Search

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

Copyright of Canadian Journal of Agricultural Economics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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

Interest in and the development of microcredentials has accelerated over the past decade and especially since 2020, in Canada and internationally. This research paper reports on findings of a study conducted in 2022 that focused on students' expectations and experiences of microcredentials. Acknowledging continued investment in microcredentials alongside challenges with national higher education data collection in Canada beyond degree-oriented programming, the case is made that microcredential data could and should be collected at a national level. [ABSTRACT FROM AUTHOR]

Visual inspection is a common approach for collecting data over time on transportation infrastructure. However, the evaluation method in visual inspections mainly depends on a subjective metric, as well as the experience of the individual performing the task. State-space models (SSMs) enable quantifying the uncertainty associated with the inspectors when modeling the degradation of bridges based on visual inspection data. The main limitation in the existing SSM is the assumption that each inspector is unbiased, due to the high number of inspectors, which makes the problem computationally demanding for optimization approaches and prohibitive for sampling-based Bayesian estimation methods. The contributions of this paper are to enable the estimation of the inspector bias and formulate a new analytical framework that allows the estimation of the inspectors' biases and variances using Bayesian updating. The performance of the analytical framework is verified using synthetic data where the true values are known, and validated using data from the network of bridges in Quebec province, Canada. The analyses have shown that the analytical framework has enabled reducing the computational time required for estimating the inspectors' uncertainty and is adequate for the estimation of the inspectors' uncertainty while maintaining a comparable performance to the gradient-based framework. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Civil Engineering is the property of Canadian Science Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper discusses insights from a larger study of popular educators' deployment of Freire's pedagogical principles during facilitator training. The paper focuses on data from two facilitators and attempts to examine how popular education principles are applied in two different socio-economic and political contexts, Canada and South Africa. Freire's early work on popular education traditions formed the base of the theoretical lens; Foley's theory of ideology with other critical theorist's concepts and critiques of Freire are drawn upon to analyse the evolution of Freire's critical pedagogy and to examine what factors affect its deployment in different contexts. The research design is grounded in interpretivist epistemology and uses a case study approach to examine Freire's pedagogical approaches in two different contexts. Three forms of qualitative data collection tools were utilised: semi-structured interviews, observations and document analysis. Key findings from this study illuminate the influential significance of facilitators' individual ideologies and organisational cultures and demands. It describes how education's relationship with the state must be analysed to assemble a comprehensive understanding of what social and political factors affect pedagogical choices and styles. This study offers more knowledge to the literature concerning the recontextualisation of pedagogy and the factors that affect it. [ABSTRACT FROM AUTHOR]

Background: Social determinants of health (SDOH) are the non-medical factors that impact health. Although geographical measures of deprivation are used, individual measures of social risk could identify those most at risk and generate more personalised care and targeted referrals to community resources. We know SDOH are important to health care, but it is not yet known whether their collection via the electronic health record (EHR) is acceptable and useful from the patient perspective. Aim: To synthesise relevant literature to explore patient perspectives on integrating information about SDOH into primary care EHRs, and the opportunities and challenges of its implementation in a general practice setting. Design & setting: Systematic review of primary care-based qualitative and mixed-method studies using thematic framework analysis. Method: Key databases were searched for articles reporting patient perspectives of SDOH collection within the primary care EHR. Qualitative and mixed-methods studies written in English were included. A framework analysis was conducted to identify themes. Results: From 14 included studies, the following five main themes were identified: rationale for SDOH screening and the anticipated outcomes; impact of the provider-patient relationship on patient perceptions; data, which included privacy concerns; screening process and referral; and recommendations for future research. Conclusion: Integration of information on SDOH into the EHR appears acceptable to patients. This review has added to the discussion of whether and how to implement SDOH screening and referral programmes into UK primary care systems. [ABSTRACT FROM AUTHOR]

Background: Moral distress is recognized as an international problem that contributes to decreased work productivity, job dissatisfaction and intent to leave for adult Critical Care nurses. Aim: To explore Critical Care nurses moral distress levels using the Moral Distress Scale Revised (MDS‐R) and its relationship with intention to stay. The study reported in this paper was part of a larger study that also investigated Critical Care nurses' work environment in Canada and the Midlands region of the UK. Study design: During January to August 2017 a cross‐sectional survey was distributed to adult Critical Care nurses in the Midlands region of the UK. Methods: Surveys were distributed to adult Critical Care Registered Nurses in the Midlands region of the UK examining moral distress levels and intention to stay in Critical Care, the organization (NHS Trust) and in the nursing profession. Results: Two hundred sixty‐six number of a potential sample of 1066 Critical Care nurses completed the survey (25% response rate). Age and moral distress were significantly positively correlated with intention to stay on their current unit (r = 0.16, P =.05), indicating older nurses were more likely to stay in the critical care unit. Moral distress was negatively correlated with intent to stay scores, showing critical care nurses with higher levels of moral distress were less likely to stay on their unit (r = −0.20, P =.02). Moral distress was also significantly negatively correlated with intention to stay with their current employer (r = −0.28, P <.001). Nurses that stated they had high rates of moral distress were more likely to consider leaving their current employer. Conclusion: Moral distress appears to be an issue among adult Critical Care nurses requiring further exploration and development of effective strategies to reduce this phenomenon and stabilize the workforce by reducing turnover. Relevance to clinical practice: By identifying the top causes of moral distress, tools and strategies can be developed to allow the Critical Care nurse to work within an ethically safe clinical environment and reduce the turnover of experienced adult Critical Care nurses. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Bioethics / Revue canadienne de bioéthique is the property of Ecole de Sante Publique de l'Universite de Montreal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper describes how a study using institutional ethnography (IE) was used as a decolonizing method of inquiry in a rural Indigenous community in Canada. IE honors lived experience, reveals institutional and colonial practices, provides clear empirical evidence, and can offer clear recommendations that can benefit Indigenous communities. At the heart of decolonizing research is the task of shifting whose knowledge is privileged – from those with power (often researchers) to those who are being researched (those subject to the effects of colonization). To highlight how IE can be used as a decolonizing method of inquiry, the authors of this paper (a) point out common pitfalls of academic research and knowledge translation (KT) practices in Indigenous health; (b) highlight decolonizing research principles and how IE can be a decolonizing method of inquiry; and (c) share an example to illustrate how IE was used in a decolonizing health study in a First Nations community context. This paper also outlines critiques of mainstream research and KT practices, highlights principles for conducting research with Indigenous people in Canada, and further discusses how IE is well positioned to facilitate both decolonizing research and strategic KT. [ABSTRACT FROM AUTHOR]

The true realization of the benefits of vibration based structural health monitoring (VBSHM) in real-world applications is acquired through long-term continuous monitoring so that one can attain a detailed grasp of the behavior of the monitored structure. The challenges in long-term continuous VBSHM include: the large volume of accumulated monitoring data; the effective extraction of engineering information amid the influences of noise and uncertainties embedded in the monitoring data; maintaining continuity and consistency in the long-term monitoring data considering that the system and instrumentation may change due to sensor failure or renewal due to advances in sensing technologies. To meet these challenges, this paper presents recent research that has resulted in the development of a framework and specialized signal processing and data analytic tools for long-term continuous VBSHM suitable for real-world monitoring applications of structures in the field. These include efficient tools for large scale intelligent data processing and analysis, management of monitoring database and extracted information relevant to the structural health of the monitored structure. The novel Automated In-Line Full Space Identification (AI-FSI) method is presented to address the needs and challenges associated with long-term continuous VBSHM, such as the automation of all data processing and analysis operations including modal parameter estimations and mode tracking, and the need of minimizing the measurement and computational uncertainties and variability in the operational modal analysis results. A smart self-diagnostic system for the monitoring of the health of the data collection sensors and monitoring system has also been developed that will allow the consistent use of the monitoring data of different sensor configurations and era in the monitoring project. Examples on the efficiency of analyzing the monitoring data collected over 20 years from the Confederation Bridge monitoring project in Atlantic Canada by using the developed novel framework and data analytic tools are presented. [ABSTRACT FROM AUTHOR]

Background: Emotional blunting—inability to feel positive or negative emotions, detachment, or reduced emotional responsiveness—is common in people with depression. However, there is a paucity of studies comprehensively investigating this symptom and its functional impact. This study investigated the experience of emotional blunting, and its impact on overall functioning and quality of life, in the acute and remission phases of depression from the perspective of patients and healthcare providers. This paper presents data on the clinical presentation of emotional blunting in depression from the patient perspective. Methods: Cross-sectional, observational study conducted in Brazil, Canada, and Spain between April 15 and May 18, 2021. Data were collected via a self-completed online survey. Respondents were adults with depression (acute or remission phase), who were currently using a prescribed antidepressant, and who reported emotional blunting during the past 6 weeks. Emotional blunting was assessed using the Oxford Depression Questionnaire (ODQ; total score range 26–130, higher scores indicate greater emotional blunting). Results: In all, 752 patients completed the survey (62% female; mean age, 45 years). Overall, 44% of patients rated their emotional blunting as extremely severe (acute phase [n = 300], 72%; remission phase [n = 452], 25%; difference, p < 0.01). In all, 56% of patients considered their emotional blunting to be caused by their depression (acute phase, 62%; remission phase, 52%). Mean ODQ total score was 94.8 for patients in the acute phase of depression and 85.7 for those in remission (difference, p < 0.01). Mean score for the ODQ 'antidepressant as cause' domain (maximum possible score, 30) was 18.0 in patients in the acute phase and 17.6 in those in remission. Overall, 45% of patients believed that their antidepressant medication was blunting their emotions and 39% were considering stopping or had already stopped their antidepressant because of perceived emotion-related side effects. Conclusions: Almost three-quarters of patients in the acute phase of depression and one-quarter of those in remission reported severe emotional blunting. Approximately 56% of patients considered their emotional blunting to be caused by their depression, while 45% believed that their antidepressant medication was negatively affecting their emotions. Just over one-third of patients were considering stopping or had stopped their antidepressant as a result. [ABSTRACT FROM AUTHOR]

This paper focuses on the availability of economic indicators and metrics to assess effects of marine aquaculture production in the North Atlantic area (the EU, Norway, Canada and USA), including also social and environmental effects. We consider how aquaculture planning and management is organised in the different countries and the usefulness of economic information to address different aquaculture‐related policies. We find that the most relevant economic data for aquaculture management should be at the local and regional levels rather than nationally. The availability of such economic data is mapped for national, regional and local level. The focus is on data that are publicly available from authorities or research institutions. The availability of data is generally fairly good for national and regional data on the direct economic effects of aquaculture. Data on how aquaculture‐related products or input markets are affected are however poorly available, as are economic data on external effects from aquaculture. Countries with a larger aquaculture sector tend to have better availability of aquaculture‐related economic data than those with a smaller sector. An index is developed and calculated to show more specifically where the countries have relatively good or poor data availability compared to their needs. While it will not always be cost‐effective or meaningful to collect economic data on the effects of aquaculture, our study indicates that several countries could benefit from expanding such data collection. It can make trade‐off decisions more consistent and easier to perform, and aquaculture policies and measures can be better tailored to specific contexts. [ABSTRACT FROM AUTHOR]

Copyright of Environmental Reviews is the property of Canadian Science Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper describes a collection of 272 three-dimensional laser scans gathered at two unique planetary analogue rover test facilities in Canada, which offer emulated planetary terrain at manageable scales for algorithmic development. This dataset is subdivided into four individual subsets, each gathered using panning laser rangefinders on different mobile rover platforms. This data should be of interest to field robotics researchers developing rover navigation algorithms suitable for use in three-dimensional, unstructured, natural terrain. All of the data are presented in human-readable text files, and are accompanied by Matlab parsing scripts to facilitate use thereof. This paper provides an overview of the available data. [ABSTRACT FROM PUBLISHER]

The ability to regularly deliver safe drinking water is a constant challenge to municipalities worldwide. In Canada, the replacement/rehabilitation cost of water mains is estimated to be $28 billion (1997–2012). Therefore, selecting cost-effective repair and/or rehabilitation scenario(s) is essential to optimise the quality of existing water mains and minimise unnecessary rehabilitation costs. The research presented in this paper identifies several rehabilitation methods for water mains, which are classified into three main categories: (1) repair (i.e. open trench, sleeves); (2) renovation (i.e. slip lining, cement mortar lining, epoxy lining, cured in place pipe (CIPP)); and (3) replacement (i.e. pipe bursting, micro-tunnelling, horizontal directional drilling, auger boring, open cut). Due to complexity, scarcity, and enormity of data required to perform life cycle cost (LCC) and select the cost-effective scenario(s), the research presented focuses on LCC data acquisition and analysis. Data were collected from contractors and municipalities in Canada. Rehabilitation decision trees were developed as a preparation step for future LCC implementation. Breakage rate analysis was successfully developed to predict the intervals of various rehabilitation alternatives. The research presented is relevant to researchers and practitioners (municipal engineers, consultants, and contractors) to prioritise pipe inspection and rehabilitation planning for existing water mains. [ABSTRACT FROM AUTHOR]

In response to current calls by the World Health Organization and United Nations to prioritize data processes regarding COVID-19 and its impact on Indigenous Peoples worldwide, this exploratory paper aims to briefly identify barriers regarding data processes for Indigenous communities impacted by COVID-19 in Canada and the U.S. Built on emergent themes contributed by current research, the research conducted qualitatively public media analysis to address communication, distrust, and community participation as issues, barriers, and solutions for thorough and accurate data processes. Funding has been a long-term existing and primary issue in addressing these three themes. Federal governments of both countries could better support the Indigenous communities by providing adequate funding, following through with their pledges of support, and sharing detailed, accumulated data with tribal authorities, and tribal epidemiologists. Better communication among federal, state/provincial, and Indigenous community authorities would improve data collection and analysis. Stimulating bottom-up community participation in COVID-19 efforts, not only promotes the data processes in Indigenous communities, but also empowers the local communities' leadership to develop solution-based responses. This cross-national pilot research sheds light on the necessity of international collaboration advancing Indigenous communities' health and well-being in both disaster and non-disaster settings. [ABSTRACT FROM AUTHOR]

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Simple Summary: Cancer care is being increasingly driven by biomarker testing. Many biomarkers are traditionally measured on a sample from a patient tumor such as a biopsy. More recently, "liquid biopsy" has emerged as a blood test to complement or replace traditional tissue-based testing. In this report, we explore one of the first case series of rapid liquid biopsy performed within a hospital setting. The results include a median 3-day time to results, compared to approximately 14 days using traditional centralized reference labs. Additional details of the cohort are shared to highlight the utility of point of care liquid biopsy. Liquid biopsy is rapidly becoming an indispensable tool in the oncologist's arsenal; however, this technique remains elusive in a publicly funded healthcare system, and real-world evidence is needed to demonstrate utility and feasibility. Here, we describe the first experience of an in-house point of care liquid biopsy program at a Canadian community hospital. A retrospective review of consecutive cases that underwent plasma-based next-generation sequencing (NGS) was conducted. Liquid biopsy was initiated at the discretion of clinicians. Sequencing followed a point of care workflow using the Genexus™ integrated sequencer and the Oncomine precision assay, performed by histotechnologists. Results were reported by the attending pathologist. Eligible charts were reviewed for outcomes of interest, including the intent of the liquid biopsy, results of the liquid biopsy, and turnaround time from blood draw to results available. A total of 124 cases, with confirmed or suspected cancer, underwent liquid biopsy between January 2021 and November 2023. The median turnaround time for liquid biopsy results was 3 business days (range 1–12 days). The sensitivity of liquid biopsies was 71%, compared to tissue testing in cases with matched tissue results available for comparison. Common mutations included EGFR (29%), in 86 lung cancer patients, and PIK3CA (22%), identified in 13 breast cancer patients. Healthcare providers ordered liquid biopsies to inform diagnostic investigations and treatment decisions, and to determine progression or resistance mechanisms, as these reasons often overlapped. This study demonstrates that rapid in-house liquid biopsy using point of care methodology is feasible. The technique facilitates precision treatment and offers many additional advantages for cancer care. [ABSTRACT FROM AUTHOR]

Health inequalities amplified by the COVID-19 pandemic have disproportionately affected racialized and equity-deserving communities across Canada. In the Municipality of Peel, existing data, while limited, illustrates that individuals from racialized and equity-deserving communities continue to suffer, receive delayed care, and die prematurely. In response to these troubling statistics, grassroots community advocacy has called on health systems leaders in Peel to work with community and non-profit organizations to address the critical data and infrastructure gaps that hinder addressing the social determinants of health in the region. To support these advocacy efforts, we used a community-based participatory research approach to understand how we might build a data collection ecosystem across sectors, alongside community residents and service providers, to accurately capture the data about the social determinants of health. This approach involved developing a community engagement council, defining the problem with the community, mapping what data is actively collected and what is excluded, and understanding experiences of sociodemographic data collection from community members and service providers. Guided by community voices, our study focused on sociodemographic data collection in the primary care context and identified which service providers use and collect these data, how data are used in their work, the facilitators and barriers to data use and collection. Additionally, we gained insight into how sociodemographic data collection could be respectful, safe, and properly governed from the perspectives of community members. From this study, we identify a set of eight recommendations for sociodemographic data collection and highlight limitations. This foundational community-based work will inform future research in establishing data governance in partnership with diverse and equity-deserving communities. [ABSTRACT FROM AUTHOR]

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Simple Summary: Sorafenib has been the standard of care for advanced hepatocellular carcinoma (aHCC) patients since 2008. Recently, new therapies have been funded that provide increased survival in this patient population. The aim of our retrospective cohort study of linked administrative databases in Ontario was to understand the characteristics of patients with aHCC, their treatment patterns, survival outcomes, healthcare resource utilization (HCRU), and costs. We observed that patients who received systemic therapy for aHCC had a higher median overall survival (mOS) from diagnosis compared to patients who received other systemic therapies or a locoregional treatment (LRT). The mean cost per patient was $52,166 CAD for all the patients in the study, with inpatient hospitalizations and oral medications as the largest cost drivers. The therapeutic landscape for aHCC has evolved in recent years, necessitating a comprehensive analysis of treatment patterns, clinical outcomes, HCRU, and costs to contextualize emerging treatments. This study aimed to investigate these outcomes using real-world data from Ontario, Canada. This retrospective cohort study was conducted using linked administrative databases from April 2010 to March 2020. Patients diagnosed with aHCC were included, and their clinical and demographic characteristics were analyzed, as well as treatment patterns, survival, HCRU, and economic burden. Among 7322 identified patients, 802 aHCC patients met the eligibility criteria for inclusion in the study. Treatment subgroups included 1L systemic therapy (53.2%), other systemic treatments (4.5%), LRT (9.0%), and no treatment (33.3%). The median age was 66 years, and the majority were male (82%). The mOS for the entire cohort from diagnosis was 6.5 months. However, patients who received 1L systemic therapy had an mOS of 9.0 months, which was significantly higher than the other three subgroups. The mean cost per aHCC-treated patient was $49,640 CAD, with oral medications and inpatient hospitalizations as the largest cost drivers. The results underscore the need for the continuous evaluation and optimization of HCC management strategies in the era of evolving therapeutic options. [ABSTRACT FROM AUTHOR]

Background: A large volume of research has been published on both the socio economic and demographic determinants of cancer and on the health of immigrants and minority groups. Yet because of data limitations, little research examines differences in the occurrence of cancer incidence between immigrants and non-immigrants and among immigrants defined by region of birth and time in the host country. In particular it is not known whether a healthy immigrant effect is present for cancer and if so, whether this advantage is lost with additional years of residence in the host country.Methods: This paper uses a large data file from Statistics Canada that links Census information on immigrant status, socioeconomic status including educational attainment, and other person-level information with administrative data on cancer and mortality over a continuous 13 year period of observation. It estimates discrete and continuous time duration models to identify differences in cancer diagnosis by immigrant subgroup after controlling for a variety of potential confounders. Differences in historical smoking behavior are not observable at the individual level in the dataset but are accounted for indirectly using various methods.Results: Results in general confirm the existence of a healthy immigrant effect for cancer in that, overall, recent immigrants to Canada are significantly less likely than otherwise comparable non-immigrant Canadians to be diagnosed with any cancer and the most common forms of cancer by site. As well, this gap appears to decline with additional years in Canada for immigrant men and women, eventually converging to Canadian-born levels. Differentiating among immigrant subgroups by period of arrival and country of birth reveals significant variation across immigrant subgroups, with immigrant men and women from developing countries typically having a lower likelihood of being diagnosed with cancer than immigrants from the US, UK and continental Europe. As well, controlling for immigrant heterogeneity this way weakens the conclusion that the gap narrows with years in Canada. Immigrant men overall continue to exhibit convergence to Canadian-born levels for diagnosis of any cancer and for prostate cancer, while immigrant women exhibit narrowing over time only for breast cancer. Although smoking behavior is not directly observed, controlling for subgroup-specific lifetime smoking behavior using survey data has only a relatively minor effect on the estimated differences.Conclusions: The specificity of the results by cancer type, gender, immigrant status and ethnicity provides useful guidance for future research by helping to narrow the possible channels through which social and economic characteristics may be affecting cancer incidence. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Naturopathic medicine uses natural and evidence-based treatments to promote health. The objective of this study was to characterize and evaluate the effectiveness of naturopathic medicine in reducing symptoms of anxiety and depression in patients seeking care from the Mental Health Shift at a Canadian naturopathic teaching clinic. Methods: Charts of 192 consecutive patients who attended appointments between 1 January 2019 and 6 March 2020 were reviewed. Subjects were included if they screened positive on the General Anxiety Disorder 7 (GAD7) or the Patient Health Questionnaire 9 (PHQ9) and attended follow up at least 4 weeks after initial treatment. Results: Of the 22 included subjects, a clinically significant decrease of at least 5 points occurred in 76% of individuals with elevated baseline PHQ9 scores and 59% of individuals with elevated GAD7 scores. Mean PHQ9 and GAD7 scores decreased 7.5 (p<0.0001) and 4.6 (p<0.008) points, respectively. Mild adverse events were reported in 9 charts (41%). No serious adverse events were reported. Most subjects were also in the care of a medical doctor and counsellor. Conclusion: Naturopathic medicine as performed on the Mental Health Shift may be effective in reducing depression and anxiety symptoms as an adjunctive treatment. Further research incorporating comparison groups is warranted. [ABSTRACT FROM AUTHOR]

Introduction: Members of the healthcare team must access and share patient information to coordinate interprofessional collaborative practice (ICP). Although some evidence suggests that electronic health records (EHRs) contribute to in-team communication breakdowns, EHRs are still widely hailed as tools that support ICP. If EHRs are expected to promote ICP, researchers must be able to longitudinally study the impact of EHRs on ICP across communication types, users, and physical locations.Objective: This paper presents a data collection and analysis tool, named the Map of the Clinical Interprofessional Communication Spaces (MCICS), which supports examining how EHRs impact ICP over time, and across communication types, users, and physical locations.Methods: The tool's development evolved during a large prospective longitudinal study conducted at a Canadian pediatric academic tertiary-care hospital. This two-phased study [i.e., pre-implementation (phase 1) and post implementation (phase 2)] of an EHR employed a constructivist grounded theory approach and triangulated data collection strategies (i.e., non-participant observations, interviews, think-alouds, and document analysis). The MCICS was created through a five-step process: (i) preliminary structural development based on the use of the paper-based chart (phase 1); (ii) confirmatory review and modification process (phase 1); (iii) ongoing data collection and analysis facilitated by the map (phase 1); (iv) data collection and modification of map based on impact of EHR (phase 2); and (v) confirmatory review and modification process (phase 2).Results: Creating and using the MCICS enabled our research team to locate, observe, and analyze the impact of the EHR on ICP, (a) across oral, electronic, and paper communications, (b) through a patient's passage across different units in the hospital, (c) across the duration of the patient's stay in hospital, and (d) across multiple healthcare providers. By using the MCICS, we captured a comprehensive, detailed picture of the clinical milieu in which the EHR was implemented, and of the intended and unintended consequences of the EHR's deployment. The map supported our observations and analysis of ICP communication spaces, and of the role of the patient chart in these spaces.Conclusions: If EHRs are expected to help resolve ICP challenges, it is important that researchers be able to longitudinally assess the impact of EHRs on ICP across multiple modes of communication, users, and physical locations. Mapping the clinical communication spaces can help EHR designers, clinicians, educators and researchers understand these spaces, appreciate their complexity, and navigate their way towards effective use of EHRs as means for supporting ICP. We propose that the MCICS can be used "as is" in other academic tertiary-care pediatric hospitals, and can be tailored for use in other healthcare institutions. [ABSTRACT FROM AUTHOR]

In recent years, action on sustainability has been highly influential around the globe and many now recognize the importance of individual and social learning for inspiring action and achieving sustainability outcomes. Transformative learning theory has been criticized, however, for insufficient development of the link between learning and action. The purpose of this paper is to deepen our understanding of the learning–action cycle among adult learners in the sustainability context. We consider this through insights from two studies in Kenya and Canada, utilizing a qualitative approach. Both studies employed semi-structured interviews as their primary data collection instrument and used other tools such as focus groups and journal writing. Three broad nodes of social action—individual, interpersonal and collective—are identified and defined based on the data collected. Results show that while all three types of action were evident in the outcomes of participants, individual social action was the most common and collective social action was the least. Barriers to applying learning in action are also derived from the data, including situational, personal, interpersonal, sociocultural and environmental obstacles. Factors that assist in overcoming such barriers include community support networks and skills training. [ABSTRACT FROM PUBLISHER]

The probabilistic distribution of wind speed is critical information required in evaluating wind resources, designing wind farms, and mitigating the possible risks in wind power expansion. Various distributions have been used in the research literature to estimate wind speed distribution. In this paper, we propose a flexible family of mixture distributions, whose elements are convex linear combinations of the skew-t-normal Birnbaum-Saunders distributions and is suitable for modelling heavy-tailed data with a heterogeneous population. These distributions are then used to estimate the wind speed distribution. The performance of the proposed family has been compared with five mixture models of the already used distributions, using wind speed data collected at nine stations across Ontario, Canada. The results indicate that mixture models generally provide a better fit than unimodal distributions, according to the model selection criterion. Based on the obtained results, the proposed family provides highly flexible models at all selected stations. It functions better than the other considered distributions at seven of the stations, whereas it is ranked second in the remaining two stations. The proposed family can be utilized in a widespread manner to describe the wind speed in Canada, as well as other regions with similar features. • The Weibull distribution may be inadequate for wind speed data that have heavy-tailed distributions. • The mixture models of STNBS distributions can have one, two or more peak points. • The results indicate that FM-STNBS model provides a better fit than the considered distributions. [ABSTRACT FROM AUTHOR]

Background: During the first wave of the H1N1 influenza pandemic in 2009, Aboriginal populations in Canada experienced disproportionate rates of infection, particularly in the province of Manitoba. To protect those thought to be most at-risk, health authorities in Manitoba listed all Aboriginal people, including Metis, among those able to receive priority access to the novel vaccine when it first became available. Currently, no studies exist that have investigated the attitudes, influences, and vaccine behaviors among Aboriginal communities in Canada. This paper is the first to systematically connect vaccine behavior with the attitudes and beliefs that influenced Metis study participants' H1N1 vaccine decision-making. Methods: Researchers held focus groups (n = 17) with Metis participants in urban, rural, and remote locations of Manitoba following the conclusion of the H1N1 pandemic. Participants were asked about their vaccination decisions and about the factors that influenced their decisions. Following data collection, responses were coded into the broad categories of a social-ecological model, nuanced by categories stemming from earlier research. Responses were then quantified to show the most influential factors in positively or negatively affecting the vaccine decision. Results: Media reporting, the influence of peer groups, and prioritization all had positive and negative influential effects on decision making. Whether vaccinated or not, the most negatively influential factors cited by participants were a lack of knowledge about the vaccine and the pandemic as well as concerns about vaccine safety. Risk of contracting H1N1 influenza was the biggest factor in positively influencing a vaccine decision, which in many cases trumped any co-existing negative influencers. Conclusions: Metis experiences of colonialism in Canada deeply affected their perceptions of the vaccine and pandemic, a context that health systems need to take into account when planning response activities in the future. Participants felt under-informed about most aspects of the vaccine and the pandemic, and many vaccine related misconceptions and fears existed. Recommendations include leveraging doctor-patient interactions as a site for sharing vaccine-related knowledge, as well as targeted, culturally-appropriate, and empowering public information strategies to supply reliable vaccine and pandemic information to potentially at-risk Aboriginal populations. [ABSTRACT FROM AUTHOR]

Introduction. Studies from Australia, Sweden, the United States, and elsewhere have found that paramedics experience violence in the emergency medical services (EMS) workplace. The objective of this study was to describe and explore violence experienced by paramedics in the ground ambulance setting, including types of violence experienced, by whom the violence was perpetrated, actions taken by paramedics, and effects of these episodes. Method. A cross-sectional study utilizing a mixed-methods paper survey was provided to a convenience sample of rural, suburban, and urban-based ground ambulance paramedics in two Canadian provinces. Paramedics were asked to describe episodes of verbal assault, intimidation, physical assault, sexual harassment, and sexual assault they were exposed to during the past 12 months. Qualitative questions inquired about the impact of these experiences. Response selections were analyzed using descriptive statistics and regression analysis, and qualitative data was analyzed using descriptive content analysis. Results. A total of 1,884 paramedics were invited to participate and 1,676 responded (89.0%). Most participants (75%) reported experiencing violence in the past 12 months. The most common form of violence reported was verbal assault (67%), followed by intimidation (41%), physical assault (26%), sexual harassment (14%), and sexual assault (3%). Patients were identified as the most common perpetrators of violence. Serious sequellae were qualitatively reported. Conclusion. The majority of Canadian paramedics surveyed experience violence in the workplace, which can lead to serious personal and professional sequellae. Strategies should be devised and studied to reduce violent events toward paramedics and to mitigate the impact such events have on the wellbeing of paramedics. [ABSTRACT FROM AUTHOR]

Medication-induced diabetes (MID) is common during induction therapy for pediatric acute lymphoblastic leukemia (ALL) and has potentially significant negative consequences. Reported risk factors for MID are variable with limited data comparing patients treated with standard-risk (SR) vs. high-risk (HR) regimens. This study aims to evaluate the incidence and risk factors for MID during induction in patients with ALL from the Maritimes over a 20-year period. We performed a retrospective single-center study of 262 patients (142 males, 120 females) diagnosed with ALL at IWK Health in Halifax, Nova Scotia, Canada, from 2000 to 2019. Older age, higher body mass index, greater central nervous system status, Trisomy 21, and prednisone steroid type were risk factors associated with MID in our cohort. HR patients developed significantly more complications than SR patients including MID and infection. Screening for MID should be routine during ALL induction treatment, particularly in those with HR disease. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Krauss et al. (2012) Respiratory tract versus cloacal sampling of migratory ducks for influenza A viruses: are both ends relevant? Influenza and Other Respiratory Viruses DOI: . Background Early studies in dabbling ducks showed that cloacal swabs yielded a larger number of avian influenza virus (AIV) isolates than did respiratory tract swabs. Historically, AIV surveillance has been performed by collecting cloacal or environmental fecal samples only. Highly pathogenic avian influenza H5N1 virus emerged in 1996 and replicated to higher titers in the respiratory rather than the gastrointestinal tract of ducks, prompting the collection of respiratory samples in addition to cloacal swabs from wild birds. Studies confirmed that some virus subtypes, especially H9 and highly pathogenic H5, are shed primarily through the respiratory tract and may not be detected in cloacal swabs. Objectives To examine prevalence and subtype differences for AIV isolates from cloacal or respiratory swabs of wild ducks and to determine whether individual respiratory tract samples should be included in AIV surveillance studies in wild birds. Methods Individual respiratory tract and cloacal swabs were collected from each of 1036 wild ducks in Alberta, Canada, during the month of August from 2007 to 2010 in an ongoing surveillance study. Virus isolation in eggs and subtype identification by antigenic and molecular methods were performed. Results and conclusions Respiratory tract and cloacal swabs yielded ten influenza virus HA subtypes representing 28 HA-NA combinations. Three HA-NA subtype combinations were found exclusively in respiratory tract samples. Only four HA subtypes (H1, H3, H4, and H7) were recovered from respiratory samples, but respiratory shedding was associated with the dominance of 1 year's subtype. Might respiratory shedding provide a risk assessment indicator? [ABSTRACT FROM AUTHOR]

The purpose of this paper is to both describe the major findings from the Canadian Incidence Study of Reported Child Abuse and Neglect, 2008 (CIS-2008), and to compare these findings to data reported by Gilbert et al. (2011), who derived their estimates from the US National Child Abuse and Neglect Data System. The CIS-2008 tracked 15,980 maltreatment-related investigations of children under the age of 16 conducted in a representative sample of 112 child welfare organizations across Canada in the fall of 2008. Bivariate analyses were used to explore the differences in service dispositions, age, and referral sources by primary maltreatment category and risk. The Canadian/US comparison reveals that rates of investigated maltreatment are nearly identical. Rates of substantiated maltreatment are also comparable, although slightly higher in Canada when substantiated risk of maltreatment is included in the substantiation category. The variation in substantiation and service response rates across types of investigated maltreatment requires closer analysis and highlights the need for a detailed understanding of each type of maltreatment. The rapid expansion of reports over the last decade in Canada invites discussion of the extent to which a response focused exclusively on child protection is appropriate for all cases and optimal for addressing a broad array of needs. The complexity of comparing rates between Canada and the United States requires an understanding of both substantiation rates and thresholds. [ABSTRACT FROM AUTHOR]

Background. To date, there has been no attempt to describe or compare physical therapy as practiced globally, nor any evidence that an international data set exists to support this effort. It is known that research evidence can be used in strategic and tactical ways, especially within the highly politicized context of the policy arena. The International Private Practitioners Association recognized the potential value a global evidence base could have in influencing policy and supporting professional development in a number of countries, yet it lacked a mechanism to achieve these aims. Objectives. The purposes of this study were: (1) to identify and test an international data set, definitions, and means of data collection and (2) to establish views in relation to the value of international collaborations. Design. A mixed, prospective design was used in the study. Method. Phase 1 (2006-2007) involved the development of a data set, definitions, and Web-based and paper-based data collection options involving 98 physical therapists from 68 physical therapy practices in 7 countries. Phase 2 (2008-2009) involved testing of the data set in 34 practices involving 3,195 patient episodes and included physical therapist feedback of experience, local relevance of the data set, and value of international collaborations. Results. Testing confirmed the relevance and reliability of the data set and definitions and a preference for Web-based data collection (74.0%). Physical therapist feedback supported these findings. Most respondents (60.0%-100.0%) reported the value of further international collaborations for their profession nationally or internationally. Limitations. Although a true international collaboration, the limited sample size should be recognized. Conclusions. It is possible to develop an agreed-upon international data set and means of data collection. Testing appears to support its acceptability and relevance for use in practice. Participants highly valued the opportunity to undertake international collaborations that may benefit their profession nationally and internationally. Further testing and use of the data set are advocated before final validation is sought. [ABSTRACT FROM AUTHOR]

This paper describes the recent changes to the regional data assimilation and forecasting system at the Canadian Meteorological Center. A major aspect is the replacement of the currently operational global variable resolution forecasting approach by a limited-area nested approach. In addition, the variational analysis code has been upgraded to allow limited-area three- and four-dimensional variational data assimilation (3D- and 4DVAR) analysis approaches. As a first implementation step, the constraints were to impose similar background error correlation modeling assumptions, equal computer resources, and the use of the same assimilated data. Both bi-Fourier and spherical-harmonics spectral representations of background error correlations were extensively tested for the large horizontal domain considered for the Canadian regional system. Under such conditions, it is shown that the new regional data assimilation and forecasting system performs as well as the current operational system and it produces slightly better 24-h accumulated precipitation scores as judged from an ensemble of winter and summer cases. Because of the large horizontal extent of the regional domain considered, a spherical-harmonics spectral representation of background error correlations was shown to perform better than the bi-Fourier representation, considering all evaluation scores examined in this study. The latter is more suitable for smaller domains and will be kept for the upcoming use in the kilometric-scale local analysis domains in order to support the Canadian Meteorological Center''s (CMC''s) operations using multiple domains over Canada. The CMC''s new regional system [[i.e., a regional limited-area 3DVAR data assimilation system coupled to a limited-area model (REG-LAM3D)]] is now undergoing its final evaluations before operational transfer. Important model and data assimilation upgrades are currently under development to fully exploit this new system and are briefly presented. [ABSTRACT FROM AUTHOR]

Objective: Several papers have reported higher prevalence of diabetes mellitus (DM) type 2 in patients suffering from bipolar disorder (BD). The possible links between these 2 disorders include treatment, lifestyle, alterations in signal transduction, and possibly, a genetic link. To study this relation more closely, we investigated whether there are any differences in the clinical characteristics of BD patients with and without DM.Method: We compared the clinical data of 26 diabetic and 196 nondiabetic subjects from The Maritime Bipolar Registry. Subjects were aged 15 to 82 years, with psychiatric diagnoses of BD I (n = 151), BD II (n = 65), and BD not otherwise specified (n = 6). The registry included basic demographic data and details on the clinical course of bipolar illness, its treatment, and physical comorbidity. In a subsequent analysis using logistic regression, we examined the variables showing differences between groups, with diabetes as an outcome variable.Results: The prevalence of DM in our sample was 11.7% (n = 26). Diabetic patients were significantly older than nondiabetic patients (P < 0.001), had higher rates of rapid cycling (P = 0.02) and chronic course of BD (P = 0.006), scored lower on the Global Assessment of Functioning Scale (P = 0.01), were more often on disability for BD (P < 0.001), and had higher body mass index (P < 0.001) and increased frequency of hypertension (P = 0.003). Lifetime history of treatment with antipsychotics was not significantly associated with an elevated risk of diabetes (P = 0.16); however, the data showed a trend toward more frequent use of antipsychotic medication among diabetic subjects.Conclusions: Our findings suggest that the diagnosis of DM in BD patients is relevant for their prognosis and outcome. [ABSTRACT FROM AUTHOR]

This paper explores the influence of an organization's information ecology, or internal information environment, on a firm's electronic commerce initiatives and plans. To investigate this problem area, results are reported from a recent case study investigation on the adoption and use of a specific e-commerce initiative – namely a corporate portal – by 20 participants at a large Canadian company. Data collection involved semi-structured interviews and field observations, while analysis comprised a variant form of grounded theory. Factors of the information ecology influencing portal utilization are identified. From these, implications are drawn to e-commerce solutions in general. Specific recommendations include the need to create a democratic steering committee to oversee the development of e-commerce solutions, gain support of upper management, and market and train organizational workers on the functionality and strategic importance of a company's e-commerce initiatives and plans. [ABSTRACT FROM AUTHOR]

Objectives: Patients with a peritonsillar abscess (PTA) often present to emergency departments as the first point of medical contact. Upper respiratory tract infections (URTIs) are more frequent in the winter. Therefore, we hypothesize that the incidence of PTAs will be more frequent in colder winter months as well. This is the first study assessing the seasonal variation and epidemiology of PTA presentations to an emergency department in Atlantic Canada, home to a unique maritime climate. Methods: A retrospective cohort study was conducted through a chart review of all patients who presented to the Saint John Regional Hospital Emergency Department from January 1, 2015, to December 31, 2020. Patient characteristics, treatment, and microbiology were reported. A chi-square goodness-of-fit test assessed the seasonal variation of PTA. Pearson correlations assessed PTA incidence per mean monthly temperature and humidity. Results: A total of 75 patients were included. 57.3% were male and 42.7% were female, with a mean age (±SD) of 35.9 ± 14.0. Most patients presented afebrile (82.7%, cutoff ≥ 38.0°C). Approximately half of all patients had an elevated WBC count (49.3%, cutoff ≥ 10.9 × 109). The most common bacteria isolated were Streptococcus species followed by anaerobic bacteria (17.9%). No significant variation was found with respect to season (X2(3) = 1.0, P =.801), temperature (r(70) = 0.198, P =.096), or humidity, (r(70) = 0.063, P =.599). Conclusion: This study did not find a seasonal variation of PTA in a maritime climate. These findings question the anecdotal hypothesis that PTA is associated with progression from acute URTIs and therefore would be more common in the winter months. [ABSTRACT FROM AUTHOR]

Simple Summary: Treatments used to cure childhood cancer can have negative long-term impacts on physical health and well-being. Here, we present the Alberta Childhood Cancer Survivorship Research Program, its foundational cohort, and descriptive statistics of outcomes ascertained through data linkage. To this end, 2580 survivors of childhood cancer were included in the cohort, the majority of which were male, diagnosed between the ages of 0 and 4 years, and had leukemia, central nervous system tumor, or lymphoma. By the study exit date, the median time since diagnosis was 5.5 years overall and 10.4 years for 5-year survivors. During the follow-up time, 82 subsequent cancers were diagnosed, 20,355 inpatient and 555,425 ambulatory/outpatient events occurred, 606,773 claims were reported, and 437 survivors died. The results from this research program seek to inform and improve clinical care and reduce cancer-related sequelae. Adverse outcomes after childhood cancer have been assessed in a range of settings, but most existing studies are historical and ascertain outcomes only after 5-year survival. Here, we describe the Alberta Childhood Cancer Survivorship Research Program and its foundational retrospective, population-based cohort of Albertan residents diagnosed with a first primary neoplasm between the ages of 0 and 17 years from 1 January 2001 to 31 December 2018. The cohort was established in collaboration with the Alberta Cancer Registry and Cancer in Young People in Canada program and has been linked to existing administrative health databases and patient-reported outcome questionnaires. The cohort comprised 2580 survivors of childhood cancer, 1379 (53.4%) of whom were 5-year survivors. Approximately 48% of the cohort was female, 47% of the cohort was diagnosed between 0 and 4 years of age, and the most frequent diagnoses were leukemias (25.4%), central nervous system tumors (24.0%), and lymphomas (14.9%). Detailed treatment information was available for 1741 survivors (67.5%), with manual abstraction ongoing for those with missing data. By the study exit date, the median time since diagnosis was 5.5 years overall and 10.4 years for 5-year survivors. During the follow-up time, 82 subsequent primary cancers were diagnosed, 20,355 inpatient and 555,425 ambulatory/outpatient events occurred, 606,773 claims were reported, and 437 survivors died. The results from this research program seek to inform and improve clinical care and reduce cancer-related sequelae via tertiary prevention strategies. [ABSTRACT FROM AUTHOR]

Introduction: Successful completion of clinical education experiences is a graduation requirement for students in occupational therapy and physical therapy programmes. A scoping review was conducted to determine what is known about possible clinical experience performance predictors and to find associated research gaps. Methods: The search included one hand‐searched journal and seven databases, which were used to identify related relevant studies: CINAHL, Education Database, Education Source, Education Resources Information Center (ERIC), PubMed, REHABDATA, and Web of Science. A research librarian guided the search process, and the review's reporting is structured by the Preferred Reporting Items for Systematic reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR) Checklist. Studies were included if they contained predictors of clinical experience success indicated by validated performance evaluation tools that were scored by clinical instructors. A multidisciplinary team reviewed the title, abstract, and full text for inclusion and conducted thematic data synthesis to categorise findings. Findings: Twenty‐six articles met the inclusion criteria. The majority of articles were of correlational design and included single institutions. Seventeen articles included occupational therapy, eight included physical therapy, with only one article including both programmes. Four categories of predictors of clinical experience success were identified: pre‐admission variables, academic preparation, learner characteristics, and demographics. Each of the main categories included three to six subcategories. Key findings included the following: (a) The most common cited predictors in clinical experiences are academic preparation and learner characteristics, (b) more experimental design studies are needed to determine the causal relationship between predictors and clinical experience success, and (c) future research is needed on ethnic disparities and clinical experience success. Conclusion: Findings from this review show that possible predictors of clinical experience success include a wide range of factors when correlating success with a standardised tool. Academic preparation and learner characteristics were the most investigated predictors. There were only a small number of studies that found a correlation with pre‐admission variables. The findings of this study suggest that students' academic achievement may be a critical element of clinical experience preparation. Future research using experimental designs and across institutions is needed to determine the main predictors for student success. [ABSTRACT FROM AUTHOR]

We aimed to examine the impact of maternal hypothyroidism on placental pathology and perinatal outcomes in singleton live births resulting from IVF, using medical records of IVF births between 2009 and 2017 at a tertiary hospital. The primary outcomes included anatomical, inflammation, vascular malperfusion, and villous maturation placental features. Secondary outcomes included foetal, maternal, perinatal, and delivery complications. There were 1,057 live births, of which 103 (9.7%) and 954 (90.3%) were in the study and control groups, respectively. Patients in the study group were more likely to have diabetes mellitus, polycystic ovarian syndrome, gestational diabetes mellitus, and non-reassuring foetal heart rate (NRFHR) tracing during delivery. After adjustment for potential confounding factors, hypothyroidism was significantly associated with the bilobed placenta (aOR 4.1; 95% CI 1.2–14.3), retroplacental haematoma (aOR 2.4; 95% CI 1.2–4.9), decidual arteriopathy (aOR 2.0; 95% CI 1.2–4.1) and subchorionic thrombi (aOR 2.4; 95% CI 1.3–5.0). Additionally, there was a statistically significant relationship with NRFHR tracing. The incidence of acute chorioamnionitis and severe foetal inflammatory response was higher in the study group. In conclusion, the placental histopathology patterns of singleton IVF live births show that maternal hypothyroidism has a significant impact on adverse perinatal outcomes. [ABSTRACT FROM AUTHOR]

Resources addressing intimate partner violence (IPV) play a role in shaping how physicians conceptualize and perform their roles in caring for affected patients. This study combines environmental scanning with critical discourse analysis (CDA) to parse how roles of physicians were represented in 28 education materials and policy documents about IPV, taking the Canadian training milieu as an example. We developed a cyclical model of three core physician roles in addressing IPV—learning about IPV, identifying patients experiencing IPV, and responding to patients' disclosures of IPV. The construction of these physician roles is suggestive of an ongoing process of medicalization of IPV. [ABSTRACT FROM AUTHOR]

Objective: To describe the pattern and risk factors for antimalarial (AM)‐induced retinopathy in patients with rheumatic diseases. Methods: A retrospective chart review was conducted at an urban Canadian center for patients with AM use of more than 3 months and documented retinopathy screening. Univariate and multivariate regression analyses were performed to determine risk factors for retinopathy. Sensitivity analyses included stratification of analysis by method of screening and by hydroxychloroquine (HCQ) versus chloroquine (CQ). Results: A total of 613 patients were included in the final analysis, with systemic lupus erythematosus (SLE) (n = 259) as the most common diagnosis. Definite AM‐induced retinal toxicity was observed in 12 patients, 11 of whom had SLE. The earliest diagnosis of toxicity occurred after 5.4 years of AM therapy, and the prevalence beyond 5 years was 3.1%. In univariate analysis, a diagnosis of SLE (P = 0.009; odds ratio [OR]: 15.66; 95% confidence interval [CI]: 2.01‐122.05), the daily weight‐based dose of HCQ (P = 0.044; OR: 1.49; 95% CI: 1.01‐2.20), cumulative CQ dose (P = 0.014; OR: 4.80; CI: 1.37‐16.84), and daily CQ weight‐based dose (P = 0.0001; OR: 5.70; 95% CI: 2.41‐13.49) were significantly associated with toxicity. In multivariate analysis, diagnosis of SLE (P = 0.022; OR: 12.14; 95% CI: 1.44‐102.44) and daily CQ weight‐based dose (P = 0.005; OR: 1.83; 95% CI: 1.83‐26.75) were significant after adjusting for standard covariates. Conclusion: The risk of AM‐induced retinopathy increases after 5 years of therapy. There may be higher rates of toxicity in patients with SLE because of longer duration of treatment, higher weight‐based dosages, and more CQ use in this population, and SLE may be an independent risk factor. [ABSTRACT FROM AUTHOR]

The increasing frequency of flooding worldwide has driven research to improve near real-time flood mapping from remote-sensing data. Improved automation and processing speed to map both open water and vegetated area flooding have resulted from these research efforts. Despite these achievements, flood mapping in urban areas where a significant number of overall impacts are felt remains a challenge. Near real-time data availability, shadowing caused by manmade infrastructure, spatial resolution, and cloud cover inhibiting optical transmission, are all factors that complicate detailed urban flood mapping needed to inform response efforts. This paper uses numerous data sources collected during two major flood events that impacted the same region of Eastern Canada in 2017 and 2019 to test different urban flood mapping approaches presented as case studies in three separate urban boroughs. Cloud-free high-resolution 3 m PlanetLab optical data acquired near peak-flood in 2019 were used to generate a maximum flood extent product for that year. Approaches using new Lidar Digital Elevation Models (DEM)s and water height estimated from nineteen RADARSAT-2 flood maps, point-based flood perimeter observations from citizen geographic information, and simulated traffic camera or other urban sensor network data were tested and verified using independent data. Coherent change detection (CCD) using multi-temporal Interferometric Wide (IW) Sentinel-1 data was also tested. Results indicate that while clear-sky high-resolution optical imagery represents the current gold standard, its availability is not guaranteed due to timely coverage and cloud cover. Water height estimated from 8 to 12.5 m resolution RADARSAT-2 flood perimeters were not sufficiently accurate to flood adjacent urban areas using a Lidar DEM in near real-time, but all nineteen scenes combined captured boroughs that flooded at least once in both flood years. CCD identified flooded boroughs and roughly captured their flood extents, but lacked timeliness and sufficient detail to inform street-level decision-making in near real-time. Point-based flood perimeter observation, whether from in-situ sensors or high-resolution optical satellites combined with Lidar DEMs, can generate accurate full flood extents under certain conditions. Observed point-based flood perimeters on manmade features with low topographic variation produced the most accurate flood extents due to reliable water height estimation from these points. [ABSTRACT FROM AUTHOR]

Nitidulidae trapping performed from 2018 to 2021 to characterize flight behaviors of potential vectors of the oak wilt pathogen yielded three new species records for Canada, six new species records for Ontario, and three new species records for Manitoba. The new records for Canada include Carpophilus (Ecnomorphus) corticinus reported from Ontario, C. (Myothorax) nepos reported from Ontario and Manitoba, and Glischrochilus (Librodor) obtusus reported from Ontario. In addition, the following species are first recorded in Ontario: Carpophilus (Ecnomorphus) antiquus, C. (Megacarpolus) sayi, Stelidota coenosa; and also in Manitoba: Carpophilus (Megacarpolus) lugubris and Cychramus adustus. Collection data is provided for the two provinces and national records. [ABSTRACT FROM AUTHOR]

The CanMars Mars Sample Return Analogue Deployment (MSRAD) was a closely simulated, end-to-end Mars Sample Return (MSR) mission scenario, with instrumentation, goals, and constraints modeled on the upcoming NASA Mars 2020 rover mission; this paper reports on the post-mission validation of the exercise. The exercise utilized the CSA Mars Exploration Science Rover (MESR) rover, deployed to Utah, USA, at a Mars-analogue field site. The principal features of the field site located near Green River, Utah are Late Jurassic inverted, fluvial paleochannels, analogous to features on Mars in sites being considered for the ESA ExoMars rover mission and present within the chosen landing site for the Mars 2020 rover mission. The in-simulation ("in-sim") mission operations team worked remotely from The University of Western Ontario, Canada. A suite of MESR-integrated and hand-held spectrometers was selected to mimic those of the Mars 2020 payload, and a Utah-based, on-site team was tasked with field operations to carry out the data collection and sampling as commanded by the in-sim team. As a validation of the in-sim mission science findings, the field team performed an independent geological assessment. This paper documents the field team's on-site geological assessment and subsequent laboratory and analytical results, then offers a comparison of mission (in-sim) and post-mission (laboratory) science results. The laboratory-based findings were largely consistent with the in-sim rover-derived data and geological interpretations, though some notable exceptions highlight the inherent difficulties in remote science. In some cases, available data was insufficient for lithologic identification given the absence of other important contextual information (e.g., textural information). This study suggests that the in-sim instruments were largely adequate for the Science Team to characterize samples; however, rover-based field work is necessarily hampered by mobility and time constraints with an obvious effect on efficiency but also precision, and to some extent, accuracy of the findings. The data show a dearth of preserved total organic carbon (TOC) – used as a proxy for ancient biosignature preservation potential – in the fluvial-lacustrine system of this field site, suggesting serious consideration with respect to the capabilities and opportunities for addressing the Mars exploration goals. We therefore suggest a thorough characterization of terrestrial sites analogous to those of Mars rover landing sites, and in-depth field studies like CanMars as important, pre-mission strategic exercises. • We present a field geological assessment of the CanMars analogue mission field site. • Characterization of terrestrial, analogous Mars landing sites is crucial for mission success. • In-depth field studies allow an understanding of how to address habitability potential. [ABSTRACT FROM AUTHOR]

The article presents a study which examined whether physical restraint, antipsychotic or sedative-hypnotic use differed by language preference in hospitalized medical patients with delirium. Topics discussed include most common non-English preferred languages, relative risk of study outcomes by preferred language, and limitations of the study.

Real‐time continuous glucose monitoring (rtCGM) and intermittently scanned CGM (isCGM) have both been shown to improve glycaemic outcomes in people with T1D. The aim of this study was to compare real‐world glycaemic outcomes at 6–12 months in a propensity score matched cohort of CGM naïve adults with T1D who initiated a rtCGM or an isCGM. Among the matched rtCGM and isCGM cohorts (n = 143/cohort), rtCGM users had a significantly greater HbA1c benefit compared to isCGM users (adjusted difference, −3 mmol/mol [95% CI, −5 to −1]; −0.3% [95% CI, −0.5 to −0.1]; p = 0.01). There was a significantly greater lowering of HbA1c for rtCGM compared to isCGM when baseline HbA1c was <69 mmol/mol (8.5%) (adjusted difference, −4 mmol/mol [95% CI, −7 mmol/mol to −2 mmol/mol]; −0.4% [95% CI, −0.6% to −0.2%]; p < 0.001), and in MDI users (adjusted difference, −3 mmol/mol [95% CI, −6 mmol/mol to −0 mmol/mol]; −0.3% [95% CI ‐0.5% to 0.0%], p = 0.04). The rtCGM cohort had significantly greater time in range (58.3 ± 16.1% vs. 54.5 ± 17.1%, p = 0.03), lower time below range (2.1 ± 2.7% vs. 6.1 ± 5.0%, p < 0.001) and lower glycaemic variability compared to the isCGM cohort. In this real‐world analysis of adults with T1D, rtCGM users had a significantly greater reduction in HbA1c at 6–12 months compared to isCGM, and significantly greater time in range, lower time below range and lower glycaemic variability, compared to a matched cohort of isCGM users. [ABSTRACT FROM AUTHOR]