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For most of Canadian economic history, French-Canadians (who composed more than a quarter of the country’s population) had living standards inferior to those of English-Canadians. This was true even within the province of Quebec, where the French-Canadians constituted a majority. Today, no significant gap remains in Quebec. Surprisingly however, the question of when the gap started to disappeared remains unanswered. Most of the attention has been dedicated to the long-available post-1970 census data, which show rapid convergence. However, it is unknown whether the convergence started before 1970. In this paper, we use more recently uncovered data from the censuses between 1901 and 1951 to provide such an answer. We find that there was convergence from 1901 to 1921, a reversal from 1921 to 1941 and a recovery between 1941 and 1951 that extended to 1971.

The Taiwan issue continually haunts WHO. However, before addressing Taiwan's inclusion into WHO, we first describe how the era in which WHO was founded, and WHO's resulting constitutional mandate, have focused the Organisation's work on infectious disease eradication. Narrowing in on pandemic management - one aspect of infectious disease eradication - we describe what WHO can offer. These two sections allude to what Taiwan is excluded from. Using Taiwan's COVID-19 experience as a case study, Taiwan's successful management suggests that it is excluded from little, and thus marginally benefits in terms of public health. Yet, there are beneficial political gains in its call for inclusion. Taiwan's recent leveraging and amplification of its COVID-19 success story is thus an extension of its health diplomacy. Extending the call for inclusion online captures a novel digitised health diplomacy effort from Taiwan. The present study computationally analyses press-release and Twitter data to understand how Taiwanese government engages in these channels to frame and respond to the Taiwan/WHO issue. We find that Taiwan brands and propagates a 'Taiwan Model' through hashtags that revolve around coordination and solidarity as opposed to exclusion, indirectly criticising WHO. The piece concludes by discussing the foundational weaknesses in WHO's pandemic management effort in contrast to Taiwan's successful effort despite exclusion. Although Taiwan's inclusion to WHO is improbable due to larger geopolitical factors, inclusion is not a zero-sum game, with potential bi-directional benefits and lessons that can fortify domestic health capacities in preparation for the next pandemic.

Background: Though high hand hygiene (HH) levels significantly reduce the risk of healthcare-associated infections (HCAIs), the current cost of HCAIs and the impact of optimal HH practices on HCAIs are poorly defined. The last NHS England financial assessment was in 2009. Methods: The number of HCAIs per bed per year for NHS England were calculated and average costs were attributed using data from three sources; National Audit Office report, a commercially available calculator, and a financial analysis by a specialist paediatric hospital in England. Improved HH compliance for NHS England was based on a sustained rise in compliance rates from 50 to 80% combined with an HCAI reduction of at least 20%. The cost savings based on such improvements were then calculated. Results: In 2020, it is estimated that the number of HCAIs per bed per year ranges from 3.0 to 9.3, with a midpoint of 5.1. The direct costs of HCAI to NHS England were found to lie between £1.6 and £5 billion. Based on a 20% reduction in HCAI rates, this could lead to cost savings of between £322 million and £1 billion per year. Conclusion: Current direct costs of HCAIs consume approximately 1.3% to 4.1% of NHS England’s annual budget. Improving HH compliance among healthcare workers can lead to significant cost savings. There appears to be a strong financial argument for investment into innovative HH compliance technologies that have been historically perceived as too expensive.

For most of Canadian economic history, French-Canadians (composing more than a quarter of the country's population) had living standards inferior to those of English-Canadians. This was true even in the province (Quebec) where the French-Canadians constituted a majority. Today, no significant gap remains. However, the question of when the gap started to disappeared remains surprisingly unanswered. Most of the attention has been dedicated to the post-1970 data when census information is available and which shows rapid convergence. However, we do not know if the convergence started before 1970. In this paper, we use data from the 1901, 1911 and 1921 censuses to provide the first elements of an answer. We find that the gap started closing modestly at the beginning of the 20th century but that it stopped closing until 1970. This is an important finding as it suggests that while there was some pre-1970 convergence, the bulk of the convergence occurred after 1970.

Singapore and Hong Kong, two high-income "Tiger economies" in Asia, were ranked as the top two most efficient health systems in the world. Despite remarkable similarities in history and socioeconomic development, both economies embraced rather different paths in health care reforms in the past decades, which reflect their respective sociopolitical dynamics. Rapidly ageing populations and the anxiety about future funding of health care have prompted them to embark on major health financing reforms in the recent three years. While Singapore has transitioned to universal health coverage with the implementation of MediShield Life (MSL), Hong Kong is about to introduce the Voluntary Health Insurance Scheme (VHIS) to supplement its health care financing. Based on secondary materials including policy documents, press releases, and anecdotal reports, this essay compares these two recent reforms on their political context, drivers of reforms, and policy contents, and assesses their prospects in terms of coverage, financial protection, and major implementation challenges. The preliminary assessment suggests that while both programs are associated with certain drawbacks, those of the VHIS may be more fatal and warrant close attention. This essay concludes with a central caveat that underscores the pivotal role of the state in managing health care reforms.

Between 1901 and 1921, there was an unprecedented nine-fold increase in the Canadian Jewish population. This paper examines the labor market attainment of Canadian Jews, using digitized, 5% random samples of the 1901, 1911, and 1921 Canadian censuses. We compared the earnings and occupational structure of Jewish working-age men to the affiliates of main Protestant denominations and Roman Catholics. We found a Jewish advantage over workers who were affiliates of most Protestant denominations and Roman Catholics across the three censuses, though the magnitude of the advantage is considerably lower for 1911 and 1921. When a distinction is made among Jews by their ethnic origin, Western European Jews are found to have the most favorable outcomes. We also compared Eastern European Jews with non-Jewish immigrants from the same regions. We found the Jewish immigrants to have a very different occupational distribution and to earn substantially more than their non-Jewish counterparts. These intriguing patterns invite scholars to do further historical research on the economic attainment of the Canadian Jewish population.

A common finding throughout the Canadian immigration literature is that, despite having high levels of education, recent immigrants endure substantial earnings disadvantages upon arrival that persist throughout their working career. This paper investigates the role of “qualitative” education-job matches in explaining these poor labor market outcomes. Using a self-reported match measure, available in the Survey of Labour and Income Dynamics (SLID), the incidence and wage penalties associated with being mismatched are found to be higher among immigrants relative to Canadian-born workers. As a consequence, mismatches on the part of immigrants are a mechanism behind the immigrant wage disadvantages reported throughout the literature. Successful matching is also found to significantly improve the return to pre-migration education and work experience.

Background Drug resistance is a growing challenge to tuberculosis (TB) control worldwide, but particularly salient to countries such as Myanmar, where the health system is fragmented across the public and private sector. A recent systematic review has identified a critical lack of evidence for local policymaking, particularly in relation to drivers of drug-resistance that could be the target of preventative efforts. To address this gap from a health systems perspective, our study investigates the healthcare-seeking behavior and preferences of recently diagnosed patients with drug-resistant tuberculosis (DR-TB), focusing on the use of private versus public healthcare providers. Methods The study was conducted in ten townships across Yangon with high DR-TB burden. Patients newly-diagnosed with DR-TB by GeneXpert were enrolled, and data on healthcare-seeking behavior and socio-economic characteristics were collected from patient records and interviews. A descriptive analysis of healthcare-seeking behavior was followed by the investigation of relationships between socio-economic factors and type of provider visited upon first feeling unwell, through univariate logistic regressions. Results Of 202 participants, only 8% reported first seeking care at public facilities, while 88% reported seeking care at private facilities upon first feeling unwell. Participants aged 25–34 (Odds Ratio = 0.33 [0.12–0.95]) and males (Odds Ratio = 0.39 [0.20–0.75]) were less likely to visit a private clinic or hospital than those aged 18–24 and females, respectively. In contrast, participants with higher income were more likely to utilize private providers. Prior to DR-TB diagnosis, 86% of participants took medications from private providers. After DR-TB diagnosis, only 7% of participants continued to take medications from private providers. Conclusion In urban Myanmar, most patients shifted to being managed exclusively in the public sector after being formally diagnosed with DR-TB. However, since the vast majority of DR-TB patients first visited private providers in the period leading to diagnosis, related issues such as unregulated quality of care, potential delays to diagnosis, and lack of care continuity may greatly influence the emergence of drug-resistance. A greater understanding of the health system and these healthcare-seeking behaviors may simultaneously strengthen TB control programmes and reduce government and out-of-pocket expenditures on the management of DR-TB.

This article provides new evidence on the economic assimilation of immigrants from the British Isles in Canada during the late nineteenth and early twentieth centuries. Using data from the 1901 and 1911 censuses and a pseudo-cohort methodology, we estimate both entry and assimilation effects. We find a non-negligible decline in entry earnings among successive cohorts of British and Irish immigrants, previously overlooked in the literature. Our estimates also reveal that the economic performance for Irish and older British arrival cohorts was better than previously reported. Overall, slow economic assimilation and sparse occupational mobility of immigrants have been a long-standing issue in the Canadian labour market.

Shame is an ineffective tool in residency education that often results in depression, isolation, and worse patient care. This study aimed to assess burnout, depersonalization, and personal achievement levels in current oral and maxillofacial surgery (OMS) residents, to assess the prevalence of the use of shame in OMS residency training, and to determine whether there is a relation between shame exposure and resident burnout, depersonalization, and personal achievement levels.An anonymous 20-question cross-sectional survey was developed incorporating the Maslach Burnout Index and a previously validated shame questionnaire and sent to all OMS program directors affiliated with the American Association of Oral and Maxillofacial Surgeons for distribution among their respective residents in 2016. Univariate analyses were used to determine the distribution of the predictor (shame) and outcome (burnout) by gender and by frequency of shaming events. Multivariable logistic regression analysis was used to assess the relation of shame to burnout. A 2-sided P value less than .05 was considered statistically significant.Two hundred seventeen responses were received; 82% of respondents were men (n = 178), 95% were 25 to 34 years old (n = 206), and 58% (n = 126) were enrolled in a 4-year program. Frequently shamed residents were more likely to have depression (58 vs 22%; P.0001), isolation (55 vs 22%; P.0001), and poor job performance (50 vs 30%; P.0001). Residents who were frequently shamed were more likely to experience moderate to severe burnout (odds ratio = 4.6; 95% confidence interval, 2.1-10.0; P.001) and severe depersonalization (odds ratio = 5.1; 95% confidence interval, 2.1-12.0; P.0001) than residents who had never or infrequently been shamed.There is a clear relation between the number of shame events and burnout and depersonalization levels. It is important to understand the negative impact that the experience of shame has on residents, including its unintended consequences.

How did early Islam gain its understanding of Christians and Christianity? How did it react to Christian claims of universality? To answer these questions, this article first identifies passages pertaining to the Christian religion in representative texts of the three main bodies of literature produced by the first Muslim writers and editors: the Qur'ān, the Hadith and the Sira. This data is then analyzed into five ideal-types of Islamic attitudes toward Christians and Christianity: 1) affirmations of the truth of the Gospel, 2) descriptions of Christians as true believers, 3) descriptions of Christians as sectarians, 4) accusations of disbelief (kufr) and 5) accusations of idolatry (shirk). The assertion of an historical relationship between sectarianism, disbelief and idolatry led to subordinating the Muslim-Christian dialogue on the recognition of the unicity of God, which could be conceived of as providing the basis either for a restricted religious pluralism or for an Islamic universalism.

Two autobiographical memory studies were conducted to better understand the social experience and memory for watching romantic movies on a date. In both studies, participants were primarily middle-class, White, young adults, who (a) recalled the experience of watching a romantic movie they had seen on a date and (b) were assessed for levels of sex-role traditionality and 4 kinds of dispositional empathy. Participants also reported with whom they watched the movie, who chose it, and the cognitions and emotions experienced during viewing. Finally, a fantasy measure asked participants to choose the types of scenes in which they and their dates might like to "stand in" for a character in the film. Results indicated that women more often than men selected the movie and liked it more, but, despite common stereotypes, men also reported favorable ratings for romantic movies seen on a date. However, both men and women thought that "most men" would not like the movie. On the fantasy measure, women underestimated me...

To the Editor: A growing body of evidence has shown that the grueling hours and expectations of residency in general, and internship in particular, lead to poor quality of life and a wide array of mental health issues including depression, anxiety, and emotional burnout. For instance, a 2008–2009 survey study of internal medicine residents [1] showed that 14.8 % of respondents reported quality of life that was “somewhat bad” or “as bad as can be,” 22.1 % reported emotional exhaustion a few times per week, and 28.9 % reported feeling depressed at least once a week. A prospective cohort study, part of the Intern Health Study led by Dr. Srijan Sen [2], followed medical interns and estimated that the prevalence of a major depressive episode during the intern year is at least 19.5 %. An increased awareness of these issues was instrumental in the decision of the Accreditation Council for Graduate Medical Education to implement stricter duty-hour restrictions in 2011. However, these implementations do not appear to have improved residents’ quality of life. For instance, Sen et al. [3] followed a new cohort of interns training after the initiation of the new duty-hour restrictions and found no significant improvement in hours slept, depressive symptoms, or well-being. Similarly, a survey study of general surgery interns training after 2011 [4] found that less than half believed that duty-hour restrictions had reduced fatigue, whereas 28 % reported weekly feelings of emotional exhaustion, 28 % reported weekly experiences of depersonalization, and 32 % felt that their personal-professional balance was “very poor” or “not great”. Among the interns surveyed, 67 % reported reflecting on satisfaction from being a surgeon on a daily or weekly basis, and 1 in 7 considered leaving their residency at least once a week. Why have the quality of life, rates of depression, and other psychiatric consequences of internship not improved with the new duty-hour restrictions? Inmy experience as an intern with a wife and two daughters under the age of 2 years, the interpersonal and psychological issues inherent to work-life balance were more stressful than residency itself. It is not just the long hours and fatigue that makes internship difficult. The feeling of constantly being supervised and evaluated, being at the bottom of the medical hierarchy, and having a tremendous responsibility for patient care that sometimes exceeds one’s experience can make internship incredibly stressful. The all-consuming nature of the job can be depleting, making one less able to perform social roles outside of work. Even with the work-hour reduction, an 80-h workweek forces most interns to radically alter the roles they play as romantic partners, parents, children, and friends. These factors havemore to do with the inherent nature of internship and its psychological effects than with the absolute number of hours worked. Reducing work hours without addressing these fundamental psychological issues will likely be ineffective for many interns. By sharing my personal experience, I hope to highlight some of these psychological difficulties and to offer specific recommendations to institutions for how to address them. Duringmy intern year, I faced overwhelming stress, a steep learning curve, and an entirely new set of expectations—and that was just from being a father. My wife and I have been blessed to have two wonderful daughters, born at the beginning of my fourth year of medical school and halfway through my intern year. The clash between my personal and professional lives came as quite a shock. As a medical student, I prided myself on my ability to balance school and family. In mymind, as well as inmy apartment, diapers and stethoscopes * Jason Dean jdean2@partners.org

The present study used autobiographical memory to investigate the social experience and short- and long-term effects of seeing frightening movies on a date, extending Zillmann and Weaver's (1996) model of differential gender-role behaviors to persons' own real-life dating experiences. Young adult participants (a) recalled the experience of watching a scary movie on a date, and (b) were assessed for levels of gender-role traditionality, sensation seeking, and dispositional empathy. Results showed that almost all individuals could recall such a date. Although men reported more positive reactions to the film and women more negative reactions, the experience appeared to have some social utility for both. Sex was a better predictor than the gender-role measures for Negative Reactions, Sleep Disturbances, and the likelihood of being Scared Today by the movie. Sensation-Seeking and Empathy were modest predictors of the same variables. In sum, the dating context seemed to encourage both men and women to behave an...

Wahhābī Islam Facing the Challenges of Modernity: Dār al-Iftā in the Modern Saudi State MUHAMMAD AL-ATAWNEH, 2010 Studies in Islamic Law and Society 32 Leiden: Brill XXII + 207 pp., €96.00 ISBN 978...