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With Canada becoming the first G20 country to legalize the recreational use of cannabis, there has been increasing interest in the emergence of this new marketplace. Newspaper framing helps to shape public opinion on legalization and news sources play a role in determining how the public perceives the use of cannabis. This research analyzes how mainstream newspapers reported on the legalization of recreational cannabis in Canada in the years before and after legalization (between 2016 and 2019). Using a content analysis of 1,390 cannabis-related articles, 11 dominant reporting themes are identified. Over time, there was a shift from negative and sensationalist cannabis news coverage toward more balanced and progressive framing. The findings identify the influence of editorial political stance on thematic coverage. [ABSTRACT FROM AUTHOR]

Prostate cancer is the most common malignancy and the third most common cause of death in Canadian men. In light of evolving diagnostic pathways for prostate cancer and the increased use of MRI, which now includes its use in men prior to biopsy, the Canadian Association of Radiologists established a Prostate MRI Working Group to produce a white paper to provide recommendations on establishing and maintaining a Prostate MRI Programme in the context of the Canadian healthcare system. The recommendations, which are based on available scientific evidence and/or expert consensus, are intended to maintain quality in image acquisition, interpretation, reporting and targeted biopsy to ensure optimal patient care. The paper covers technique, reporting, quality assurance and targeted biopsy considerations and includes appendices detailing suggested reporting templates, quality assessment tools and sample image acquisition protocols relevant to the Canadian healthcare context. [ABSTRACT FROM AUTHOR]

The Canadian Association of Radiologists Incidental Findings Working Group consists of both academic subspecialty and general radiologists and is tasked with adapting and expanding upon the American College of Radiology incidental findings white papers to more closely apply to Canadian practice patterns, particularly more comprehensively dealing with the role of ultrasound and pursuing more cost-effective approaches to the workup of incidental findings without compromising patient care. Presented here are the 2020 Canadian guidelines for the management of hepatobiliary incidental findings. Topics covered include initial assessment of hepatic steatosis and cirrhosis, the workup of incidental liver masses identified on ultrasound and computed tomography (with algorithms presented), incidental gallbladder findings (wall thickening, calcification, and polyps), and management of incidental biliary dilatation. [ABSTRACT FROM AUTHOR]

This paper investigates the role of admission forms in the regulation of asylum confinement in the second half of the nineteenth century. Taking the Toronto Lunatic Asylum as a case study it traces the evolution of the forms' content and structure during the first decades of this institution. Admission forms provide important material for understanding the medico-legal assessment of lunacy in a certain jurisdiction. First, they show how the description of insanity depended on a plurality of actors. Second, doctors were not necessarily required to indicate symptoms of derangement. Third, patients' relatives played a fundamental role in providing clinical information. From an historiographical perspective, this paper invites scholars to consider the function of standardized documents in shaping the written identity of patients. [ABSTRACT FROM AUTHOR]

The application of big data, radiomics, machine learning, and artificial intelligence (AI) algorithms in radiology requires access to large data sets containing personal health information. Because machine learning projects often require collaboration between different sites or data transfer to a third party, precautions are required to safeguard patient privacy. Safety measures are required to prevent inadvertent access to and transfer of identifiable information. The Canadian Association of Radiologists (CAR) is the national voice of radiology committed to promoting the highest standards in patient-centered imaging, lifelong learning, and research. The CAR has created an AI Ethical and Legal standing committee with the mandate to guide the medical imaging community in terms of best practices in data management, access to health care data, de-identification, and accountability practices. Part 1 of this article will inform CAR members on principles of de-identification, pseudonymization, encryption, direct and indirect identifiers, k-anonymization, risks of reidentification, implementations, data set release models, and validation of AI algorithms, with a view to developing appropriate standards to safeguard patient information effectively. [ABSTRACT FROM AUTHOR]

The application of big data, radiomics, machine learning, and artificial intelligence (AI) algorithms in radiology requires access to large data sets containing personal health information. Because machine learning projects often require collaboration between different sites or data transfer to a third party, precautions are required to safeguard patient privacy. Safety measures are required to prevent inadvertent access to and transfer of identifiable information. The Canadian Association of Radiologists (CAR) is the national voice of radiology committed to promoting the highest standards in patient-centered imaging, lifelong learning, and research. The CAR has created an AI Ethical and Legal standing committee with the mandate to guide the medical imaging community in terms of best practices in data management, access to health care data, de-identification, and accountability practices. Part 2 of this article will inform CAR members on the practical aspects of medical imaging de-identification, strengths and limitations of de-identification approaches, list of de-identification software and tools available, and perspectives on future directions. [ABSTRACT FROM AUTHOR]

Examines the 19th-century Canadian paper money's iconographies. Discussion on the intersection of culture, society and economy; Indepth look at the consolidation of paper monies in the 18th and 19th centuries; Analysis of the design and production of paper money; Exploration of the national and imperial monetary narratives.

Artificial intelligence (AI) software that analyzes medical images is becoming increasingly prevalent. Unlike earlier generations of AI software, which relied on expert knowledge to identify imaging features, machine learning approaches automatically learn to recognize these features. However, the promise of accurate personalized medicine can only be fulfilled with access to large quantities of medical data from patients. This data could be used for purposes such as predicting disease, diagnosis, treatment optimization, and prognostication. Radiology is positioned to lead development and implementation of AI algorithms and to manage the associated ethical and legal challenges. This white paper from the Canadian Association of Radiologists provides a framework for study of the legal and ethical issues related to AI in medical imaging, related to patient data (privacy, confidentiality, ownership, and sharing); algorithms (levels of autonomy, liability, and jurisprudence); practice (best practices and current legal framework); and finally, opportunities in AI from the perspective of a universal health care system. [ABSTRACT FROM AUTHOR]

Abstract Artificial intelligence (AI) is rapidly moving from an experimental phase to an implementation phase in many fields, including medicine. The combination of improved availability of large datasets, increasing computing power, and advances in learning algorithms has created major performance breakthroughs in the development of AI applications. In the last 5 years, AI techniques known as deep learning have delivered rapidly improving performance in image recognition, caption generation, and speech recognition. Radiology, in particular, is a prime candidate for early adoption of these techniques. It is anticipated that the implementation of AI in radiology over the next decade will significantly improve the quality, value, and depth of radiology's contribution to patient care and population health, and will revolutionize radiologists' workflows. The Canadian Association of Radiologists (CAR) is the national voice of radiology committed to promoting the highest standards in patient-centered imaging, lifelong learning, and research. The CAR has created an AI working group with the mandate to discuss and deliberate on practice, policy, and patient care issues related to the introduction and implementation of AI in imaging. This white paper provides recommendations for the CAR derived from deliberations between members of the AI working group. This white paper on AI in radiology will inform CAR members and policymakers on key terminology, educational needs of members, research and development, partnerships, potential clinical applications, implementation, structure and governance, role of radiologists, and potential impact of AI on radiology in Canada. [ABSTRACT FROM AUTHOR]

In pediatric settings, the concept of hope is frequently positioned as a fundamental aspect of care and at odds with the possibility and proximity of death. This arguably fosters silence about death and dying in childhood despite evidence indicating the benefits of open communication at the end of life. In this paper, we describe the unspeakable nature of death and dying in childhood, including its conceptual and clinical causes and dimensions, its persistence, and the associated challenges for children and youth facing critical illnesses, their families, and society. We explore how the tension between hope and death can be reframed and apply our analysis to the context of medical assistance in dying for mature minors in Canada. Considering the lack of related literature, this paper offers initial reflections to form a framework for the unspeakable nature of death and dying in childhood and to advance the crucial need for research. [ABSTRACT FROM AUTHOR]

Examines changes in the structure and practices of the Quebec paper industry union, Federation des travailleurs de papier et de la foret. Review of literature on union responses to economic restructuring in North America; Unions' bargaining structures in the Canadian pulp and paper industry; Changes in labor-management relations in pulp and paper mills.

This paper explores the knowledge and opinions of cannabis users regarding Canadian laws regulating possession of cannabis. Our study is based on data from 165 in-depth interviews with adult cannabis users from four Canadian cities. Our participants revealed a limited awareness of cannabis policy in Canada. When researchers informed them about actual Canadian laws, the majority of participants regarded the specified laws as "harsh," "excessive," "absurd" and/or "ridiculous." In practice, the common experience of participants suggests the existence of two sets of enforcement practice in Canada--"there's what's on paper and then there's what happens, out on the sidewalk." We situate our analysis of these practices in the context of broader debates regarding the putative normalization of drugs like cannabis in Canada. We conclude that greater consideration of the character of local law enforcement practices has the capacity to add further conceptual and analytical clarity to existing theories of normalization. [ABSTRACT FROM AUTHOR]

The article discusses the conclusions and recommendations from the position paper on interventional radiology (IR) in Canada. The Millennium Research Group has been commissioned to produce a position paper on IR in the country, as part of a lobbying and public relations campaign initiated by the Canadian Interventional Radiology Association. The position paper has aimed to highlight the current state of IR in the country, to identify disease and treatment trends.

This paper has been substantially revised by the Canadian Psychiatric Association's Research Committee and approved for republication by the CPA's Board of Directors on May 3, 2017. The original policy paper1 was developed by the Scientific and Research Affairs Standing Committee and approved by the Board of Directors on November 10, 2008. [ABSTRACT FROM AUTHOR]

Birthday cards are a ceremonial token that may purposefully or unintentionally transmit stereotypes about the ageing process. In the current study, the authors examined 150 age-specific paper birthday cards sold in retail outlets located in a small metropolitan area. Results suggest that a greater proportion of the cards' textual messages represented ageing in a negative manner (66.7%). Further, the negativity of these written messages did not appear to vary as a function of the intended recipient's chronological age or sex. The findings are compared to those of previous studies conducted in this area. As well, limitations and directions for future research are outlined. [ABSTRACT FROM AUTHOR]

List several papers presented at the First International Conference on the Critical and Qualitative Approaches to Health Psychology in NewFoundland on July 1999. 'Acquiring Personal Knowledge for Theory and Therapy,' by Nick Milton; Theorizing Personal Change in Health,' by Carla Willig and Angela Harden; 'Health Psychology as Agent of Change,' by David Marks.

Comments on the six papers presented at the Symposium on the Ontario Experience which represent a valuable contribution to the literature on health services research and on treatment systems. Comparison of the Ontario assessment and referral (A/R) centers for addicts to a transistor; Crucial importance of determining outcome; Flow diagrams and design document.

Discusses the efficacy of the psychotherapies in Canada. Skills needed by psychiatrists to be effective and competent; Role of psychotherapies in psychiatry; Economic impact of psychotherapy; Limitations of psychotherapy.

This article explores ordinary individuals' understandings of nationhood. In so doing, it focuses on the case of Armenian migrants from Turkey to Canada and their conceptualizations of the host country. The paper captures multiple strands of nationhood and argues that these are pertinent to different boundary-making processes. The outer boundary of nationhood is defined along inclusive and civic lines where difference is recognized and appreciated. Living with difference, on the other hand, brings to the fore the tension between recognizing it on the one hand and accommodating it on the other. The case study further reveals how the exercise of state power and individuals' encounters with the state shape their understandings of nationhood. [ABSTRACT FROM AUTHOR]

Background: Palliative care is insufficiently integrated in the continuum of care for older people. It is unclear to what extent healthcare policy for older people includes elements of palliative care and thus supports its integration. Aim: (1) To develop a reference framework for identifying palliative care contents in policy documents; (2) to determine inclusion of palliative care in public policy documents on healthcare for older people in 13 rapidly ageing countries. Design: Directed documentary analysis of public policy documents (legislation, policies/strategies, guidelines, white papers) on healthcare for older people. Using existing literature, we developed a reference framework and data extraction form assessing 10 criteria of palliative care inclusion. Country experts identified documents and extracted data. Setting: Austria, Belgium, Canada, Czech Republic, England, Japan, Mexico, Netherlands, New Zealand, Singapore, Slovenia, South Korea, Spain. Results: Of 139 identified documents, 50 met inclusion criteria. The most frequently addressed palliative care elements were coordination and continuity of care (12 countries), communication and care planning, care for family, and ethical and legal aspects (11 countries). Documents in 10 countries explicitly mentioned palliative care, nine addressed symptom management, eight mentioned end-of-life care, and five referred to existing palliative care strategies (out of nine that had them). Conclusions: Health care policies for older people need revising to include reference to end-of-life care and dying and ensure linkage to existing national or regional palliative care strategies. The strong policy focus on care coordination and continuity in policies for older people is an opportunity window for palliative care advocacy. [ABSTRACT FROM AUTHOR]

Statelessness in Canada is an emerging site of inquiry with recent investigations into its causes and consequences, focusing on legislative and policy analyses and the lived experiences of stateless persons. Yet, health care experiences generally and access to mental and physical health care in particular remain under-researched. This study attempts to bridge this gap by examining how statelessness impacts physical health, mental health, access to health care services, and overall well-being. To answer these questions, we conducted semi-structured interviews with stateless or formerly stateless persons to understand their views and experiences. The study reports on negative health outcomes in four broad areas: The limited ability of stateless persons (SPs) to access health care. Mental health challenges. The failure to treat health issues until they have reached a dangerous point and the reliance on self-care strategies. The negative impact of lack of status on four social determinants of health: employment, education, housing, and food security. From these findings, the paper makes three arguments: Legal Status is a key determinant of health and lack of status leads to negative health outcomes. SPs heavily depend upon others for their life-needs, which can lead to exploitation and encourage forms of adaptive and negotiated agency. SPs in Canada experience a physical and mental liminality [a condition of uncertainty]. The paper concludes that Canada should recognize stateless individuals either as stateless or as Canadian nationals, and should implement a context-tailored institutional response to statelessness. [ABSTRACT FROM AUTHOR]

Although women's representation in STEM fields and occupations has increased, science and math continue to be stereotyped as male domains. This paper links psychological and sociological explanations for gendered disparities in STEM by examining the relationship between the local "micro-situational" female learning environment and the gender gap in academic self-concept in math and science. We applied hybrid models to TIMSS 2015 data comprised of a pseudo-panel of repeated measures for individual student and peer achievement, academic self-concept, utility value, and interest-enjoyment value in math/science (at age 14). We analyzed data from three countries, including a subsample of students who were taught by the same teacher in both math and science, thus eliminating unobserved teacher heterogeneity. Results indicate that female peer climate in the classroom is important for understanding how girls' self-concept in math/science is formed, even though it was unrelated to the gender gap. [ABSTRACT FROM AUTHOR]

Researchers have found that many post-secondary music students suffer from physical and mental health issues. However, researchers have mainly studied these problems at the individual level, with little investigation of how music students' work is shaped by the coordinating effects of policies, texts, and discourses at and beyond their local site. This paper describes a protocol for an international project that will explore the health of music students in the context of their daily work. Using an institutional ethnography approach, we will examine the social organization of music students' work at three universities: two in Canada and one in Australia. This will be the first set of studies that use institutional ethnography specifically for the purpose of understanding how the social organization of music students' work shapes their health. Data will be collected using several methods common to institutional ethnography: interviews, focus groups, observations, and collecting texts. Data analysis will begin during the data collection process and proceed in two fluid stages. The first stage will involve a detailed investigation of the pertinent work activities at each music school. The second will involve linking that work to specific social relations within and beyond the institution. After data analysis has been completed at all three sites, findings will be compared to one another to identify commonalities and differences in how students' work is organized. Findings of the entire project may inform policy-making and lead to positive change at the institutions studied, as well as others where similar social organization may occur. The novel approach described here will provide opportunities to expand current knowledge about music students' work and health beyond what has been learned through approaches that focus on students' individual behaviours and attributes. [ABSTRACT FROM AUTHOR]

Epidemiology of mental disorders emerged in the post-1945 era at the intersections of different areas of knowledge. Given its ambitions, the Stirling County Study provides an instructive case study. It is also a good example of how the epidemiology applied methodological skills from social sciences. This paper aims, first, to reconstruct one of the first episodes in the development of psychiatric epidemiology. Its second purpose is to provide a detailed description of interdisciplinarity at work, and to examine its effects. After explaining some of the major features of the Stirling County Study, I emphasize the links between some of the first results, particularly regarding young people as a population at risk, and the job market after the Great Depression. [ABSTRACT FROM AUTHOR]

The article presents information about Canada's Green Paper on Immigration Policy. Minister of Manpower and Immigration, the Honorable Robert Andras, finally tabled the Canadian government's Green Paper on immigration policy, in the House of Commons on February 3, 1975. Canadian governments produce green papers in order to initiate a national discussion on particular issues, and white papers when they wish to make specific policy proposals, often leading to legislation. It examines the contents of Canada's Green Paper and to reflect upon the circumstances in which it was written and on the implications it may have for the future development of our immigration policy and programs. Throughout the post-war period, Canadian immigration policy has had very short-term objectives, although there has always been an underlying assumption that immigration meant population growth and that this was what Canada needed. The motivation of the Canadian government in setting up a task force-the Canadian Immigration and Population Study-in September 1973 to produce a Green Paper on immigration and population growth.

Medical Assistance in Dying (MAID) legislation has evolved rapidly in Canada with significant impacts on nursing practice. The purpose of this paper is to describe evolving complexities in legislative context and practice standards that influence the experiences nurse practitioners and registered nurses have with MAID. Qualitative interviews were conducted with 25 registered nurses and 10 nurse practitioners from diverse contexts across Canada. Participants described their practices and considerations when discussing MAID as part of advance care planning; their use of, and challenges with, waivers of consent; their practice considerations in negotiating the complexities of clients for whom death is not reasonably foreseeable; and their moral wrestling with the inclusion of MAID for persons whose sole underlying medical condition is mental illness. Findings illustrate the moral complexities inherent in the evolving legislation and the importance of robust health and social care systems to the legal and ethical implementation of MAID in Canada. [ABSTRACT FROM AUTHOR]

Summary: Drawing on historical constructions of Indigenous peoples, this paper analyses the continued impact of settler discourses of Indigenous families, parenting, and children on child welfare policy in Canada today. Findings: In this work, two provincial children's Advocate reports on the deaths of Indigenous children in care, Tina Fontaine and Alex Gervais, are critically assessed in order to explore the processes through which these colonial constructions operate to create adverse outcomes for Indigenous people. Through this analysis, a number of contemporary colonial narratives are made visible, including the belief that Indigenous parents are inherently incapable of caring for their children, and the gendered construction of Indigenous men and boys as criminal and deviant and Indigenous girls as sexually exploitable. Application: These findings suggest that greater critical reflection is needed when working with Indigenous peoples, including greater awareness of the ongoing impact of settler colonialism and the necessity of engaging in anti-colonial work. [ABSTRACT FROM AUTHOR]

There exist ongoing calls among social work scholars and practitioners to cultivate applied knowledge of critical and emancipatory practice. In this paper, I explore the utility of text-based vignettes as instruments that can be used to elicit insight from marginalized service users on critical social work practice. To do this work, I draw on data from interviews with 20 transgender and gender diverse (TGD) social service users, along with 10 social workers, whose responses to a text-based vignette were originally used to build an understanding of the constituents of equitable social work practice with TGD people. Incorporating critical pragmatism as a conceptual framework and constructivist grounded theory as a methodological orientation, I analyze data from this study as an exemplar that substantiates the promise of using text-based vignettes in qualitative social work research to generate knowledge of critical social work practice. Specifically, I demonstrate how text-based vignettes in this study (1) contextualized the meaning, significance, and impact of oppression for service users, (2) built insight on practice that reflects solidarity and allyship, and (3) identified opportunities for social workers' reflexive use of professional power to effect change. Accounting for the tensions between empiricism and critical praxis in social work, I consider the promise of incorporating text-based vignettes to develop empirical social work literature that is rooted in the voices of marginalized service users. [ABSTRACT FROM AUTHOR]

Background: The gender disparity in surgical disciplines, specifically in speakers across North American medical and surgical specialty conferences, has been highlighted in recent literature. Improving gender diversity at society meetings and panels may provide many benefits. Our aim was to determine the state of gender diversity amongst presenters and speakers at the annual Canadian Society of Otolaryngology-Head and Neck Surgery (CSO) meetings. Methods: Scientific programs for the CSO annual meetings from 2008 to 2020 were obtained from the national society website. Participant name, role, gender, location, and subspecialty topic were recorded for all roles other than poster presenter. Gender (male or female) was determined using an online search. The total number of opportunity spots and proportion of women was then calculated. Gender differences were analyzed using chi-square test and logistic regression with odds ratios. Four categories were analyzed: Society Leadership, Invited Speaker Opportunities, Workshop Composition (male-only panels or "manels", female-only panels, or with at least one female speaker), and Oral Paper Presenters (first authors). Results: There were 1874 leadership opportunity spots from 2008 to 2020, of which 18.6% were filled by women. Among elected leadership positions in the society, only 92 unique women filled 738 leadership opportunity spots. 13.2% of workshop chairs, 20.8% of panelists and 22.7% of paper session chairs were female. There was an overall increase in the proportion of leadership positions held by women, from 13.9% of leadership spots in 2008 to 30.1% in 2020. Of the 368 workshops, 61.1% were led by men only, 36.4% by at least 1 female surgeon, and 2.5% by women only. "Manels" have comprised at least 37.5% of workshops each year. Conclusions: The proportion of women in speaking roles at the annual CSO meetings has generally increased over time, particularly among panelists, leading to fewer male-only speaking panels. However, there has been a slower rate of growth in the proportion of unique women in speaker roles. There remains an opportunity to increase gender/sex diversity at the major Canadian otolaryngology meeting. [ABSTRACT FROM AUTHOR]

Canada's Trans Mountain Expansion Pipeline project is one of the country's most controversial in recent history. At the heart of the controversy lie questions about how to conduct impact assessments (IAs) of oil spills in marine and coastal ecosystems. This paper offers an analysis of two such IAs: one carried out by Canada through its National Energy Board and the other by Tsleil-Waututh Nation, whose unceded ancestral territory encompasses the last twenty-eight kilometers of the project's terminus in the Burrard Inlet, British Columbia. The comparison is informed by a science and technology studies approach to coproduction, displaying the close relationship between IA law and applied scientific practice on both sides of the dispute. By attending to differing perspectives on concepts central to IA such as significance and mitigation, this case study illustrates how coproduction supports legal pluralism's attention to diverse forms of world making inherent in IA. We close by reflecting on how such attention is relevant to Canada's ongoing commitments, including those under the UN Declaration on the Rights of Indigenous Peoples. [ABSTRACT FROM AUTHOR]

Background: Chronic rhinosinusitis with nasal polyposis (CRSwNP) often coexists with lower airway disease. With the overlap between upper and lower airway disease, optimal management of the upper airways is undertaken in conjunction with that of the lower airways. Biologic therapy with targeted activity within the Type 2 inflammatory pathway can improve the clinical signs and symptoms of both upper and lower airway diseases. Knowledge gaps nevertheless exist in how best to approach patient care as a whole. There have been sixteen randomized, double-blind, placebo-controlled trails performed for CRSwNP targeted components of the Type 2 inflammatory pathway, notably interleukin (IL)-4, IL-5 and IL-13, IL- 5R, IL-33, and immunoglobulin (Ig)E. This white paper considers the perspectives of experts in various disciplines such as rhinology, allergy, and respirology across Canada, all of whom have unique and valuable insights to contribute on how to best approach patients with upper airway disease from a multidisciplinary perspective. Methods: A Delphi Method process was utilized involving three rounds of questionnaires in which the first two were completed individually online and the third was discussed on a virtual platform with all the panelists. A national multidisciplinary expert panel of 34 certified specialists was created, composed of 16 rhinologists, 7 allergists, and 11 respirologists who evaluated the 20 original statements on a scale of 1–9 and provided comments. All ratings were quantitively reviewed by mean, median, mode, range, standard deviation and inter-rater reliability. Consensus was defined by relative interrater reliability measures—kappa coefficient (κ ) value > 0.61. Results: After three rounds, a total of 22 statements achieved consensus. This white paper only contains the final agreed upon statements and clear rationale and support for the statements regarding the use of biologics in patients with upper airway disease. Conclusion: This white paper provides guidance to Canadian physicians on the use of biologic therapy for the management of upper airway disease from a multidisciplinary perspective, but the medical and surgical regimen should ultimately be individualized to the patient. As more biologics become available and additional trials are published we will provide updated versions of this white paper every few years. [ABSTRACT FROM AUTHOR]

The Protocol of Amendment to the Agreement between the United States of America, Canada and the United Mexican States erased many of the TRIPS-plus provisions inserted earlier into the Canada- United States of America-Mexico Agreement (hereafter, CUSMA) signed on 30 November 2018. While the erasure of the provisions shows the contributions made to promote access to medicines, the Agreement still retains TRIPS-plus provisions, including the provisions on patent term extensions. Thus seen, irrespective of the changes introduced by the Protocol of Amendment, patent term extensions may have a negative implication on access to cost-cutting medicines (biosimilars and generics). Against this backdrop, this paper focuses on patent term extensions, as contained in the CUSMA's Intellectual Property Rights (IPRs) chapter. The paper investigates if & how the patent term extension has the potential to impede access to affordable medicines (biologics and chemically synthesized medicines). In so doing, the paper provides possible responses to the question, do the provisions on patent term extensions hinder the timely access to affordable medicines? As such, the first part of the paper succinctly looks at CUSMA. Section "Patent protection under the TRIPS agreement" examines the TRIPS patent regime. While "The CUSMA's rules on patent term extension" section discusses the nature of obligations included in the CUSMA's IPRs chapter, the Section "The CUSMA's rules on patent term extension vis-à-vis access to medicines" analyzes the potential implications of patent term extensions on access to affordable medicines. The final section concludes the paper. [ABSTRACT FROM AUTHOR]

Background: Play is an important part of the childhood. The learning potential of playing and creating non-digital games, like tabletop games, however, has not been fully explored. Aim: The study discussed in this paper identified a range of activities through which learners redesigned a mathematics-oriented tabletop game to develop their ideas and competencies in an integrated STEM (science, technology, engineering, and mathematics) class. Method: Third and fourth graders worked as teams to make changes on Triominos over a period of six weeks. Considering what could be changed from the original game, each group provided a different design for Triominos to accommodate the changes introduced. We gathered data through weekly observations of two classes (about 45 learners, ranging from age eight to ten) in a west-Canada school. In this paper, we present the works of three groups of three teammates. Results: We found that any change made by learners not only influenced mechanics, dynamics, and aesthetics of the game but also helped engage learners, encourage unconventional ideas, promote learning, and solve problems. Based on our findings, we suggest redesigning games facilitated learners deepen their understanding of mathematical concepts as part of a designed game system in STEM classes. [ABSTRACT FROM AUTHOR]

This paper is an examination of the methodological and theoretical perspectives of a study with an inquiry focus on the experiences and perspectives of staff who worked at an injectable opiate assisted (iOAT) clinic. Twenty-two staff members, including nurses, social workers, and peer support workers, were interviewed. The goal of the study was to uncover how the clinic staff provided care to the clients who attend the clinic, their perspectives on how the clinic program impacted both them and their clients, and their experiences with the program itself. This interpretive descriptive study was underpinned by critical social theory. Thematic analysis was undertaken to identify recurring, converging, and contradictory patterns of interaction, key concepts and emerging themes. In this paper we examine and discuss how the relationship between critical social theory and interpretive description enhanced the study. Examples from the study are presented to provide insight into the relationship. [ABSTRACT FROM AUTHOR]

Recent efforts within geography to deconstruct anthropocentric readings of the urban and explore the city as 'multispecies' or 'more-than-human' face substantial methodological challenges. This paper contributes an empirical case study of human-coyote urban cohabitations in the Greater Toronto Area, Canada, using a 'hybrid' methodological approach to individual animal geographies. It builds on dialogues surrounding animals' geographies that centre individual animal lifeworlds and experiences, exploring coyotes as subjects and actors who participate in the co-creation of shared urban worlds. A methodological approach based on collaboration and storying recounts the tales of two coyotes – Urban10 and Blondie – and their kin whose stories are gleaned by weaving together diverse social and ecological research tools, including: participant observation with Coyote Watch Canada, document review, semi-structured interviews, GPS collar data, field investigations, ethological observations, and trail cameras. The discussion details implications in terms of cynanthropy – 'becoming-canid' as methodology, delving into coyote lifeworlds using hybrid tools – as well as synanthropy – coyote synurbization and more-than-human urban belongings. Dwelling with Urban10 and Blondie in cynanthropic exploration makes visible opportunities for multispecies researchers to generate knowledge collaboratively with other-than-humans. Findings surrounding synanthropy highlight the practices involved in adapting to and participating, ecologically and socially, in life in the multispecies city. Overall, this paper advances efforts aimed at developing innovative and experimental hybrid methodologies for animal geographies, and theoretical discussions around re-storying the more-than-human city towards livable multispecies futures. [ABSTRACT FROM AUTHOR]

Healthcare services in many countries have been partially or completely disrupted by the Coronavirus (COVID-19) pandemic since its onset in the end of 2019. Amongst the most impacted are the elective medical and surgical services in order to conserve resources to care for COVID-19 patients. As the number of infected patients decrease across Canada, elective surgeries are being restarted in a staged manner. Since Otolaryngologists – Head & Neck Surgeons manage surgical diseases of the upper aerodigestive tract where the highest viral load reside, it is imperative that these surgeries resume in a safe manner. The aim of this document is to compile the current best evidence available and provide expert consensus on the safe restart of rhinologic and skull base surgeries while discussing the pre-operative, intra-operative, and post-operative care and tips. Risk assessment, patient selection, case triage, and pre-operative COVID-19 testing will be analyzed and discussed. These guidelines will also consider the optimal use of personal protective equipment for specific cases, general and specific operative room precautions, and practical tips of intra-operative maneuvers to optimize patient and provider safety. Given that the literature surrounding COVID-19 is rapidly evolving, these recommendations will serve to start our specialty back into elective rhinologic surgeries over the next months and they may change as we learn more about this disease. [ABSTRACT FROM AUTHOR]

Provides guidelines for clinical care related to the practice of psychotherapies. Reflection on the clinical experiences of Canadian psychiatrists; Differentiation between psychiatric management and formal psychotherapies; Ethical guidelines for psychotherapies; Factors for effective therapeutic bond between the patient and the psychiatrist.

Background: The purpose of this paper is to provide a preliminary evaluation of treatment outcomes, retention and client satisfaction following a 12-week combined cognitive behavioural therapy (CBT) and motivational enhancement therapy (MET) group treatment for cannabis use disorder (CUD) delivered in an outpatient setting. Implementation of the program is also described. Methods: A retrospective observational cohort study was conducted using data collected from medical records and self-report assessments. Participants were treatment-seeking cannabis users at the Centre for Addiction and Mental Health, Toronto. Cannabis use, cannabis-related problems, craving, withdrawal symptoms, self-efficacy for remaining abstinent, depression and anxiety were assessed pre- and post-treatment. Treatment retention was calculated by inspecting clinic attendance records, and client satisfaction was evaluated using an anonymous feedback survey. Potential predictors of treatment outcomes and retention were investigated in exploratory analyses. Results: Cannabis use was lower and days of abstinence higher post-treatment (vs pre-treatment). Post-treatment improvements in cannabis-related problems, craving, withdrawal symptoms, self-efficacy and mood were also observed. Completion of group treatment (⩾75% of sessions attended) was 57% and moderate levels of treatment satisfaction were reported. Conclusions: This study provides preliminary evidence that a 12-week combined CBT and MET treatment for cannabis use disorder delivered in a novel group setting improves cannabis use outcomes. Potential predictors of reduced cannabis use and retention were identified. Future controlled studies are warranted, and strategies for increasing retention should be explored. [ABSTRACT FROM AUTHOR]

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Planning often tries to shape human behavior for public benefit. Planning also seeks to implement broad constructs, like livability and sustainability. In response to both tasks, qualitative explanatory research can help build crucial understanding. Still, qualitative approaches are often underused and undertheorized due to misconceptions about their resource and time-demands. This paper explores how rapid ethnography, already used in health and other disciplines, could help planning researchers improve their understanding of human behavior and of broad constructs. It then illustrates the methodology through a case study exploring performances of authentic community at an arts festival in Victoria, BC, Canada. [ABSTRACT FROM AUTHOR]

The novel Coronavirus (COVID-19) has created a worldwide deadly pandemic that has become a major public health challenge. All semi-urgent and elective medical care has come to a halt to conserve capacity to care for patients during this pandemic. As the numbers of COVID-19 cases decrease across Canada, our healthcare system also began to reopen various facilities and medical offices. The aim for this document is to compile the current evidence and provide expert consensus on the safe return to clinic practice in Otolaryngology – Head & Neck Surgery. These recommendations will also summarize general precaution principles and practical tips for office across Canada to optimize patient and provider safety. Risk assessment and patient selection are crucial to minimizing exposure to COVID-19. Controversial topics such as COVID-19 mode of transmission, duration of exposure, personal protective equipment, and aerosol-generating procedures will be analyzed and discussed. Practical solutions of pre-visit office preparation, front office and examination room set-up, and check out procedures are explored. Specific considerations for audiology, pediatric population, and high risk AGMPs are also addressed. Given that the literature surrounding COVID-19 is rapidly evolving, these guidelines will serve to start our specialty back into practice over the next weeks to months and they may change as we learn more about this disease. [ABSTRACT FROM AUTHOR]

Despite the prevalence of professional sport in contemporary societies, there is little known by academics about professional sports consumers. We know much more about other cultural domains, such as music and the arts. This study examines consumption and sport in Canada to further understand how patterns of sports consumption fit into broader leisure lifestyles. Through investigation of how five professional sports leagues in Canada are consumed, this paper draws conclusions about the lifestyle of these consumers to assess which prevailing theories of cultural consumption are most useful for this segment. By utilising latent class analysis and regression modelling, this paper finds that cultural omnivores are the most likely consumers of these leagues. This group also maps onto theorisations of omnivores as high-status persons. Additionally, this paper suggests that theories of cosmopolitanism in omnivorous consumption may have particular salience for the Canadian case. [ABSTRACT FROM AUTHOR]

This paper qualitatively examines "privation of inclusion" at work in the lived experiences of racialized participants hired in publicly funded places of employment. Taking the position that the dualistic inclusion-exclusion paradigm fails to capture their lived realities with inclusive exclusions and exclusive inclusions, it presents privative inclusion as a third space, between inclusion and exclusion, for a more robust framework in understanding how racialized bodies were marked and targeted for differential treatment. The paper then outlines and discusses findings as key indicators of privative mechanisms that had undermined life chances by limiting career mobility of racialized participants of this study. It concludes by emphasizing the need for additional research in this area given the salience of racism at work as well as the demographic changes that Canada is currently experiencing. [ABSTRACT FROM AUTHOR]

Background: Recent evidence suggests that biologic therapy with targeted activity within the Type 2 inflammatory pathway can improve the clinical signs and symptoms of chronic rhinosinusitis with nasal polyposis (CRSwNP). There remains a population in CRSwNP that despite medical therapy and endoscopic sinus surgery have persistent signs and symptoms of disease. Therefore, biologics, monoclonal antibody agents, could be beneficial therapeutic treatments for these patients. There have been eight randomized, double-blind, placebo-controlled trails performed for CRSwNP targeted components of the Type 2 inflammatory pathway, notably interleukin (IL)-4, IL-5 and IL-13, IL-5R, IL-33, and immunoglobulin (Ig)E. However, there are no formal recommendations for the optimal use of biologics in managing Chronic Rhinosinusitis (CRS) within the Canadian health care environment. Methods: A Delphi Method process was utilized involving three rounds of questionnaires in which the first two were completed individually online and the third was discussed on a virtual platform with all the panelists. 17 fellowship trained rhinologists across Canada evaluated the 28 original statements on a scale of 1–10 and provided comments. A rating within 1–3 indicated disagreement, 8–10 demonstrated agreement and 4–7 represented being neutral towards a statement. All ratings were quantitively reviewed by mean, median, mode, range and standard deviation. Consensus was defined by removing the highest and lowest of the scores and using the "3 point relaxed system". Results: After three rounds, a total of 11 statements achieved consensus. This white paper only contains the final agreed upon statements and clear rationale and support for the statements regarding the use of biologics in patients with CRS. Conclusion: This white paper provides guidance to Canadian physicians on the use of biologic therapy for the management of patients with CRS, but the medical and surgical regimen should ultimately be individualized to the patient. As more biologics become available and additional trials are published we will provide updated versions of this white paper every few years. [ABSTRACT FROM AUTHOR]

As uses of plasma-derived medical products increase globally, so does the demand to collect plasma from donors. There is evidence that positive interactions with center staff motivate plasma donors to return. This paper reports on a focused ethnography investigating experiences of nurses and phlebotomists in one of Canadian Blood Services' first source plasma collection center during the COVID-19 pandemic. Participants found the transition from whole blood collection to source plasma amid a global pandemic challenging, but they adapted by coming together as a team, and then worked to put the donor experience first. Their experience resonates with scholarship on emotional labor. As blood services worldwide attempt to increase source plasma collection, there is a need to understand care work that nurses and phlebotomists perform on the front-line. This study offers insight into how blood services can support staff in plasma operations by recognizing emotional labor. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. 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.)

The ethic of care is a moral philosophy that has been used to describe and guide the work of educators, especially those working with students with special education needs (SEN). In this study, 36 principals and vice principals from four provinces in Canada were interviewed about their work with students with SEN during the pandemic. Responses were analyzed using the ethic of care framework. Accordingly, responses indicated that principals were particularly aware of, and responsive towards, the wide range of need experienced by students, their families, and school staff. Principals appeared especially concerned about the social needs of their students with SEN, the emotional support needs of the students' families, and the teachers' distress at not being able to meet all the educational needs of their students. Although most principals described the emotional toll of their work during the pandemic, none identified efforts directed towards self-care. This paper considers these findings in regard to motivational displacement as it relates to an ethic of care and calls for a broader consideration of need within education, such that support is extended to students, school staff and school leaders as the most effective means to foster healthy, future-ready schools. Key words: pandemic, principal, inclusive education, ethic of care, mental health. [ABSTRACT FROM AUTHOR]

Photovoice is an emerging qualitative research method used to engage community members in research that highlights their lived experiences and initiate change. Photovoice offers potential benefits to research conducted by and with Indigenous communities through privileging Indigenous knowledge and perspectives. There is a lack of synthesized evidence about the usage, benefits, and challenges of conducting Photovoice research by and with Indigenous communities, which this systematic methods review aims to address. We specifically focus on Indigenous young people in Canada, Australia, Aotearoa New Zealand, and the United States. Five databases were searched systematically for articles including keywords for 'Indigenous' and 'Photovoice'. Empirical studies and methods papers reporting the use of Photovoice with majority cohorts of young Indigenous participants were included. Relevant data were extracted and Photovoice methods analysed using an integrative approach. Database searches yielded 1402 articles, with 109 reviewed in full and 41 included in the review. These articles represented 37 unique studies, with most from Canada (n = 17), and the United States (n = 14). Our analysis revealed great variability in how Photovoice has been applied across studies with Indigenous young people. However, some notable commonalities include recruitment of participants via community networks, and participant involvement in data collection and analysis. The potential benefits associated with using Photovoice with Indigenous young people included: fostering participant autonomy and authority; photography being familiar and fun; the visual medium being culturally appropriate for Indigenous peoples; and the method being effective for engaging the whole community. Challenges associated with Photovoice included: engagement difficulties between researchers and participants; issues with photography; and ethical complexities. These findings suggest that Photovoice is an appropriate and largely effective method to engage young Indigenous people in research. However, there are logistical and ethical issues associated with the method that require careful consideration. [ABSTRACT FROM AUTHOR]