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Extensive research exists on the potential impacts of foresight; however, a comprehensive understanding of the factors that lead to foresight impact, particularly in influencing senior management decisions, is relatively sparse. This study addresses this by reporting on a Delphi and expert panel involving eight senior Canadian government foresight program leaders. These leaders were asked to help identify and then rate a list of factors that they felt resulted in their foresight projects impacting senior management decisions. Results suggested that factors such as foresight methodology, while leading to good foresight, do not necessarily result in senior decision-maker impact. Instead, criteria defined in this paper as the "consultants' toolkit," such as understanding the senior decision maker's pain points and foresight managers having a strong understanding of the organization's inner workings, play a crucial role. The expert panel discussion suggested that the importance of senior management decision-making factors depends on three mediating variables: The temporal orientation of the Department, the foresight orientation of the department's senior management, and the nature of the relationship between the foresight manager and the senior decision maker. • Paper identifies factors that lead to senior management accepting and implementing the results and recommendations of foresight projects. • A two round Delphi and expert panel was held as part of this study with eight senior Canadian government foresight program leaders • Managers identified factors that relate more to a consultant tool kit than foresight methodology that results in decision impact foresight. • A contingency model is presented with three elements which the impact factors importance • The paper highlights the importance of research partnerships that include both academics and practitioners [ABSTRACT FROM AUTHOR]

Abstract: This paper draws on an analysis of migration from a coastal community in Atlantic Canada through the fisheries crisis of the last decade. Despite a persistent rhetoric of crisis and decline, the community remains difficult to leave for many young people. This paper examines the dimensions of this difficulty and the way that formal education sets up expectations for outmigration but few supports to families who have multi-generational linkages to local communities. Ironically the very discourse of crisis that is meant to propel youth out of the community may end up playing into a parallel discourse that has long predicted the collapse of urban economic and social structures. This in turn generates and propels a survivalism that inflects educational decision-making in ways that create deeply ambivalent and problematic conceptions of place and mobility for rural youth. This discourse in turn complicates simplistic neoliberal notions of educational choice. [Copyright &y& Elsevier]

Abstract: High quality agricultural land is extremely scarce in the province of British Columbia, Canada. As a consequence of this scarcity and development pressure, the provincial government established a province-wide land preservation scheme – the agricultural land reserve – in 1973. The principal focus of the paper is an examination of the consequences of recent changes to the reserve''s enabling legislation. One of the changes is of particular importance: the Commission which manages the reserve is now explicitly required to consider community needs within the over-arching objective of land preservation. An important question immediately presents itself: how will the Commission balance the two conflicting objectives? An outline for a land evaluation and site assessment (LESA) framework is presented which – if adopted – would ensure that the Commission''s land use decisions reflected a range of concerns; including, the agricultural value of the parcels of land being considered for removal from the reserve, the likely impact of the removal of a parcel on the agricultural value of nearby parcels, the impact that development of a parcel removed from the reserve would have on environmental, recreational and open space amenities, the social, cultural and heritage effects stemming from the removal of a parcel, and community needs. The paper also addresses the likelihood of government support for the implementation of a LESA framework. [Copyright &y& Elsevier]

Abstract: Watersheds are under increasing stress from the cumulative environmental effects of water and land use disturbances caused by both anthropogenic and natural causes. Yet, while the science of watershed cumulative effects assessment and management (CEAM) is advancing much less is known about the institutional and capacity requirements to implement and sustain watershed CEAM. Based on lessons from a transboundary watershed in western Canada this paper presents eight institutional requirements, or requisites, for the implementation of watershed-based CEAM. We suggest that effective watershed CEAM requires government leadership to move beyond the current inward focus on project approvals toward an outward focus on the cumulative effects of all disturbances in a watershed; complementary monitoring programs at the project and watershed scale, and a means to ensure the sharing of monitoring data across watershed stakeholders; and a nested planning framework to coordinate watershed planning objectives with individual project impact assessment and decision making. Results of this paper show that simply scaling up from individual project-based assessments to the watershed scale exposes many institutional constraints that can impede CEAM action. [Copyright &y& Elsevier]

Abstract A comparison of a Norwegian and two Canadian management plans reveals that most of the measures in the Norwegian plan were put into practice, whereas the Canadian plans did not result in the implementation of any new measures. This paper applies implementation theory to explain the different results. First, there is a striking difference in the leadership of the two governments and the way they organized for the planning. The Norwegian government led the process in a top-down manner and tried to apply a "whole-of-government" approach. The Canadian government delegated the entire task to the regional branches of one ministry alone. The different roles taken may be explained by different political and economic contexts that create different motivations for the governments to engage. Second, there were different ways of deciding when conflicts arose. The Norwegian coalition government negotiated internal compromises in the form of package deals. In Canada, the collaborative planning based on consensus concealed disagreements in high-level statements and pushed concrete solutions forward to later action planning that never occurred. These processes reflect different national policy styles and resulted in policy designs that created a very different impetus for implementation. The analysis demonstrate how theory-driven case-study methodology can lead to cumulative results. Highlights • The measures in a Norwegian plan have mostly been implemented, whereas two Canadian plans did not lead to any implementation. • Top-down political leadership with cross-sectoral coordination and support of planning were important success criteria. • Delegation of planning without solving governance issues, defining deliverables, dead-lines and ensuring support, created problems. • Conflicts were not solved in consensus-based collaborative planning, but were when the government decided. • As opposed to expectations from prior conclusions, a policy-driven approach delivered better results than a legally based. [ABSTRACT FROM AUTHOR]

In 2015, the Government of Canada committed to protecting 5% of marine and coastal areas by 2017, and 10% by 2020. While admirable progress towards this target has been made, less attention has been given to improving the quality of protection afforded to marine areas. Extensive scientific study supports that several factors are critical to the success of Marine Protected Areas (MPAs) for marine biodiversity conservation and management objectives, including no-take areas and prohibitions on extractive and industrial activities. However, the majority of Canada's MPAs allow extractive uses within their boundaries. As Canada works toward international and national commitments to marine protection targets, it is critical to consider the degree of protection afforded by the legal designations used to create these areas. This paper reviews the current inconsistent standards of protection across marine protected areas (MPAs) designated under the Oceans Act , Canada's flagship legislation for marine protection. Recommended amendments to the law include standards of protection that would exclude all extractive industrial activities from MPAs in order to better guide the designation and decision-making processes for marine protection. [ABSTRACT FROM AUTHOR]

Abstract: This paper reports on a qualitative study examining everyday practices of healthy living (HL). Forty-four semi-structured interviews were undertaken with Canadian and UK citizens, aged 45 – 70, in April–May 2010. The research sits within the now substantial literature concerned with how health information is mediated, both by people and technologies, and employed in the context of ‘good’ health citizenship. Throughout this work, notions of ‘choice’ and ‘empowerment’ have been interrogated, theoretically and empirically, to reveal both the knowledge/power relationships integral to ‘informing’ processes and the shifting relationship between information and care in contemporary health encounters. In this paper, we analyse how people make sense of what it means to live healthily and how they know if they are doing so by focussing on three ways in which study participants become informed about healthy living: through their engagement with universal HL messages, through their own information searches, and through their attempts to measure their ‘healthiness’. Following critique of the “logic of choice” in contemporary healthcare, we understand healthy living as a “situation of choice” where complex problems are framed as simple matters of choice and where information and technologies are understood as neutral aids to decision-making in support of ‘correct’ choices. Our analysis builds on and extends Mol’s work by exploring how participants negotiate between this “logic of choice” and her alternative “logic of care” in their accounts of everyday HL informing practices and how the two logics “interfere” with one another. These accounts show resistance to the logic of choice through ‘calls for care’ but they also show clearly how the disciplining logic of choice works to (re)present such calls for care as failed attempts at healthy living, undermining the very practices the logic of choice seeks to encourage. [Copyright &y& Elsevier]

Objectives: To identify what factors affect women's' decisions to delay childbearing, and to explore women's' experiences and their perceptions of associated risks. Design: Systematic procedures were used for search strategy, study selection, data extraction and analysis. Findings were synthesised using an approach developed from meta-ethnography. Data sources: We included qualitative papers, not confined to geographical area (1980–2009). Databases included CINAHL, MEDLINE, EMBASE, PsycInfo, ASSIA, MIDIRS, British Nursing Index and the National Research Register. We selected qualitative empirical studies exploring the views and experiences of women of advanced maternal age who were childless or primigravidae with a singleton pregnancy or primiparous. Review methods: Twelve papers fulfilled the selection criteria and were included for synthesis. Results: Women appear to face an issue of ‘informed and uninformed decision making’; those who believe they are informed but may not be, those who are not informed and find out they are at risk once pregnant, and those who are well informed but choose to delay pregnancy anyway. Maternity services could provide information to enable informed choice regarding timing of childbearing. Conclusions: Health professionals need to be mindful of the fact that women delay childbearing for various reasons. A strategy of pre-conception education may be beneficial in informing childbearing decisions. Obstetricians and midwives should be sensitive to the fact that women may not be aware of all the risks associated with delayed childbearing. [Copyright &y& Elsevier]

Abstract: This paper addresses three questions: What is the extent of clinical guideline utilization by decision-makers in provincial health ministries, regional health authorities and hospitals in Canada? Are there differences between these work settings in regard to the extent of clinical guideline utilization? What are the determinants of clinical guidelines utilization in health ministries, regional health authorities and hospitals? Based on a survey of 899 decision-makers from Canadian provincial health ministries, regional health authorities and hospitals, the results indicate that there are large differences between work settings in regard to clinical guideline utilization. Not surprisingly, work settings like hospitals rely more intensively on clinical guidelines than the other work settings (health ministries or agencies and regional health authorities). The results of the regression models indicate that cognitive factors, social factors, technological factors, organizational factors and individual attributes significantly predict the utilization of clinical practice guidelines by decision-makers. However, the results of the regression models also indicate that some factors that predict clinical guideline utilization by decision-makers in hospitals do not predict clinical guidelines utilization by decision-makers working in ministries or in regional health authorities. Therefore, these results suggest that customized interventions would be appropriate in order to efficiently increase the utilization of clinical practice guidelines in different work settings. The paper concludes with suggestions for future research. [Copyright &y& Elsevier]

The decision to substantiate child maltreatment is one of the many complex decisions workers must make daily. Utilizing data from the Ontario Incidence study 2013, this paper examines what child, family and environmental characteristics workers paid attention to when making the determination that a child had experienced maltreatment. This study adds to the Canadian body of research on factors that influence the decision to substantiate maltreatment by exploring the Ontario population. Caregiver risk factors, uncooperative parents, older children, and children with emotional or mental health concerns all increase the likelihood of substantiation. The decision to substantiate current maltreatment was strongly influenced by the workers' assessment of the future risk of maltreatment. Further research is need to explore worker and organizational factors that also influence this risk focus and how much of an influence the current risk assessment tools have on the workers' assessment of future risk and substantiation. [ABSTRACT FROM AUTHOR]

Copyright of Environmental Impact Assessment Review is the property of Elsevier B.V. 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.)

Increasingly, Indigenous Peoples are being re-empowered to make decisions about whether to approve development on their lands. But how these decisions are made has received little attention in the literature. Oftentimes, referenda or the solicitation of individual preferences through surveys may be used as input into the acceptability of proposed development. However, the focus on individuals does not necessarily incorporate how community members perceive the collective benefits associated with these land use decisions, nor recognize the collective deliberation procedures employed by many of these cultures. Drawing on the results from a choice experiment with two Canadian First Nations groups, this paper examines whether communication in a group-setting influences individual preferences for three land use alternatives: Industrial Development , Tourism Promotion, and Conservation & Restoration . These alternatives had different economic and environmental attributes, expressed at more individual and collective levels. While respondents preferred land use alternatives that generated higher compensation and jobs, they preferred Conservation & Restoration activities over Tourism Promotion and Industrial Development ranked last. Introducing communication in a group context led to a change in individual preferences, where respondents switched their votes from the other two alternatives to Tourism Promotion . The results offer important insight into the role of ‘collective reflection’ in research methods to assess Indigenous Peoples land use preferences, and for the design of nascent processes for Free, Prior and Informed Consent (FPIC). [ABSTRACT FROM AUTHOR]

The nature of unpaid caregiving is changing significantly in response to the changing nature of families, increased average life expectancy, and the rise in elderly populations. In order to adapt to these challenges, there is an increased focus on the workplace as a source of support for caregiver-employees (CEs), or employees providing unpaid care to a family member or friend while also working in paid employment. As demonstrated by Ireson et al. (2016), a number of workplaces in Canada and abroad are currently showing leadership with respect to the provision of caregiver-friendly workplace policies (CFWPs). The purpose of this study was to explore what is currently being offered to caregiver-employees by Canadian and international workplaces, as well as how these strategies have been defined, developed, introduced, integrated and sustained within the workplace. For the purposes of this study, CEs are defined as individuals engaged in paid employment, while simultaneously serving as an unpaid elder-care provider. To achieve the aims of this paper, a qualitative comparative case study of 21 workplaces was conducted. Participants were recruited via strategies such as snowball sampling, cold-calling and social media blasts. These workplaces, which operate as exemplars in meeting the needs of caregiver-employees, are pivotal to understanding the process which takes place in the implementation and success of CFWPs across various sectors/industries. The results of this study will be used to inform the wide gap in our knowledge about CFWPs while providing the evidence needed to workplaces and other organizations to introduce CFWPs into their employment practices. [ABSTRACT FROM AUTHOR]

Collaborative approaches are increasingly being used by governments in western countries to address complex environmental policy problems. These approaches often bring together diverse actors in settings that allow for joint problem solving. However, the effectiveness of collaboration can be undermined if governments choose to ignore the outcomes of collaboration in their decision making processes. In this paper we report findings from a study of a drought-based collaborative process. We evaluate the extent to which the provincial government in Ontario, Canada, used recommendations from collaborative groups in its Low Water Response program. Interviews, document analysis and personal observations provided the data for a qualitative, multi-case study analysis. Three cases were chosen where collaborative teams made decisions designed to balance ecological and economic water issues during drought. The Institutional Analysis and Development framework provided a conceptual foundation for evaluating the extent to which collaborative outcomes were used by government. Even though the provincial government did not accept the most important decision made by collaborative teams (to declare severe drought), participants were generally satisfied with outcomes achieved through collaboration, especially social and environmental outcomes. Challenges revealed through the study included insufficient capacity, lack of clear program requirements, and issues inherent with low water. [ABSTRACT FROM AUTHOR]

Rationale Living with a chronic illness poses many challenges, especially during the adolescent stage of development. Few studies have explored young people’s experiences of talking about their illness and how they go about deciding if and when they should tell others about their condition. Objective Our study sought the perspectives of Canadian children and adolescents living with inflammatory bowel disease (IBD) to determine how they go about deciding if and when to tell others about their illness. Methods Twenty-five participants with IBD, ranging in age from 10 to 17 years old, were interviewed about their experiences. Results Our participants highlighted that they generally preferred to conceal their illness. However, when they did disclose, they drew on a diverse range of contextual factors such as their knowledge of the illness as well as the severity of their illness, to make the decision. They also highlighted that one of the main challenges they experience is dealing with negative reactions to the news of their illness. This paper presents a decision-making model describing how children decide whether to disclose or conceal their IBD. Conclusion Our study illustrates that for children and adolescents, managing others’ knowledge about their illness has important implications for illness identity management. We argue that knowledge of how children with IBD make disclosure decisions is an important part of understanding the social experience of having IBD, and in creating environments that allow them to adapt to life with IBD. Our study clearly highlights the need for specific programs to be implemented to normalize IBD and to create supportive environments for children and adolescents diagnosed with IBD. [ABSTRACT FROM AUTHOR]

Non-invasive prenatal testing (NIPT) using cell-free DNA (cfDNA) offers numerous benefits to pregnant women and their families. It also raises ethical, legal and social concerns regarding, for instance, the possible effects of a routinization of prenatal genetic testing on free and informed decision-making by prospective parents, and the role of the state in governing its use. Technological advances are allowing cfDNA analyses to detect an increasing number of genetic risks and conditions in the fetus, potentially further exacerbating such concerns. From May 2015 to December 2016, we conducted a three-round Policy Delphi study (N R1 = 61, N R2 = 58, N R3 = 47; overall retention rate = 77.0%) to explore the social acceptability (SA) of current and potential future uses of NIPT in Canada according to participants with relevant professional, research or advocacy expertise. Participants came from four groups: healthcare professionals (N R3 = 14), social sciences and humanities researchers (N R3 = 13), patients/disability rights advocates (N R3 = 14), and cultural/religious communities advocates (N R3 = 6). This paper presents SA criteria and contextual contingencies relevant to the assessment of NIPT's SA according to the group. It also reports what uses (conditions or motives) participants thought should be banned, permitted, publicly funded, or promoted as a public health strategy. According to them, conditions resulting in severe pain or early death, as well as trisomies (13, 18, 21) and sex chromosome abnormalities, should be covered by Canadian public health insurance. However, there was wide agreement that direct-to-consumer NIPT should be legally banned, and that testing for fetal sex for non-medical reasons using NIPT should be either proscribed or discouraged. In addition to identifying areas of consensus, our results point to disagreement regarding, for instance, the required level of governance of whole-genome sequencing and testing for late onset conditions with low penetrance. This study also provides a model for exploring the SA of emerging technologies using the Policy Delphi method. • NIPT's social acceptability in Canada is explored using a three-round Delphi method. • Social acceptability is associated with 12 criteria of variable relevance. • Social acceptability depends on conditions tested, governance decisions and context. • Salient ethical tensions between reproductive autonomy and regulation are discussed. • A four-dimension model is proposed to explore social acceptability with experts. [ABSTRACT FROM AUTHOR]

The governance framework for wild-capture fisheries varies widely across the world, but most frameworks generate and use science advice in decision-making, developed with some level of peer-review. The Canadian Science Advisory Secretariat (CSAS) oversees the peer-review process of science related to the management of Canada's fisheries and oceans; the resultant publications with science advice are the main source of scientific evidence used in decision-making in Canada's fisheries. The CSAS has a publicly available policy intended to ensure transparency and timely dissemination of publications that is currently under review. To examine the effectiveness of the existing policy, inform its revision and development of similar policies in other jurisdictions, this paper evaluates the timeliness of the publication of scientific information to support the management of Canada's fisheries and oceans from recent CSAS meetings against current policy deadlines. It was found that from 2017 to 2019, implementation of the policy was poor, with most documents published late, if at all. Furthermore, the science advice considered most during fisheries management decision-making was often not publicly available until after the decision was made and communicated. Despite having a policy to promote transparency, public engagement in policy and decision-making is being limited and a common understanding of the science evidence underlying advice inhibited. Transparency, which is becoming a cornerstone principle in modern fisheries management, is being compromised in Canadian fisheries management. [ABSTRACT FROM AUTHOR]

Abstract: Canada''s Arctic environment is rich in hydrocarbon resources. As international attention turns to the Arctic to meet global energy demands there is increased recognition of the need to advance upstream impact assessment and decision-making to plan for energy development. There have been several applications of strategic environmental assessment (SEA) over the past decade in the international offshore energy sector; however, SEA remains underdeveloped offshore in comparison to project-based environmental impact assessment and unchartered territory in Canada''s Arctic. This paper examines stakeholder perceptions of the opportunities and risks of advancing SEA for offshore energy planning and development in Canada''s Beaufort Sea. Results indicate a number of perceived opportunities for SEA, including improved regulatory efficiency, better regional baselines and planning practices, an opportunity to assess cumulative effects, more meaningful project-based assessment, and greater certainty for industry stakeholders. At the same time there are a number of perceived risks, including foregoing anticipated development opportunities, the loss of flexibility in decision making, adding another layer of bureaucracy, and the added uncertainties of a novel approach. The implications of these findings for advancing SEA in the offshore energy sector are discussed. [Copyright &y& Elsevier]

Abstract: Environment Canada currently assesses dredged material proposed for disposal at sea using a two-tiered assessment framework. Tier 1 determines sediment geophysical properties and concentrations of four regulated chemical constituents (Cd, Hg, PAH and PCB), and “other chemicals of interest” based on lower action levels; this is followed by biological assessment. EC is pursuing a “data mining” approach to evaluate potential refinements by compiling sediment chemistry and toxicity datasets, and subjecting them to a series of decision protocols. This paper reports on database development and initial use, and recommends potential changes to Tier 1 chemical protocols and further work to address other aspects of the framework. Major findings include the poor performance of Hg and Cd as sentinels for other metals, the significance of the list of analytes (vs. the specific SQGs used) in decisions, and the potential for chemical upper action levels to save the expense of unnecessary toxicity testing. [Copyright &y& Elsevier]

Abstract: Abstract: Strategic environmental assessment (SEA) for offshore oil and gas planning and development is utilized in select international jurisdictions, but the sector has received limited attention in the SEA literature. While the potential benefits of and rationale for SEA are well argued, there have been few empirical studies of SEA processes for the offshore sector. Hence, little is known about the efficacy of SEA offshore, in particular its influence on planning and development decisions. This paper examines SEA practice and influence in three international offshore systems: Norway, Atlantic Canada and the United Kingdom, with the intent to identify the challenges, lessons and opportunities for advancing SEA in offshore planning and impact assessment. Results demonstrate that SEA can help inform and improve the efficacy and efficiency of project-based assessment in the offshore sector, however weak coordination between higher and lower tiers limit SEA''s ability to influence planning and development decisions in a broad regional environmental and socioeconomic context. [Copyright &y& Elsevier]

Abstract: The Environmental Health Research Division (EHRD) of the First Nations and Inuit Health Branch, Health Canada conducts science-based activities and research with Canadian Indigenous communities in areas such as climate change adaptation, environmental contaminants, water quality, biomonitoring, risk assessment, health impact assessment, and food safety and nutrition. EHRD''s research activities have been specifically designed to not only inform Health Canada''s policy decision-makers but as well, Indigenous community decision-makers. This paper will discuss the reasons why Indigenous community engagement is important, what are some of the barriers preventing community engagement; and the efforts by EHRD to carry out community-based participatory research activities with Indigenous peoples. [Copyright &y& Elsevier]

Abstract: The complexity of emerging issues in science, technology, and medicine calls for new strategies to deal with risk and uncertainty. This paper explores the production of medical isotopes in Canada as an illustration of complex issues requiring decision support. It proposes a four-feature strategy for policy makers. Tightly but inversely connected, risks generated by either the production or non-production of medical isotopes are multidimensional and located on both the demand (healthy citizens and their well-being) and supply (safety of production) sides. The decision making also involves multidisciplinary considerations. Another feature of the process is the geographic scale. Production goes beyond domestic needs as global society depends on medical isotopes and must rely on very few producers. Finally, time scale adds to the complexity of the strategy, as developing technology alternatives on both the supply and demand sides requires a long-term perspective. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Ärztliche Fortbildung und Qualität im Gesundheitswesen is the property of Elsevier GmbH, Urban & Fischer Verlag 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.)

Abstract: In this paper we argue in favour of using a decision analysis framework for more integrated decision-making when managing protected areas. Such an approach will enable agencies to balance between the frequently conflicting goals of visitor management and ecological integrity. We present a case study from the West Coast Trail in Pacific Rim National Park Reserve, BC, Canada, in which we use a hybrid of ELECTRE and AHP to establish a ranking of several management options. We conclude by suggesting that such a more formal framework constitutes a more objective decision support tool, assists in framing relevant management questions and tradeoffs, and at the same time provides guidance for data collection. [Copyright &y& Elsevier]

Abstract: Around 25% of practicing physicians in Canada are graduates of medical schools outside of Canada. These physicians are more likely to be working in rural communities, and in particular account for more than half of new physicians starting practice in rural regions. The extent to which particular health regions and provinces are able to retain their physicians is crucial if shortages in the delivery of physician and surgeon services in both the short and longer terms are to be avoided. In this paper, we use data from the confidential master files of the Canadian Census over the years 1991–2006 to study the geographic mobility of immigrant and non-immigrant physicians who are already resident in Canada. We consider both inter- and intra-provincial migration, with a particular focus on migration to and from rural areas of Canada. We exploit the fact that it is possible to link individuals within families in the Census files in order to investigate the impact on the migration decision of the characteristics of a married physician’s spouse. Our results indicate that the magnitude of outflows is substantial and that the retention of immigrant physicians in rural areas and in some provinces will continue to be difficult. We find strong evidence that migration is a family decision, and spousal characteristics (education, age, years in Canada for immigrants) are important. As well, we find that large Canadian cities (mainly in Ontario) are the likely destination for the types of immigrant physicians typically able to be recruited to other areas, implying recruitment efforts of smaller provinces may have significant implications for the size of health care costs in larger provinces. [Copyright &y& Elsevier]

Abstract: Water management decisions in regulated rivers are associated with uncertainty and complexity. For example, quantitative approaches for estimating immediate and long-term impacts of high flow events on fish populations have not sufficiently been addressed in the literature despite the institutional motivation for doing so. In this paper, a probabilistic model for estimating the long-term fish population recovery, given flood induced fish and egg losses, is developed. A framework that incorporates this model for estimating flood impacts in the form of risk-based performance measures of fish population is also presented. The performance measures are operational indicators that account for uncertainty in fish population response to high flow events. They include vulnerability, engineering resilience, and ecological resilience, as well as a modification of these measures introduced herein, which is equivalent to vulnerability multiplied by expected recovery time. Such measures characterize both short- and long-term fisheries impacts of water management decisions, and may be useful in planning, design, and real-time operation of reservoirs, and in participatory water use planning projects, along with other risk measures (e.g., life safety and economical risks). Applicability of the fish population recovery model and the estimated risk-based performance measures is explored for the case study of the Lower Campbell River in British Columbia, Canada. [Copyright &y& Elsevier]

Abstract: We describe a decision support system that has been developed to inform management and planning in a portion of the St. Lawrence Estuary in Canada (covering the Saguenay-St. Lawrence Marine Park and the proposed St. Lawrence Estuary Marine Protected Area). The system is composed of a spatiotemporal, georeferenced database, a simulator (3MTSim) that reproduces the spatiotemporal movement of marine mammals and maritime traffic in the estuary, and data post-processing tools that can be used to analyse the output of 3MTSim. 3MTSim allows users to test different management scenarios for maritime traffic (e.g., area closures, speed limits, regulations concerning the observation of marine mammals) in order to assess their effects on navigational patterns which may influence marine mammal exposure to vessels. 3MTSim includes an individual-based model of marine mammal movement patterns that has been elaborated based on existing telemetry data on fin, blue, and beluga whales as well as on land-based theodolite tracking of humpback and minke whales. Observations recorded aboard research and whale-watching vessels have provided the spatial data necessary to estimate species’ abundances and distribution maps that are used to initialise the whale model. Different types of vessels, including cargo ships and commercial whale-watching boats are also modelled individually, using an agent-based approach. The boat model represents the decision-making process of boat captains as a function of environmental conditions, the contextual setting, and their respective goals. An extensive database of real-time tracking data available for the different types of vessels, coupled with observations and interviews, has served in the elaboration of the boat model. In this paper, an overview of the entire system is presented and its effectiveness as a decision support tool is demonstrated via the results from a sample of scenario-based simulations. [Copyright &y& Elsevier]

Abstract: Attempts to evaluate public consultations, participatory technology assessment, and deliberative democracy have typically considered impacts on either policy or participants. The determination of impacts on policy institutions has been limited due to the challenges of tracing effects through the policy process, or penetrating bureaucratic walls. This paper presents findings from a retrospective study exploring the institutional lessons learned from a 2001 Canadian national public consultation on xenotransplantation. The consultation was conducted through an arm’s-length process and involved the use of citizen juries in six regional sites. We conducted in-depth interviews of regulatory and policy actors who were engaged in early policy discussions and the consultation process. We reviewed evaluations of this process, both internal and external, which gave us richer insights into what institutional actors saw as the impacts of this consultative experience on their policy environment. Participants in our research identified a broader shift toward openness in policy culture which they linked specifically to the innovative consultation process employed for xenotransplantation. We argue that beyond input into policy decisions, a consultation may have an impact in terms of its contribution to overall shifts in institutional culture (related to institutional learning), such as an “opening” of technological decision processes to a broader range of actors, knowledge, and values. [Copyright &y& Elsevier]

Objective: This paper examined the relative influence of clinical and organizational characteristics on the decision to place a child in out-of-home care at the conclusion of a child maltreatment investigation. It tested the hypothesis that extraneous factors, specifically, organizational characteristics, impact the decision to place a child in out-of-home care. A secondary aim was to identify possible decision making influences related to disparities in placement decisions tied to Aboriginal children. Research suggests that the Aboriginal status of the child and structural risk factors affecting the family, such as poverty and poor housing, substantially account for this overrepresentation. Methods: The decision to place a child in out-of-home care was examined using data from the Canadian Incidence Study of Reported Child Abuse and Neglect. This child welfare dataset collected information about the results of nearly 5,000 child maltreatment investigations as well as a description of the characteristics of the workers and organization responsible for conducting those investigations. Multi-level statistical models were developed using MPlus software, which can accommodate dichotomous outcome variables, which are more reflective of decision making in child welfare. Mplus allows the specific case of the logistic link function for binary outcome variables under maximum likelihood estimation. Results: Final models revealed the importance of the number of Aboriginal reports to an organization as a key second level predictor of the placement decision. It is the only second level factor that remains in the final model. This finding was very stable when tested over several different levels of proportionate caseload representation ranging from greater than 50% to 20% of the caseload. Conclusions: Disparities among Aboriginal children in child welfare decision making were identified at the agency level. Practice implications: The study provides additional evidence supporting the possibility that one source of overrepresentation of Aboriginal children in the Canadian foster care system is a lack of appropriate resources at the agency or community level. [Copyright &y& Elsevier]

Abstract: The Discrete Choice Experiment (DCE) has become increasingly popular as a method for eliciting patient or population preferences. If DCE estimates are to inform health policy, it is crucial that the answers they provide are valid. Convergent validity is tested in this paper by comparing the results of a DCE exercise with the answers obtained from direct, open-ended questions. The two methods are compared in terms of preferred attribute levels and willingness to pay (WTP) values. Face-to-face interviews were held with 292 women in Calgary, Canada. Similar values were found between the two methods with respect to preferred levels for two out of three of the attributes examined. The DCE predicted less well for levels outside the range than for levels inside the range reaffirming the importance of extensive piloting to ensure appropriate level range in DCEs. The mean WTP derived from the open-ended question was substantially lower than the mean derived from the DCE. However, the two sets of willingness to pay estimates were consistent with each other in that individuals who were willing to pay more in the open-ended question were also willing to pay more in the DCE. The difference in mean WTP values between the two approaches (direct versus DCE) demonstrates the importance of continuing research into the different biases present across elicitation methods. [Copyright &y& Elsevier]

Abstract: Compensation for losses of non-market values experienced by aboriginal peoples, due to adverse impacts on their land or resource base caused by others, is an important issue for law and social justice. Yet the standard methods of economic valuation as a basis for determining compensation are not always suited to addressing the diverse values of aboriginal people. This paper discusses an approach to valuation that employs concepts and methods of decision analysis, informed by behavioral decision research, in an applied context. It uses a multi-attribute value assessment as a basis for characterizing the relative significance of resource damages that affect deeply held, complex, intangible values. We draw on the experience of conducting analyses for three Metis settlements in Alberta, Canada, to illustrate the approach using a case study. Interpretations of the results as a basis for negotiation regarding compensation are examined. [Copyright &y& Elsevier]

• The main considerations in stormwater infrastructure management are discussed. • A model is developed to investigate sustainable funding strategies. • Stormwater fee-based funding strategy is explored for Canadian municipalities. Most cities in Canada do not charge a stormwater fee; consequently, stormwater programs may need to compete with other funding priorities in public works. This often leads to a lack of dedicated and predictable cash flow, which can limit municipalities' capacity to sustain stormwater services. In such situations, it is useful to identify available revenue sources and expected expenditures, so that sustainable funding strategies can be determined. In this paper, we explore a novel system dynamics model to investigate sustainable funding strategies. The model consists of a qualitative assessment that uses causal loop diagrams to provide a conceptual system representation and a mathematical formulation for a quantitative assessment. The model is used to explore the potential of introducing stormwater fees in the city of Vernon, Canada. It is shown that the model is helpful in strategic asset management decision making, and can be used to build arguments for implementing proactive asset management programs. [ABSTRACT FROM AUTHOR]

Occupant behavior in residential buildings has a direct impact on the effectiveness of energy-saving measures. In order to realize a buildings' carbon mitigation targets, the impact of individual occupancy profiles needs to be integrated with building simulation models. This paper introduces a decision support framework as a potential solution to make energy performance upgrade choices based on different occupancy profiles. This framework has been demonstrated through a case study of two single-family detached homes in Canada, which were highly instrumented with sensors for monitoring energy input and output. The case studies represented two common occupancy profiles-(1) a family of four (consisting of 2 working adults and 2 teenagers); and (2) a retired couple. Firstly, calibrated energy models were developed by using one-year energy use data collected through an intrusive load monitoring technique. Secondly, energy upgrade combinations were considered for each profile and tested for additional investment, payback period and greenhouse gas (GHG) emissions. Lastly, the most suitable combination of energy upgrade for each profile was ranked using a multi-criteria decision-making method (e.g., TOPSIS). Results indicated that the retired couple used more energy than the family of four and required energy upgrades with usually higher payback periods to achieve the same level of GHG emission reduction. The results of this research are timely for energy policymaking and developing best management practices, which need to be implemented along with the deployment of more stringent building standards and codes. • A scenario-based framework was developed for residential homes energy upgrades. • It considers occupant behavior and preference in selecting energy upgrades. • Field data is used to represent energy use of a family of four and a stay-at-home retired couple. • Energy upgrades are same under pro-economic choices for two profiles. • Energy upgrades vary under pro-environmental scenarios for two profiles. [ABSTRACT FROM AUTHOR]

• Majority of the approaches developed to improve the performance of CDN utilize the CDN utility as a key metric to evaluate their effectiveness. • CDN utility does not take into account the utilization of CDN resources. • CDN utilization has a direct impact on the energy consumption of CDN resources and can be utilized as a tool to implement energy-aware policies in CDN environment. • Hence, CDN utilization should be considered as an important metric to evaluate the performance of CDN policy. The exponential increase in the Internet of Things (IoT) has drastically augmented the need for computing and storage resources. IoT devices generate massive data that requires to be efficiently stored and disseminated for further processing and decision making. Given this, Content Distribution Networks (CDN) play a vital role to store and serve contents through geographically distributed surrogate servers in an IoT environment. Thanks to the explosive rise in IoT devices, CDN installations are also significantly increasing, hence, consuming a substantial amount of energy. The dynamic energy consumption of CDN resources is proportional to their utilization. Therefore, it is very crucial to design and develop utilization aware policies and strategies for sustainable content distribution. In the literature, different approaches have been proposed to improve the CDN performance by improving CDN utility in terms of security, authentication, and confidentiality, etc. Whereas, these works largely neglect the efficient utilization of CDN resources. In this perspective, this paper investigates the fact that CDN utility does not reflect the utilization of CDN resources. For this purpose, a comprehensive analysis is performed by comparing both metrics - CDN utility and CDN utilization, under various CDN scenarios. The results show that CDN utilization exhibits lower values even if the CDN utility is showing promising results. Hence, we recommend to consider utilization as a major metric to evaluate the performance of a CDN policy. [ABSTRACT FROM AUTHOR]