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There is general consensus that teaching and learning centres have a positive impact on promoting and supporting a culture that values teaching and learning, yet there is limited evidence on how centres evaluate their work. For this purpose, a survey was developed and administered to the directors of 88 Canadian centres; 46 of which completed the survey. In this paper, we share centres' approaches to evaluation that emerged from the survey findings and the artifact analysis. By raising awareness of evaluation approaches, we are better positioned to identify further opportunities to develop a more systematic and coherent approach to evaluation.

This paper is the last in a series of three manuscripts published in the TQR journal over the past few years. This work is part of a larger program of research that has been carried out by a team of researchers detailing various aspects of a three year action research project carried out from 2005 and 2008. This particular paper addresses issues of quality in action research by critiquing our research against five interdependent principles and criteria raised in the literature specifically by Davison, Martinson and Kock which was published in 2004. Our action research project aimed to facilitate interprofessional education for health care learners in the Faculty of Health Sciences at a Canadian University. (Contains 1 table and 1 footnote.)

Background: Current evidence suggests that chlamydia screening programmes can be cost-effective, conditional on assumptions within mathematical models. We explored differences in cost estimates used in published economic evaluations of chlamydia screening from seven countries (four papers each from UK and the Netherlands, two each from Sweden and Australia, and one each from Ireland, Canada and Denmark).Methods: From these studies, we extracted management cost estimates for seven major chlamydia sequelae. In order to compare the influence of different sequelae considered in each paper and their corresponding management costs on the total cost per case of untreated chlamydia, we applied reported unit sequelae management costs considered in each paper to a set of untreated infection to sequela progression probabilities. All costs were adjusted to 2013/2014 Great British Pound (GBP) values.Results: Sequelae management costs ranged from £171 to £3635 (pelvic inflammatory disease); £953 to £3615 (ectopic pregnancy); £546 to £6752 (tubal factor infertility); £159 to £3341 (chronic pelvic pain); £22 to £1008 (epididymitis); £11 to £1459 (neonatal conjunctivitis) and £433 to £3992 (neonatal pneumonia). Total cost of sequelae per case of untreated chlamydia ranged from £37 to £412.Conclusions: There was substantial variation in cost per case of chlamydia sequelae used in published chlamydia screening economic evaluations, which likely arose from different assumptions about disease management pathways and the country perspectives taken. In light of this, when interpreting these studies, the reader should be satisfied that the cost estimates used sufficiently reflect the perspective taken and current disease management for their respective context. [ABSTRACT FROM AUTHOR]

Issues: Drug consumptions rooms (DCR) and supervised injecting facilities (SIF) are expanding internationally. Previous reviews have not systematically addressed evaluation methodologies.Approach: Results from systematic searches of scientific databases in English until June 2017 were coded for paper type, country and year of publication. For evaluation papers, study outcome, methodology/study design and main indicators of DCR/SIF 'exposure' were recorded.Key Findings: Two hundred and nineteen eligible peer-reviewed papers were published since 1999: the majority from Canada (n = 117 papers), Europe (n = 36) and Australia (n = 32). Fifty-six papers reported evaluation outcomes. Ecological study designs (n = 10) were used to assess the impact on overdose, public nuisance and crime; modelling techniques (n = 6) estimated impact on blood-borne diseases, overdose deaths and costs. Papers using individual-level data included four prospective cohorts (n = 28), cross-sectional surveys (n = 7) and service records (n = 5). Individual-level data were used to assess safer injecting practice, uptake into health and social services and all the other above outcomes except for impact on crime and costs. Four different indicators of DCR/SIF attendance were used to measure service 'exposure'.Implications: Research around DCRs/SIFs has used ecological, modelling, cross-sectional and cohort study designs. Further research could involve systematic inclusion of a control group of people who are eligible but do not access SIFs, validation of self-reported proportion of injections at SIFs or a stepped-wedge or a cluster trial comparing localities.Conclusions: Methodologies appropriate for DCR/SIF evaluation have been established and can be readily replicated from the existing literature. Research on operational aspects, implementation and transferability is also warranted. [ABSTRACT FROM AUTHOR]

This paper suggests a particular question that higher education researchers might ask: "Do educational programs use teaching methods that are environmentally, socially and economically sustainable?" It further proposes that program evaluation research (PER) can be used to answer the question. Consideration is given to: a) program evaluation research processes and indicators, and their modifications for evaluating the sustainability of teaching methods; and b) institutional sustainability evaluation research tools and their modifications for the evaluation of teaching. North American university and college program evaluation websites and sustainability evaluation tools used to assess universities in North America are examined. (Contains 1 table.)

This paper explores the implications of the effective integration of research, teaching and learning for academic development through the lens of an international multi-institutional comparison of student perceptions of research and its impact on their learning environment. The study, with a sample of over 500 final-year undergraduate students across three institutions in the UK and Canada, represents a spectrum of research and teaching intensive universities and is one of the largest exploring undergraduate student perceptions of research in the linking teaching and research literature. The results indicate a complex relationship between student perceptions and experiences of research and the type of institution, as well as the individual, institutional and national context. They also inform the discussion of particular issues that academic developers face and the strategies they use to improve the integration of research and teaching to benefit the undergraduate learning experience in their institution. (Contains 6 tables.)

Background: The study purpose was to compare the effectiveness of monthly or quarterly peer reminder knowledge translation interventions, with monthly or quarterly paper-based reminders, to sustain a mobility innovation, the sit-to-stand activity.Method: A cluster RCT using a stratified 2 × 2 factorial design was conducted in 24 Canadian residential care facilities with 416 residents and 54 peer reminder care aides. The 1-year intervention included two intensities of reminders (high: socially based peer reminders delivered by volunteer care aides to other care aides; low: paper-based reminders posted in residents' rooms), at two frequencies (monthly; every 3 months). Intervention fidelity was assessed using questionnaires and observations. Monthly sustainability rate of the sit-to-stand activity was calculated as the percentage of opportunities that residents successfully completed the activity in 30 days. Residents' sustainability rates were analyzed using a linear mixed model that mirrored the clustered repeated-measures factorial trial design. The model included a random intercept to account for clustering within sites. An unstructured covariance structure characterized the interdependence of repeated measures over time.Results: Twenty-four sites were randomized. One site was excluded because of falsifying data, leaving 23 sites and 349 residents for intention-to-treat analysis. Paper reminders were implemented with high fidelity across all arms (91.5% per protocol), while the peer reminders were implemented with moderate fidelity in the monthly group (81.0% per protocol) and poor fidelity in the quarterly group (51.7% per protocol). At month 1, mean sustainability ranged from 40.7 to 47.2 per 100 opportunities, across the four intervention arms (p = 0.43). Mean rate of sustainability in the high intensity, high frequency group diverged after randomization, yielding statistically significant differences among the groups at 4 months which persisted for the remainder of the trial. After 12 months, the mean sustainability in the high intensity, high frequency group was approximately twice that of the other three groups combined (64.1 versus 37.8 per 100 opportunities, p < 0.001).Conclusions: A monthly peer reminder intervention was more effective than a quarterly peer reminder intervention, a monthly paper-based reminder intervention, and a quarterly paper-based reminder intervention, in supporting care aides to sustain a mobility innovation in residential care facilities over 1 year.Trial Registration: ClinicalTrials.gov , NCT01746459. Registered 11 December 2012: https://clinicaltrials.gov/ct2/show/NCT01746459 . [ABSTRACT FROM AUTHOR]

This paper reports on the creation of an instrument for use by instructors, students, or researchers to identify, measure or promote critical thinking (CT) in online asynchronous discussions (OADs). Four models of CT were reviewed, synthesised, analysed, and evaluated to clarify the construct. Indicators of specific cognitive processes related to CT were identified, and subsequently retained, rejected or modified to show how the construct might be operationalised in real contexts of use. Subsequent empirical testing of the instrument for the analysis of a transcript of an OAD revealed that while the instrument was valuable in identifying and measuring CT in the OAD, issues of practicality need to be addressed. Implications for research and practice are presented. (Contains 3 tables.)

An account of three researchers' efforts to make sense of preservice teachers' assessment practices reveals how methodologically diverse investigations emanated from the context of a single study. Developments, findings, and warrants that characterize this inquiry are presented, as well as arguments describing this study as exploratory, mixed-method, and non-foundationalist research. Contains 26 references. (Author/SV)

Background: Rigorously designed longitudinal studies can inform how best to reduce the widening health gap between Indigenous and non-Indigenous children.Methods: A systematic review was performed to identify and present the breadth and depth of longitudinal studies reporting the health and well-being of Indigenous children (aged 0-18 years) globally. Databases were searched up to 23 June 2020. Study characteristics were mapped according to domains of the life course model of health. Risk of bias was assessed using the National Institutes of Health (NIH) Study Quality Assessment Tools. Reported level of Indigenous involvement was also appraised; PROSPERO registration CRD42018089950.Results: From 5545 citations, 380 eligible papers were included for analysis, representing 210 individual studies. Of these, 41% were located in Australia (n = 88), 22.8% in the USA (n = 42), 11.9% in Canada (n = 25) and 10.9% in New Zealand (n = 23). Research tended to focus on either health outcomes (50.9%) or health-risk exposures (43.8%); 55% of studies were graded as 'good' quality; and 89% of studies made at least one reference to the involvement of Indigenous peoples over the course of their research.Conclusions: We identified gaps in the longitudinal assessment of cultural factors influencing Indigenous child health at the macrosocial level, including connection to culture and country, intergenerational trauma, and racism or discrimination. Future longitudinal research needs to be conducted with strong Indigenous leadership and participation including holistic concepts of health. This is critical if we are to better understand the systematic factors driving health inequities experienced by Indigenous children globally. [ABSTRACT FROM AUTHOR]

Methadone has several unique characteristics that make it an attractive option for pain relief in serious illness, but the safety of methadone has been called into question after reports of a disproportionate increase in opioid-induced deaths in recent years. The American Pain Society, College on Problems of Drug Dependence, and the Heart Rhythm Society collaborated to issue guidelines on best practices to maximize methadone safety and efficacy, but guidelines for the end-of-life scenario have not yet been developed. A panel of 15 interprofessional hospice and palliative care experts from the U.S. and Canada convened in February 2015 to evaluate the American Pain Society methadone recommendations for applicability in the hospice and palliative care setting. The goal was to develop guidelines for safe and effective management of methadone therapy in hospice and palliative care. This article represents the consensus opinion of the hospice and palliative care experts for methadone use at end of life, including guidance on appropriate candidates for methadone, detail in dosing, titration, and monitoring of patients' response to methadone therapy. [ABSTRACT FROM AUTHOR]

Stepped-wedge cluster randomized trials, which randomize clusters of subjects to treatment sequences in which clusters switch from control to intervention conditions, are being conducted with increasing frequency. Due to the real-world nature of this design, methodological and implementation challenges are ubiquitous. To account for such challenges, more complex statistical models to plan studies and analyze data are required. In this paper, we consider stepped-wedge trials that accommodate treatment effect heterogeneity across clusters, implementation periods during which no data are collected, or both treatment effect heterogeneity and implementation periods. Previous work has shown that the sequence-period cells of a stepped-wedge design contribute unequal amounts of information to the estimation of the treatment effect. In this paper, we extend that work by considering the amount of information available for the estimation of the treatment effect in each sequence-period cell, sequence, and period of stepped-wedge trials with more complex designs and outcome models. When either treatment effect heterogeneity and/or implementation periods are present, the pattern of information content of sequence-period cells tends to be clustered around the times of the switch from control to intervention condition, similarly to when these complexities are absent. However, the presence and degree of treatment effect heterogeneity and the number of implementation periods can influence the information content of periods and sequences markedly. [ABSTRACT FROM AUTHOR]

Background: Walkability is a popular term used to describe aspects of the built and social environment that have important population-level impacts on physical activity, energy balance, and health. Although the term is widely used by researchers, practitioners, and the general public, and multiple operational definitions and walkability measurement tools exist, there are is no agreed-upon conceptual definition of walkability.Method: To address this gap, researchers from Memorial University of Newfoundland hosted "The Future of Walkability Measures Workshop" in association with researchers from the Canadian Urban Environmental Health Research Consortium (CANUE) in November 2017. During the workshop, trainees, researchers, and practitioners worked together in small groups to iteratively develop and reach consensus about a conceptual definition and name for walkability. The objective of this paper was to discuss and propose a conceptual definition of walkability and related concepts.Results: In discussions during the workshop, it became clear that the term walkability leads to a narrow conception of the environmental features associated with health as it inherently focuses on walking. As a result, we suggest that the term Active Living Environments, as has been previously proposed in the literature, are more appropriate. We define Active Living Environments (ALEs) as the emergent natural, built, and social properties of neighbourhoods that promote physical activity and health and allow for equitable access to health-enhancing resources.Conclusions: We believe that this broader conceptualization allows for a more comprehensive understanding of how built, natural, and social environments can contribute to improved health for all members of the population. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to assess the prevalence of orthostatic hypotension (OH) in a sample of late life depression (LLD) patients and to determine the validity of a standardized questionnaire, the Orthostatic Hypotension Questionnaire (OHQ). Secondarily, we wished to assess variables associated with OH.Methods: We conducted a cross-sectional study on 82 consecutive geriatric outpatients presenting with LLD. OH was defined as a fall in systolic blood pressure of greater than 20 mm Hg and/or 10 mm Hg on diastolic blood pressure on an orthostatic stress test from sitting to standing. Logistic regressions were used to identify factors associated with OH.Results: The prevalence of OH as measured on the orthostatic stress test and on the OHQ was 28% and 57%, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the OHQ were 69.6% (95% CI 47%-87%), 47.5% (95%CI 34%-61%), 0.54 (95% CI: 0.43-0.64), 34% (95%CI 21%-49%), and 80% (95%CI 63%-92%), respectively. Females were more likely to have OH (OR: 3.96, 95%CI 1.06-14.89, P = .041), and those married or in a common-law relationship were less likely to have OH (OR: 0.25, 95% CI 0.08-0.72, P = .011).Conclusions: OH is common in patients with LLD conferring them a risk of gait instability and falls. Females had a higher risk of having OH while participants who were married or in a common-law relationship were less likely to have OH. Although the OHQ is a quick to administer paper-based screening test, it did not show adequate diagnostic accuracy in patients with LLD seen in a routine psychiatry clinic. [ABSTRACT FROM AUTHOR]

Background: In the past decade, patient-oriented research (POR) has been at the forefront of healthcare research in Canada because it has the potential to make research more meaningful and relevant to patient needs. Despite this growing emphasis on and expectation to conduct POR, there is limited guidance about how to apply POR in practice. To address this capacity building need, the Knowledge Translation (KT) Program and patient partners co-designed, delivered, and evaluated Partners in Research (PiR), a 2-month online course for patients and researchers to collectively learn how to conduct and engage in POR. Methods: PiR was delivered to 4 cohorts of patients and researchers between 2017 and 2018. For each cohort, we evaluated the impact of the course on participants' knowledge, self-efficacy, intentions, and use of POR using surveys at 3 time points: baseline, post-course and 6-months post-course. We also monitored the process of course design and delivery by assessing implementation quality of the PiR course. Participants were asked to rate their satisfaction with course format, course materials, quality of delivery and their level of engagement via a 7-point Likert scale in the post-course survey. Results: A total of 151 participants enrolled in the PiR course throughout the 4 cohorts. Of these, 49 patients and 33 researchers (n = 82 participants) consented to participate in the course evaluation. Process and outcome evaluations collected over a 9-month period indicated that participation in the PiR course increased knowledge of POR concepts for patients (p <.001) and for researchers (p <.001) from pre-course to post-course timepoints. Likewise, self-efficacy to engage in POR increased from baseline to post-course for both patients (p <.001) and researchers (p <.001). Moreover, participants reported high levels of satisfaction with content, delivery and interactive components of the course. Conclusions: The PiR course increased capacity in POR for both researchers and patients. This work enhances our understanding of how to design useful and engaging education opportunities to increase patient and researcher capacity in POR. Plain English Summary: Patient-oriented research (POR) is the meaningful inclusion of patients as active contributing partners in research. In meaningful POR, patients are engaged and valued as contributory members of the research team throughout the research process, from developing research questions, participating in research activities, to sharing new research findings. In Canada, POR is recognized as an important component of research and many healthcare institutions aim to engage patients in their work. However, there is little guidance on how patients and researchers can effectively participate as equal partners in research activities. To address the need for POR education opportunities, we launched Partners in Research (PiR), a 2–month online course for patients and researchers to learn how to conduct and engage in POR. This paper describes the design, delivery, and evaluation of the PiR course, with a focus on the following objectives: To assess the impact of the PiR course on participant knowledge, confidence, intentions and use of POR To determine the quality of course design and delivery and its ability to achieve learning objectives To identify factors that limit and facilitate participation in POR The findings from the evaluation show that the PiR course was effective in increasing knowledge of, and confidence in POR concepts. In addition, the course was well-received, with participants reporting a high level of engagement in course content and activities. Overall, this work supports our understanding of how to design useful and engaging opportunities to increase patient and researcher capacity in POR. [ABSTRACT FROM AUTHOR]

Objective: To systematically review the literature with respect to treatment-seeking rates for depression and associated mediating factors. This review focuses on adolescents and adults of all ages.Methods: A structured literature review using Medline and PsychInfo databases revealed 38 relevant papers. Two trained reviewers independently and blindly assessed each study according to 4 inclusion criteria. A total of 17 papers met all 4 criteria.Results: Between 17.0% and 77.8% of individuals with depressive episodes or disorders sought treatment in these studies. We could explain the range in rates by diverse measures of depression, mediating factors that influence treatment-seeking, varied years in which the studies were done, and different time periods over which treatment-seeking was assessed.Conclusions: Treatment-seeking rates for major depression appear to have increased over the years. Age, race, social supports, and clinical and psychiatric factors seem to influence treatment-seeking rates most. Public health initiatives can use this information to facilitate service access and delivery. [ABSTRACT FROM AUTHOR]

Background: Although abuse experienced by older adults is common and expected to increase, disclosure, reporting and interventions to prevent or mitigate abuse remain sub-optimal. Incorporating principles of harm reduction into service provision has been advocated as a strategy that may improve outcomes for this population. This paper explores whether and how these principles of harm reduction were employed by professionals who provide services to older adults experiencing abuse.Methods: Thematic analysis of qualitative interviews with 23 professionals providing services to older adults experiencing abuse across three Western provinces of Canada was conducted. Key principles of harm reduction (humanism, incrementalism, individualism, pragmatism, autonomy, and accountability without termination) were used as a framework for organizing the themes.Results: Our analysis illustrated a clear congruence between each of the six harm reduction principles and the approaches reflected in the narratives of professionals who provided services to this population, although these were not explicitly articulated as harm reduction by participants. Each of the harm reduction principles was evident in service providers' description of their professional practice with abused older adults, although some principles were emphasized differentially at different phases of the disclosure and intervention process. Enactment of a humanistic approach formed the basis of the therapeutic client-provider relationships with abused older adults, with incremental, individual, and pragmatic principles also apparent in the discourse of participants. While respect for the older adult's autonomy figured prominently in the data, concerns about the welfare of the older adults with questionable capacity were expressed when they did not engage with services or chose to return to a high-risk environment. Accountability without termination of the client-provider relationship was reflected in continuation of support regardless of the decisions made by the older adult experiencing abuse.Conclusions: Harm reduction approaches are evident in service providers' accounts of working with older adults experiencing abuse. While further refinement of the operational definitions of harm reduction principles specific to their application with older adults is still required, this harm reduction framework aligns well with both the ethical imperatives and the practical realities of supporting older adults experiencing abuse. [ABSTRACT FROM AUTHOR]

Background: Participation in on-the-land programs that encourage traditional cultural activities may improve health and well-being. The Income Security Program (ISP) - a financial incentive-based on-the-land program - for Eeyouch (Cree) hunters and trappers in Eeyou Istchee was created as a result of the 1975 James Bay and Northern Quebec Agreement to help mitigate the effects of hydroelectric development on the Cree people of northern Quebec, Canada. Beyond the ISP's financial incentives, little is known about the health measures of those who are eligible to participate in the ISP (i.e. spent ≥120 days on-the-land during the previous year). Therefore, this paper's objective was to assess the health measures of northern Quebec Cree, who were eligible for participation in the ISP.Methods: Using participant data (n = 545) compiled from the Nituuchischaayihtitaau Aschii Multi-Community Environment-and-Health Study, we assessed 13 different health measures in generalized linear models with the independent variable being the eligibility to participate in the ISP.Results: Participants in the present study who were eligible for the ISP had significantly higher levels of vigorous and moderate activity per week, and higher concentrations of omega-3 polyunsaturated fatty acids in the blood compared to those ineligible for the ISP (i.e. spent ≤119 days on-the-land during the previous year). Encouragingly, following model adjustment for age and sex, participants eligible for the ISP did not have higher blood concentrations of mercury than those who were not eligible for the ISP.Conclusions: Our results suggest that the participants eligible for participation in the ISP are likely to be healthier than those who are ineligible to participate - and are promising for on-the-land programs for Indigenous peoples beyond a financial incentive - with no apparent higher risk of increasing contaminant body burden through traditional on-the-land-activities (e.g. fish consumption). [ABSTRACT FROM AUTHOR]

This paper explores the experiences of, and thoughts on, interprofessional learning and care of first year health science students at a large Canadian university within a broad socioeconomic context. We apply discourse analysis to survey data collected to evaluate an introductory interprofessional event involving first year students from a variety of health professions. Follow-up focus-group interviews were conducted to gain greater understanding of student issues and concerns emerging from the survey, providing a second source of data. A significant paper entitled, 'Education, enterprise culture and the entrepreneurial self: A Foucauldian perspective' by Peters (2001) provides an historical and theoretical framework for this paper. Peters notes the changing nature of professionalism and global crises in public institutions under neoliberalism as governments divest themselves of social responsibility, shifting it onto individuals through increased privatization and focus on entrepreneurialism. In exploring the thoughts and experiences of students through the historical lens of a shifting professional discourse and changing cultural and political environment, a unique view of professionalism and this interprofessional project comes to light. Reflective of the paradigm shift that Peters documents, there was evidence of students 'internalizing' responsibility for a sustainable health care system through acquisition of interprofessional knowledge and behaviours. [ABSTRACT FROM AUTHOR]

This paper describes findings from an institutional ethnography that arose out of the concerns of women living with HIV in Ontario, Canada, regarding the disclosure of their HIV status while accessing perinatal care. The enquiry traces the connections between women's experiences of perinatal care, the activities of healthcare providers delivering such care and the ruling relations that organise women's experiences and healthcare providers' activities. Focusing on HIV disclosure as a concern expressed by women, the findings make visible the day-to-day, routinised practices of healthcare providers working in perinatal care for women living with HIV, as well as the ideological discourses of 'fear of contagion' and 'AIDS hysteria' that contributed to producing the kinds of care experiences that were articulated by women. Opportunities to strengthen perinatal care policies and practices for women living with HIV are discussed. [ABSTRACT FROM AUTHOR]

In order to improve individual research achievements (IRA), this study investigates which affiliated countries and authors earn the most cited IRAs and whether those types of articles are associated with the number of cited papers on schizophrenia from a leading journal in the field. The Kano model was used for displaying the IRAs. Clusters of medical subject headings (MeSH) were applied to explore the core concepts of a given journal. This study aimed to apply social network analysis (SNA) and an authorship-weighted scheme (AWS) to inspect the association between MeSH terms and IRA. About 2,008 abstracts published between 2012 and 2016 in the journal Schizophrenia Research were downloaded from Pubmed Central using the keyword (Schizophr Res)[Journal] on September 20, 2018. The MeSH terms were clustered by using SNA to separate the core concepts and compare the differences in bibliometric indices (i.e., h, Ag, x and author impact factor or AIF). Visual dashboards were shown on Google Maps. Results indicate that (1) the US, the UK, and Canada earn the highest x-index; (2) the top one author from the US has the highest x-index (= 5.73 with x-core at cited = 16.44 and citable = 2); (3) the article type of schizophrenic psychology shows distinctly higher frequencies than others; and (4) article types are associated with the number of cited papers. Four approaches of the Kano model, SNA, MeSH terms, and AWS can be accommodated to display IRAs, classify article types, and quantify coauthor contributions in the article byline, respectively, and applied to other scientific disciplines in the future, not just in this specific journal. [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.)

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.)

Objective: Suicide is a leading cause of death, yet the accurate prediction of suicidal behavior is an elusive target for clinicians and researchers. The current paper examines the predictive validity of the Mini Neuropsychiatric Interview (MINI) Suicidality subscale for suicide attempts (SAs) for a homeless population with mental illness.Methods: Two thousand two hundred and fifty-five homeless individuals with mental illness across five Canadian cities enrolled in the At Home/Chez Soi Housing First trial interviewed at baseline using the MINI Suicidality subscale with 2-year follow-up of self-reported SAs.Results: Two thousand two hundred and twenty-one participants were included in the analysis. High rates of mood and substance use disorders were present (56.5% and 67.4%, respectively). The mean MINI Suicidality subscale score was 7.71. Among 1,700 participants with follow-up data, 11.4% reported a SA over the 2-year study period. MINI Suicidality subscale scores were predictive of SAs (AUC ≥ 0.70) among those with and without a history of SAs, even among those with missing answers. A positive predictive value of 0.20 and a negative predictive value of 0.95 were demonstrated, with a relatively low number needed to assess of 4.5-5.Conclusion: The MINI Suicidal subscale shows promise as an easy to use and accurate suicide risk prediction tool among homeless individuals with mental illness. [ABSTRACT FROM AUTHOR]

Background: Lone parents and their children experience higher than average levels of adverse health and social outcomes, much of which are explained by high rates of poverty. Many high income countries have attempted to address high poverty rates by introducing employment requirements for lone parents in receipt of welfare benefits. However, there is evidence that employment may not reduce poverty or improve the health of lone parents and their children.Methods: We conducted a systematic review of qualitative studies reporting lone parents' accounts of participation in welfare to work (WtW), to identify explanations and possible mechanisms for the impacts of WtW on health and wellbeing. Twenty one bibliographic databases were searched. Two reviewers independently screened references and assessed study quality. Studies from any high income country that met the criteria of focussing on lone parents, mandatory WtW interventions, and health or wellbeing were included. Thematic synthesis was used to investigate analytic themes between studies.Results: Screening of the 4703 identified papers and quality assessment resulted in the inclusion of 16 qualitative studies of WtW in five high income countries, USA, Canada, UK, Australia, and New Zealand, covering a variety of welfare regimes. Our synthesis found that WtW requirements often conflicted with child care responsibilities. Available employment was often poorly paid and precarious. Adverse health impacts, such as increased stress, fatigue, and depression were commonly reported, though employment and appropriate training was linked to increased self-worth for some. WtW appeared to influence health through the pathways of conflict and control, analytical themes which emerged during synthesis. WtW reduced control over the nature of employment and care of children. Access to social support allowed some lone parents to manage the conflict associated with employment, and to increase control over their circumstances, with potentially beneficial health impacts.Conclusion: WtW can result in increased conflict and reduced control, which may lead to negative impacts on mental health. Availability of social support may mediate the negative health impacts of WtW. [ABSTRACT FROM AUTHOR]

This paper discusses recent migration to North America with reference to the 1962 and 1967 Canadian immigration regulations and the 1965 United States Immigration and Nationality Act. Despite the similar emphasis on manpower and kinship criteria as the basis for the admission of immigrants, differences between Canada and the United States exist with respect to the importance of immigration for the respective economies, the organization of immigration, the formal regulations, and the size and composition of migrant streams. After an examination of the volume, origin, and occupational composition of immigration to Canada and the United States, flows between the two countries are studied. The paper concludes with a scrutiny of changes in immigration regulations which are pending in both countries. [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.)

Introduction and Aims: Tranquilizer use is associated with negative health outcomes among people who use drugs. This paper aims to estimate the incidence rate (initiation) and identify predictors of tranquilizer misuse (TM) among cocaine users.Design and Methods: A prospective cohort study was conducted in Montreal, Canada. Interviewer-administered questionnaires were carried out at 3-month intervals. Initiation was defined as misusing a tranquilizer for the first time during follow-up. 'Lasting-initiation', defined as reporting TM at the next visit following first use, was also examined. Cox proportional hazard regression analyses were carried out to assess predictors of initiation to TM.Results: Among the 245 participants who were eligible for the initiation analyses, 123 started TM during follow-up for an incidence rate of 40.49 per 100 person-years (95% confidence interval, CI: 33.80-48.15). Of the 123 initiates, 35.7% were still using at the interview following initiation for an incidence rate of 14.70 per 100 person-years (95% CI: 10.82-19.56). Multivariate models showed that independent predictors of initiation and 'lasting initiation' were identical as having had a criminal activity as the main source of income, having been recently in treatment for a substance use disorder (SUD) and reporting non-medical use of prescription opioids.Discussion and Conclusions: The incidence rate of TM initiation was high among a sample of cocaine users. Initiation was predicted by a problematic drug use pattern involving polydrug use, involvement in the street economy and having been in treatment for a SUD. These findings have implications for prevention and harm reduction strategies. [ABSTRACT FROM AUTHOR]

Health care expenditure studies of the Organization for Economic Cooperation and Development (OECD) countries remain important because their findings often suggest cost containment and other policy initiatives. This paper focuses on the compatibility of OECD health data with the "expenditure inertia" (or lagged adjustments) hypothesis, by modeling individual country time-series data of 21 nations for the 1960-1993 period. Maximum likelihood estimates of the Box-Cox transformation regression models reveal that: (a) the hypothesized impact of health "expenditure inertia" is both pervasive and strong, averaging 0.64 across the countries; (b) the real GDP elasticities of health care expenditures vary widely among the countries and average 0.34 in the short run--implying that health care is a necessity; (c) the long run GDP elasticities are less than 1 in 8 countries, unitary elastic in 8 countries and elastic in 5 countries--suggesting that health care is not universally a necessity or a luxury commodity for the OECD countries; (d) physician-inducement effects (dis-inducement in a few countries) are weak, with a mean elasticity estimate of 0.17; and (e) no unique functional form approximation model is globally compatible with the data across the countries. Health care cost containment policy implications of these findings are explored. [ABSTRACT FROM AUTHOR]

Background: The Stroke Canada Optimization of Rehabilitation by Evidence-Implementation Trial (SCORE-IT) showed that a facilitated knowledge translation (KT) approach to implementing a stroke rehabilitation guideline was more likely than passive strategies to improve functional walking capacity, but not gross manual dexterity, among patients in rehabilitation hospitals. This paper presents the results of a planned process evaluation designed to assess whether the type and number of recommended treatments implemented by stroke teams in each group would help to explain the results related to patient outcomes.Methods: As part of a cluster randomized trial, 20 rehabilitation units were stratified by language and allocated to a facilitated or passive KT intervention group. Sites in the facilitated group received the guideline with treatment protocols and funding for a part-time nurse and therapist facilitator who attended a 2-day training workshop and promoted guideline implementation for 16 months. Sites in the passive group received the guideline excluding treatment protocols. As part of a process evaluation, nurses, and occupational and physical therapists, blinded to study hypotheses, were asked to record their implementation of 18 recommended treatments targeting motor function, postural control and mobility using individualized patient checklists after treatment sessions for 2 weeks pre- and post-intervention. The percentage of patients receiving each treatment pre- and post-intervention and between groups was compared after adjusting for clustering and covariates in a random-effects logistic regression analysis.Results: Data on treatment implementation from nine and eight sites in the facilitated and passive KT group, respectively, were available for analysis. The facilitated KT intervention was associated with improved implementation of sit-to-stand (p = 0.028) and walking (p = 0.043) training while the passive KT intervention was associated with improved implementation of standing balance training (p = 0.037), after adjusting for clustering at patient and provider levels and covariates.Conclusions: Despite multiple strategies and resources, the facilitated KT intervention was unsuccessful in improving integration of 18 treatments concurrently. The facilitated approach may not have adequately addressed barriers to integrating numerous treatments simultaneously and complex treatments that were unfamiliar to providers.Trial Registration: Unique identifier- NCT00359593. [ABSTRACT FROM AUTHOR]

Background: Older adults living in long term care (LTC) homes are nutritionally vulnerable, often consuming insufficient energy, macro- and micronutrients to sustain their health and function. Multiple factors are proposed to influence food intake, yet our understanding of these diverse factors and their interactions are limited. The purpose of this paper is to fully describe the protocol used to examine determinants of food and fluid intake among older adults participating in the Making the Most of Mealtimes (M3) study.Methods: A conceptual framework that considers multi-level influences on mealtime experience, meal quality and meal access was used to design this multi-site cross-sectional study. Data were collected from 639 participants residing in 32 LTC homes in four Canadian provinces by trained researchers. Food intake was assessed with three-days of weighed food intake (main plate items), as well as estimations of side dishes, beverages and snacks and compared to the Dietary Reference Intake. Resident-level measures included: nutritional status, nutritional risk; disease conditions, medication, and diet prescriptions; oral health exam, signs of swallowing difficulty and olfactory ability; observed eating behaviours, type and number of staff assisting with eating; and food and foodservice satisfaction. Function, cognition, depression and pain were assessed using interRAI LTCF with selected items completed by researchers with care staff. Care staff completed a standardized person-directed care questionnaire. Researchers assessed dining rooms for physical and psychosocial aspects that could influence food intake. Management from each site completed a questionnaire that described the home, menu development, food production, out-sourcing of food, staffing levels, and staff training. Hierarchical regression models, accounting for clustering within province, home and dining room will be used to determine factors independently associated with energy and protein intake, as proxies for intake. Proportions of residents at risk of inadequate diets will also be determined.Discussion: This rigorous and comprehensive data collection in a large and diverse sample will provide, for the first time, the opportunity to consider important modifiable factors associated with poor food intake of residents in LTC. Identification of factors that are independently associated with food intake will help to develop effective interventions that support food intake.Trial Registration: ClinicalTrials.gov ID: NCT02800291 , retrospectively registered June 7, 2016. [ABSTRACT FROM AUTHOR]

Studying patients during the end of life is important, as it has the potential to lead to improvements in care for the dying. For patients who die after a controlled withdrawal of life-sustaining therapies in the intensive care unit, information about the natural history of death and the process of removing life support has additionally led to advances in practice for deceased organ donation. However, this unique population of severely critically ill and imminently dying patients has been difficult to study, largely due to assumptions made by research teams and ethics boards alike about the logistical difficulties of obtaining consent and completing research procedures before or during the process of withdrawal of life-sustaining therapies. In this paper, we describe the ethics substudy of the first prospective observational research study in Canada to obtain consent and collect clinical data on patients during the process of withdrawal of life-sustaining therapies in the intensive care unit. We describe in detail the process of protocol development, review by five institutional research ethics boards and bedside staff satisfaction with the study. We conclude that prospective research on a critically ill and imminently dying population is feasible and can be conducted in an ethical manner. Further information is needed about the experiences and motivations of families and substitute decision makers who provide consent for research on critically ill intensive care unit patients at the end of life. [ABSTRACT FROM AUTHOR]

Background: Drowning is a significant public health issue, with females accounting for one third of global drowning deaths. The rate of female drowning has not decreased within high-income countries and presentations to hospital have increased. This scoping review aimed to explore adult female unintentional drowning, including risk factors, clinical treatment and outcomes of females hospitalised for drowning.Methods: A systematic search of the literature following the PRISMA-ScR framework was undertaken. The databases OVID MEDLINE, Embase, CINAHL, OVID Emcare, Web of Science, Informit and Scopus were accessed. Study locations of focus were Australia, Canada, New Zealand, the United Kingdom, and the United States. Studies from January 2003 to April 2019 were included. The quality of evidence of included studies was assessed using GRADE guidelines.Results: The final search results included 14 studies from Australia (n = 4), Canada (n = 1), New Zealand (n = 1), United States (n = 6), United Kingdom (n = 1), and one study reporting data from both Australia and United States. Nine studies reported risk factors for female drowning including age, with the proportion of female drowning incidence increasing with age. Although females are now engaging in risk-taking behaviours associated with drowning that are similar to males, such as consuming alcohol and swimming in unsafe locations, their exposure to risky situations and ways they assess risk, differ. Females are more likely to drown from accidental entry into water, such as in a vehicle during a flood or fall into water. This review found no evidence on the clinical treatment provided to females in hospital after a drowning incident, and only a small number of studies reported the clinical outcomes of females, with inconsistent results (some studies reported better and some no difference in clinical outcomes among females).Conclusion: Adult females are a group vulnerable to drowning, that have lacked attention. There was no single study found which focused solely on female drowning. There is a need for further research to explore female risk factors, the clinical treatment and outcomes of females hospitalised for drowning. This will not only save the lives of females, but also contribute to an overall reduction in drowning. [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]

Background: Many older adults with mobility limitations use assistive technology to help them perform daily activities. However, little attention has been paid to the impact on their family caregivers. This neglect produces an incomplete portrayal of the outcomes of assistive technology provision. This paper describes the protocol for a study that examines the impact of a tailored assistive technology intervention that is inclusive of assistance users and their family caregivers.Methods/design: This research will use a combination of quantitative and qualitative methods. The quantitative portion will be an experimental, single-blinded study in which participants are randomly assigned to either an experimental assistive technology intervention or a standard care group. We will enroll 240 participants (120 dyads) into the study from three Canadian sites. Participants will include older adults (>55) and family caregivers who provide ≥4 h per week of assistance with daily activities and social participation. The primary outcome measure for the older adults will be the Functional Autonomy Measurement System, and the primary outcome measure for the caregivers will be the Caregiver Assistive Technology Outcomes Measure. Qualitative data will be collected through detailed records of the therapists' interventions, as well as through interviews with dyads and therapists following the interventions. Data collection will occur at baseline (T0) with follow-ups at 6 weeks (T1), 22 weeks (T2), and 58 weeks (T3) after baseline evaluation.Discussion: The findings from this study will help service providers and clinicians to move forward with assistive technology recommendations that are more attuned to the needs of both older adults with mobility limitations and their family caregivers. Additionally, the study's findings will enhance our conceptual understanding of the spectrum of assistive technology outcomes and set the stage for econometric studies assessing cost-effectiveness.Trial Registration: ClinicalTrials.gov Identifier: NCT01640470 . Registered 11/21/2011. [ABSTRACT FROM AUTHOR]

Background: Lyme disease control strategies may include tick control interventions in high risk areas. Public authorities may be interested to assess how these types of interventions are perceived by the public which may then impact their acceptability. The aims of this paper are to compare socio-cognitive factors associated with high acceptability of tick control interventions and to describe perceived issues that may explain their low acceptability in populations living in two different regions, one being an endemic region for LD since the last 30 years, the Neuchâtel canton, in Switzerland, and another where the disease is emerging, the Montérégie region, in Canada.Methods: A mixed methods' design was chosen. Quantitative data were collected using web-surveys conducted in both regions (n = 814). Multivariable logistic regressions were used to compare socio-cognitive factors associated with high acceptability of selected interventions. Qualitative data were collected using focus group's discussions to describe perceived issues relative to these interventions.Results: Levels of acceptability in the studied populations were the lowest for the use of acaricides and landscaping and were under 50 % in both regions for six out of eight interventions, but were higher overall in Montérégie. High perceived efficacy of the intervention was strongly associated with high acceptability of tick control interventions. A high perceived risk about LD was also associated with a high acceptability of intervention under some models. High level of knowledge about LD was negatively associated with high acceptability of the use of acaricides in Neuchâtel. Perceived issues explaining low acceptability included environmental impacts, high costs to the public system, danger of individual disempowerment and perceptions that tick control interventions were disproportionate options for the level of LD risk.Conclusion: This study suggests that the perceived efficacy and LD risk perception may be key factors to target to increase the acceptability of tick control interventions. Community-level issues seem to be important considerations driving low acceptability of public health interventions. Results of this study highlight the importance for decision-makers to account for socio-cognitive factors and perceived issues that may affect the acceptability of public health interventions in order to maximize the efficacy of actions to prevent and control LD. [ABSTRACT FROM AUTHOR]

Background: Administration of magnesium sulphate (MgSO4) to women with imminent preterm birth at <34 weeks is an evidence-based antenatal neuroprotective strategy to prevent cerebral palsy. Although a Society of Obstetricians and Gynaecologists of Canada (SOGC) national guideline with practice recommendations based on relevant clinical evidence exists, ongoing controversies about aspects of this treatment remain. Given this, we anticipated managed knowledge translation (KT) would be needed to facilitate uptake of the guidelines into practice. As part of the Canadian Institutes of Health Research (CIHR)-funded MAG-CP (MAGnesium sulphate to prevent Cerebral Palsy) project, we aimed to compare three KT methods designed to impact both individual health care providers and the organizational systems in which they work.Methods: The KT methods undertaken were an interactive online e-learning module available to all SOGC members, and at MAG-CP participating sites, on-site educational rounds and focus group discussions, and circulation of an anonymous 'Barriers and Facilitators' survey for the systematic identification of facilitators and barriers for uptake of practice change. We compared these strategies according to: (i) breadth of respondents reached; (ii) rates and richness of identified barriers, facilitators, and knowledge needed; and (iii) cost.Results: No individual KT method was superior to the others by all criteria, and in combination, they provided richer information than any individual method. The e-learning module reached the most diverse audience of health care providers, the site visits provided opportunity for iterative dialogue, and the survey was the least expensive. Although the site visits provided the most detailed information around individual and organizational barriers, the 'Barriers and Facilitators' survey provided more detail regarding social-level barriers. The facilitators identified varied by KT method. The type of knowledge needed was further defined by the e-learning module and surveys.Conclusions: Our findings suggest that a multifaceted approach to KT is optimal for translating national obstetric guidelines into clinical practice. As audit and feedback are essential parts of the process by which evidence to practice gaps are closed, MAG-CP is continuing the iterative KT process described in this paper concurrent with tracking of MgSO4 use for fetal neuroprotection and maternal and child outcomes until September 2015; results are anticipated in 2016. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to examine the impact of mindfulness awareness practice (MAP) on mid-level health-care managers' leadership.Design/methodology/approach: In total, 11 mid-level health-care managers in eastern Canada took part in an intensive weekend retreat and a follow-up webinar on mindfulness awareness. Perceived stress and leadership effectiveness were assessed pre- and post-intervention (i.e. four and eight weeks). A control group (n=10) also completed the same measures twice. Additionally, informants (n=28) provided assessments of participants' leadership pre- and post-intervention. Follow-up interviews were carried out with eight participants 12-16 weeks post-intervention.Findings: In comparison to controls, retreat participants showed significant increases in mindfulness and corresponding decreases in stress that were sustained across eight weeks post-retreat; retreat participants reported significant positive changes in their leadership effectiveness that were corroborated by informants. Qualitative data, however, suggest that sustaining a mindfulness practice presents significant challenges to middle managers in a health care setting.Research Limitations/implications: The findings are useful to management working in health services that are plagued by increasing demands and changes. Despite the small sample and lack of random assignment, the pilot data support the efficacy of MAP in improving leadership.Originality/value: Little empirical research supports the claim that MAP enhances leadership. The present study employed a mixed methods approach to address this gap and demonstrates the potential benefits of MAP among mid-level managers. [ABSTRACT FROM AUTHOR]

Background: Metabolic risk factors, low cognitive function and history of depression are known risk factors for future depressive episodes. This paper aims to evaluate the potential interactions between these factors on the risk of a major depressive episodes in middle-age.Methods: Baseline and follow-up data from a population-based study of Quebec, Canada were used. The sample consisted of 1788 adults between 40 and 69 years of age without diabetes. Cognitive function and metabolic risk factors were assessed at baseline. Three cognitive domains were assessed: processing speed, episodic memory and executive function. History of depression was assessed five years later by a clinical interview. Logistic regression analysis was conducted to evaluate interactions between individual metabolic factors, low cognitive function, and depression history.Results: Participants with a comorbidity of at least one metabolic factor, history of depression and low cognitive function had the highest risk of experiencing a depressive episode in middle age. The highest risk was observed in individuals with abdominal obesity, low cognitive function, and a history of depression (OR= 8.66, 95% CI 3.83-19.59). The risks for those with abdominal obesity only, depression history only, and low cognitive function were 1.20 (95%CI 0.71-2.02), 3.10 (95%CI 1.81-5.24), and 1.39 (95%CI 0.72-2.67), respectively.Limitations: Depression was only assessed at follow-up.Conclusion: Metabolic risk factors comorbid with low cognitive function in middle-aged individuals with a history of depression were associated with an increased risk of a future depressive episode. This study highlights the importance of screening for metabolic and cognitive comorbidities in patients with a history of depression. [ABSTRACT FROM AUTHOR]

Objective: This paper uses the Taxonomy of Everyday Self-management Strategies (TEDSS) to provide insight and understanding into the complex and interdependent self-management strategies people with neurological conditions use to manage everyday life.Methods: As part of a national Canadian study, structured telephone interviews were conducted monthly for eleven months, with 117 people living with one or more neurological conditions. Answers to five open-ended questions were analyzed using qualitative content analysis. A total of 7236 statements were analyzed.Results: Findings are presented in two overarching patterns: 1) self-management pervades all aspects of life, and 2) self-management is a chain of decisions and behaviours. Participants emphasized management of daily activities and social relationships as important to maintaining meaning in their lives.Conclusion: Managing everyday life with a neurological condition includes a wide range of diverse strategies that often interact and complement each other. Some people need to intentionally manage every aspect of everyday life.Practice Implications: For people living with neurological conditions, there is a need for health providers and systems to go beyond standard advice for self-management. Self-management support is best tailored to each individual, their life context and the realities of their illness trajectory. [ABSTRACT FROM AUTHOR]

Anthony Doob's career as a criminologist has been distinguished by his commitment to evidence-based policy development and to making criminological research relevant not just to other scholars but, perhaps more importantly, to policy makers, criminal justice practitioners, and the public. This paper provides an overview of the underdeveloped state of evaluation research on crime prevention and policy in Canada and discusses some of the obstacles to conducting rigorous evaluations. Fortunately, these obstacles - which include a tendency to rely on ideology and intuition as opposed to empirical evidence and a lack of sufficient resources for evaluation studies - have not discouraged Doob in his efforts to improve our criminal laws and justice system so that they reflect the fundamental Canadian values of justice, fairness, and humanity. Through his own research and his promotion of others' research - through, for example, Criminological Highlights - he has worked tirelessly to promote interventions by the criminal justice system that are informed by these values as well as by sound empirical evidence as to their effectiveness. [ABSTRACT FROM AUTHOR]

Objective: In the current paper, we sought to clarify when and why Asian Americans/Canadians and European Americans/Canadians differ in self-consistency (the consistency of personality traits across situations).Method: European Canadian (n = 220) and second-generation Asian Canadian (n = 166) undergraduates (Mage = 19 years) described the traits they expressed and the traits others wanted them to express (i.e., injunctive norms, or injunctions) in four different social situations (i.e., with parents, with friends, with siblings, and with professors).Results: Self-consistency was greater among European Canadians than Asian Canadians, but only when comparing behavior with parents versus with peers (i.e., friends and siblings). The same pattern was found for injunctive consistency (cross-situational consistency of trait injunctions). Injunctions strongly predicted the behavior of both Asian and European Canadians, but because the injunctions from parents versus peers diverged more for Asian Canadians, so did their behaviors. Controlling for the effect of inconsistent injunctions across situations eliminated the ethnic difference in self-consistency. Finally, Asian Canadians who perceived their immigrant parents as embracing a Canadian identity were as cross-situationally consistent as European Canadians because they tended to behave-and believe their parents approved of their behaving-with parents similarly to how they behaved with peers (e.g., more carefree and outspoken).Conclusion: Contrary to previous theorizing, cultural influences on broad cognitive or motivational dispositions (e.g., dialecticism, collectivism) alone cannot explain the observed pattern of ethnic differences in consistency. To understand when bicultural individuals are less consistent across situations also requires an understanding of the specific situations across which they tend to encounter divergent social norms. (PsycINFO Database Record (c) 2019 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

Improved measurement in early child development (ECD) is a strategic focus of the WHO, UNICEF and World Bank Nurturing Care Framework. However, evidence-based approaches to monitoring and evaluation (M&E) of ECD projects in low-income and middle-income countries (LMIC) are lacking. The Grand Challenges Canada®-funded Saving Brains® ECD portfolio provides a unique opportunity to explore approaches to M&E of ECD programmes across diverse settings. Focused literature review and participatory mixed-method evaluation of the Saving Brains portfolio was undertaken using an adapted impact framework. Findings related to measurement of quality, coverage and outcomes for scaling ECD were considered. Thirty-nine ECD projects implemented in 23 LMIC were evaluated. Projects used a 'theory of change' based M&E approach to measure a range of inputs, outputs and outcomes. Over 29 projects measured cognitive, language, motor and socioemotional outcomes. 18 projects used developmental screening tools to measure outcomes, with a trade-off between feasibility and preferred practice. Environmental inputs such as the home environment were measured in 15 projects. Qualitative data reflected the importance of measurement of project quality and coverage, despite challenges measuring these constructs across contexts. Improved measurement of intervention quality and measurement of coverage, which requires definition of the numerator (ie, intervention) and denominator (ie, population in need/at risk), are needed for scaling ECD programmes. Innovation in outcome measurement, including intermediary outcome measures that are feasible and practical to measure in routine services, is also required, with disaggregation to better target interventions to those most in need and ensure that no child is left behind. [ABSTRACT FROM AUTHOR]

Introduction: Validity of research linking built environments to health relies on the availability and reliability of data used to measure exposures. As cities transform, it is important to track when and where urban changes occur, to provide detailed information for urban health intervention research. This paper presents an online observation method of the implementation of traffic-calmingfeatures using Google Street View Time Machine. The method is used to validate an existingadministrative database detailing the implementation of curb extensions and speed bumps.Methods: Online observation of curb extensions and speed bumps was conducted for four boroughsin Montreal, Canada, in autumn 2016, and compared with administrative data documenting traffic-calming measures implemented between 2008 and 2014. All images available through the Time Machine function between 2007 and 2016 for 708 intervention sites were visualized online. Records in the administrative database were compared to real-world Google Street View observations and tested in terms of sensitivity, specificity, and positive predicted value.Results: Google Street View Time Machine allowed the visualization of a median of seven different dates per street intersection and six dates per street segment. This made it possible to analyze built environment changes within 3,973 distinct time periods at 708 locations. Validation of the administrative data regarding presence of an intervention showed 99% (95% CI=97%, 99%) sensitivity, 58% (95% CI=51%, 64%) specificity, and 77% (95% CI=73%, 81%) positive predictive value.Conclusions: Google Street View Time Machine allowed past (2007-2016) online documentation of microscale urban interventions-curb extensions and speed bumps. The proposed method offers a new way to document historic changes to the built environment, which will be useful for urban health intervention research. [ABSTRACT FROM AUTHOR]

Background: Endoscopic hemostasis is commonly practiced during GI endoscopy practice. We hypothesized that, because the choice of endoscopic intervention is influenced by many factors, for example personal experience, prior training, guidelines, etc., there would be differences in practice patterns among different groups of endoscopists.Objective: To explore the potentially different practices for endoscopic hemostasis between the "East" (eight Asian countries) and the "West" (USA and Canada).Design: Cross-sectional descriptive study (internet-based survey).Study Subjects: We administered a questionnaire survey to American Society of Gastrointestinal Endoscopy (ASGE) and Korean Society of Gastroenterology (KSGE) members (see: http://www4.utsouthwestern.edu/inetdemo/endoscopy/hemostasis.html , or supplementary paper for review online).Results: Eastern ASGE members (n = 112) were more likely to complete this survey than ASGE members in the West (n = 180): 15.1 vs. 5.0%, P < 0.001. Choice of hemostatic method, regardless of primary or recurrent bleeding, varied significantly among Eastern and Western endoscopists. For example, for treatment of a gastric ulcer with a visible vessel, a vast majority (70%) of Western endoscopists preferred pre-injection followed by thermocoagulation whereas responses from the East were more diverse, with endoclip application +/- pre-injection being the top choice (29%) (P < 0.001). Personal EGD volume and hospital bed numbers did not seem to be associated with hemostatic choices in either the East or the West.Conclusions: Endoscopic hemostasis practice patterns for upper GI tract bleeding differed among Eastern and Western endoscopists, suggesting fundamental differences in practice habit determinants. [ABSTRACT FROM AUTHOR]

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Objective: : Research has shown differences in health status and health care utilization related to culture, economic status, and health care development. This paper reports on a study comparing attitudes of women in three countries, at various stages of development, about their own health and self-worth and asks if these differences account for differences in health care utilization and inequities in health status.Method: : A questionnaire, administered to 100 women in each of Yemen, Uganda and Canada, explored women's perception of their own health and health care seeking behavior.Result: : Women's perception of themselves as worthy of care was positively related to utilization. The ability to make one's own health care decisions varied with her country's development level. Implementation strategies must consider women's decision-making capacity.Conclusion: : To achieve improved health status, policies and programs must commit to encouraging appropriate social and cultural changes, using a 'cross-sectoral approach', involving both gender and development issues. [ABSTRACT FROM AUTHOR]