Search

Inuit living in the northern region of Nunavik continue to experience significant health inequalities, which are rooted in colonialism that still have repercussions on their health-related perceptions and practices, including vaccination. This study aimed to explore the perceptions and determinants of routine vaccination among the Inuit of Nunavik by describing factors influencing vaccination decisions from the perspective of community members and health professionals. Semi-structured interviews focusing on the perception of vaccination and experience with vaccination and health services were conducted with 18 Inuit and 11 non-Inuit health professionals. Using the socio-ecological model, factors acting at the community and public policy (e.g. rumours and misinformation about vaccination, language barrier), organisational (e.g. complexity of the vaccination process, staff turnover, lack of specialised vaccination workers and interpreters), and intrapersonal and interpersonal (e.g. past experiences with vaccination, vaccine attitudes, social norms) levels were identified as having an impact on vaccination decisions. Improving vaccination coverage in Nunavik requires a more global reflection on how to improve and culturally adapt the health care and services offered to the Inuit population. [ABSTRACT FROM AUTHOR]

Globally, self-employed people were among the hardest hit by the repercussions of the COVID-19 pandemic and faced hardships such as financial decline, restrictions, and business closures. A plethora of financial support measures were rolled out worldwide to support them, but there is a lack of research looking at the effect of the policy measures on self-employed people. To understand how different governmental financial support measures enhanced the resilience of the self-employed and improved their ability to manage the pandemic, we conducted a mixed-method study using policy analysis and semi-structured interviews. The documents described policies addressing governmental financial support in Sweden and Canada during the pandemic, and the interviews were conducted with Swedish and Canadian self-employed people to explore how they experienced the support measures in relation to their resilience. The key results were that self-employed people in both countries who were unable to telework were less resilient during the pandemic due to financial problems, restrictions, and lockdowns. The interviews revealed that many self-employed people in hard-hit industries were dissatisfied with the support measures and found them to be unfairly distributed. In addition, the self-employed people experiencing difficulties running their businesses reported reduced well-being, negatively affecting their business survival. [ABSTRACT FROM AUTHOR]

The performance of constant false alarm rate (CFAR) detectors is often severely degraded in clutter edge and under multiple target interference. CFAR detection in the above environments often uses generalised likelihood ratio method or mean ratio method to find out the clutter edge demarcation line and suppress the sharp increase of false alarm rate, or remove the interference and modify the threshold factor to suppress the interference and improve the detection performance, but this sacrifices the detection gain from the number of clutter samples. In this paper, the feature information is fused to construct feature vectors, and the edge location is judged by the modulus of the cross product of the feature vector pair (MCPFVP), this edge demarcation line detection method fusing with features can be implemented without the need of clutter statistical distribution information. In addition, this paper reconstructs the sea clutter masked by multiple target interference by fusing the sea clutter amplitude correlation information, and these reconstructed sea clutter samples are used for power estimation together with the unmasked sea clutter without changing the threshold factor. This method can not only suppress the target masking effect of multiple target interference as the censoring type CFAR detector, but also maintain the detection gain from the number of clutter samples, which is not possible with the traditional censoring type CFAR detector. In addition, the relative weighted ratio summation (RWRS) is proposed to detect the multiple target interference, which takes into account the asymmetry of the shape of the statistical distribution. Both simulated and real sea clutter data are used to validate the above methods. The measured data are obtained from radar data collected at Yantai Yangma Island, China, Darmouth, Canada and Grimsby, Canada. (The latter two datasets are collected by the IPIX radar - Ice Multiparameter Imaging X-Band Radar). [ABSTRACT FROM AUTHOR]

This paper investigates the relationships among the important process parameters that impact Post-combustion Carbon Capture (PCC) carbon dioxide (C O 2) separation. A better understanding of the complex relationships among those parameters can support optimization and performance enhancement of the separation process. Being able to precisely predict the process parameters will enable the operator to determine the current state of the process, forecast any potential changes or events, and adjust process parameters to enhance the plant's performance. With the objective of studying the process parameters' correlations in the amine-based PCC process, we modeled the multi-year historical production data of the Clean Energy Technologies Research Institute (CETRi) (formerly known as the International Test Center for PCC or ITC) in Regina, Saskatchewan, Canada, using a Decision Forest approach. The model validation process revealed that the Decision Forest model produced higher predictive accuracy than previous efforts. The Decision Forest models we developed also represent knowledge about the importance of parameters involved in the capture process, and such knowledge is useful for further optimization of the capture process in the future. • Modeling the parameters of the Carbon Capture process with machine learning (ML). • The ML models used Decision Forest with Gradient Boosting and Oblique Split. • The ML models achieved superior predictive accuracy compared to past efforts. • The ML models support interpretability by visualizing weights and prediction paths. [ABSTRACT FROM AUTHOR]

Geothermal systems installed at intermediate depths (∼1–2 km) in sedimentary basins represent an attractive option to provide low-carbon heat in cold countries, even where the geothermal gradient is low, using either closed- or open loop systems combined with heat pumps. However, the installation of such systems is costly and risky due to the uncertainty associated with the geological, hydrogeological and thermal properties of the targeted unit(s). Additionally, the performance of different types of systems is seldom compared in the literature for a given geological context. This paper presents a numerical approach to readily assess the maximum energy that could be produced by different geothermal systems (a deep borehole heat exchanger (DBHE) and three types of doublets) and compare their performance for preselection purposes. Since deep formations are often poorly characterized, the sensitivity of these systems to the most impactful site properties is evaluated. For each scenario of site properties, the systems were simulated for different operation flow rates. The maximum usable flow rate is determined from simulation results. The flow rate maximizing net energy production is used for the DBHE, while the maximum flow rate ensuring safe injection pressure has been selected for the doublets. The heating power produced per length drilled and system COP are calculated for each simulation and interpolated for the maximum usable flow rate to fairly compare the systems' performance. An illustrative case using the Bécancour area (eastern Canada) highlights that, even if the site stratigraphy and properties have been relatively well characterized previously, uncertainty regarding key properties significantly affects simulation results and, consequently, the choice of the geothermal system to install. Our numerical approach is intended as a decision-making aid in order to properly plan the installation of these expensive systems. [Display omitted] • New method for pre-selecting 1–2 km geothermal systems and assess heating potential. • Compares the DBHE and geothermal doublet performances for various designs. • Includes a sensitivity analysis to permeability, thermal conductivity and heat flux. • Determines the maximum usable flow rate for each system and scenario. • An application demonstrates the need to consider the uncertainty of rock properties. [ABSTRACT FROM AUTHOR]

The pulp and paper industry use biomass residues, such as paper sludge and bark as fuel to provide energy for their plants. However, issues such as high-water content or low heating value limit the amount of energy that can be utilized. Processes to improve heat generation include biomass densification, which facilitates transportation and handling and can increase energy yield. However, the technical feasibility of briquetting is a function of the feedstock and preprocessing. This study introduces a novel approach to briquette production from biomass residues by utilizing wet biomass with water as a natural binder, contrasting with conventional methods that require forced drying and/or the addition of binders. The objective of this research was to investigate the impact of briquetting both unprocessed biomass and post-hydrothermal carbonization. The study focused on manufacturing briquettes derived from different sources, including bark (Balsam fir), paper sludge, and hydrochar of paper sludge. The feedstock was characterized for ash content and higher heating value. Biomass particle size (range), moisture content (range), process temperature (range), process pressure (range), and process residence time (range) were varied in briquetting experiments to determine conditions to produce high-quality briquettes with minimal energy input. Moisture content as high a 50 wt% in feedstock produced technically feasible briquettes, with appropriate physical-mechanical properties (durability, volumetric expansion and apparent density), and energetic potential (calorific value). The addition of heat (pressing temperature of 150 °C) during the pressing process resulted in briquettes with enhanced physical-mechanical, and energetic properties, surpassing those produced at room temperature. Further tests with additional steps in the production process are required to meet commercialization standards in Canada, but the treatments conducted in this study effectively improved the energy potential of biomass for internal industrial energy gains. • Wet briquettes (20 wt% and 50 wt%) production was technically feasible. • Briquettes with added heat (150 °C) exhibited superior properties. • All biomass briquettes exhibited improved energy potential. • Hydrochar briquettes showed superior energy content and durability. [ABSTRACT FROM AUTHOR]

Research has reported inconsistent findings with respect to how female and male police officers use force. This study examined this issue in a Canadian context. Use of force data over 9 years were collected from a large Canadian police agency. The results demonstrated that, overall, female officers used force less frequently than male officers relative to the number of female and male officers within the participating police agency. Female officers had lower odds of using physical control "hard" options (e.g., stuns and strikes) and higher odds of using intermediate weapons (e.g., conducted energy weapon) compared with male officers. Female officers also generally reported less effectiveness, more injuries to themselves, and fewer injuries to subjects related to their use of force compared with male officers. Literature on police use of force and social role theory are used to help explain the findings, and recommendations for improving outcomes in police–public interactions are suggested. [ABSTRACT FROM AUTHOR]

This Special Section explores the interplay between Indigenous peoples, industry, and the state in five proposed and active mining projects in Canada and Sweden. The overall aim is to identify factors shaping the quality of Indigenous community-industry-state interactions in mining and mine development. An ambition underlying the research is to develop knowledge to help manage mining related land-use conflicts in Sweden by drawing on Canadian comparisons and experience. This paper synthesizes the comparative research that has been conducted across jurisdictions in three Canadian provinces and Sweden. It focuses on the interplay between the properties of the governance system, the quality of interaction and governance outcomes. We combine institutional and interactive governance theory and use the concept of governability to assess how and why specific outcomes, such as mutually beneficial interaction, collaboration, or opposition, occurred. The analysis suggests there are measures that can be taken by the Swedish Government to improve the governability of mining related issues, by developing alternative, and more effective, avenues to recognize, and protect, Sámi rights and culture, to broaden the scope and increase the legitimacy and transparency of the EIAs, to raise the quality of interaction and consultation, and to develop tools to actively stimulate and support collaboration and partnerships on equal terms. Generally, we argue that Indigenous community responses to mining must be understood within a larger framework of Indigenous self-determination, in particular the communities' own assessments of their opportunities to achieve their long-term objectives using alternative governing modes and types of interactions. [ABSTRACT FROM AUTHOR]

Background: Improving equity and early access to palliative care for underserved populations in Canada is a priority. Little is known regarding access to palliative and end-of-life care in the Black population. Methods: We undertook a scoping review using the framework by Arksey and O'Malley to identify knowledge, access gaps, and experiences of palliative and end-of-life care among Blacks living with life-limiting illnesses in Canada. Primary studies, discussion papers, books, and reports were considered eligible. We followed a comprehensive search strategy developed by an information scientist. Searches were performed in the following bibliographic databases: Medline, EMBASE, PsycINFO via OVID, CINAHL via EBSCOhost, Scopus and Cochrane Library via Wiley. The search strategy was derived from three main concepts: (1) Black people; (2) Canada and Canadian provinces; (3) Palliative, hospice, or end-of-life care. No publication date or language limits were applied. Titles and abstracts were screened for eligibility by one reviewer and full text by two independent reviewers. Results: The search yielded 233 articles. Nineteen articles were selected for full-text review, and 7 articles met the inclusion criteria. These studies were published between 2010 and 2021, and conducted in the provinces of Ontario and Nova Scotia only. Studies used both quantitative and qualitative methods and included cancer decedents, next of kin, family caregivers and religious leaders. Sample sizes in various studies ranged from 6 − 2,606 participants. Included studies reported a general lack of understanding about palliative and end-of-life care, positive and negative experiences, and limited access to palliative and end-of-life care for Blacks, across all care settings. Conclusion: Findings suggest limited knowledge of palliative care and inequities in access to palliative and end-of-life care for Blacks living with life-limiting illnesses in 2 Canadian provinces. There is an urgent need for research to inform tailored and culturally acceptable strategies to improve understanding and access to palliative care and end-of-life care among Blacks in Canada. [ABSTRACT FROM AUTHOR]

Introduction: In response to several high-profile cases of senior leaders in the Canadian Armed Forces (CAF) being accused of various forms of sexual and professional misconduct, the organization has committed to culture change. Drawing on the group engagement model and empirical evidence, we propose that CAFmembers' experience of thwarted belongingness reduces their capacity to show empathy, which in turn affects their support for culture change. Method: Participants were 139 Naval and Officer Cadets from the Royal Military College of Canada who were predominantly male (61%), between 18 and 21 years old (80%), and not members of a visible minority group (68%). Data was collected via an online self-report survey assessing thwarted belongingness, empathy, and attitudes toward culture change. Results: Whether participants experienced thwarted belongingness was not directly related to their level of support for culture change. Individuals' thwarted belongingness was indirectly and negatively associated with support for culture change, through its impact on empathy. Discussion: Taken together, the results demonstrate that cadets' experience of belongingness contributed to their level of empathy, which together predicted their support for culture change initiatives. Efforts to change the culture of the CAF may need to consider improving members' levels of belongingness and, by extension, their levels of empathy. Implications for inclusion efforts are discussed. [ABSTRACT FROM AUTHOR]

This paper aims to introduce a novel family of probability distributions by the well-known method of the T–X family of distributions. The proposed family is called a "Novel Generalized Exponent Power X Family" of distributions. A three-parameters special sub-model of the proposed method is derived and named a "Novel Generalized Exponent Power Weibull" distribution (NGEP-Wei for short). For the proposed family, some statistical properties are derived including the hazard rate function, moments, moment generating function, order statistics, residual life, and reverse residual life. The well-known method of estimation, the maximum likelihood estimation method is used for estimating the model parameters. Besides, a comprehensive Monte Carlo simulation study is conducted to assess the efficacy of this estimation method. Finally, the model selection criterion such as Akaike information criterion (AINC), the correct information criterion (CINC), the Bayesian information criterion (BINC), the Hannan–Quinn information criterion (HQINC), the Cramer–von-Misses (CRMI), and the ANDA (Anderson–Darling) are used for comparison purpose. The comparison of the NGEP-Wei with other rival distributions is made by Two COVID-19 data sets. In terms of performance, we show that the proposed method outperforms the other competing methods included in this study. [ABSTRACT FROM AUTHOR]

Greenhouse gases (GHGs) can be produced from a broad range of anthropogenic activities at different spatial and temporal scales. In particular, emissions from urban area are an import source of GHGs. City is a complicated system consisting of various component and processes. Efforts have been made to reduce urban GHG emissions. However, there is a lack of available methods for effective assessment of such emissions. Many urban sources and factors which can influence the emissions are still unknown. In the present study, the GHG emissions from municipal activities was assessed. A model for the assessment of urban GHG emissions was developed. Based on the collected data, a case study was conducted to evaluate urban GHG emissions. The comprehensive assessment included the emissions from transportation, electricity consumption, natural gas, waste disposal, and wastewater treatment. There was a variation for GHG emissions from these sectors in different years. This study provided a new approach for comprehensive evaluation of urban GHG emissions. The results can help better understand the emission process and identify the major emission sources. [ABSTRACT FROM AUTHOR]

Freshwater ecosystems are biologically important habitats that provide many ecosystem services. Calcium concentration and pH are two key variables that are linked to multiple chemical processes in these environments, influence the biology of organisms from diverse taxa, and can be important factors affecting the distribution of native and non-native species. However, it can be challenging to obtain high-resolution data for these variables at regional and national scales. To address this data gap, water quality data for lakes and rivers in Canada and the continental USA were compiled and used to generate high-resolution (10 × 10 km) interpolated raster layers, after comparing multiple spatial interpolation approaches. This is the first time that such data have been made available at this scale and resolution, providing a valuable resource for research, including projects evaluating risks from environmental change, pollution, and invasive species. This will aid the development of conservation and management strategies for these vital habitats. [ABSTRACT FROM AUTHOR]

Background: Variations in primary care practices may explain some differences in health outcomes during the COVID-19 pandemic. We sought to evaluate the characteristics of primary care practices by the proportion of patients unvaccinated against SARS-CoV-2. Methods: We conducted a population-based, cross-sectional cohort study using linked administrative data sets in Ontario, Canada. We calculated the percentage of patients unvaccinated against SARS-CoV-2 enrolled with each comprehensive-care family physician, ranked physicians according to the proportion of patients unvaccinated, and identified physicians in the top 10% (v. the other 90%). We compared characteristics of family physicians and their patients in these 2 groups using standardized differences. Results: We analyzed 9060 family physicians with 10 837 909 enrolled patients. Family physicians with the largest proportion (top 10%) of unvaccinated patients (n = 906) were more likely to be male, to have trained outside of Canada, to be older, and to work in an enhanced fee-for-service model than those in the remaining 90%. Vaccine coverage (≥ 2 doses of SARS-CoV-2 vaccine) was 74% among patients of physicians with the largest proportion of unvaccinated patients, compared with 87% in the remaining patient population. Patients in the top 10% group tended to be younger and live in areas with higher levels of ethnic diversity and immigration and lower incomes. Interpretation: Primary care practices with the largest proportion of patients unvaccinated against SARS-CoV-2 served marginalized communities and were less likely to use team-based care models. These findings can guide resource planning and help tailor interventions to integrate public health priorities within primary care practices. [ABSTRACT FROM AUTHOR]

Background: Over the past two decades, Canadian provinces and territories have introduced a series of primary care reforms in an attempt to improve access to and quality of primary care services, resulting in diverse organizational structures and practice models. We examine the impact of these reforms on family physicians' (FPs) ability to adapt their roles during the COVID-19 pandemic, including the provision of routine primary care. Methods: As part of a larger case study, we conducted semi-structured qualitative interviews with FPs in four Canadian regions: British Columbia, Newfoundland and Labrador, Nova Scotia, and Ontario. During the interviews, participants were asked about their personal and practice characteristics, the pandemic-related roles they performed over different stages of the pandemic, the facilitators and barriers they experienced in performing these roles, and potential roles FPs could have filled. Interviews were transcribed and a thematic analysis approach was applied to identify recurring themes in the data. Results: Sixty-eight FPs completed an interview across the four regions. Participants described five areas of primary care reform that impacted their ability to operate and provide care during the pandemic: funding models, electronic medical records (EMRs), integration with regional entities, interdisciplinary teams, and practice size. FPs in alternate funding models experienced fewer financial constraints than those in fee-for-service practices. EMR access enhanced FPs' ability to deliver virtual care, integration with regional entities improved access to personal protective equipment and technological support, and team-based models facilitated the implementation of infection prevention and control protocols. Lastly, larger group practices had capacity to ensure adequate staffing and cover additional costs, allowing FPs more time to devote to patient care. Conclusions: Recent primary care system reforms implemented in Canada enhanced FPs' ability to adapt to the uncertain and evolving environment of providing primary care during the pandemic. Our study highlights the importance of ongoing primary care reforms to enhance pandemic preparedness and advocates for further expansion of these reforms. [ABSTRACT FROM AUTHOR]

Despite their strong humanitarian reputations abroad, Norway and Canada have adopted domestic immigration policies that produce permanently precarious residents. These policies affect individuals—including refugees, permanent residents, and naturalized citizens—who have traditionally enjoyed secure legal statuses. Adopting the analytic lens of 'probationary immigration', this article explores the legal mechanisms behind three interrelated developments in both countries: 1) the fragmentation of protection regimes in terms of access, rights and duration; 2) stricter/less predictable requirements for permanent residence and citizenship; and 3) intensified practice regarding the revocation of citizenship. [ABSTRACT FROM AUTHOR]

Varicella zoster virus (VZV) is a highly contagious human herpes virus responsible for causing chickenpox (varicella) and shingles (herpes zoster). Despite the approval of a highly effective vaccine, Shingrix®, the global incidence of herpes zoster is increasing and the economic burden to the health care system and society are substantial due to significant loss of productivity and health complications, particularly among elderly and immunocompromised individuals. This is primarily because access to the vaccines remains mostly limited to countries within developed economies, such as USA and Canada. Therefore, similarly effective vaccines against VZV that are more accessible to the rest-of-the-world are necessary. In this study, we aimed to evaluate immunogenicity and memory response induced by three mRNA-LNP-based vaccine candidates targeting VZV's surface glycoprotein E (gE). C57BL/6 mice were immunized with each candidate vaccine, and humoral and cellular immune responses were assessed. Our results demonstrate that the mRNA-LNP-based vaccine candidates elicited robust and durable humoral responses specific to the gE antigen. Notably, mice vaccinated with the mRNA-LNP vaccines exhibited significantly higher antigen-specific T-cell cytokine production compared to the group receiving Shingrix®, the current standard of care vaccine. Additionally, mRNA-LNP vaccines induced long-lasting memory response, as evidenced by detection of persistent gE-specific Long-Lived Plasma Cells (LLPCs) and memory T cells four months after final immunization. These findings underscore the potential of our mRNA-LNP-based vaccine candidates in generating potent immune responses against VZV, offering promising prospects for their clinical development as an effective prophylactic vaccine against herpes zoster. [ABSTRACT FROM AUTHOR]

This paper presents the findings of fifteen energy audits conducted on industrial sites in Canada's Greater Toronto Area (GTA). The audits covered a range of industries including food processing, packaged goods, and finishing processes (powder-coating). The primary focus of the audits was to analyze the natural gas consumption and the performance of major-gas-consuming equipment. The audits identified natural-gas-consuming equipment that could be optimized to yield energy and operational cost savings and greenhouse gas (GHG) reduction opportunities. Food production plants' energy intensity ranges from 5.59 m3/ft2 to 17.73 m3/ft2. Therefore, there is a significant opportunity to improve energy consumption through better technology integration. The results of the audits indicate a trend of an increase in the percentage of non-productive consumption with non-productive time. The proposed energy-saving measures include reducing non-productive natural gas consumption, gas-fired equipment tune-up, optimizing boiler loads, and reducing oven exhaust by using variable frequency drives (VFDs). The findings of this study could be used to develop a demand-side management program specifically for small- and medium-sized industrial facilities in the Greater Toronto Area and other parts of Canada. [ABSTRACT FROM AUTHOR]

Introduction: Ocean equity is a key aim of blue economy frameworks globally and is a pillar of the international High Level Panel for A Sustainable Ocean Economy. However, the Panel offers only a general definition of ocean equity, with limited guidance for countries. Canada, as a party to the High Level Panel's blue economy agenda, is developing its own blue economy strategy, seeking to reshape its ocean-based industries and advocate for new ones. How equity will be incorporated across scales is not yet known but has implications for how countries like Canada will develop their ocean-based industries. This raises important questions, including what are Canada's equity commitments in relation to its blue economy and how will they be met? Currently, the industries identified in Canada's emerging blue economy narratives are governed through both federal and provincial legislation and policies. These will shape how equity is implemented at different scales. Methods: In this paper, we examine how the term equity is defined in relevant federal and provincial legislation and look to how understandings of equity found in critical feminist, environmental justice, and climate justice scholarship could inform policy and its implementation within Canada's blue economy. We focus on two industries that are important for Canada's blue economy: offshore oil and marine salmon aquaculture in the Canadian province of Newfoundland and Labrador. We investigate how existing legislation and policy shapes the characterization, incorporation, and implementation of equity in these industries. Results and discussion: Our analysis highlights how a cohesive approach to ocean equity across the scales of legislation and policy is needed to ensure more robust engagement with social and environmental equity issues in blue economy discourse and implementation. [ABSTRACT FROM AUTHOR]

Canada's forests play a critical role in the global carbon (C) cycle and are responding to unprecedented climate change as well as ongoing natural and anthropogenic disturbances. However, the representation of disturbance in boreal regions is limited in pre-existing land surface models (LSMs). Moreover, many LSMs do not explicitly represent subgrid-scale heterogeneity resulting from disturbance. To address these limitations, we implement harvest and wildfire forcings in the Canadian Land Surface Scheme Including Biogeochemical Cycles (CLASSIC) land surface model alongside dynamic tiling that represents subgrid-scale heterogeneity due to disturbance. The disturbances are captured using 30 m spatial resolution satellite data (Landsat) on an annual basis for 33 years. Using the pan-Canadian domain (i.e., all of Canada south of 76° N) as our study area for demonstration, we determine the model setup that optimally balances a detailed process representation and computational efficiency. We then demonstrate the impacts of subgrid-scale heterogeneity relative to standard average individual-based representations of disturbance and explore the resultant differences between the simulations. Our results indicate that the modeling approach implemented can balance model complexity and computational cost to represent the impacts of subgrid-scale heterogeneity resulting from disturbance. Subgrid-scale heterogeneity is shown to have impacts 1.5 to 4 times the impact of disturbance alone on gross primary productivity, autotrophic respiration, and surface energy balance processes in our simulations. These impacts are a result of subgrid-scale heterogeneity slowing vegetation re-growth and affecting surface energy balance in recently disturbed, sparsely vegetated, and often snow-covered fractions of the land surface. Representing subgrid-scale heterogeneity is key to more accurately representing timber harvest, which preferentially impacts larger trees on higher quality and more accessible sites. Our results show how different discretization schemes can impact model biases resulting from the representation of disturbance. These insights, along with our implementation of dynamic tiling, may apply to other tile-based LSMs. Ultimately, our results enhance our understanding of, and ability to represent, disturbance within Canada, facilitating a comprehensive process-based assessment of Canada's terrestrial C cycle. [ABSTRACT FROM AUTHOR]

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

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

A novel, complex chronic condition emerged from the COVID-19 pandemic: long COVID. The persistent long COVID symptoms can be multisystem and varied. Effective long COVID management requires multidisciplinary, collaborative models of care, which continue to be developed and refined. Alberta's provincial health system developed a novel long COVID pathway. We aimed to clarify the perspectives of multidisciplinary healthcare providers on the early implementation of the provincial long COVID pathway, particularly pathway acceptability, adoption, feasibility, and fidelity using Sandelowki's qualitative description. Provider participants were recruited from eight early-user sites from across the care continuum. Sites represented primary care (n = 4), outpatient rehabilitation (n = 3), and COVID-19 specialty clinics (n = 2). Participants participated in structured or semi-structured virtual interviews (both group and 1:1 were available). Structured interviews sought to clarify context, processes, and pathway use; semi-structured interviews targeted provider perceptions of pathway implementation, including barriers and facilitators. Analysis was guided by Hsieh and Shannon as well as Sandelowski. Across the eight sites that participated, five structured interviews (n = 13 participants) and seven semi-structured interviews (n = 15 participants) were completed. Sites represented primary care (n = 4), outpatient rehabilitation (n = 3), and COVID-19 specialty clinics (n = 2). Qualitative content analysis was used on transcripts and field notes. Provider perceptions of the early implementation outcomes of the provincial long COVID pathway revealed three key themes: process perceptions; awareness of patient educational resources; and challenges of evolving knowledge. [ABSTRACT FROM AUTHOR]

Paratuberculosis, also known as Johne's disease, is a chronic wasting disease caused by Mycobacterium avium subs paratuberculosis (MAP) in ruminants. Paratuberculosis causes a significant reduction of milk production in the affected dairy sheep or goats and increase the cost of diagnosis, treatment, and culling of the infected animals. Paratuberculosis is currently recognised as a disease of major economic significance in cattle, sheep, goats, and wild ruminants globally. Recent reports also suggest that paratuberculosis affects wild ruminants and farmed deer. Despite the widespread occurrence of MAP, there are variations in the seroprevalence and global distribution patterns of disease among small ruminants and deer herds due to the influence of interacting epidemiological variables in different places. This systematic review aims to provide insights on the current global seroprevalence status and distribution pattern of paratuberculosis among small ruminants and deer herds. The review compiled, analyzed, and narratively synthesized 36 eligible research articles published between January 1, 2010, and January 31, 2024, from the SCOPUS and PubMed databases based on the 22-point Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. The average global seroprevalence of paratuberculosis in sheep was 14.02% (0.7-66.8), with the highest rate in Canada (66.8%) and the lowest in Austria (0.7%). Comparatively, the average global seroprevalence in goats was 18.44% (0.3-83), with the highest rate in Canada (83%) and the lowest in the West Indies (0.3%). The average global prevalence of paratuberculosis in deer was 14.76% (3.7-30.2), with the highest rate in Spain (30.2%) and the lowest rate in the Czech Republic (3.7%). This review revealed that Canada is a hot spot for both caprine and ovine paratuberculosis and there was a higher global seroprevalence rates in goats than sheep and deer. The lack of data on the seroepidemiology of paratuberculosis among small ruminant stock in Southeast Asia and other regions is a gap in our current knowledge of its distribution. Therefore, seroprevalence surveys of paratuberculosis among the small ruminant and deer livestock are required to furnish information for planning suitable interventions in these areas. [ABSTRACT FROM AUTHOR]

We study how social connectedness affected active mutual fund manager trading behavior in the first half of 2020. In the first quarter during which the coronavirus disease 2019 (COVID-19) outbreak occurred, fund managers located in or socially connected to COVID-19 hotspots sold more stock holdings compared with a control group of unconnected managers. The economic impact of social connectedness on stock holdings was comparable with that of COVID-19 hotspots and was elevated among "epicenter" stocks most susceptible to the pandemic shock. In the second quarter, social interaction had an overall negative effect on fund performance, but this effect depended on manager skill; unskilled managers who were connected to the hotspots underperformed, whereas skillful managers suffered no deleterious effect. Our evidence suggests that social connections can intensify salience bias for all but the most skilled institutional investors, and policy makers should be wary of the destabilizing role of social networks during market downturns. This paper was accepted by Gustavo Manso, finance. Funding: This work was supported by the Social Science and Humanities Research Council of Canada. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2023.4814. [ABSTRACT FROM AUTHOR]

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

Background: Influenza vaccination is recommended for those at increased risk of influenza complications and their household contacts to help reduce influenza exposure. Adults who require care often experience health issues that could increase the risk of severe influenza and have close contact with caregivers. Assessing influenza vaccination prevalence in caregivers and care recipients can provide important information about uptake. Objectives: We aimed to (1) estimate influenza non-vaccination prevalence and (2) assess factors associated with non-vaccination among caregivers aged ≥ 45 years and among care recipients aged ≥ 65 years. Methods: We conducted an analysis of cross-sectional data from the Canadian Longitudinal Study on Aging collected 2015–2018. We estimated non-vaccination prevalence and reported adjusted odds ratios with 95% confidence intervals from logistic regression models to identify factors associated with non-vaccination among caregivers and care recipients. Results: Of the 23,500 CLSA participants who reported providing care, 41.4% (95% CI: 40.8%, 42.0%) reported not receiving influenza vaccine in the previous 12 months. Among the 5,559 participants who reported receiving professional or non-professional care, 24.8% (95% CI: 23.7%, 26.0%) reported not receiving influenza vaccine during the same period. For both groups, the odds of non-vaccination were higher for those who had not visited a family doctor in the past year, were daily smokers, and those who identified as non-white. Discussion: Identifying groups at high risk of severe influenza and their close contacts can inform public health efforts to reduce the risk of influenza. Our results suggest sub-optimal influenza vaccination uptake among caregivers and care recipients. Efforts are needed to increase influenza vaccination and highlight the direct and indirect benefits for caregiver-care recipient pairs. Conclusion: The proportions of both caregivers and care recipients who had not been vaccinated for influenza was high, despite the benefits of vaccination. Influenza vaccination campaigns could target undervaccinated, high-risk groups to increase coverage. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic laid bare many of societies' existing social and economic inequalities, one of which is illustrated in the challenges facing food and farm workers across the food chain. Despite this upsurge in public recognition, the circumstances facing food and farm workers remain unchanged, and this lack of action is reflected within the work of food systems-focused civil society organizations (CSO) in Canada. Several authors have noted the lack of recognition of labor issues within food systems work. This paper further explores the nature of this disengagement, particularly in food systems governance work, and identifies barriers to more meaningful engagement and possible avenues to overcome these challenges. Findings draw from a set of 57 interviews conducted from 2020 to 2023 with a range of food system CSO representatives across Canada, examining their understanding of, and engagement in, food systems governance work and their involvement in labor issues (or lack thereof). The paper concludes that though there exists widespread awareness of the challenges facing food and farm workers, and a desire to engage in a more sustained fashion, many food system CSOs have not yet found the tools or pathways to do so on an organizational level. Several discursive openings are identified that offer an opportunity to leverage the heightened awareness of food and farm workers during the pandemic into concrete collective action. [ABSTRACT FROM AUTHOR]

Background: The onset of the COVID-19 pandemic has had an adverse impact on children, youth, and families with eating disorders (EDs). The COVID-19 pandemic exacerbated pre-existing personal and financial costs to youth, caregivers, and health professionals accessing or delivering ED services. The objectives of this mixed methods study were to (1) understand the indirect, direct medical and non-medical costs reported by youth, caregivers, and clinicians; (2) understand how the COVID-19 pandemic may have impacted these costs, and (3) explore implications of these costs with regards to barriers and resources to inform future decisions for the ED system of care. Methods: Youth (aged 16–25 years) with lived/living experience, primary caregivers, clinicians, and decision-makers were recruited with support from various partners across Canada to complete group specific surveys. A total of 117 participants responded to the survey. From those respondents, 21 individuals volunteered to further participate in either a discussion group or individual interview to provide additional insights on costs. Results: Youth and primary caregivers reported costs relating to private services, transportation and impacts of not attending school or work. Additionally, primary caregivers reported the top direct medical cost being special food or nutritional supplements (82.8%). In discussion groups, youth and caregivers elaborated further on the challenges with long waitlists and cancelled services, impact on siblings and effect on family dynamics. Clinicians and decision-makers reported increased work expectations (64.3%) and fear/isolation due to COVID-19 in the workplace (58.9%). Through discussion groups, clinicians expanded further on the toll these expectations took on their personal life. Approximately 1 in 3 health professionals reported contemplating leaving their position in 1–2 years, with greater than 60% of this group stating this is directly related to working during the pandemic. Conclusions: Findings demonstrate the need for increased support for youth and caregivers when accessing ED services both during crisis and non-crisis times. Additionally, attention must be given to acknowledging the experience of health professionals to support better retention and resource management as they continue to navigate challenges in the health care system. Plain English summary: The COVID-19 pandemic has had significant impacts for children, youth and families with eating disorders (EDs) and those who care for them. The objective of this study was to understand the impacts on financial and personal costs to youth, caregivers and clinicians when either accessing or delivering ED services during the pandemic. This study consisted of an online survey and discussion groups with youth (16-25 years old) with lived experience of an ED, primary caregivers, clinicians and decision-makers delivering ED services to understand the costs they experienced. Although many reported costs were financial, including direct medical costs (i.e. private therapy) and direct non-medical costs (i.e. transportation, accommodation costs), there were also significant personal costs to individuals and their families. Healthcare professionals also reported extensive challenges with resources and increased work expectations due to the pandemic context. Acknowledging the costs experienced by young people, families and healthcare professionals during the pandemic allows for the discussion of how we can better support those accessing or delivering ED services in times of crisis and non-crisis. [ABSTRACT FROM AUTHOR]

Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder of the central nervous system with common symptoms of rapid onset of eye pain, loss of vision, neck/back pain, paralysis, bowel and bladder dysfunction and heat sensitivity. The rare, unpredictable, and debilitating nature of NMOSD constitutes a unique psychological burden for patients and their caregivers, the specific nature and extent of which is not yet known. This mixed methods study, informed by both quantitative and qualitative data collected via self-report measures, focus groups, and in-depth interviews, aims to investigate and understand the psychological burden of patients with NMOSD and their caregiver/loved ones, so as to inform a specialized intervention. 31 adults living with NMOSD and 22 caregivers of people with NMOSD in the United States and Canada, recruited from NMOSD patient advocacy groups, social media groups, and through word of mouth from other participants, completed a battery of standardized self-report measures of anxiety, depression, trauma, cognitive fusion, valued living, and coping styles. Semi-structured focus group sessions were conducted via HIPAA-compliant Zoom with 31 patients, and separate focus groups were conducted with 22 caregivers. A subset of these samples, comprised of 16 patients and 11 caregivers, participated in individual semi-structured interviews, prioritizing inclusion of diverse perspectives. Descriptive statistics and bivariate correlations were run on quantitative self-report data using SPSS [Version 28.0.1]; data were stored in REDCap. Reflexive thematic analysis was employed regarding qualitative individual interview data. The majority of patients reported experiencing anxiety, depression, cognitive fusion, over-controlled coping, and lack of values-based living. Caregivers also reported heightened anxiety, cognitive fusion, and over-controlled coping, although they did not endorse clinically significant depression. Patient and caregiver degree of anxiety and of overcontrolled coping were both strongly positively correlated, likely affecting how both parties manage NMOSD-related stressors, both individually and as a dyad. Patients reported more anxiety, depression, psychological inflexibility, and lack of values-based living, compared with caregivers. Patient and caregiver narrative themes included mistrust of medical professionals, lack of support immediately following diagnosis, changes in relationships, deviation from values-based living, internalization of feelings, and avoidant coping strategies to manage the psychological burden of NMOSD. A novel mental health intervention targeting the specific psychological burden of life with NMOSD is proposed. [ABSTRACT FROM AUTHOR]

Background: Heart disease is one of the leading causes of death in Canada. Many heart disease patients are referred for cardiac rehabilitation, a multidisciplinary outpatient program often consisting of exercise training. Cardiac rehabilitation has been proven to be a successful secondary preventative measure in reducing mortality and improving overall health in heart disease patients, and its completion is important for both sexes as there is growing evidence that women benefit as much as men, if not more, with regard to mortality. It is important to note that previous studies have shown that healthy men and women respond differently to aerobic and resistance training, possibly due to hormones, body composition, autonomic and/or cardiovascular differences. However, evaluating sex differences in the efficacy of standard cardiac rehabilitation programs has not yet been fully explored with many studies investigating clinical or anthropometric data but not physiological outcomes. This systematic review aimed to investigate physiological differences in male and female heart disease patients after cardiac rehabilitation. The inclusion criteria were purposefully broad to encompass many cardiac rehabilitation scenarios, many cardiac disease states, and various program lengths and intensities with the intention of highlighting strengths and weaknesses of the current body of literature. Methods: To conduct a synthesis without meta-analysis, a search strategy was generated to examine the relationships between heart disease patients, a supervised exercise program, physiological outcomes, and sex differences. The review was registered (Prospero: CRD42021251614) and the following databases were searched from inception to 19 December 2023: APA PsycInfo (Ovid), CINAHL Complete (EBSCOhost), Embase (Ovid), Emcare Nursing (Ovid), Medline All (Ovid; includes PubMed non-Medline), and Web of Science Core Collection. Eighty-eight studies pertaining to fitness, metabolism, body composition, respiratory function, cardiac function and C-reactive protein underwent data extraction. Results and conclusions: Importantly, this review suggests that men and women respond similarly to a wide-range of cardiac rehabilitation programs in most physiological variables. However, many studies discussing maximal oxygen consumption, functional capacity, six-minute walk distances, and grip strength suggest that men benefit more. Further research is required to address certain limitations, such as appropriate statistical methods and type/intensity of exercise interventions. [ABSTRACT FROM AUTHOR]

Mothers' experiences of caring for children with Prader-Willi Syndrome (PWS) is largely unknown. With no treatment for PWS, parents undertake (extra)ordinary care practices to keep children safe from overeating and self harm. Knowledge of these care practices could lead to effective interventions. Narrative inquiry was used to study everyday experience with Canadian mothers. Participants cared for a child 3 to 17 years old who had hyperphagia. Participants were interviewed 8 to 12 times each over the course of a year. Narrative accounts were co-composed through a collaborative process of analysis. Engaging with participants' everyday experiences amplified complex care needs for families and gaps in health and social care systems. Narrative threads focused on engaging in (extra)ordinary care practices, rigid care work to keep children healthy and safe, tension from others while enacting these care practices, and difficulty conforming to social expectations with childrearing and care work. Recommendations for practice and policy include (a) shifting from untenable care practices, (b) reconceptualizing care work, and (c) alternative care models. [ABSTRACT FROM AUTHOR]

Background: The rapidly rising average age of the older adults has brought various global healthcare challenges. A core challenge is how to enhance their quality of life (QoL). Objective: The objective of the current study was to test the significance of biopsychosocial determinants of quality of life of older adults in Pakistan and Canada. Methodology: A cross-sectional survey was carried out on a conveniently approached purposive sample of 1,005 older adults (Pakistani = 557 and Canadian = 448) of age range between 60 years and 80 years. The data were collected via demographic datasheet, World Health Organization Quality of Life Brief Scale, Health and Lifestyle Questionnaire, General Self-Efficacy Scale, Rosenberg Self-Esteem Scale, and Berlin Social Support Scale. Results: The results of hierarchical regression analysis showed that biopsychosocial factors (viz., health and lifestyle, chronic illness, self-efficacy, self-esteem, and social support) significantly predicted (R² = .27, and.68) quality of life of older adults in Pakistan and Canada, respectively, after controlling the demographic variables. Significant differences were found between Pakistani and Canadian older adults on biopsychosocial factors: Canadian older adults scored significantly higher on health and lifestyle, self-efficacy, and quality of life, and older adults in Pakistan scored significantly higher on self-esteem and social support. Conclusion: A significant amount of better QoL of older adults can be achieved through enhancing the biopsychosocial correlates of their QoL, both in Pakistan and Canada. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic exposed long-standing inequities in Canada's long-term residential care (LTRC) sector with life-threatening consequences. People from marginalized groups are overrepresented among those who live in, and work in LTRC facilities, yet their voices are generally silenced in LTRC research. Concerns about these silenced voices have sparked debate around ways to change LTRC policy to better address long-standing inequities and enhance the conditions that foster dignity for those who live and work in LTRC. Weaving an analysis of historical and cultural attitudes about LTRC, and promising strategies for engaging people with lived experience, we argue that the voices of people with lived experience of life and work (paid and unpaid) in LTRC are essential for ethically and effectively shifting long-standing inequities. Lessons from a 4-year, national, multi-disciplinary research study, known as the Seniors Adding Life to Years (SALTY) project, suggest that resident-determined quality of life can be prioritized by centring the perspectives of residents, their family/friends, direct care workers, volunteers, and people living with dementia in the research process. Accordingly, we highlight strategies to include these voices so that meaningful and impactful system change can be realized. Plain Language Summary: This article argues that long-term residential care facilities in Canada have a long history of perpetuating social inequalities, beginning with seventeenth century poor houses and almshouses, from which long-term residential care facilities evolved in North America. We highlight that those who currently reside in long-term residential care are more likely to be people with less social power—for example women, people living with dementia, and people with low-income. These residents are rarely included in research projects as co-designers of research, co-producers of knowledge, or experts on the realities of long-term residential care. We explore strategies for addressing these underrepresented voices and inequalities in research by highlighting promising examples of resident, family, and worker-engagement emerging from a pre-pandemic to early pandemic pan-Canadian research project on quality of life in long-term residential care. We argue that long-term residential care residents, their family/friend caregivers, people living with dementia, and direct care workers have voices that are essential in residential care design and research engagement strategies. By prioritizing these voices in research, we can better amplify their critical perspectives in broader policy and decision-making processes that guide meaningful and impactful system change. [ABSTRACT FROM AUTHOR]

Lettuce is an economically major leafy vegetable that is affected by numerous diseases. One of the most devastating diseases of lettuce is white mold caused by Sclerotinia sclerotiorum. Control methods for this fungus are limited due to the development of genetic resistance to commonly used fungicides, the large number of hosts and the long-term survival of sclerotia in soil. To elaborate a new and more sustainable approach to contain this pathogen, 1,210 Pseudomonas strains previously isolated from agricultural soils in Canada were screened for their antagonistic activity against S. sclerotiorum. Nine Pseudomonas strains showed strong in vitro inhibition in dual-culture confrontational assays. Whole genome sequencing of these strains revealed their affiliation with four phylogenomic subgroups within the Pseudomonas fluorescens group, namely Pseudomonas corrugata, Pseudomonas asplenii, Pseudomonas mandelii, and Pseudomonas protegens. The antagonistic strains harbor several genes and gene clusters involved in the production of secondary metabolites, including mycin-type and peptin-type lipopeptides, and antibiotics such as brabantamide, which may be involved in the inhibitory activity observed against S. sclerotiorum. Three strains also demonstrated significant in planta biocontrol abilities against the pathogen when either inoculated on lettuce leaves or in the growing substrate of lettuce plants grown in pots. They however did not impact S. sclerotiorum populations in the rhizosphere, suggesting that they protect lettuce plants by altering the fitness and the virulence of the pathogen rather than by directly impeding its growth. These results mark a step forward in the development of biocontrol products against S. sclerotiorum. [ABSTRACT FROM AUTHOR]

Background: Self-rated health (SRH) is a globally recognized measure of health status. Both impaired sleep (IS) and the presence of multimorbidity are related to poorer SRH, but the precise nature of these associations remains unclear. This study explored the association between IS, multimorbidity, and SRH among Canadian adults. Method: We used 2017-18 Canadian Community Health Survey (CCHS) data for this study. The main variable of interest, self-rated health (SRH), measured participants' health on a 5-point Likert scale, later categorized as "good or better" vs. "fair or poor". The primary predictor, IS, was derived from two variables and categorized into four groups: no sleep issues; fewer sleeping hours (<7 hours) only; trouble sleeping only; and fewer hours & trouble sleeping. Multimorbidity was present (yes/no) if a participant indicated being diagnosed with two or more chronic conditions. Results: Just over one in ten Canadians reported fair/poor SRH and approximately one-quarter had multimorbidity or experienced few sleep hours in combination with trouble sleeping. The adjusted model indicated greater odds of fair/poor SRH associated with the 40-64 years age group, male sex, and lower socio-economic status. It also suggested the presence of multimorbidity (AOR= 4.63, 95% CI: 4.06-5.28) and a combination of fewer sleep hours and troubled sleep (AOR= 4.05, 95% CI: 2.86-5.74) is responsible for poor SRH. Forty-four percent of the total effect of IS on SRH was mediated by multimorbidity. Conclusion: This unique finding highlights the mediating role of multimorbidity, emphasizing the importance of addressing it alongside sleep issues for optimal health outcomes. [ABSTRACT FROM AUTHOR]

This paper introduces the MinCan database that presents mine-level estimates for the Canadian mining industry with a persistent annual coverage between 1950 and 2022. These estimates are based on archival maps and a selection of historical sources, which follows a hierarchy of criteria-based credibility and standardization. The information contained in MinCan covers 947 mines and provides information about their location (longitude and latitude in decimal), the company ownership, the principal commodities produced, and the years of operation (opening and closing dates). It is the first open access database to propose an exhaustive, free, and reliable compilation of the principal past and present mines producing in Canada. The geographic coordinates enable matching with other local, regional, and national databases, and allow for a wide range of research objectives to be met. [ABSTRACT FROM AUTHOR]

Objectives: Despite Canada's universal health system, sex workers across the country face an alarmingly high number of barriers when they seek to healthcare services. This has resulted in unmet healthcare needs and substantially poorer health outcomes than the general Canadian population. The objective of this study was to use a systems thinking approach to gain an in-depth understanding of the barriers sex workers face and how access could be improved. Methods: The analysis was conducted using a systems thinking methodology, which incorporates systems tools and inquiry processes. The methodology comprised 2 domains of inquiry: (1) Problem Landscape, (2) Solutions Landscape. Systems tools and methods, such as causal loop diagrams, iceberg diagram, and systems mapping, investigated the problem landscape for understanding the interconnected nature of the issue, alongside review of both published and gray literature. An environmental scan explored the current solutions landscape. These methods connected through systemic inquiry processes, including ongoing review and application of diverse perspectives, boundary judgments, interrelationships; enabled gaps and levers of change to be determined. Results: The main barriers sex workers face are stigma, criminalization, accessibility, and cost of healthcare. The stigma of sex work stems from otherization, paternalism, and moralistic, faith-based beliefs. The barriers unique to sex work are stigma and criminalization; both of which surface as avoidance, dislike, and/or fear of medical professionals. Five gaps each with a lever of change to improve access were identified: (1) Stigma – Collectivization and external collaboration, (2) Criminal status of sex work – Decriminalization, (3) Lack of adequate education - Improved healthcare professional training and anti-discriminatory health policies, (4) Lack of support – Increased community-based healthcare services, (5) Cost of healthcare – Universal coverage of "secondary" healthcare components. Conclusion: Through reducing the stigma surrounding sex work, making changes that improve the healthcare services that sex workers receive, and collaboration between involved parties, sex workers can be prevented from falling through the cracks of the Canadian healthcare system; lessening the health inequities sex workers face and improving their health outcomes. [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]

Purpose: Lung cancer is the leading cause of cancer deaths in Canada, and because early cancers are often asymptomatic screening aims to prevent mortality by detecting cancer earlier when treatment is more likely to be curative. These reviews will inform updated recommendations by the Canadian Task Force on Preventive Health Care on screening for lung cancer. Methods: We will update the review on the benefits and harms of screening with CT conducted for the task force in 2015 and perform de novo reviews on the comparative effects between (i) trial-based selection criteria and use of risk prediction models and (ii) trial-based nodule classification and different nodule classification systems and on patients' values and preferences. We will search Medline, Embase, and Cochrane Central (for questions on benefits and harms from 2015; comparative effects from 2012) and Medline, Scopus, and EconLit (for values and preferences from 2012) via peer-reviewed search strategies, clinical trial registries, and the reference lists of included studies and reviews. Two reviewers will screen all citations (including those in the previous review) and base inclusion decisions on consensus or arbitration by another reviewer. For benefits (i.e., all-cause and cancer-specific mortality and health-related quality of life) and harms (i.e., overdiagnosis, false positives, incidental findings, psychosocial harms from screening, and major complications and mortality from invasive procedures as a result of screening), we will include studies of adults in whom lung cancer is not suspected. We will include randomized controlled trials comparing CT screening with no screening or alternative screening modalities (e.g., chest radiography) or strategies (e.g., CT using different screening intervals, classification systems, and/or patient selection via risk models or biomarkers); non-randomized studies, including modeling studies, will be included for the comparative effects between trial-based and other selection criteria or nodule classification methods. For harms (except overdiagnosis) we will also include non-randomized and uncontrolled studies. For values and preferences, the study design may be any quantitative design that either directly or indirectly measures outcome preferences on outcomes pertaining to lung cancer screening. We will only include studies conducted in Very High Human Development Countries and having full texts in English or French. Data will be extracted by one reviewer with verification by another, with the exception of result data on mortality and cancer incidence (for calculating overdiagnosis) where duplicate extraction will occur. If two or more studies report on the same comparison and it is deemed suitable, we will pool continuous data using a mean difference or standardized mean difference, as applicable, and binary data using relative risks and a DerSimonian and Laird model unless events are rare (< 1%) where we will pool odds ratios using Peto's method or (if zero events) the reciprocal of the opposite treatment arm size correction. For pooling proportions, we will apply suitable transformation (logit or arcsine) depending on the proportions of events. If meta-analysis is not undertaken we will synthesize the data descriptively, considering clinical and methodological differences. For each outcome, two reviewers will independently assess within- and across-study risk of bias and rate the certainty of the evidence using GRADE (Grading of Recommendations Assessment, Development, and Evaluation), and reach consensus. Discussion: Since 2015, additional trials and longer follow-ups or additional data (e.g., harms, specific patient populations) from previously published trials have been published that will improve our understanding of the benefits and harms of screening. The systematic review of values and preferences will allow fulsome insights that will inform the balance of benefits and harms. Systematic review registration: PROSPERO CRD42022378858 [ABSTRACT FROM AUTHOR]

Background: An understanding of the prevalence of gestational diabetes mellitus among pregnant women is essential at local, national and international level so that appropriate health care interventions can be planned, financed and delivered. Methods: A systematic review and meta-analysis of primary research reporting the prevalence of gestational diabetes mellitus in Canada or the United States were carried out according to Meta-analysis of Observational Studies in Epidemiology guidelines. Four electronic databases were systematically searched in June 2023 to identify articles that reported gestational diabetes mellitus prevalence using universal screening in pregnant women from eligible general population samples. Estimates were combined using a random effects model, and the effects of moderator variables analysed. Results: There were 36 separate samples of women or deliveries (total sample size 1,550,917). Overall mean prevalence of gestational diabetes mellitus was 6.9% (95% CI: 5.7–8.3); 13.7% (95% CI: 10.7–17.3) in studies using a one-step screening strategy, and 5.2% (95% CI: 4.4–6.1) in those using a two-step strategy. Heterogeneity in technical methods between studies produced differences in estimates, as did different diagnostic thresholds used. Conclusions: The meta-analysis suggests a slightly higher prevalence of gestational diabetes mellitus in Canada and the United States, compared to Europe, but highlights the need for standardised protocols for estimating gestational diabetes mellitus prevalence. [ABSTRACT FROM AUTHOR]

The global call to address climate change and advance sustainable development has created rapid growth in research, investment, and policymaking regarding the renewable energy transition of Indigenous communities. From a rightsholder perspective, Indigenous Peoples' vision of sustainability, autonomy, and sovereignty should guide research on their energy needs. In this paper, we present a multi-method, inductive examination to identify gaps between Indigenous communities' expressed needs and rights, and the questions researchers and policymakers investigate in energy transition research conducted in the context of Indigenous communities located in Canada. We combine a systematic review of the extant literature, a scoping review of the grey literature on off-grid communities by Indigenous and non-Indigenous governments and non-governmental policy bodies, qualitative primary data collected via fieldwork, and an in-depth study of an Indigenous-led renewable energy transition study conducted by Haíɫzaqv Nation's Climate Action Team. We holistically examine these different perspectives and identify emergent themes to recommend ways to bridge the gaps between off-grid renewable energy research and stated Indigenous community priorities. Specifically, we recommend designing equitable research practices, understanding community worldviews, developing holistic research goals, respecting Indigenous data sovereignty, and sharing or co-developing knowledge with communities to align with community priorities closely. • There is a research-practice gap in Indigenous communities' energy transitions. • We used a multi-method inquiry integrating Indigenous and Western approaches. • Renewable energy literature diverges from the Indigenous community vision and goals. • Indigenous research methods can reduce the research-practice gap in high-tech fields. • Community-based approaches can use traditional laws to yield actionable outcomes. [ABSTRACT FROM AUTHOR]

Fusarium head blight (FHB), caused by Fusarium graminearum, is currently the most devastating disease for barley (Hordeum vulgare) in Canada. Associated mycotoxins can compromise grain quality, where deoxynivalenol (DON) is considered particularly damaging due to its frequency of detection. Breeding barley with a lower DON content is difficult, due to the poor adaptation and malt quality of resistance sources. A set of European-derived heritage varieties were screened in an FHB nursery in Charlottetown, PE, with selections tested at Brandon, MB, between 2018–2022. Genetic evaluation demonstrated a distinct clustering of Canadian varieties from the heritage set. At Brandon, 72% of the heritage varieties ranked lower for DON content than did the moderately resistant Canadian check 'AAC Goldman', but resistance was associated with later heading and taller stature. In contrast with Canadian modern malting variety 'AAC Synergy', general deficiencies were observed in yield, enzyme activity, and extract, along with higher protein content. Nonetheless, several resistant varieties were identified with reasonable a heading date and yield, including 'Chevallier Chile', 'Domen', 'Djugay', 'Hannchen', 'Heils Franken', 'Moravian Barley', 'Loosdorfer' with 'Golden Melon', 'Nutans Moskva', and 'Vellavia', these being some of the most promising varieties when malting quality characteristics were also considered. These heritage resources could be used as parents in breeding to develop FHB-resistant malting barley varieties. [ABSTRACT FROM AUTHOR]

Background: Primary health care (PHC) has historically led and implemented successful immunization programs, driven by strong relationships with patients and communities. During the COVID-19 pandemic, Canada began its vaccination strategy with mass immunizations that later included local efforts with PHC providers. This study seeks to understand how PHC contributed to the different phases of the COVID-19 vaccination rollouts in Ontario, Canada's most populous province. Methods: We conducted a descriptive qualitative study with focus groups consisting of PHC providers, administrators, and staff in Ontario. Eight focus groups were held with 39 participants representing geographic diversity across the six Ontario Health regions. Participants reflected a diverse range of clinical, administrative, and leadership roles. Each focus group was audio-recorded and transcribed with transcriptions analyzed using thematic analysis. Results: With respect to understanding PHC teams' participation in the different phases of the COVID-19 vaccination rollouts, we identified five themes: (i) supporting long-term care, (ii) providing leadership in mass vaccinations, (iii) integrating vaccinations in PHC practice sites, (iv) reaching those in need through outreach activities; and (v) PHC's contributions being under-recognized. Conclusions: PHC was instrumental in supporting COVID-19 vaccinations in Ontario, Canada across all phases of the rollout. The flexibility and adaptability of PHC allowed teams to participate in both large-scale and small-scale vaccination efforts. [ABSTRACT FROM AUTHOR]

Falls are a leading cause of injury-related deaths and hospitalizations among Canadians. Falls risk has been reported to be increased in individuals who are older and with certain health conditions. It is unclear whether rurality is a risk factor for falls. This study aimed to investigate: 1) fall profiles by age group e.g., 45 to 54 years, 55 to 64 years, 65 to 74 years, 75 to 85 years; and 2) falls profiles of individuals, by age group, living in rural versus urban areas of Canada. Data (N = 51,338) from the Canadian Longitudinal Study on Aging was used to examine the relationship between falls and age, rurality, chronic conditions, need for medical attention, and fall characteristics (manner, location, injury). Self-reported falls within a twelve-month period occurred in only 4.8% (single fall) and 0.8% (multiple falls) of adults. Falls were not related to rural residence or age, but those with memory impairment, multiple sclerosis, as well as other chronic conditions such as mood disorder, anxiety disorder, and hyperthyroidism not often thought to be associated with falls, were also more likely to fall. Older individuals were more likely to fall indoors or fall while standing or walking. In contrast, middle-aged individuals were more likely to fall outdoors or while exercising. Type of injury was not associated with age, but older individuals were more likely to report hospitalization after a fall. This study shows that falls occur with a similar frequency in individuals regardless of age or urban/rural residence. Age was associated with fall location and activity. A more universally applicable multi-facted approach, rather than one solely based on older age considerations, to screening, primary prevention and management may reduce the personal, social, and economic burden of falls and fall-related injuries. [ABSTRACT FROM AUTHOR]

Background: Our previous study revealed that the COVID-19 pandemic posed mental health challenges to eye care professionals and students. The intent of this study was to identify the longitudinal impact of the COVID-19 pandemic on mental health among ophthalmic personnel and students. Additionally, the potential risk factors for mental health problems were investigated. Methods: A two-phase survey among eye care professionals and students in the USA and Canada was conducted. Phase 1 was administrated from June 23 to July 8, 2020, and has been published; Phase 2 was conducted from January 21 to February 2, 2021. A total of 824 eye care professionals and students participated in Phase 2, with a response rate of 44.1%. Symptoms of depression, anxiety, and stress were measured and calculated. Results: Compared with Phase 1, stress scores in Phase 2 were significantly reduced (P<0.001) although they were still higher than the pre-COVID level (P <.001). Scores for depression (P = 0.20) and anxiety (P = 0.40) showed no change, comparing Phase 2 to Phase 1. Reduction of stress scores significantly differed among occupations (P = 0.005); students had less reduction of stress than other eye care professionals (all P<0.05). Vaccination status was significantly associated with a reduction in stress scores (P = 0.04). Conclusions: With the continuing COVID pandemic, although stress level was reduced at 7-month follow-up, the mental health of eye care professionals was still impacted. In this population, COVID-19 vaccination was associated with fewer stress symptoms. These results indicate that the COVID-19 pandemic continues impacting mental health among eye care professionals, especially students. These study results warrant future interventions for eye care personnel and students to prevent or treat mental health disorders. [ABSTRACT FROM AUTHOR]

Integrated renewable energy systems are becoming a promising option for electrification in remote communities. Integrating multiple renewable energy sources allows the communities to counteract the weaknesses of one renewable energy source with the strengths of another. This study aims to model, design and optimize integrated renewable energy systems consisting of solar photovoltaic (PV) panels, wind turbines, a biomass power generator, and storage batteries for applications in remote communities in Canada. Biomass is used as a fuel to produce electricity during periods when solar power and wind power are not capable of meeting the power demand. A methodology is developed to optimize the integrated renewable energy systems design, with the aim of minimizing the net present cost (NPC) and the levelized cost of electricity (LCOE) of the energy systems. Results show that the NPC is $3.61 M and the LCOE is $0.255/kWh for an optimized integrated renewable energy system in a sample remote community that has a peak power consumption of 238.7 kW and an average load demand of 2230 kWh/day. Through the present research, the integrated energy systems are evidenced to be an effective option for electrification in remote communities. [ABSTRACT FROM AUTHOR]

Background: Pain and addiction are one of the most common reasons for adults to seek health care, yet educational programs focused on pain are often underrepresented in medical school curricula. In January 2021, the Association of Faculties of Medicine of Canada (AFMC) launched an online national, bilingual, competency-based curriculum for undergraduate medical (UGME) students in pain management and substance use in response to the opioid crisis and to bridge the content gaps in programs across Canada. The purpose of this study is to evaluate the pilot of this national curriculum. Methods: UGME students, from across Canada, participated in the program evaluation by completing online pre- and post-program surveys that assessed the influence of the curriculum on participants' knowledge as well as the value, usability, and feasibility of this curriculum. Results: Participants' perceived confidence in their new knowledge and in utilizing resources required to maintain their knowledge significantly increased (75% and 51% respectively). Their perceived knowledge that addressed the 72 learning objectives within the curriculum significantly increased from pre- to post-program. Over 90% of participants reported that the curriculum was valuable, feasible, and usable. The most frequently discussed program strengths were the clear and comprehensive content, interactive and well-organized design, and relevance of curriculum content for future clinical practice. The overall weakness of the curriculum included the length, repetition of content, the lack of clarity and relevance of the assessment questions, end-user technology issues, and French translation discrepancies. Participant's recommendations for improving the curriculum included streamlining content, addressing technology issues, and enhancing the clarity and relevance of assessment questions embedded within each of the modules. Conclusion: Participants agreed that an online pain management and substance use curriculum is a valuable, usable, and feasible learning opportunity. Given the severity of the opioid crisis in Canada, these online modules provide a curriculum that can be integrated into existing UGME programs or can provide self-directed learning. [ABSTRACT FROM AUTHOR]

Background: Parents/guardians can greatly influence their child's movement behaviours (i.e., physical activity, sedentary behaviour, and sleep). Yet, they have reported to lack sufficient background knowledge to foster healthy movement habits, and little is known about specific educational gaps. The aim of this study was to explore the educational background and needs regarding promoting healthy movement behaviours in early childhood among parents/guardians living in Canada. Methods: A cross-sectional study was conducted with parents/guardians living in Canada who had at least one child under the age of 5 years. Participants completed an online survey capturing their demographics, information they received about movement behaviours in early childhood during their prenatal/postnatal care or child's pediatrician appointments, where they sourced information about these topics, content areas they would like more information on, and preferred format for delivery. Descriptive statistics and frequencies were calculated for all outcome variables and logistic regression was used to explore if sociodemographic variables were associated with receiving movement behaviour-related education across care types. Results: Among the 576 parents/guardians who completed the survey, many reported no mention of any movement behaviour in their prenatal (49.4%), postnatal (29.6%), and pediatric care (37.2%). Physical activity was the most cited movement behaviour across care types, with 42.4%, 57.9%, and 54.8% of participants indicating this was discussed in their prenatal, postnatal, and pediatric care, respectively. Only 41.7% of parents/guardians reported asking their child's pediatrician about movement behaviours, while most relied on social media (70.9%), internet websites/news articles (68.7%), and family/friends (67.6%). The most sought-after movement behaviour topics included incorporating movement into traditionally sedentary activities (68.8%) and activity ideas to break up sitting time (65.0%), and participants expressed preference to receive more information via social media (63.2%), an online resource package (47.8%), or email (46.6%). Conclusions: Given the noted inconsistencies in education relating to movement behaviours in maternal and pediatric care, this study highlights the opportunity for greater integration of this type of education across care types. Ensuring all parents/guardians receive evidence-based and consistent guidance on their child's movement behaviours will help ensure young children receive the best start to a healthy active life. [ABSTRACT FROM AUTHOR]