Search

Purpose: Children and youth who enter the care system have lower educational outcomes and university participation rates than their peers. This study aims to understand trend exceptions by examining the background of care-experienced undergraduates attending a research-intensive university in Canada. Design/methodology/approach: Informed by social affordance theory, this study examined the presence of four indicators of stability (home, household occupants, school and legal status) during participants' final three years of secondary education. Care-experienced undergraduates (N = 30) completed an online questionnaire. Associations between stability indicators, child welfare involvement in the final year of high school, educational outcomes and routes into higher education were analysed. Findings: Stability across three to four indicators was experienced by 40% of participants, while 47% reported changes across three to four indicators. Only 20% had a change of school as compared to 47%–60% for other indicators. During their final year of high school, 73% of participants were supported by the child welfare system, with 50% being supported via a support program specifically for 16- to 18-year-olds. Stability scores were significantly lower for this latter subgroup compared to those who spent time in foster or group care and those who did not receive child welfare support during the final year of high school. Ninety percent of participants graduated from high school, 67% with the grades required to attend university. Three trajectories into undergraduate study were identified but could not be predicted using regression models. Originality/value: This paper focuses on what has supported progression into a research-intensive university for care-experienced young adults and highlights the role of support programs for 16- to 18-year-olds. [ABSTRACT FROM AUTHOR]

This paper investigates how positive and negative work-personal life interface constructs are differentially associated with intentions to stay in or leave the profession. The findings help map work-personal life interface constructs on the typology of determinants of intention to stay and intention to leave (disengagers, retainers, criticals, and neutrals). The ordered logistic regression (ologit) modelling of cross-sectional data from a representative sample (n = 601) of midwives in Canada shows that work interference with personal life is a disengager, which has a stronger association with intention to leave than with intention to stay in the profession. Among the work-personal life interface constructs, work enhancement of personal life seems to be the most critical determinant, showing the most substantive association with both intention to stay and intention to leave. This finding suggests that interventions to increase midwives' intention to stay and decrease their intention to leave should focus on amplifying the enhancing effects of working on midwives' personal lives. Interventions that aim to reduce work interference with personal life might be more effective in decreasing intention to leave the profession than increasing intention to stay. [ABSTRACT FROM AUTHOR]

Simple Summary: The current approach to breast cancer screening, which is based on a person's age, overlooks individual-level differences in breast cancer risk. As a result, many people are over- or under-screened according to their actual risk of breast cancer. Risk-stratified breast screening may overcome the limitations of age-based screening, but there are still many knowledge gaps regarding how best to implement it in the population setting. This study will generate the first Canadian evidence on the adoption of breast cancer risk assessment in the population setting, to support the future implementation of risk-stratified breast cancer screening. This study demonstrated that, while risk assessment for risk-stratified screening at the population level is feasible, an equity lens must be considered in implementation to ensure cancer-screening disparities are not widened. Risk-stratified breast screening has been proposed as a strategy to overcome the limitations of age-based screening. A prospective cohort study was undertaken within the PERSPECTIVE I&I project, which will generate the first Canadian evidence on multifactorial breast cancer risk assessment in the population setting to inform the implementation of risk-stratified screening. Recruited females aged 40–69 unaffected by breast cancer, with a previous mammogram, underwent multifactorial breast cancer risk assessment. The adoption of multifactorial risk assessment, the effectiveness of methods for collecting risk factor information and the costs of risk assessment were examined. Associations between participant characteristics and study sites, as well as data collection methods, were assessed using logistic regression; all p-values are two-sided. Of the 4246 participants recruited, 88.4% completed a risk assessment, with 79.8%, 15.7% and 4.4% estimated at average, higher than average and high risk, respectively. The total per-participant cost for risk assessment was CAD 315. Participants who chose to provide risk factor information on paper/telephone (27.2%) vs. online were more likely to be older (p = 0.021), not born in Canada (p = 0.043), visible minorities (p = 0.01) and have a lower attained education (p < 0.0001) and perceived fair/poor health (p < 0.001). The 34.4% of participants requiring risk factor verification for missing/unusual values were more likely to be visible minorities (p = 0.009) and have a lower attained education (p ≤ 0.006). This study demonstrates the feasibility of risk assessment for risk-stratified screening at the population level. Implementation should incorporate an equity lens to ensure cancer-screening disparities are not widened. [ABSTRACT FROM AUTHOR]

Despite increased access to and improvements in contraceptives, unintended pregnancy continues to be a problem globally and is associated with adverse outcomes for mothers and infants. This paper seeks to unravel the mediators of intended versus unintended pregnancies among Black women living with HIV. The paper draws on survey data from a broader multi-country mixed methods study that used a community-based participatory research approach to investigate the psychosocial experiences of Black mothers living with HIV. The study participants were Black mothers living with HIV drawn through venue-based sampling from Ottawa, Canada (n = 89), Port Harcourt, Nigeria (n = 400), and Miami, Florida, United States (n = 201). We used Hierarchical Binary Logistic Regression Modelling (HBLM) to estimate the independent associations of pregnancy intention (intended versus unintended) with blocks of predictor variables (sociodemographic, sociocultural, and psychosocial predictors) at alpha level of 0.5. Specifically, 44.2%, 67.3%, and 17.7% of the women had unintended pregnancies in Ottawa, Miami, and Port Harcourt, respectively. There were important results from the HBLM. The odds of intended relative to unintended pregnancies were (i) reduced in larger households (OR = 0.56, 95% CI = 0.36/0.87), but increased with employment (OR = 7.84, 95% CI = 1.52/40.54) and HIV knowledge (OR = 3.13, 95% CI = 1.42/6.90) in Ottawa; (ii) reduced with age (OR = 0.93, 95% CI = 0.88/0.98), but increased with marriage (OR = 2.90, 95% CI = 1.43/5.88) and social support (pregnancy (OR = 3.77, 95% CI = 1.98/7.19) in Port Harcourt; (iii) reduced with social support (OR = 0.95, 95% CI = 0.91/1.00) but increased with HIV status disclosure (OR = 1.73, 95% CI = 1.01/2.97) and the influence of specific referent (OR = 1.68, 95% CI = 1.13/2.52) in Miami-FL. The incidence of unintended pregnancy is more prevalent among Black women living with HIV in the North American cities relative to the African city. Also, unique combinations of sociodemographic, sociocultural, and psychosocial factors influence pregnancy intention in each city. This implies that policy and practices to address reproductive health needs of WLHIV must consider these contextual issues. [ABSTRACT FROM AUTHOR]

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

Recent debates surrounding intimate partner violence (IPV) have focused on its gender symmetry and gender-oriented nature. These debates center on findings from various data sources, like victimization or self-reported surveys and police-based reports. Data by Statistics Canada, from 1999 to 2014, has shown that the prevalence of IPV is similar for male and female victims, except for sexual assaults. However, there has been a paucity of studies on the severity and risk factors of IPV against men by female partners. Thus, this paper examines the severity of and risk factors for physical IPV against heterosexual men in Canada using the General Social Survey (Victimization) data of 2014. This study revealed that there is a symmetry in the experiences of physical violence between male and female victims. This study also revealed that male victims experience more severe violence than female victims. Using binary logistic regression analysis, years of dwelling together, the victim's age, childhood victimization, and marijuana use were found to predict physical IPV against heterosexual men. This paper concludes with suggestions about how these predicting factors can be used to identify male victims and the need for a more inclusive approach toward addressing IPV, which should include male victims. [ABSTRACT FROM AUTHOR]

The different life paths of the generation following immigration have become a matter of public discussion and scholarly research in the past decades in many migrant-receiving countries. These differences would be key points for the immigration decision made by first-generation immigrants. This paper adopts a new perspective to study the differences in task supplies and economic status between natives and two generations of immigrants to see their different life paths. This paper estimates differences in task supply and earnings between natives and immigrants in 1970 and 2015, which are the beginning and end of the fifth (and current) wave of immigration to Canada. Furthermore, using a three-fold Blinder-Oaxaca decomposition, I link the average weekly wage of workers to their task productivity, and try to find the effects of the returns to tasks as well as different task supplies on the average wage gap between natives and immigrants. Finally, I use ordered probit and logit models to demonstrate and measure the significant effects of immigrant status on an employee's labour market segment. [ABSTRACT FROM AUTHOR]

This paper investigates how to best compare algorithms for predicting chronic homelessness for the purpose of identifying good candidates for housing programs. Predictive methods can rapidly refer potentially chronic shelter users to housing but also sometimes incorrectly identify individuals who will not become chronic (false positives). We use shelter access histories to demonstrate that these false positives are often still good candidates for housing. Using this approach, we compare a simple threshold method for predicting chronic homelessness to the more complex logistic regression and neural network algorithms. While traditional binary classification performance metrics show that the machine learning algorithms perform better than the threshold technique, an examination of the shelter access histories of the cohorts identified by the three algorithms show that they select groups with very similar characteristics. This has important implications for resource constrained not-for-profit organizations since the threshold technique can be implemented using much simpler information technology infrastructure than the machine learning algorithms. [ABSTRACT FROM AUTHOR]

Annual turnover of home care workers represents a huge loss of revenue and is a key source of inefficiency in the home health care industry. In this article, we propose a data-driven approach to monitor employee churn and to capture the evolution of employee intent to leave. Unlike most papers in the literature, we use machine learning techniques to analyze over 2 million visits in the US, Canada, and Australia between 2016 and 2019. Results show that the gap between the number of hours worked and in the contract is the most important factor to predict employee intent to leave, which means an employee should be given as many hours as requested in the contract to improve retention. Secondary results show that having diverse shift lengths and continuity in services and patients seem to be associated with less turnover. [ABSTRACT FROM AUTHOR]

Background & Aims: Given that standardized language measures alone are inadequate for identifying functionally defined developmental language disorder (fDLD), this study investigated whether non‐linguistic cognitive abilities (procedural learning, motor functions, executive attention, processing speed) can increase the prediction accuracy of fDLD in children in linguistically diverse settings. Methods & Procedures: We examined non‐linguistic cognitive abilities in mono‐ and bilingual school‐aged children (ages 8–12) with and without fDLD. Typically developing (TD) children (14 monolinguals, 12 bilinguals) and children with fDLD (28 monolinguals, 12 bilinguals) completed tasks measuring motor functions, procedural learning, executive attention and processing speed. Children were assigned as fDLD based on parental or professional concerns regarding children's daily language functioning. If no concerns were present, children were assigned as TD. Standardized English scores, non‐verbal IQ scores and years of maternal education were also obtained. Likelihood ratios were used to examine how well each measure separated the fDLD versus TD groups. A binary logistic regression was used to test whether combined measures enhanced the prediction of identifying fDLD status. Outcomes & Results: A combination of linguistic and non‐linguistic measures provided the best distinction between fDLD and TD for both mono‐ and bilingual groups. For monolingual children, the combined measures include English language scores, functional motor abilities and processing speed, whereas for bilinguals, the combined measures include English language scores and procedural learning. Conclusions & Implications: A combination of non‐linguistic and linguistic measures significantly improved the distinction between fDLD and TD for both mono‐ and bilingual groups. This study supports the possibility of using non‐linguistic cognitive measures to identify fDLD in linguistically diverse settings. What this paper adds: What is already known on the subject: Given that standardized English language measures may fail to identify functional language disorder, we examined whether supplementing English language measures with non‐linguistic cognitive tasks could resolve the problem. Our study is based on the hypothesis that non‐linguistic cognitive abilities contribute to language processing and learning. This is further supported by previous findings that children with language disorder exhibit non‐linguistic cognitive deficits. What this paper adds to existing knowledge: The results indicated that a combination of linguistic and non‐linguistic cognitive abilities increased the prediction of functional language disorder in both mono‐ and bilingual children. What are the potential or actual clinical implications of this work?: This study supports the possibility of using non‐linguistic cognitive measures to identify the risk of language disorder in linguistically diverse settings. [ABSTRACT FROM AUTHOR]

In many countries, loan guarantee programs are important elements of government policy with respect to small- and medium-sized enterprises (SMEs). If loan guarantee schemes are to be effective, a majority of firms obtaining assistance through such a scheme ought not to be able to obtain financing from existing sources: a property known as incrementality or additionality. This paper describes a new approach to measuring incrementality. This work uses a two-stage process to estimate the incrementality of loans made under the terms of the Canada Small Business Financing (CSBF) program. First, a logistic regression-based model of loan outcomes (essentially a credit-scoring model) is estimated based on a large representative sample of SMEs. The resulting model was consistent with prior expectations and exhibited high levels of goodness-of-fit. The model was then employed to classify a sample of firms that had received loans under the terms of the loan guarantee scheme. Incremental loans ought to be classified as “turndowns” by the model; hence the proportion of loan guarantee recipients that the model classified as turndowns is a direct measure of incrementality. For the CSBF loan guarantee program incrementality was estimated (with 95% confidence) as 74.8±9.0%. [ABSTRACT FROM AUTHOR]

This paper used a structural perspective to examine unmet healthcare needs in women at risk for eating disorders in Canada utilizing the Canadian Community Health Survey. The results revealed that body dissatisfied women had reported significantly higher unmet needs compared to body satisfied women (χ 2(1) =29.31, p <.05). Body dissatisfied women were also more likely to identify structural reasons for unmet needs. Considering the high costs associated with eating disorders, barriers creating inequitable health services need to be addressed in clinical practice, organizational structures, policy, and in research to improve treatment pathways. [ABSTRACT FROM AUTHOR]

Understanding the temporal trends in the place of death among patients in receipt of home‐based palliative care can help direct health policies and planning of health resources. This paper aims to assess the temporal trends in place of death and its determinants over the past decade for patients receiving home‐based palliative care. This paper also examines the impact of early referral to home‐based palliative care services on patient's place of death. Survey data collected in a home‐based end‐of‐life care program in Toronto, Canada from 2005 to 2015 were analysed using a multivariate logistic model. The results suggest that the place of death for patients in receipt of home‐based palliative care has changed over time, with more patients dying at home over 2006–2015 when compared to 2005. Also, early referral to home‐based palliative care services may not increase a patient's likelihood of home death. Understanding the temporal shifts of place of death and the associated factors is essential for effective improvements in home‐based palliative care programs and the development of end‐of‐life care policies. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Jewish Studies / Études Juives Canadiennes is the property of Association for Canadian Jewish Studies 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.)

Purpose: The purpose of this paper is to examine the association between immigrants' sense of community belonging and self-rated general and mental health status in Canada as well as estimate how this relationship is moderated by sex differences. Design/methodology/approach: This cross-sectional study used pooled data from seven cycles of the Canadian Community Health Survey (N = 98,011) conducted between 2005 and 2018. Data were pooled to increase the sample size of the immigrant population. The surveys covered content areas such as well-being, sociodemographic, chronic diseases, self-rated general and mental health. A binary logistic regression fitted the model. Both univariate and multivariate analyses were performed between predictor variables and immigrants' self-rated general and mental health. Descriptive statistics and adjusted odds ratios and 95% confidence intervals were estimated. Sex differences were also assessed. Findings: This study found that slightly more than half of the respondents were female (53.2%). Generally, immigrants with a weak sense of community belonging were more likely to rate their general and mental health as poor although the association is stronger in mental health. Also factors such as older age, lower educational level, those single or never married, smoking status, physical inactivity, overweight or obesity and life stress were predictors of both poor self -rated general and mental health among immigrants. Sex differences in these risk factors were also noted. Research limitations/implications: This study has several limitations that should be noted. The first limitation is the fact that causality cannot be deduced due to the cross-sectional nature of our pooled data. Secondly, responses from this data are subject to recall bias given that the data were self-reported. Therefore, the interpretation of these results must be done with caution. Further, questions regarding the primary exposure variable of this study were restrictive. The definition of the local community which forms part of the one-item community belonging question did not define what is meant by local community, and as such, the question might be subject to different interpretations (i.e. urban or rural geography?). Lastly, this study's findings did not stratify immigrants into countries or continents of origin. Immigrants from some countries or continents may be more prone to mental health than others. Originality/value: This study shows a link between weak immigrants' sense of community belonging and poor self-rated general and mental health status in Canada and provides suggestive evidence of how contextual factors influence health outcomes differently in society. [ABSTRACT FROM AUTHOR]

In power systems, an asset class is a group of power equipment that has the same function and shares similar electrical and/or mechanical characteristics. Predicting failures for different asset classes is critical for electric utilities toward developing cost-effective asset management strategies. Previously, physical age based Weibull distribution has been widely used for failure prediction. However, this mathematical model cannot incorporate asset condition data. As a result, the prediction cannot be very specific and accurate for individual assets. To solve this important problem, this paper proposes a novel and comprehensive data-driven approach based on asset condition data: K-means clustering as an unsupervised learning method is used to analyze the inner structure of historical asset condition data and produce the asset conditional ages; logistic regression as a supervised learning method takes in both asset physical ages and conditional ages to classify and predict asset operation statuses. Furthermore, an index called average aging rate is defined to quantify, track, and estimate the relationship between asset physical age and conditional age. This approach was applied to a medium-voltage cable class in an urban distribution system in West Canada. Case studies and comparison with standard Weibull distribution are provided. The proposed approach demonstrates higher accuracy measured by F1-Score than Weibull distribution method for asset class failure prediction. [ABSTRACT FROM AUTHOR]

Given the disproportionate alcohol-related consequences experienced by North American Indigenous youth, there is a critical need to identify related risk and protective factors. Self-compassion, which has been found to mitigate the effects of trauma exposure, may serve as one such protective factor given the high degree of historical trauma and contemporary discrimination identified as contributing to the alcohol-related disparities experienced by Indigenous communities. However, no research has examined how self-compassion (i.e. the ability to be kind and accepting and to extend compassion toward oneself) plays a unique role in Indigenous peoples' experiences with alcohol. First Nation adolescents between the ages of 11 and 18 living on a reserve in Eastern Canada (N = 106, Mage = 14.6, 50.0% female) completed a pencil-and-paper survey regarding their alcohol use, alcohol-related problems, and self-compassion. Self-compassion was significantly inversely associated with alcohol-related problems (b = -.51, p =.01, 95%CI [-.90, −.12], and significantly interacted with frequency of alcohol use in predicting alcohol-related problems (b = -.42, p =.04, 95%CI [-.82, −.03]). Simple slopes analyses revealed that the association between frequency of alcohol use and frequency of experiencing alcohol-related problems was significant and positive at low (b = 4.68, p <.001, 95%CI [2.62, 6.73]), but was not significant at high (b = -.29, p =.89, 95%CI [−4.35, 3.77]) levels of self-compassion. Binary logistic regression revealed that higher scores of self-compassion were associated with a lower odds of being in the high-risk group for AUD (OR = 0.90, 95%CI [0.83, 0.98], p =.02). Our results suggest self-compassion may be protective against experiencing alcohol problems in Indigenous youth and thus may be a target for behavioral interventions. [ABSTRACT FROM AUTHOR]

Objectives: Differences in health among migrant groups are related to the length of stay in host countries. We examined the health of people reporting Caribbean ethnic origins within and outside of Canada; and the possible associations between length of stay and poorer physical and mental health outcomes. Method: Analyses were conducted on population data collected in Canada (2000/2001, 2003, 2005), Jamaica (2005) and Guyana (2005). Physician-diagnosed and self-rated health measures were used to assess physical and mental health statuses. Results: Rates of chronic conditions were generally higher among people reporting Caribbean ethnic origins in Canada compared to those living in the Caribbean region. Self-rated fair or poor general health rates, however, were higher among participants in the Caribbean region. Higher rates of any mood disorders were also found among Caribbean region participants in comparison to those in Canada. Logistic regression analyses revealed that new Caribbean immigrants (less than 10 years since immigration) in Canada had better physical health than those who were more established. Those who immigrated more than 20 years ago showed consistently better health conditions than those who had immigrated between 11 and 20 years ago. This healthy immigration effect, however, was not present for all chronic conditions among all Caribbean origin migrant groups. Moreover, mood disorders were highest among new immigrants compared to older immigrants. Conclusions: When and where ethnic Caribbeans migrate to and emigrate from matters in health statuses. These results have implications for policies related to health and well-being in support of ethnic Caribbean origin individuals who relocate to Canada. The paper concludes with suggestions for future studies regarding the health of ethnic origin Caribbeans living within and outside their regions of birth. [ABSTRACT FROM AUTHOR]

More than 1 million Canadian adults play recreational ice hockey. Compared to elite players, very little is known about the physical and health characteristics of people who play the game for fun. Analyzing data from Statistics Canada's 2011/12 Canadian Community Health Survey, the paper found that there is an association between physically active males age 35 or over who play ice hockey regularly (at least once a week) and enhanced health more so than other physically active males. While these players are larger in body size, they have significantly lower rates of diabetes, high blood pressure and heart disease and report significantly higher rates of self-assessed health. Given the potential health benefits associated with this high intensity sport, the paper discusses ways in which participation can be promoted among less physically active adults and people who are new to the game or who have historically lower levels of participation including women and recent immigrants. Finally, the paper argues that compared to the very high costs associated with child and youth hockey, participation in adult recreational ice hockey is quite affordable. [ABSTRACT FROM AUTHOR]

Examining multi-level vertical party linkages in Canada’s largest province, this paper makes two primary contributions to the literature. First, drawing on data from a unique survey of constituency associations, the paper focuses on an often unexplored aspect of parties: their local organisations. Second, the paper offers an exploratory analysis of constituency level factors in order to determine which types of constituency associations are the most likely to be integrated. The results of the logistic regression demonstrate the possibility of non-party-based factors such as electoral strength that may contribute to vertical party integration. [ABSTRACT FROM AUTHOR]

Past research in Hamilton, Ontario has found that age and longevity of residence are positively associated with evaluations of sense of place (SoP); further, evaluations of SoP between immigrants and Canadian-born individuals have shown no clear pattern (Williams et al. ; Williams and Kitchen ). This paper builds on this work by further examining evaluations of SoP among both immigrants and Canadian-born residents and across gender in Hamilton, while expanding the study to two other small-to-medium sized cities: Saskatoon, Saskatchewan and, Charlottetown, Prince Edward Island. This paper has two objectives: (1) to establish measures of SoP across immigrant status and gender in Hamilton, Saskatoon, and Charlottetown; and, (2) to determine how SoP varies according to immigrant status, length of residence in Canada, age, income, and neighbourhood length of residence across the three city sites. Telephone survey data (n = 1,132) was used to compare evaluations of SoP across various groups and to construct an ordered logistic regression model for SoP. Results suggest that immigrants tended to rate their SoP lower than their Canadian-born counterparts. Hamilton residents were found to rate their SoP lowest, followed by Saskatoon residents and, finally, Charlottetown residents. Younger individuals, those with lower income levels, and those with shorter neighbourhood residency in the cities concerned were more likely to have lower evaluations of SoP. This research suggests that greater attention is needed to nurture immigrants' connection with their new home. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to document the need for implementing a fall prevention strategy in an emergency department (ED). The paper also spells out the research process that led to approving an assessment tool for use in hospital outpatient services. Design/methodology/approach The fall risk assessment tool was based on the Morse Fall Scale. Gender mix and age above 65 and 80 years were assessed on six risk assessment variables using χ2 analyses. A logistic regression analysis and model were used to test predictor strength and relationships among variables. Findings In total, 5,371 (56.5 percent) geriatric outpatients were deemed to be at fall risk during the study. Women have a higher falls incidence in young and old age categories. Being on medications for patients above 80 years exposed both genders to equal fall risks. Regression analysis explained 73-98 percent of the variance in the six-variable tool. Originality/value Canadian quality and safe healthcare accreditation standards require that hospital staff develop and adhere to fall prevention policies. Anticipated physiological falls can be prevented by healthcare interventions, particularly with older people known to bear higher risk factors. An aging population is increasing healthcare volumes and medical challenges. Precautionary measures for patients with a vulnerable cognitive and physical status are essential for quality care. [ABSTRACT FROM AUTHOR]

Child homicides are rare occurrences, but when they occur, they often cause significant outrage. This paper examines the role of varying degrees of intimacy between victims and perpetrators in determining characteristics in child homicide cases. Focusing on 533 cases of child homicide between 1985 and 2012 in Ontario, Canada, characteristics of intrafamilial and extrafamilial cases, biological and step/foster parents, and maternal and paternal perpetrators are compared. Results show that characteristics of the child homicide vary depending on the degree of intimacy between victims and perpetrators, including: perpetrator and victim age, weapon use, suicide following the offence, sexual violence and use of excessive force. These findings provide support for developmental victimology and a routine activities theoretical perspective. Suggestions for future research and policy implications are also discussed. 'Examines the role of varying degrees of intimacy between victims and perpetrators in determining characteristics in child homicide cases' Key Practitioner Messages: Younger children are at a greater risk of homicide from family members, while older children are at a greater risk of homicide from individuals outside the family.Developmental victimology and routine activities theory can contribute to a better understanding of the dynamics between victims and perpetrators in child homicide.Collaboration should take place between researchers, child death review committees, mental health services, social services and policymakers to improve child homicide prevention and intervention initiatives. [ABSTRACT FROM AUTHOR]

Background: In spite of the substantial benefits of physical activity for healthy aging, older adults are considered the most physically inactive segment of the Canadian population. This paper examines leisure-time physical inactivity (LTPA) and its correlates among older Canadian adults. Methods: We use data from the Canadian Community Health Survey with 45,265 individuals aged 50-79 years. A logistic regression is estimated and separate regressions are performed for males and females. Results: About 50% of older Canadian adults are physically inactive. Higher odds of physical inactivity are found among current smokers (OR = 1.52, CI = 1.37-1.69), those who binge-drink (OR = 1.24, CI = 1.11-1.39), visible minorities (OR = 1.60, CI = 1.39-1.85), immigrants (OR = 1.13, CI = 1.02-1.25), individuals with high perceived life stress (OR = 1.48, CI = 1.31-1.66). We also find lower odds of physical inactivity among: males (OR = 0.89, CI = 0.83 to 0.96), those with strong social interaction (OR = 0.71, CI = 0.66-0.77), with general life satisfaction (OR = 0.66, CI = 0.58-0.76) and individuals with more education. Similar results are obtained from separate regressions for males and females. Conclusions: Identifying the correlates of LTPA among older adults can inform useful intervention measures. [ABSTRACT FROM AUTHOR]

Accessible Summary What is known on the subject? Persons with different mental illnesses smoke for reasons based on their particular diagnosis., As compared to those without, persons with mental illnesses are less able to quit smoking when using smoking cessation medications., What this paper adds to existing knowledge? This paper shows that there may be differences in the ability to quit smoking between persons with different mental illness diagnoses., What are the implications for practice? Clinicians should be aware that persons with anxiety disorders may find it more difficult to quit smoking as compared to those with other mental illnesses., Clinicians should be aware that of all medications, varenicline seems to help those with mood disorders to quit the best., Clinicians should be aware that persons with psychotic disorders likely need longer treatment durations for smoking cessation as compared to persons with other mental illnesses., Abstract Introduction Individuals with mental illnesses ( MI) have diagnosis-specific reasons for smoking and achieve low smoking cessation when using cessation medications. Aim To assess differences in smoking cessation outcomes by MI diagnosis and cessation medications in outpatient mental health and addictions treatment settings in Vancouver, Canada. Method This is a retrospective analysis of tobacco treatment outcomes from 539 participants. The programme consists of cessation pharmacotherapy with 8 to 12 weeks of behavioural counselling and 12 weeks of support group. Smoking cessation was verified by expired carbon monoxide levels. Generalized estimating equations models assessed differences in cessation by type of medication in both total and stratified samples. Results There were no significant differences in cessation by pharmacotherapy in the total sample. Individuals with a mood disorder were two times more likely to achieve cessation as compared to those with an anxiety disorder. Among individuals with mood disorders, receiving varenicline alone resulted in three times the likelihood of cessation as compared to receiving single NRT. Discussion The differences in outcomes by MI diagnosis suggest the need for more diagnosis-specific approaches to optimize cessation. Implications for Practice Compared with other diagnoses, persons with anxiety disorders may have a greater challenge quitting and those with a psychotic disorder may require longer treatment durations. [ABSTRACT FROM AUTHOR]

Best practice in mass reach physical activity campaigns includes a role for communities to support the initiative with sustained programs and shorter-term events. The purpose of this paper was to report on an outcome evaluation of ParticipACTION's 150 Play List, a population-level, year-long, national mass reach campaign that included community events. Participants (N = 1,185) were recruited in the last month of the program to complete a questionnaire measuring demographic information, leisure-time physical activity, campaign awareness, attitudes, intentions, and behavioral trialing. Data were also collected, measured using cell phone proximity, on the number of people who attended 150 Play List events, which ranged from large-scale (e.g. national sports events) to smaller community events. Approximately 43% of respondents were aware of the 150 Play List and 19.5% reported participating in some way (e.g. visiting the website). Almost half of the participants who were aware of the campaign reported increased sport or physical activity-related intentions. Among those who participated, 90.6% reported trying at least one physical activity or sport related behavior as a result of the 150 Play List, whereas only 27.5% (n = 75) of those who were aware but did not participate in the 150 Play List tried a behavior. Event attendance goals were mostly met or exceeded. The 150 Play List was valued by those aware of it and the campaign was related to interest in sport and physical activity in Canada. The community events had potential to augment campaign effects but adequate evaluation requires sufficient resources. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to explore whether a relationship exists between the number of disasters a jurisdiction has experienced and the presence of disaster-specific pharmacy legislation. Methods: Pharmacy legislation specific to disasters was reviewed for five countries: Australia, Canada, UK, US and New Zealand. A binary logistic regression test using a generalised estimating equation was used to examine the association between the number of disasters experienced by a state, province, territory or country and whether they had disaster-specific pharmacy legislation. Results: Three of six models were statistically significant, suggesting that the odds of a jurisdiction having disaster-specific pharmacy legislation increased as the number of disasters increased for the period 2007–17 and 2013–17. There was an association between the everyday emergency supply legislation and the presence of the extended disaster-specific emergency supply legislation AH19093_IE1.gif. Conclusions: It is evident from this review that there are inconsistencies as to the level of assistance pharmacists can provide during times of crisis depending on their jurisdiction and location of practice. It is not a question of whether pharmacists have the skills and capabilities to assist, but rather what legislative barriers are preventing them from being able to contribute further to the disaster healthcare team. What is known about the topic?: The contributing factors to disaster-specific pharmacy legislation has not previously been explored in Australia. It can be postulated that the number of disasters experienced by a jurisdiction increases the likelihood of governments introducing disaster-specific pharmacy legislation based on other countries. What does this paper add?: This study compared five countries and their pharmacy legislation specific to disasters. It identified that as the number of disasters increases, the odds of a jurisdiction having disaster-specific emergency supply or disaster relocation or mobile pharmacy legislation increases. However, this is likely to be only one of many factors affecting the political decisions of when and what legislation is passed in relation to pharmacists' roles in disasters. What are the implications for practitioners?: Pharmacists are well situated in the community to be of assistance during disasters. However, their ability to help patients with chronic disease management or providing necessary vaccinations in disasters is limited by the legislation in their jurisdiction. Releasing pharmacists' full potential in disasters could alleviate the burden of low-acuity patients on other healthcare services. This could subsequently free up other healthcare professionals to treat high-acuity patients and emergencies. [ABSTRACT FROM AUTHOR]

Universities around the world seek to increase their students' learning abroad in forms like international co-op and exchange. The authors build on findings in a 2016 publication by Behrisch in this journal to focus on the correlation of perceived risk with students' completion of a learning abroad experience. Using binary logistic regression analysis, findings suggest that students' perceived risk is negatively correlated with their likelihood of completing a learning abroad experience. Drawing on approach/inhibition theory and sensation seeking literature, the authors form a picture of how risk perception interacts with other factors to influence students' completion of learning abroad. Risk is typically regarded at the institutional and student levels as something negative to avoid. Reframing risk within the university as a conversation about learning, opportunity, and cognitive processing is recommended, since learning and teaching are essential elements of universities. The goal is to increase student engagement in learning abroad. [ABSTRACT FROM AUTHOR]

Childhood adversity is known to have an enduring effect on health outcomes of victims. The objective of the study was to examine the association between childhood adversity and psychosocial health outcomes among immigrants in Canada. Using descriptive and inferential statistics and fitting negative loglog regression models to the 2014 General Social Survey, the paper examined the relationship between experience of childhood adversity (i.e. physical and sexual abuse before age 15) and its association with psychosocial health outcomes (i.e. psychological-mental condition and self-rated mental health) among immigrants in Canada. After accounting for relevant socioeconomic and demographic factors, the results show that physical abuse during childhood resulted in 29% and 31% increased likelihood of having a psychological mental condition and poor self-rated mental health, respectively. Also, sexual abuse during childhood was associated with 28% increased likelihood of poor self-rated mental health. In conclusion, the findings show that experience of physical and sexual abuse during childhood is associated with negative mental health outcomes in later life. [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.)

From a public health perspective, gambling shares many of the same characteristics as alcohol. Notably, excessive gambling is associated with many physical and emotional health harms, including depression, suicidal ideation, substance use and addiction and greater utilization of health care resources. Gambling also demonstrates a similar 'dose-response' relationship as alcohol—the more one gambles, the greater the likelihood of harm. Using the same collaborative, evidence-informed approach that produced Canada's Low-Risk Alcohol Drinking and Lower Risk Cannabis Use Guidelines, a research team is leading the development of the first national Low-Risk Gambling Guidelines (LRGGs) that will include quantitative thresholds for safe gambling. This paper describes the research methodology and the decision-making process for the project. The guidelines will be derived through secondary analyses of several large population datasets from Canada and other countries, including both cross-sectional and longitudinal data on over 50 000 adults. A scientific committee will pool the results and put forward recommendations for LRGGs to a nationally representative, multi-agency advisory committee for endorsement. To our knowledge, this is the first systematic attempt to generate a workable set of LRGGs from population data. Once validated, the guidelines inform public health policy and prevention initiatives and will be disseminated to addiction professionals, policy makers, regulators, communication experts and the gambling industry. The availability of the LRGGs will help the general public make well-informed decisions about their gambling activities and reduce the harms associated with gambling. [ABSTRACT FROM AUTHOR]

This study explored the association between socioecological factors and outdoor physical activity (PA) and play in children with disabilities during the COVID-19 pandemic. Parents (N = 133) completed a survey to report changes in their child's outdoor PA and play during the pandemic (from prepandemic levels), and child, household, and neighborhood environment factors. Children with a PA-supporting parent and from multichild and White households had lower odds of reporting decreased outdoor PA. Children from multichild, higher income, married couple households and a PA-supporting parent had lower odds of decreased outdoor play. Living in neighborhoods with higher urbanization (i.e., high dwelling density, street intersections, and land-use mix) was associated with greater odds of decreased outdoor PA and play. Future research that uses larger and more representative samples of children with disabilities is needed to test for the multivariate effects of socioecological variables on outdoor PA and play. [ABSTRACT FROM AUTHOR]

Background: The literature has opposing views regarding the magnitude of the association between substance use and TBI. Most studies have examined clinical samples which are not representative of the entire head injured population. Clinical samples provide very limited insight into TBI patients whom do not seek care. Objectives: This paper examines the associations between TBI and substance use/misuse. Its primary aim is to test whether or not individuals with a past-year TBI have higher rates of substance use/misuse than Canadians without a TBI or back and/or spine injury controls drawing on self-report population level data. Methods: Using the 2009-2010 Canadian Community Health Survey, a nationally representative cross-sectional survey of Canadians 12 years and older, this paper assessed substance use (i.e., illicit drug use; drinking and binge drinking; current smoking) among those with a TBI, as compared to two control groups: (1) individuals with a back or spinal injury (BSI); and (2) healthy noninjured controls. Multivariate regressions (logistic and multinomial), both unadjusted and adjusting for a range of injury and sociodemographic covariates, were used in hypothesis testing. Results: Those with a past-year TBI demonstrated significantly elevated rates of illicit drug use relative to non-injured Canadians. Relative to the BSI group those with a TBI were less likely to drink alcohol, did not differ in binge drinking, cigarette smoking and illicit drug use. Conclusion: Health care professionals working with the TBI population should integrate screening, brief intervention, and referral programming as a means to reduce future harm related to substance misuse. [ABSTRACT FROM AUTHOR]

This is the second in a series of papers that deal with care-giving in Canada, as based on data available from the Canadian General Social Survey (2007). Building on the first paper, which reviewed the differences between short-term, long-term and end-of-life ( EOL) caregivers, this paper uniquely examines the caregiver supports employed by EOL caregivers when compared to non- EOL caregivers (short-term and long-term caregivers combined). Both papers employ data from Statistics Canada's General Social Survey ( GSS Cycle 21: 2007). The GSS includes three modules, where respondents were asked questions about the unpaid home care assistance that they had provided in the last 12 months to someone at EOL or with either a long-term health condition or a physical limitation. The objective of this research paper was to investigate the link between the impact of the care-giving experience and the caregiver supports received, while also examining the differences in these across EOL and non- EOL caregivers. By way of factor analysis and regression modelling, we examine differences between two types of caregivers: (i) EOL and (ii) non- EOL caregivers. The study revealed that with respect to socio-demographic characteristics, health outcomes and caregiver supports, EOL caregivers were consistently worse off. This suggests that although all non- EOL caregivers are experiencing negative impacts from their care-giving role, comparatively greater supports are needed for EOL caregivers. [ABSTRACT FROM AUTHOR]

Purpose: To identify risk and protective factors associated with physician performance in practice; to use this information to create a risk assessment scale; and, to test use of the risk assessment scale with a new population of assessed physicians. Design: Physician assessments that were completed by community-based physicians between March 2016 and February 2022 (n=2708) were gathered to determine what professional characteristics and practice context factors were associated with poor peer practice assessment (PPA). The predictive capacity of the resulting model was then tested against a new sample of physician assessments completed between March 2022 and February 2023 (n=320). Results: N=2401 physicians were eligible for inclusion in a logistic regression analysis, which resulted in an empirical model containing 11 variables that was able to account for 21.6% of the variance in the likelihood of receiving a poor PPA generated by the College of Physicians and Surgeons of British Columbia. The resulting model, when tested against 320 new cases, was able to predict good versus poor PPA performance with a sensitivity of 0.79 and specificity of 0.75. Not having undertaken peer review (OR=1.47) created a risk like that arising from a full decade passing since completion of medical school (OR=1.50). Conclusion: In addition to being the largest known study of its type, this work builds on similar studies by demonstrating the capacity to use regulator-mandated peer review to empirically identify physicians who are at risk of substandard performance using factors that are safe from claims of violating Human Rights Codes; that emphasize modifiable aspects of practice; and that can be readily updated to account for change over time. [ABSTRACT FROM AUTHOR]

Background More than half (56%) of Canadian children aged 0 to 5 years are in non-parental child care, but data on child care attendance among children with disabilities is limited. This study examines child care participation among young children with disabilities in Canada, with a focus on different disability types. Data and methods Analyses were conducted on 1,189 children aged 0 to 5 years identified with disabilities from Statistics Canada’s 2023 Survey on Early Learning and Child Care Arrangements – Children with Long-term Conditions and Disabilities. Rates of child care participation, difficulties finding child care, difficulties within child care, and whether parents reported that their child had ever been denied a child care space because of their condition were examined. Logistic regression models tested for differences in the main child care arrangement and difficulty finding child care based on the child’s disability while controlling for sociodemographic variables. Results Among children aged 0 to 5 years with disabilities, 45% attended a daycare centre, preschool, centre de la petite enfance, or before or after school care as their main child care arrangement; 17% attended another type of child care, such as a family child care home or care by a relative; and 38% did not regularly attend non-parental child care. The parents of nearly half of children with disabilities reported difficulty finding a child care arrangement, particularly for children with emotional conditions. Close to 1 in 10 parents of children with disabilities who were using child care reported that their child had been denied a child care space because of their condition. Interpretation These findings highlight the need for information to support inclusive policies, practices, and resources for children with disabilities within the Canada-wide early learning and child care system. [ABSTRACT FROM AUTHOR]

Background: Bleeding in early pregnancy is a common emergency department (ED) presentation. Although variability in approaches has been demonstrated, research is relatively uncommon on practices and outcomes. This study investigated the influence of clinical pattern of care, utility, and contribution of pelvic examination aimed at diagnosing and managing bleeding in early pregnancy at three Canadian EDs. Methods: After obtaining informed consent, data were collected from adult women who were pregnant and from treating ED physicians using a structured questionnaire. We defined the change in management based on the initial clinical plan at the time of the initial physician assessment in the ED and any subsequent changes made after the pelvic examination was performed. Patient telephone follow-up was supplemented by linking with provincial administrative data for births. Univariable and multivariable binary logistic regression analyses were performed to identify factors associated with a change in patient management following pelvic examination in the ED. Results: Overall, 200 women were enrolled. The mean age was 31 years, patients had been bleeding for a median of 1 day and stayed in the ED for a median of 5 h. Of these, 166 (83.0%) received a pelvic examination, including speculum examination and/or bimanual palpation. Pregnancy outcome data were available for 192 pregnancies; 107 (56%) experienced a miscarriage. Factors significantly associated with a change in management after pelvic examination in the univariate logistic regression analysis were brown/dark-red bleeding per vaginam (physician determined), tachycardia, right lower quadrant tenderness, and bimanual palpation. In the multivariate logistic regression analysis, brown/dark-red bleeding per vaginam was independently associated with a reduced likelihood of a change in management after pelvic examination (aOR = 0.37; 95% CI: 0.14–0.98). Conclusion: Among women presenting to the ED with bleeding in early pregnancy prior to 20 weeks gestation, only brown/dark-red vaginal bleeding, potentially indicative of bleeding resolution, significantly independently influenced the baseline odds of a change in management after pelvic examination. Until the debate on the utility of pelvic examination in the ED for this presentation is resolved, physician preferences and shared decision making with patients should guide practice regarding speculum examination/bimanual palpation for the management of bleeding in early pregnancy. [ABSTRACT FROM AUTHOR]

Power engineering certification in Canada comprises a hierarchical, graduated system available to both young and adult learners. This paper offers insight into the knowledge gap regarding factors influencing Canadian power engineers' decision to pursue advanced certification in the Provinces of British Columbia and Alberta, with implications for adult learning in the power engineering sector of Canada. Comprehension of factors that influence intentions for power engineering certification may illuminate barriers and enablers to adult learning and provide evidentiary knowledge to support a format that facilitates advancement of certification. The research methodology was quantitative correlational design in which linear and logistic regressions employing a modified Bonferroni equivalent alpha were utilised. An original survey was developed for the study and pilot tested for validity and reliability. The sample comprised 1st, 2nd, and 3rd Class power engineers in British Columbia and Alberta. The dependent variable (DV) was the power engineers' advancement intention. In the context of this paper, advancement intention is an influence leading to the inclination or reluctance to pursue promotion, succession, or advancement in employment. The independent variables (IVs) were time commitment, educational support, locus of control, time elapsed since previous certification, responsibility, and peer appraisal. Revealed in the results were positive, statistically significant relationships between the DV of advancement intention and three of the six IVs. Time commitment, responsibility, and elapsed time exert statistically significant effects on advancement intention (DV). The three remaining IVs that did not exhibit significant relationships with the DV were educational support, locus of control, and peer appraisal. This indicated that the IVs of educational support, locus of control, and peer appraisal did not significantly influence the DV when compared to the significant influences of time commitment, responsibility, and elapsed time on the DV. Comprehension of the influential factors regarding the intention of Canadian power engineers to pursue advanced certification may assist industry and academia with insight into the barriers and enablers to higher certification, and the correlation of decision factors with advancement intention. [ABSTRACT FROM AUTHOR]

Aims: This paper presents updated prevalence estimates of awareness, ever‐use, and current use of nicotine vaping products (NVPs) from 14 International Tobacco Control Policy Evaluation Project (ITC Project) countries that have varying regulations governing NVP sales and marketing. Design, Setting, Participants and Measurements: A cross‐sectional analysis of adult (≥ 18 years) current smokers and ex‐smokers from 14 countries participating in the ITC Project. Data from the most recent survey questionnaire for each country were included, which spanned the period 2013–17. Countries were categorized into four groups based on regulations governing NVP sales and marketing (allowable or not), and level of enforcement (strict or weak where NVPs are not permitted to be sold): (1) most restrictive policies (MRPs), not legal to be sold or marketed with strict enforcement: Australia, Brazil, Uruguay; (2) restrictive policies (RPs), not approved for sale or marketing with weak enforcement: Canada, Malaysia, Mexico, New Zealand; (3) less restrictive policies (LRPs), legal to be sold and marketed with regulations: England, the Netherlands, Republic of Korea, United States; and (4) no regulatory policies (NRPs), Bangladesh, China, Zambia. Countries were also grouped by World Bank Income Classifications. Country‐specific weighted logistic regression models estimated adjusted NVP prevalence estimates for: awareness, ever/current use, and frequency of use (daily versus non‐daily). Findings NVP awareness and use were lowest in NRP countries. Generally, ever‐ and current use of NVPs were lower in MRP countries (ever‐use = 7.1–48.9%; current use = 0.3–3.5%) relative to LRP countries (ever‐use = 38.9–66.6%; current use = 5.5–17.2%) and RP countries (ever‐use = 10.0–62.4%; current use = 1.4–15.5%). NVP use was highest among high‐income countries, followed by upper–middle‐income countries, and then by lower–middle‐income countries. Conclusions: With a few exceptions, awareness and use of nicotine vaping products varied by the strength of national regulations governing nicotine vaping product sales/marketing, and by country income. In countries with no regulatory policies, use rates were very low, suggesting that there was little availability, marketing and/or interest in nicotine vaping products in these countries where smoking populations are predominantly poorer. The higher awareness and use of nicotine vaping products in high income countries with moderately (e.g. Canada, New Zealand) and less (e.g. England, United States) restrictive policies, is likely due to the greater availability and affordability of nicotine vaping products. [ABSTRACT FROM AUTHOR]

Purpose: Mental health problems are prevalent after combat; they are also common in its absence. Estimates of deployment-attributability vary. This paper quantifies the contribution of different subtypes of occupational trauma to post-deployment mental health problems.Methods: Participants were a cohort of 16,193 Canadian personnel undergoing post-deployment mental health screening after return from the mission in Afghanistan. The screening questionnaire assessed post-traumatic stress disorder, depression, panic disorder, generalized anxiety disorder, and exposure to 30 potentially traumatic deployment experiences. Logistic regression estimated adjusted population attributable fractions (PAFs) for deployment-related trauma, which was treated as count variables divided into several subtypes of experiences based on earlier factor analytic work.Results: The overall PAF for overall deployment-related trauma exposure was 57.5% (95% confidence interval 44.1, 67.7) for the aggregate outcome of any of the four assessed problems. Substantial PAFs were seen even at lower levels of exposure. Among subtypes of trauma, exposure to a dangerous environment (e.g., receiving small arms fire) and to the dead and injured (e.g., handling or uncovering human remains) had the largest PAFs. Active combat (e.g., calling in fire on the enemy) did not have a significant PAF.Conclusions: Military deployments involving exposure to a dangerous environment or to the dead or injured will have substantial impacts on mental health in military personnel and others exposed to similar occupational trauma. Potential explanations for divergent findings in the literature on the extent to which deployment-related trauma contributes to the burden of mental disorders are discussed. [ABSTRACT FROM AUTHOR]

Background Fewer than half of individuals with a mental disorder seek formal care in a given year. Much research has been conducted on the factors that influence service use in this population, but the methods generally used cannot easily identify the complex interactions that are thought to exist. In this paper, we examine predictors of subsequent service use among respondents to a population health survey who met criteria for a past-year mood, anxiety or substance-related disorder. Methods To determine service use, we use an administrative database including all physician consultations in the period of interest. To identify predictors, we use classification tree (CART) analysis, a data mining technique with the ability to identify unsuspected interactions. We compare results to those from logistic regression models. Results We identify 1213 individuals with past-year disorder. In the year after the survey, 24% (n=312) of these had a mental health-related physician consultation. Logistic regression revealed that age, sex and marital status predicted service use. CART analysis yielded a set of rules based on age, sex, marital status and income adequacy, with marital status playing a role among men and by income adequacy important among women. CART analysis proved moderately effective overall, with agreement of 60%, sensitivity of 82% and specificity of 53%. Conclusion Results highlight the potential of data-mining techniques to uncover complex interactions, and offer support to the view that the intersection of multiple statuses influence health and behaviour in ways that are difficult to identify with conventional statistics. The disadvantages of these methods are also discussed. [ABSTRACT FROM AUTHOR]

Purpose Food insecurity (FI) is an important social determinant of health and is linked with higher health care costs. There is a high prevalence of FI among recent migrant households in Canada. The purpose of this paper is to evaluate the prevalence of FI in Sub-Saharan African and Caribbean migrants in Ottawa, and to explore determinants of FI in that population.Design/methodology/approach A cross-sectional study was conducted among 190 mothers born in Sub-Saharan Africa or the Caribbean living in Ottawa and having a child between 6 and 12 years old. Health Canada’s Household Food Security Survey Module was used to evaluate participants’ food security in the past 12 months. χ2 tests and multivariate logistic regression analyses were used to measure determinants of FI (n=182).Findings A very high rate of FI (45.1 percent) was found among participants. When numerous determinants of FI were included in a multivariate model, household FI was associated with Caribbean origin, low education attainment, lone motherhood, living in Canada for five years or less and reliance on social assistance.Originality/value These findings highlight the need for FI to be explicitly addressed in migrant integration strategies in order to improve their financial power to purchase sufficient, nutritious and culturally acceptable foods. Enhancing migrants’ access to affordable child care and well-paid jobs, improving social assistance programs and providing more affordable subsidized housing programs could be beneficial. [ABSTRACT FROM AUTHOR]

Purpose International studies indicate that offenders have higher rates of infectious diseases, chronic diseases, and physical disorders relative to the general population. Although social determinants of health have been found to affect the mental health of a population, less information is available regarding the impact of social determinants on physical health, especially among offenders. The purpose of this paper is to examine the relationship between social determinants and the physical health status of federal Canadian offenders. Design/methodology/approach The study included all men admitted to federal institutions between 1 April 2012 and 30 September 2012 ( n=2,273) who consented to the intake health assessment. Logistic regression analyses were used to explore whether age group, Aboriginal ancestry, and each of the individual social determinants significantly predicted a variety of health conditions. Findings The majority of men reported having a physical health condition and had experienced social determinants associated with adverse health outcomes, especially men of Aboriginal ancestry. Two social determinants factors in particular were consistently related to the health of offenders, a history of childhood abuse, and the use of social assistance. Research limitations/implications The study is limited to the use of self-report data. Additionally, the measures of social determinants of health were indicators taken from assessments that provided only rough estimates of the constructs rather than from established measures. Originality/value A better understanding of how these factors affect offenders can inform strategies to address correctional health issues and reduce the impact of chronic conditions through targeted correctional education and intervention programmes. [ABSTRACT FROM AUTHOR]

Background: Food insecurity is a social determinant of health linked with elevated HIV exposure. Safer sex efficacy (SSE), the ability to navigate sexual decision-making and condom use, is an important marker of sexual wellbeing. Pathways from food insecurity to SSE are understudied, particularly among adolescents in Arctic regions who are at the nexus of food insecurity and sexual health disparities. We examined pathways from food insecurity to SSE among adolescents in the Northwest Territories (NWT), Canada. Methods: We implemented cross-sectional surveys with adolescents aged 13–18 recruited through venue-based sampling in 17 NWT communities. We conducted multivariable logistic regression to assess socio-demographic factors associated with food insecurity. We then conducted structural equation modeling (SEM) using maximum likelihood estimation to assess direct effects of food insecurity on SSE and indirect effects via resilience, depression, and relationship power inequity. We assessed both condom use SSE (e.g., confidence in using condoms) and situational SSE (e.g., SSE under partner pressure). Results: Most participants (n = 410) identified as Indigenous (79%) and 45% reported experiencing food insecurity. In SEM, we did not find a significant direct effect from food insecurity to SSE; however, we found indirect effects from food insecurity to condom use SSE through resilience and depression and from food insecurity to situational SSE through resilience. Conclusions: Findings call for structural interventions to address food insecurity, alongside resilience-focused strategies that address the intersection of sexual and mental health. Sexual health strategies focused on individual behavior change are insufficient to address larger contexts of poverty among Northern youth. [ABSTRACT FROM AUTHOR]

The current prostate cancer (PCa) screen test, prostate-specific antigen (PSA), has a high sensitivity for PCa but low specificity for high-risk, clinically significant PCa (csPCa), resulting in overdiagnosis and overtreatment of non-csPCa. Early identification of csPCa while avoiding unnecessary biopsies in men with non-csPCa is challenging. We built an optimized machine learning platform (ClarityDX) and showed its utility in generating models predicting csPCa. Integrating the ClarityDX platform with blood-based biomarkers for clinically significant PCa and clinical biomarker data from a 3448-patient cohort, we developed a test to stratify patients' risk of csPCa; called ClarityDX Prostate. When predicting high risk cancer in the validation cohort, ClarityDX Prostate showed 95% sensitivity, 35% specificity, 54% positive predictive value, and 91% negative predictive value, at a ≥ 25% threshold. Using ClarityDX Prostate at this threshold could avoid up to 35% of unnecessary prostate biopsies. ClarityDX Prostate showed higher accuracy for predicting the risk of csPCa than PSA alone and the tested model-based risk calculators. Using this test as a reflex test in men with elevated PSA levels may help patients and their healthcare providers decide if a prostate biopsy is necessary. [ABSTRACT FROM AUTHOR]

Early research suggests that the COVID-19 pandemic may impact parental functioning. The purpose of this study was to examine parents' concerns during the pandemic and to explore the characteristics of families who may be particularly vulnerable to parenting concerns. Data were drawn from an online crowdsourcing survey of parents of children under age 15 in Canada (N = 32,228). Many parents were very or extremely concerned about managing child behaviour (61%) and having less patience with, scolding, or yelling at their children (46%). Family characteristics, including working from home, age of children, number of adults in the home, and child disability were associated with these parenting concerns in logistic regression models. Results are discussed in the context of the known impacts of stress on parenting and families, highlighting family-level and pandemic-specific stressors. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to assess empirically Chinese immigrants' perceptions of the police in Toronto, Canada. Design/methodology/approach - Data were analyzed based on 293 surveys conducted with Chinese immigrants who participated in various community service organizations in Toronto, Canada, between March and May 2005. Ordinary least squares and ordered logit regressions are used for the analysis. Findings - The paper shows that individuals who had previous contact with police rated police less favorably than those who had not had contact with police in the past. In general, people who rated police as helpful when they called them for assistance expressed a higher degree of respect for police. In addition, poor communication was a significant predictor of Chinese immigrants' perception of police prejudice. Finally, a majority of respondents expressed the concern that more bilingual police were needed in the city. Research limitations/implications - As with any study utilizing a non-probability sample, care must be taken to avoid generalizing the findings to all Chinese immigrants in Toronto. Since the sample was taken from participants of various community service organizations in Toronto, the findings may not be appropriate to generalize to the other constituencies in the Chinese community, such as young people. Practical implications - The paper highlights the need for improving the quality of police services, recruiting more bilingual officers (or officers from their communities), strengthening police training in racial and cultural diversity, and reducing communication barriers to improve Chinese immigrants' evaluations of the police. Originality/value - This research is the first to specifically examine Chinese communities' perceptions of law enforcement in Canada. Law enforcement can utilize these findings to improve their services and address the Chinese community's concerns; not only can this promote the police-citizens relationship, but it can also encourage the Chinese community's participation in a crime reduction partnership. [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]