may be needed for centres providing undesirable amounts of screen time to children. Such interventions should consider implementing resources to support the translation of policy into practice or the translation of practice into policy. [ABSTRACT FROM AUTHOR]

Pregnant women with chronic hepatitis B (CHB) are a priority population for hepatitis B care. Identification of HBV status prior to pregnancy would facilitate timely maternal interventions and perinatal care. In our study, we aimed to study the epidemiology of CHB among women of childbearing age (WoCBA, 18-49 years) in Alberta, Canada. We retrospectively analysed Alberta Analytics databases to study CHB epidemiology, natural history and care linkage among WoCBA in Alberta, between April 2012 and March 2021. A Poisson regression was conducted to estimate incidence of newly identified CHB cases and prevalence trends, whereas predictors of care linkage were determined using logistic regression. Age/sex-adjusted incidence of newly identified CHB among WoCBA between 2015 and 2020 was 36.2/100,000 person/years, highest among individuals aged 30-39 years. Incidence of newly identified CHB decreased from 52.6 to 18.2/100,000 between 2015 and 2020, but prevalence increased from 131.7 to 248.6/100,000 in the same period. Newly identified CHB incident cases (n = 2124) had lower survival rates than age/sex-matched Canadians, with a standardized mortality ratio of 5.7 (95% CI 2.6-11.0). Increasing age (years) at diagnosis (HR, 1.2; 95% CI 1.1-1.3) was independently associated with mortality. Comorbid hepatocellular carcinoma, anti-HBV treatment and year of diagnosis were not significantly associated with mortality. Of the 1927 women with 2436 hepatitis B surface antigen-positive pregnancies from 2012 to 2020, only 27.6% had recommended HBV assessment during pregnancy. Of those women meeting criteria for antiviral therapy to prevent mother-to-child transmission (MTCT), only 66.4% received treatment. Suboptimal management during pregnancy and overall lower survival rates highlight the need to address care linkage barriers in women of childbearing age living with CHB., (© 2024 The Authors. Journal of Viral Hepatitis published by John Wiley & Sons Ltd.)

Background: Adult day programs provide critical supports to older adults and their family or friend caregivers. High-quality care in the community for as long as possible and minimizing facility-based continuing care are key priorities of older adults, their caregivers, and health care systems. While most older adults in need of care live in the community, about 10% of newly admitted care home residents have relatively low care needs that could be met in the community with the right supports. However, research on the effects of day programs is inconsistent. The methodological quality of studies is poor, and we especially lack robust, longitudinal research., Objective: Our research objectives are to (1) compare patterns of day program use (including nonuse) by province (Alberta, British Columbia, and Manitoba) and time; (2) compare characteristics of older adults by day program use pattern (including nonuse), province, and time; and (3) assess effects of day programs on attendees, compared with a propensity score-matched cohort of older nonattendees in the community., Methods: In this population-based retrospective cohort study, we will use clinical and health administrative data of older adults (65+ years of age) who received publicly funded continuing care in the community in the Canadian provinces of Alberta, British Columbia, and Manitoba between January 1, 2012, and December 31, 2024. We will compare patterns of day program use between provinces and assess changes over time. We will then compare characteristics of older adults (eg, age, sex, physical or cognitive disability, area-based deprivation indices, and caregiver availability or distress) by pattern of day program use or nonuse, province, and time. Finally, we will create a propensity score-matched comparison group of older adults in the community, who have not attended a day program. Using time-to-event models and general estimating equations, we will assess whether day program attendees compared with nonattendees enter care homes later; use emergency, acute, or primary care less frequently; experience less cognitive and physical decline; and have better mental health., Results: This will be a 3-year study (July 1, 2024, to June 30, 2027). We received ethics approvals from the relevant ethics boards. Starting on July 1, 2024, we will work with the 3 provincial health systems on data access and linkage, and we expect data analyses to start in early 2025., Conclusions: This study will generate robust Canadian evidence on the question whether day programs have positive, negative, or no effects on various older adult and caregiver outcomes. This will be a prerequisite to improving the quality of care provided to older adults in day programs, ultimately improving the quality of life of older adults and their caregivers., Trial Registration: ClinicalTrials.gov NCT06440447; https://clinicaltrials.gov/study/NCT06440447., International Registered Report Identifier (irrid): PRR1-10.2196/60896., (©Matthias Hoben, Colleen J Maxwell, Andrea Ubell, Malcolm B Doupe, Zahra Goodarzi, Saleema Allana, Ron Beleno, Whitney Berta, Jennifer Bethell, Tamara Daly, Liane Ginsburg, Atiqur SM - Rahman, Hung Nguyen, Kaitlyn Tate, Kimberlyn McGrail. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 30.08.2024.)

Background: The COVID-19 pandemic necessitated public health policies to limit human mobility and curb infection spread. Human mobility, which is often underestimated, plays a pivotal role in health outcomes, impacting both infectious and chronic diseases. Collecting precise mobility data is vital for understanding human behavior and informing public health strategies. Google's GPS-based location tracking, which is compiled in Google Mobility Reports, became the gold standard for monitoring outdoor mobility during the pandemic. However, indoor mobility remains underexplored., Objective: This study investigates in-home mobility data from ecobee's smart thermostats in Canada (February 2020 to February 2021) and compares it directly with Google's residential mobility data. By assessing the suitability of smart thermostat data, we aim to shed light on indoor mobility patterns, contributing valuable insights to public health research and strategies., Methods: Motion sensor data were acquired from the ecobee "Donate Your Data" initiative via Google's BigQuery cloud platform. Concurrently, residential mobility data were sourced from the Google Mobility Report. This study centered on 4 Canadian provinces-Ontario, Quebec, Alberta, and British Columbia-during the period from February 15, 2020, to February 14, 2021. Data processing, analysis, and visualization were conducted on the Microsoft Azure platform using Python (Python Software Foundation) and R programming languages (R Foundation for Statistical Computing). Our investigation involved assessing changes in mobility relative to the baseline in both data sets, with the strength of this relationship assessed using Pearson and Spearman correlation coefficients. We scrutinized daily, weekly, and monthly variations in mobility patterns across the data sets and performed anomaly detection for further insights., Results: The results revealed noteworthy week-to-week and month-to-month shifts in population mobility within the chosen provinces, aligning with pandemic-driven policy adjustments. Notably, the ecobee data exhibited a robust correlation with Google's data set. Examination of Google's daily patterns detected more pronounced mobility fluctuations during weekdays, a trend not mirrored in the ecobee data. Anomaly detection successfully identified substantial mobility deviations coinciding with policy modifications and cultural events., Conclusions: This study's findings illustrate the substantial influence of the Canadian stay-at-home and work-from-home policies on population mobility. This impact was discernible through both Google's out-of-house residential mobility data and ecobee's in-house smart thermostat data. As such, we deduce that smart thermostats represent a valid tool for facilitating intelligent monitoring of population mobility in response to policy-driven shifts., (©Kirti Sundar Sahu, Joel A Dubin, Shannon E Majowicz, Sam Liu, Plinio P Morita. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 20.03.2024.)

Background: Maximizing quality of life (QoL) is a major goal of care for people with dementia in nursing homes (NHs). Social determinants are critical for residents' QoL. However, similar to the United States and other countries, most Canadian NHs routinely monitor and publicly report quality of care, but not resident QoL and its social determinants. Therefore, we lack robust, quantitative studies evaluating the association of multiple intersecting social determinants with NH residents' QoL. The goal of this study is to address this critical knowledge gap., Methods: We will recruit a random sample of 80 NHs from 5 Canadian provinces (Alberta, British Columbia, Manitoba, Nova Scotia, Ontario). We will stratify facilities by urban/rural location, for-profit/not-for-profit ownership, and size (above/below median number of beds among urban versus rural facilities in each province). In video-based structured interviews with care staff, we will complete QoL assessments for each of ~ 4,320 residents, using the DEMQOL-CH, a validated, feasible tool for this purpose. We will also assess resident's social determinants of QoL, using items from validated Canadian population surveys. Health and quality of care data will come from routinely collected Resident Assessment Instrument - Minimum Data Set 2.0 records. Knowledge users (health system decision makers, Alzheimer Societies, NH managers, care staff, people with dementia and their family/friend caregivers) have been involved in the design of this study, and we will partner with them throughout the study. We will share and discuss study findings with knowledge users in web-based summits with embedded focus groups. This will provide much needed data on knowledge users' interpretations, usefulness and intended use of data on NH residents' QoL and its health and social determinants., Discussion: This large-scale, robust, quantitative study will address a major knowledge gap by assessing QoL and multiple intersecting social determinants of QoL among NH residents with dementia. We will also generate evidence on clusters of intersecting social determinants of QoL. This study will be a prerequisite for future studies to investigate in depth the mechanisms leading to QoL inequities in LTC, longitudinal studies to identify trajectories in QoL, and robust intervention studies aiming to reduce these inequities., (© 2024. The Author(s).)

Background: As part of its recreational cannabis legalization in October 2018, Canada imposed an excise tax of 10% (or $1 a gram, whichever is higher) on both recreational and medical cannabis. There is little evidence to inform the ongoing debate on whether the legalization had adverse impacts on medical cannabis use. Methods: We used an interrupted time series design and data on medical cannabis shipments (i.e., mail-order deliveries of cannabis from a licensed producer to a patient authorized to obtain medical cannabis) in Canada between quarter 1 of 2014 and quarter 1 of 2020. We examined changes in medical cannabis shipments after Canada's recreational cannabis legalization both across Canada and for each province. As this study used publicly available, province-level aggregate data, ethics approval was not required. Results: Recreational cannabis legalization was associated with significant reductions in medical cannabis use in 7 out of 10 Canadian provinces. Compared with the counterfactual estimated from prelegalization trends, the reduction in quarter 1 of 2020 varied from 500 shipments per 100,000 population (95% CI=312-688 shipments per 100,000 population) or 32% (95% CI=22-43%) in Newfoundland and Labrador to 3,778 shipments per 100,000 population (95% CI=2,972-4,585 shipments per 100,000 population) or 74% (95% CI=68-79%) in Alberta. At the national level, the number of medical cannabis shipments decreased by 823 per 100,000 population (95% CI=725-921 shipments per 100,000 population) or 48% (95% CI=45-52%). Conclusions: Recreational cannabis legalization was associated with reductions in medical cannabis use. Our findings call for policy attention to address possible adverse impacts of recreational cannabis legalization on medical cannabis users.