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The re-emergence of Brachyspira-associated disease in pigs since the late 2000s has illuminated some of the diagnostic challenges associated with this genus; notably, the lack of standardized antimicrobial susceptibility testing (AST) methods and interpretive criteria. Consequently, laboratories have relied heavily on highly variable in-house developed methods. There are currently no published investigations describing the antimicrobial susceptibility of Brachyspira isolates collected from pigs in Canada. The first objective of this study was therefore to develop a standardized protocol for conducting agar dilution susceptibility testing of Brachyspira spp., including determining the optimal standardized inoculum density, a key test variable that impacts test performance. The second objective was to determine the susceptibility of a collection of western Canadian Brachyspira isolates using the standardized methodology. After assessing multiple media, an agar dilution test was standardized in terms of starting inoculum (1–2 × 108 CFU/ml), incubation temperature and time, and assessed for repeatability. The antimicrobial susceptibility of a collection of clinical porcine Brachyspira isolates (n = 87) collected between 2009–2016 was then determined. This method was highly reproducible; repeat susceptibility testing yielded identical results 92% of the time. Although most of the isolates had very low MICs to the commonly used antimicrobials to treat Brachyspira-associated infections, several isolates with elevated MICs (>32 μg/ml) for tiamulin, valnemulin, tylosin, tylvalosin, and lincomycin were identified. Overall, this study underscores the importance of establishing CLSI approved clinical breakpoints for Brachyspira to facilitate the interpretation of test results and support the evidence-based selection of antimicrobials in swine industry. [ABSTRACT FROM AUTHOR]

As six patient partners in Canada, we aim to contribute to learning and to provide an opportunity to reflect on patient engagement (PE) in research and healthcare environments. Patient engagement refers to "meaningful and active collaboration in governance, priority setting, conducting research and knowledge translation" with patient partners as members of teams, rather than participants in research or clinical care. While much has been written about the benefits of patient engagement, it is important to accurately document and share what we term 'patient engagement gone wrong.' These examples have been anonymized and presented as four statements: patient partners as a check mark, unconscious bias towards patient partners, lack of support to fully include patient partners, and lack of recognizing the vulnerability of patient partners. The examples provided are intended to demonstrate that patient engagement gone wrong is more common than discussed openly, and to simply bring this to light. This article is not intending to lay blame, rather to evolve and improve patient engagement initiatives. We ask those who interact with patient partners to reflect so we can all work towards improving patient engagement. Lean into the discomfort with these conversations as that is the only way to change these all too recognizable examples, and which will lead to better project outcomes and experiences for all team members. Plain English summary: We are six patient partners in Canada who aim to contribute to learning and to provide an opportunity to reflect on patient engagement (PE) in research and healthcare environments. Patient engagement refers to "meaningful and active collaboration in governance, priority setting, conducting research and knowledge translation," where patient partners are members of the teams, rather than participants in research or those seeking clinical care. It appears more has been written on the benefits rather than the risks of patient engagement and we feel it is important to document and share what we call 'patient engagement gone wrong.' We have anonymized these examples and sorted them into four statements: patient partners as a check mark, unconscious bias towards patient partners, lack of support to fully include patient partners, and lack of recognizing the vulnerability of patient partners. These statements and their examples are meant to show that patient engagement gone wrong is more common than discussed openly, and to simply bring this to light. With this commentary, we do not mean to lay blame, and instead wish to evolve and improve patient engagement initiatives. We ask those who interact with patient partners to reflect so we can all work towards improving patient engagement. Lean into the discomfort with these examples, as that is the only way to change these all too recognizable statements, and which will lead to better project outcomes and experiences for all team members. [ABSTRACT FROM AUTHOR]

In this paper we propose a machine learning-based approach to predict a multitude of insurance claim categories related to canine diseases. We introduce several machine learning approaches that are evaluated on a pet insurance dataset consisting of 785,565 dogs from the US and Canada whose insurance claims have been recorded over 17 years. 270,203 dogs with a long insurance tenure were used to train a model while the inference is applicable to all dogs in the dataset. Through this analysis we demonstrate that with this richness of data, supported by the right feature engineering, and machine learning approaches, 45 disease categories can be predicted with high accuracy. [ABSTRACT FROM AUTHOR]

The development of cyanobacteria blooms is of increasing concern in many lakes worldwide, and as a result, modeling their predictors is vital for understanding where and why they occur. In this study, we developed and analyzed a 640‐lake data set that spans Canada and 12 ecozones to identify the drivers of cyanobacteria biomass and of several key toxin‐ and bloom‐forming genera (Microcystis, Aphanizomenon, and Dolichospermum). The database consisted of an exhaustive list of potential predictors (n = 55), including water chemistry, land‐use, and zooplankton variables. We applied a series of empirical modeling approaches to identify significant predictors and thresholds (generalized linear and additive models, mixed effect regression trees), all while accounting for ecozone variability. Across all modeling approaches, and ecozones total phosphorus was identified as the most important predictor of total cyanobacterial and focal genera biomass. In addition, cyanobacteria across Canada showed significant associations with increasing dissolved organic and inorganic carbon, and several ions. Despite the widely held notion that cyanobacteria are often toxic and/or a poor food source for zooplankton, we found a positive relationship between cyanobacteria and zooplankton, particularly with daphnid and copepod biomass. Localized top‐down forces and evolutionary adaptations resulting from long‐term exposure in eutrophic lakes are among the possible explanations for this observed positive association. By considering a suite of complementary modeling approaches, we found that nonlinear models provided greater predictive power and the random ecozone effect was minor due to the overarching importance of local abiotic and biotic factors. [ABSTRACT FROM AUTHOR]

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

Background: There is a paucity of literature on the normative levels of plasma renin concentration (PRC) and serum aldosterone (SA) in premature neonates. This study aims to provide normative data on PRC and SA levels in preterm neonates in the first 2 weeks after birth and explore associations with maternal, perinatal, or postnatal factors. Methods: Neonates born at 26- to 34-week gestation were recruited from two neonatal intensive care units in Canada and Australia. The direct renin assay PRC and SA were analyzed on day 1 and days 14–21 after birth to compare across categorical variables and to produce normative values. Results: A total of 262 subjects were enrolled from the Canadian (29%) and Australian (71%) sites. The mean gestational age was 30 weeks, with a mean birth weight of 1457 g. The normative values of PRC and SA for neonates born between 26 + 0 and 29 + 6 weeks and 30 + 0 and 34 + 0 weeks of gestation were produced for day 1 and day 14–21 after birth. Both PRC and SA increased from day 1 to day 14–21. The more premature neonates reached a higher PRC on days 14–21 after birth but exhibited lower SA levels on day 1 after birth. When comparing gender, birth weight, and maternal risk factor categories, no statistical differences in PRC or SA were found. A small but significant decrease in PRC, but not SA, was noted for neonates with placental pathology. Conclusions: This study produced normative values of PRA and SA in clinically stable preterm neonates that can be referenced for use in clinical practice. [ABSTRACT FROM AUTHOR]

Canada has recently emerged as a hotspot in a burgeoning global surrogacy bio‐economy. On the grounds that any commercial trade in reproductive capabilities would result in the exploitation of marginalised women willing to sell their eggs and wombs, Canada's Assisted Human Reproduction Act (AHRA) bans commercial surrogacy, allowing only for altruistic arrangements. Drawing together analysis of the AHRA and related legal, regulatory, and policy documents, feminist political economic theory, and a growing body of critical social scientific scholarship on surrogacy, this paper troubles altruism as a means of insulating surrogacy from market‐based exploitation. It contributes to the extant literature an explicit focus on the law as a key site in the reproduction of the gendered division of labour. Acknowledging the serious concerns that dog commercial markets in reproductive biology, it argues that the legal constitution of gestational work as altruistic is part of a broader juridico‐economic apparatus that has systematically devalued reproductive labour under capitalism. Efforts to insulate surrogacy from the market by legally designating it as a gift freely given facilitate the ongoing appropriation of reproductive labour, which is assigned, once again, to the realm of non‐value. A feminist political‐economic critique of altruism, this paper does not forward an argument in favour of commercialisation. Rather, its aim is to upend the commercial/altruistic binary that has circumscribed so much of the thinking and legislating around surrogacy. This paper explores the role of the law in devaluing reproductive labour under capitalism. It does so via an examination of Canada's burgeoning surrogacy bio‐economy and the legislation – the Assisted Human Reproduction Act – designed to regulate it. [ABSTRACT FROM AUTHOR]

Introduction: Osteoporosis is a major disease state associated with significant morbidity, mortality, and health care costs. Less than half of the individuals sustaining a low energy hip fracture are diagnosed and treated for the underlying osteoporosis. Objective: A multidisciplinary Canadian hip fracture working group has developed practical recommendations to meet Canadian quality indicators in post hip fracture care. Methods: A comprehensive narrative review was conducted to identify and synthesize key articles on post hip fracture orthogeriatric care for each of the individual sections and develop recommendations. These recommendations are based on the best evidence available today. Conclusion: Recommendations are anticipated to reduce recurrent fractures, improve mobility and healthcare outcomes post hip fracture, and reduce healthcare costs. Key messages to enhance postoperative care are also provided. [ABSTRACT FROM AUTHOR]

For children and youth, the COVID-19 pandemic surfaced at a critical time in their development. Children have experienced extended disruptions to routines including in-person schooling, physical activities, and social interactions—things that bring meaning and structure to their daily lives. We estimated the prevalence of anxiety and depression symptoms of children and youth and their experiences of health-related quality of life (HRQoL), during the first year of the pandemic, and identified factors related to these outcomes. Further, we examined these effects among ethnocultural minority families. We conducted an online survey (March–July 2021) with 510 children and youth aged 8–18 years and their parents/caregivers. The sample was representative of the targeted population. We modelled the relationship between anxiety, depression (measured using the Revised Child Anxiety and Depression Scale), HRQoL (measured using KIDSCREEN-10), and sociodemographic, behavioural, and COVID-19-contributing factors using binary logistic regression. A priori-selected moderating effects of sociodemographic characteristics and self-identified ethnocultural minority groups on the outcomes were tested. The point-in-time prevalence of medium-to-high anxiety symptoms and depression symptoms was 10.19% and 9.26%, respectively. Almost half (49.15%) reported low-to-moderate HRQoL. Children reporting medium-to-high anxiety symptoms, depression symptoms, and low-to-moderate HRQoL were more likely to be aged 8–11 years, 16–18 years, ethnocultural minority participants, living in rural/urban areas, having good/fair MH before COVID-19, experiencing household conflicts, having less physical activity, and having ≥3 h of recreational screen time. Those who had more people living at home and ≥8 h of sleep reported low anxiety and depression symptoms. Ethnocultural minority 16–18-year-olds were more likely to report low-to-moderate HRQoL, compared to 12–15-year-olds. Additionally, 8–11-year-olds, 16–18-year-olds with immigrant parents, and 16–18-year-olds with Canadian-born parents were more likely to report low–moderate HRQoL, compared to 12–15-year-olds. Children and youth MH and HRQoL were impacted during the pandemic. Adverse MH outcomes were evident among ethnocultural minority families. Our results reveal the need to prioritize children's MH and to build equity-driven, targeted interventions. [ABSTRACT FROM AUTHOR]

In the last decade, there has been an increasing demand for wild-captured fish, which attains higher prices compared to farmed species, thus being prone to mislabeling practices. In this work, fatty acid composition coupled to advanced chemometrics was used to discriminate wild from farmed salmon. The lipids extracted from salmon muscles of different production methods and origins (26 wild from Canada, 25 farmed from Canada, 24 farmed from Chile and 25 farmed from Norway) were analyzed by gas chromatography with flame ionization detector (GC-FID). All the tested chemometric approaches, namely principal components analysis (PCA), t-distributed stochastic neighbor embedding (t-SNE) and seven machine learning classifiers, namely k-nearest neighbors (kNN), decision tree, support vector machine (SVM), random forest, artificial neural networks (ANN), naïve Bayes and AdaBoost, allowed for differentiation between farmed and wild salmons using the 17 features obtained from chemical analysis. PCA did not allow clear distinguishing between salmon geographical origin since farmed samples from Canada and Chile overlapped. Nevertheless, using the 17 features in the models, six out of the seven tested machine learning classifiers allowed a classification accuracy of ≥99%, with ANN, naïve Bayes, random forest, SVM and kNN presenting 100% accuracy on the test dataset. The classification models were also assayed using only the best features selected by a reduction algorithm and the best input features mapped by t-SNE. The classifier kNN provided the best discrimination results because it correctly classified all samples according to production method and origin, ultimately using only the three most important features (16:0, 18:2n6c and 20:3n3 + 20:4n6). In general, the classifiers presented good generalization with the herein proposed approach being simple and presenting the advantage of requiring only common equipment existing in most labs. [ABSTRACT FROM AUTHOR]

As the scholarly landscape evolves into a more open plain, so do the shapes of institutions, labs, centres, and other places and spaces of research, including those of the digital humanities (DH). The continuing success of such research largely depends on a commitment to open access and open source philosophies that broaden opportunities for a more efficient, productive, and universal design and use of knowledge. The Electronic Textual Cultures Laboratory (ETCL; etcl.uvic.ca) is a collaborative centre for digital and open scholarly practices at the University of Victoria, Canada, that engages with these transformations in knowledge creation through its umbrella organization, the Canadian Social Knowledge Institute (C-SKI), that coordinates and supports open social scholarship activities across three major initiatives: the ETCL itself, the Digital Humanities Summer Institute (DHSI; dhsi.org), and the Implementing New Knowledge Environments (INKE; inke.ca) Partnership, including sub-projects associated with each. Open social scholarship is the practice of creating and disseminating public-facing scholarship through accessible means. Working through C-SKI, we seek ways to engage communities more widely with publicly funded humanities scholarship, such as through research creation and dissemination, mentorship, and skills training. This article discusses how the Electronic Textual Cultures Lab aims to promote open social scholarship. [ABSTRACT FROM AUTHOR]

The article reports on the decision of Paladin Labs, a Canadian specialty drug company. to apply for full over the counter status for its women's emergency contraceptive, which is known as Plan B in the U.S. and Canada, and is known as Levonelle in Great Britain. A discussion of approval of the over the counter statues which was managed by Canada's drug advisory committee, is presented. Prior to the approval a woman in Canada seeking the drug had to obtain a prescription from her physician or obtain it from a pharmacy after consulting with a pharmacist.

Health behaviors that do not effectively prevent disease can negatively impact psychological wellbeing and potentially drain motivations to engage in more effective behavior, potentially creating higher health risk. Despite this, studies linking "moral foundations" (i.e., concerns about harm, fairness, purity, authority, ingroup, and/or liberty) to health behaviors have generally been limited to a narrow range of behaviors, specifically effective ones. We therefore explored the degree to which moral foundations predicted a wider range of not only effective but ineffective (overreactive) preventative behaviors during the COVID-19 pandemic. In Study 1, participants from Canada, the United Kingdom, and the United States reported their engagement in these preventative behaviors and completed a COVID-specific adaptation of the Moral Foundations Questionnaire during the pandemic peak. While differences occurred across countries, authority considerations consistently predicted increased engagement in both effective preventative behaviors but also ineffective overreactions, even when controlling for political ideology. By contrast, purity and liberty considerations reduced intentions to engage in effective behaviors like vaccination but had no effect on ineffective behaviors. Study 2 revealed that the influence of moral foundations on U.S participants' behavior remained stable 5-months later, after the pandemic peak. These findings demonstrate that the impact of moral foundations on preventative behaviors is similar across a range of western democracies, and that recommendations by authorities can have unexpected consequences in terms of promoting ineffective—and potentially damaging—overreactive behaviors. The findings underscore the importance of moral concerns for the design of health interventions that selectively promote effective preventative behavior. [ABSTRACT FROM AUTHOR]

Background: Electronic nicotine delivery systems (ENDS), such as the JUUL system, are nicotine products for adults who currently smoke cigarettes but are looking for an alternative to combustible cigarettes. Sales of ENDS products were legislatively acknowledged and authorized federally in Canada with the Royal Assent of the Tobacco and Vaping Products Act in 2018. Methods: With the unique dataset from a major chain retailer in Canada, we evaluated the impacts of JUUL market entry on cigarette sales across Canada from January 2017 to August 2019 using two-way fixed effects panel regression models by leveraging on the entry time variation at the city level. We conducted various robustness checks and a permutation test to validate our results. Results: Our estimates suggested that JUUL market entry was, on average, significantly correlated with a 1.65% per-month decrease in cigarette sales during the initial months, and with a potentially larger impact on urban areas. Our results were robust across various specifications and tests. These findings implied that JUUL and combustible cigarettes act as economic substitutes during the study time period in Canada. Conclusions: These results suggested that local availability of ENDS products, such as JUUL, has the potential to reduce local cigarette consumption. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Pathology is the property of Canadian Association of Pathologists 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.)

Peatlands provide vital ecosystem and carbon services, and Canada is home to a significant peatland carbon stock. Global climate warming trends are expected to lead to increased carbon release from peatlands, as a consequence of drought and wildfire. Monitoring hydrologic regimes is a key in understanding the impacts of warming, including monitoring changes in small and temporally variable water bodies in peatlands. Global surface water mapping has been implemented, but the spatial and temporal scales of the resulting data products prevent the effective monitoring of peatland water bodies, which are small and prone to rapid hydrologic changes. One hurdle in the quest to improve remote-sensing-derived global surface water map quality is the omission of small and temporally variable water bodies. This research investigated the reasons for small peatland water body omission as a preparatory step for surface water mapping, using Sentinel-1 SAR data and image classification methods. It was found that Sentinel-1 backscatter signatures for small peatland water bodies differ from large water bodies, due in part to differing physical characteristics such as waves and emergent vegetation, and limitations in detectable feature sizes as a result of SAR image processing and resolution. The characterization of small peatland water body backscatter provides a theoretical basis for the development of SAR-based surface water mapping methods with high accuracy for our purposes of wildfire susceptibility monitoring in peatlands. This study discusses the implications of small peatland water body omission from surface water maps on carbon, climate, and hydrologic models. [ABSTRACT FROM AUTHOR]

Environmental DNA (eDNA)‐based methods of species detection are enabling various applications in ecology and conservation including large‐scale biomonitoring efforts. qPCR is widely used as the standard approach for species‐specific detection, often targeting a fish species of interest from aquatic eDNA. However, DNA metabarcoding has the potential to displace qPCR in certain eDNA applications. In this study, we compare the sensitivity of the latest Illumina NovaSeq 6000 NGS platform to qPCR TaqMan assays by measuring limits of detection and by analysing eDNA from water samples collected from Churchill River and Lake Melville, NL, Canada. Species‐specific, targeted next generation sequencing (NGS) assays had significantly higher sensitivity than qPCR, with limits of detection 14‐ to 29‐fold lower. For example, when analysing eDNA, qPCR detected Gadus ogac (Greenland cod) in 21% of samples, but targeted NGS detected this species in 29% of samples. General NGS assays were as sensitive as qPCR, while simultaneously detecting 15 fish species from eDNA samples. With over 34,000 fish species on the planet, parallel and sensitive methods such as NGS will be required to support effective biomonitoring at both regional and global scales. [ABSTRACT FROM AUTHOR]

An unusually intense atmospheric river affected the southern coastal region of British Columbia in mid-November 2021. Flooding and several ground failures such as landslides and riverbank erosion caused significant damage and interrupted the main transportation corridors, including major highways and railroads, severing land connectivity between Metro Vancouver and the rest of Canada. In this short note, we summarize and describe slope and riverbank ground failures in the Lower Mainland and connecting corridors to the interior such as the Fraser Canyon and the Coquihalla Valley, with focus on those that produced damage on highways. Field observations are discussed in the context of potential future similar disasters in the region due to more frequent extreme climatic events associated with climate change. [ABSTRACT FROM AUTHOR]

Virtual reality (VR) has served the entertainment industry all the way to world-leading museums in delivering engaging experiences through multisensory virtual environments (VEs). Today, the rise of the Metaverse fuels a growing interest in leveraging this technology, bringing along an emerging need to better understand the way different dimensions of VEs, namely social and interactive, impact overall user experience (UX). This between-subject exploratory field study investigates differences in the perceived and lived experience of 28 participants engaging, either individually or in dyads, in a VR experience comprising different levels of interactivity, i.e., passive or active. A mixed methods approach combining conventional UX measures, i.e., psychometric surveys and user interviews, as well as psychophysiological measures, i.e., wearable bio- and motion sensors, allowed for a comprehensive assessment of users' immersive and affective experiences. Results pertaining to the social dimension of the experience reveal that shared VR elicits significantly more positive affect, whereas presence, immersion, flow, and state anxiety are unaffected by the copresence of a real-world partner. Results pertaining to the interactive dimension of the experience suggest that the interactivity afforded by the VE moderates the effect of copresence on users' adaptive immersion and arousal. These results support that VR can be shared with a real-world partner not only without hindering the immersive experience, but also by enhancing positive affect. Hence, in addition to offering methodological directions for future VR field research, this study provides interesting practical insights into guiding VR developers toward optimal multiuser virtual environments. [ABSTRACT FROM AUTHOR]

The detection of gene fusions by RNA-based next-generation sequencing (NGS) is an emerging method in clinical genetic laboratories for oncology biomarker testing to direct targeted therapy selections. A recent Canadian study (CANTRK study) comparing the detection of NTRK gene fusions on different NGS assays to determine subjects' eligibility for tyrosine kinase TRK inhibitor therapy identified the need for recommendations for best practices for laboratory testing to optimize RNA-based NGS gene fusion detection. To develop consensus recommendations, representatives from 17 Canadian genetic laboratories participated in working group discussions and the completion of survey questions about RNA-based NGS. Consensus recommendations are presented for pre-analytic, analytic and reporting aspects of gene fusion detection by RNA-based NGS. [ABSTRACT FROM AUTHOR]

This article presents a history of the development of U–Pb geochronology with emphasis on the role of Canadian researchers and some of its applications to Canadian geology. Modern U–Pb dating is the result of work by many individuals over the past 60 years, but the most important was Tom Krogh, who established methods that allowed determination of precise ages (<0.1% errors) on zircon using isotope dilution thermal ionization mass spectrometry. This was followed by the introduction of new analytical approaches by others, notably secondary ion mass spectrometry and laser ablation inductively coupled plasma mass spectrometry that allow intracrystal domains to be dated. U–Pb geochronology is now an indispensable tool for understanding the Earth. In collaboration with field mapping, it has vastly improved our understanding of the geological history of Canada as well as important geological events such as mass extinctions, secular changes in geological processes, and the birth of the solar system. [ABSTRACT FROM AUTHOR]

Peatland open‐water pools can be net carbon (C) emitters within heterogeneous peatland ecosystems that are generally net C sinks. However, the intra‐ and inter‐regional patterns and drivers of CO2 and CH4 production, as well as their link with dissolved organic matter (DOM) quality and quantity, remain poorly understood. We analyzed a range of optical characteristics and chemical variables controlling DOM and CO2 and CH4 concentrations in peatland pools across two regions with contrasting geographical properties (i.e., climate, topography, morphometry, and vegetation cover) of eastern Canada and Chilean Patagonia. We found inter‐regional patterns in CO2, CH4 and DOM concentrations and composition that were coherent with patterns in mean annual temperature and precipitation, and vegetation cover. Cross‐regional patterns of CO2 and CH4 were driven by morphometry, vegetation cover, and protein‐like DOM composition, a proxy of high biological activity, whereas temporal variations of CO2 and CH4 concentrations were further influenced by seasonal changes in humic‐like DOM composition, dissolved organic carbon and nutrients (i.e., total phosphorus and total nitrogen) concentrations, as well as pH and oxygen levels. Our results suggest that geophysical constraints associated with local peat and pool characteristics as well as climate patterns are major drivers of DOM and greenhouse gases concentrations and the links between them in broadly distributed peatland pools. Key Points: Broad‐scale patterns in peatland pools dissolved organic matter (DOM) and CO2 were driven by vegetation cover and pool morphometryBroad‐scale patterns in CH4 were the most responsive among C‐species to long‐term climate averages across regionsProtein‐like DOM controls within‐pool greenhouse gases (GHG) concentrations across regions, while humic‐like DOM drives within‐site temporal GHG concentrations [ABSTRACT FROM AUTHOR]

Background: Accessible measures specific to the Canadian context are needed to support health system planning for older adults living with frailty. We sought to develop and validate the Canadian Institute for Health Information (CIHI) Hospital Frailty Risk Measure (HFRM). Methods: Using CIHI administrative data, we conducted a retrospective cohort study involving patients aged 65 years and older who were discharged from Canadian hospitals from Apr. 1, 2018, to Mar. 31, 2019. We used a 2-phase approach to develop and validate the CIHI HFRM. The first phase, construction of the measure, was based on the deficit accumulation approach (identification of age-related conditions using a 2-year look-back). The second phase involved refinement into 3 formats (continuous risk score, 8 risk groups and binary risk measure), with assessment of their predictive validity for several frailty-related adverse outcomes using data to 2019/20. We assessed convergent validity with the United Kingdom Hospital Frailty Risk Score. Results: The cohort consisted of 788 701 patients. The CIHI HFRM included 36 deficit categories and 595 diagnosis codes that cover morbidity, function, sensory loss, cognition and mood. The median continuous risk score was 0.111 (interquartile range 0.056–0.194, equivalent to 2–7 deficits); 35.1% (n = 277 000) of the cohort were found at risk of frailty (≥ 6 deficits). The CIHI HFRM showed satisfactory predictive validity and reasonable goodness-of-fit. For the continuous risk score format (unit = 0.1), the hazard ratio (HR) for 1-year risk of death was 1.39 (95% confidence interval [CI] 1.38–1.41), with a C-statistic of 0.717 (95% CI 0.715–0.720); the odds ratio for high users of hospital beds was 1.85 (95% CI 1.82–1.88), with a C-statistic of 0.709 (95% CI 0.704–0.714), and the HR of 90-day admission to long-term care was 1.91 (95% CI 1.88–1.93), with a C-statistic of 0.810 (95% CI 0.808–0.813). Compared with the continuous risk score, using a format of 8 risk groups had similar discriminatory ability and the binary risk measure had slightly weaker performance. Interpretation: The CIHI HFRM is a valid tool showing good discriminatory power for several adverse outcomes. The tool can be used by decision-makers and researchers by providing information on hospital-level prevalence of frailty to support system-level capacity planning for Canada's aging population. [ABSTRACT FROM AUTHOR]

People from the same country often hold shared, culturally-shaped memories about important events from that country's history, known as collective memories. Although empirical research has started to shed light on the properties of these memories, none has systematically examined the functions these memories. To what extent do collective memories serve functions? We hypothesised that collective memories serve functions for a collective similar to those that autobiographical memories serve for individuals—directive, identity, and social functions. We conducted two experiments using adapted versions of the Thinking About Life Experiences questionnaire (TALE) in which we asked people to rate the functions of their collective memories. Across both experiments, we found evidence that collective memories serve directive, identity, and social functions for the collective. These results suggest collective memories perform important roles in their collectives. [ABSTRACT FROM AUTHOR]

The environment could alter growth and resistance tradeoffs in plants by affecting the ratio of resource allocation to various competing traits. Yet, how and why functional tradeoffs change over time and space is poorly understood particularly in long-lived conifer species. By establishing four common-garden test sites for five lodgepole pine populations in western Canada, combined with genomic sequencing, we revealed the decoupling pattern and genetic underpinnings of tradeoffs between height growth, drought resistance based on δ13C and dendrochronology, and metrics of pest resistance based on pest suitability ratings. Height and δ13C correlation displayed a gradient change in magnitude and/or direction along warm-to-cold test sites. All cold test sites across populations showed a positive height and δ13C relationship. However, we did not observe such a clinal correlation pattern between height or δ13C and pest suitability. Further, we found that the study populations exhibiting functional tradeoffs or synergies to various degrees in test sites were driven by non-adaptive evolutionary processes rather than adaptive evolution or plasticity. Finally, we found positive genetic relationships between height and drought or pest resistance metrics and probed five loci showing potential genetic tradeoffs between northernmost and the other populations. Our findings have implications for deciphering the ecological, evolutionary, and genetic bases of the decoupling of functional tradeoffs due to environmental change. [ABSTRACT FROM AUTHOR]

Assessing the policy analytical capacity (PAC) of governments has suffered in the past from the anecdotal nature of most studies, leading to different evaluations of specific analytical activities and of the overall competences and capacities of governments as a whole. What is needed to advance the field is a set of metrics that can generate insights into the capabilities of different units and how changes to their and overall government capacity develop over time. Focusing on this component of policy capacity, we map and measure the distribution of policy professionals in the provincial, territorial, and federal governments in Canada. Our measures are tested against two major findings regarding PAC: first that variation among governmental PAC varies by size of the civil service, with smaller jurisdictions likely to have less capacity, and second, that concentration of professionals in specific issue areas underscores that area's political and/or policy salience to the government concerned. Both measures prove robust in assessing Canadian government activities in these areas. Points for practitioners: Policy capacity is acknowledged as a significant perquisite for policy success.While some general frameworks exist highlighting policy relevant competences and capabilities important to policy success, how to measure these remains under‐investigated.Focusing on policy analytical capacity, this paper draws on the literature on policy professionals to develop two measures of this component of policy capacity linked to the extent to which an agency focuses on analysis and the proportion of their staff who work on the subject compared to other agencies.The measures are deployed in an illustrative case of Canada and Canadian governments at the territorial, provincial, and federal level which confirms their utility and robustness as indicators of the different levels of analytical capacity different agencies employ. [ABSTRACT FROM AUTHOR]

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

Background: In Canada, severe asthma affects an estimated 5–10% of people with asthma and is associated with frequent exacerbations, poor symptom control and significant morbidity from the disease itself, as well as the high dose inhaled, and systemic steroids used to treat it. Significant heterogeneity exists in service structure and patient access to severe asthma care, including access to biologic treatments. There appears to be over-reliance on short-acting beta agonists and frequent oral corticosteroid use, two indicators of uncontrolled asthma which can indicate undiagnosed or suboptimally treated severe asthma. The objective of this modified Delphi consensus project was to define standards of care for severe asthma in Canada, in areas where the evidence is lacking through patient and healthcare professional consensus, to complement forthcoming guidelines. Methods: The steering group of asthma experts identified 43 statements formed from eight key themes. An online 4-point Likert scale questionnaire was sent to healthcare professionals working in asthma across Canada to assess agreement (consensus) with these statements. Consensus was defined as high if ≥ 75% and very high if ≥ 90% of respondents agreed with a statement. Results: A total of 150 responses were received from HCPs including certified respiratory educators, respirologists, allergists, general practitioners/family physicians, nurses, pharmacists, and respiratory therapists. Consensus amongst respondents was very high in 37 (86%) statements, high in 4 (9%) statements and was not achieved in 2 (5%) statements. Based on the consensus scores, ten key recommendations were proposed. These focus on referrals from primary and secondary care, accessing specialist asthma services, homecare provision for severe asthma patients and outcome measures. Conclusions: Implementation of these recommendations across the severe asthma care pathway in Canada has the potential to improve outcomes for patients through earlier detection of undiagnosed severe asthma, reduction in time to severe asthma diagnosis, and initiation of advanced phenotype specific therapies. [ABSTRACT FROM AUTHOR]

The paper describes a system and experimental procedure that use integrating passive detectors, such as thermoluminescent dosimeters (TLDs), for the measurement of ultra-low-level ambient dose equivalent rate values at the underground SNOLAB facility located in Sudbury, Ontario, Canada. Because these detectors are passive and can be exposed for relatively long periods of time, they can provide better sensitivity for measuring ultra-low activity levels. The final characterization of ultra-low-level ambient dose around water shielding for ongoing direct dark matter search experiments in Cube Hall at SNOLAB underground laboratory is given. The conclusion is that TLDs provide reliable results in the measurement of the ultra-low-level environmental radiation background. [ABSTRACT FROM AUTHOR]

Background: Timely access and attachment to a primary healthcare provider is associated with better population health outcomes. In Canada, community pharmacists are highly accessible and patients struggling to access a family physician or nurse practitioner (i.e., "unattached") may seek care from a community pharmacist. Community pharmacists took on additional roles during the COVID-19 pandemic; however, little is known about how community pharmacists managed the needs of attached and unattached patients before and during the COVID-19 pandemic. Aim: To describe Nova Scotian community pharmacists' roles in caring for unattached patients before and during the COVID-19 pandemic and identifying barriers and facilitators to optimizing patient access. Method: Semi-structured interviews with community pharmacists (n = 11) across the province of Nova Scotia (Canada) were conducted. Results: Five key themes were noted: (1) rising pressure on pharmacists to meet unique health needs of attached and unattached patients; (2) what pharmacists have to offer (e.g., accessibility, trustworthiness); (3) positioning pharmacists in the system (e.g., how pharmacists can address gaps in primary healthcare); (4) pharmacist wellbeing; and, (5) recommendations for practice post-pandemic (e.g., maintain some policy changes made during the COVID-19 pandemic). Conclusion: Before and during the pandemic, community pharmacists played a significant and increasing role providing care to patients, especially unattached patients. With growing numbers of unattached patients, it is vital that community pharmacists are supported to provide services to care for the health needs of patients. [ABSTRACT FROM AUTHOR]

Neonicotinoid‐coated corn and soybean seeds are a common crop in Canada and the US. A growing body of research is demonstrating that, through various exposure routes, neonicotinoids can impact a suite of nontarget organisms including beneficial insects such as bees. However, to date, only a few studies have examined the effects of neonicotinoids in field settings.We assessed the relationship between agricultural crop soil neonicotinoid levels and wild bee abundance and diversity at 16 agricultural sites representing different soil neonicotinoid levels. We detected clothianidin at 11 sites, thiamethoxam at three sites; imidacloprid was not detected.Hedgerow and crop soils were consistent in terms of where clothianidin was detected; thiamethoxan was not detected in hedgerow soils. Based on model outcomes, fields with higher levels of soil neonicotinoids exhibited significantly lower wild bee abundance and diversity than those with low or no neonicotinoids detected.Crop soil neonicotinoid level, hedgerow floral resource abundance and crop type were consistent predictors of bee abundance across models; only neonicotinoid level and crop type were significant predictors of diversity.Our results are consistent with recent findings in the midwestern US, and underscore the potential risk of soil neonicotinoids to wild bee populations across regions and crop systems. [ABSTRACT FROM AUTHOR]

Urbanization exerts many pressures on species, yet little is known about how these pressures impact species interactions. Studies of urban plant-pollinator systems provide mounting evidence that urbanization impairs pollinator movement in fragmented urban landscapes, yet the consequences for pollinator-mediated plant reproduction remains unclear. In non-urban areas, habitat corridors can facilitate the movement of organisms including pollinators, but whether these corridors facilitate plant-pollinator interactions in urban areas remains understudied. To examine how urban environments and a green corridor influence plant-pollinator interactions, we measured reproductive success in the native plant common milkweed (Asclepias syriaca), and the community structure of its pollinators, for two years along two urban–rural transects in the Greater Toronto Area, Canada, one of which followed a green corridor. We found that urbanization decreased male fitness (i.e., pollen removal), increased fruit set (i.e., mean no. of follicles per inflorescence), and inconsistently affected female fitness (i.e., no. of follicles) in A. syriaca. Urbanization simultaneously decreased pollinator abundance but increased pollinator richness. Proximity to a green corridor inconsistently affected male fitness but increased reproductive effort (i.e., no. of inflorescences) in A. syriaca, while pollinator diversity and richness was lower in the corridor. Notably, there were no consistent relationships between pollinator community structure and reproductive success in A. syriaca in both the presence, and absence, of a green corridor. These results demonstrate the complexity with which urbanization, a green corridor, and pollinator communities can shape the reproductive investment and fitness of native plant populations. [ABSTRACT FROM AUTHOR]

In this study we explored nurse practitioner-provided medication abortion in Canada and identified barriers and enablers to uptake and implementation. Between 2020–2021, we conducted 43 semi-structured interviews with 20 healthcare stakeholders and 23 nurse practitioners who both provided and did not provide medication abortion. Data were analyzed using interpretive description. We identified five overarching themes: 1) Access and use of ultrasound for gestational dating; 2) Advertising and anonymity of services; 3) Abortion as specialized or primary care; 4) Location and proximity to services; and 5) Education, mentorship, and peer support. Under certain conditions, ultrasound is not required for medication abortion, supporting nurse practitioner provision in the absence of access to this technology. Nurse practitioners felt a conflict between wanting to advertise their abortion services while also protecting their anonymity and that of their patients. Some nurse practitioners perceived medication abortion to be a low-resource, easy-to-provide service, while some not providing medication abortion continued to refer patients to specialized clinics. Some participants in rural areas felt unable to provide this service because they were too far from emergency services in the event of complications. Most nurse practitioners did not have any training in abortion care during their education and desired the support of a mentor experienced in abortion provision. Addressing factors that influence nurse practitioner provision of medication abortion will help to broaden access. Nurse practitioners are well-suited to provide medication abortion care but face multiple ongoing barriers to provision. We recommend the integration of medication abortion training into nurse practitioner education. Further, widespread communication from nursing organizations could inform nurse practitioners that medication abortion is within their scope of practice and facilitate public outreach campaigns to inform the public that this service exists and can be provided by nurse practitioners. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic challenged healthcare systems worldwide and disrupted primary care, particularly prevention, screening, and lifestyle counselling. BETTER WISE is a comprehensive and structured approach that proactively addresses cancer and chronic disease prevention and screening (CCDPS), including cancer survivorship and screening for poverty and lifestyle risks for patients aged 40 to 65. Patients from 13 primary care clinics (urban, rural, and remote) in Alberta, Ontario, and Newfoundland & Labrador, Canada were invited for a 1-hour visit with a prevention practitioner (PP), a member of the primary care team with specialized training in CCDPS to provide patients an overview of eligible screening and assist with lifestyle counselling. This qualitative sub-study describes how the COVID-19 pandemic impacted BETTER WISE in a constantly changing medical landscape. Methods: We conducted 17 focus groups and 48 key informant interviews with a total of 132 primary care providers (PPs, physicians, allied health professionals, and clinic staff) over three different time points to better understand their perspectives on the BETTER WISE project. We also received 585 patient feedback forms of the 1005 patients who agreed to participate in the study. We also collected field notes and memos and employed thematic analysis using a constant comparative method focused on the impact of the pandemic on BETTER WISE. Results: We identified four themes related to how the COVID-19 pandemic impacted the BETTER WISE study: 1) Switch of in-person visits to visits over the phone; 2) Lack of access to preventive care and delays of screening tests; 3) Changes in primary care providers' availability and priorities; 4) Mental health impacts of the pandemic on patients and primary care providers. Conclusions: The COVID-19 pandemic had and, at the time of writing, continues to have an impact on primary care, particularly on prevention, screening, and lifestyle counselling. Despite structural, procedural, and personal challenges throughout different waves of the pandemic, the primary care clinics participating in BETTER WISE were able to complete the study. Our results underscore the importance of the role of primary care providers in adapting to changing circumstances and support of patients in these challenging times. Trial registration: This qualitative study is a sub-component of the BETTER WISE pragmatic, cRCT, trial registration ISRCTN21333761 (date of registration 19/12/2016). [ABSTRACT FROM AUTHOR]

The procurement and provision of expert-driven, evidence-informed, and independent science advice is integral to timely decision-making during public health emergencies. The 2019 coronavirus disease (COVID-19) pandemic has underscored the need for sound evidence in public health policy and exposed the challenges facing government science advisory mechanisms. This paper is a jurisdictional case study describing (i) the federal science advice bodies and mechanisms for public health in Canada (i.e., the federal science advice "ecosystem"); and (ii) how these bodies and mechanisms have mobilized and evolved to procure expertise and evidence to inform decisions during the first two years of the COVID-19 pandemic. We reviewed publicly accessible Government of Canada documents, technical reports, and peer-reviewed articles available up to December 2021. Canada's federal landscape of science advisory bodies for public health within the Health Portfolio was largely shaped by Canada's experiences with the 2003 severe acute respiratory syndrome and 2009 H1N1 outbreaks. In parallel, Canada has a designated science advisory apparatus that has seen frequent reforms since the early 2000s, with the current Office of the Chief Science Advisor created within the Science Portfolio in 2018. The COVID-19 pandemic has further complicated Canada's science advice ecosystem, with involvement from departments, expert advisory groups, and partnerships within both the federal Health and Science Portfolios. Although the engagement of federal departments outside the health sector is promising, the COVID-19 experience in Canada supports the need to institutionalize science advisory bodies for public health to improve pandemic preparedness and ensure rapid mobilization of well-coordinated and independent advice in future emergencies. This review also identified pressing areas for further inquiry to strengthen science advice for public health in Canada, including to assess the independence of science advisory actors and the interaction between federal and subnational authorities. [ABSTRACT FROM AUTHOR]

Background: Electronic consultation (eConsult) programs are crucial components of modern healthcare that facilitate communication between primary care providers (PCPs) and specialists. eConsults between PCPs and specialists. They also provide a unique opportunity to use real-world patient scenarios for reflective learning as part of professional development. However, tools that guide and document learning from eConsults are limited. The purpose of this study was to develop and pilot two eConsult reflective learning tools (RLTs), one for PCPs and one for specialists, for those participating in eConsults. Methods: We performed a four-phase pragmatic mixed methods study recruiting PCPs and specialists from two public health systems located in two countries: eConsult BASE in Canada and San Francisco Health Network eConsult in the United States. In phase 1, subject matter experts developed preliminary RLTs for PCPs and specialists. During phase 2, a Delphi survey among 20 PCPs and 16 specialists led to consensus on items for each RLT. In phase 3, we conducted cognitive interviews with three PCPs and five specialists as they applied the RLTs on previously completed consults. In phase 4, we piloted the RLTs with eConsult users. Results: The RLTs were perceived to elicit critical reflection among participants regarding their knowledge and practice habits and could be used for quality improvement and continuing professional development. Conclusion: PCPs and specialists alike perceived that eConsult systems provided opportunities for self-directed learning wherein they were motivated to investigate topics further through the course of eConsult exchanges. We recommend the RLTs be subject to further evaluation through implementation studies at other sites. [ABSTRACT FROM AUTHOR]

Background: Since the onset of the COVID-19 pandemic in March 2020 in Canada, the availability of sexual health services including sexually transmitted and blood-borne infection (STBBI) testing has been negatively impacted in the province of Ontario due to their designation as "non-essential" health services. As a result, many individuals wanting to access sexual healthcare continued to have unmet sexual health needs throughout the pandemic. In response to this, sexual health service providers have adopted alternative models of testing, such as virtual interventions and self-sampling/testing. Our objective was to investigate service providers' experiences of disruptions to STBBI testing during the COVID-19 pandemic in Ontario, Canada, and their acceptability of alternative testing services. Methods: Between October 2020-February 2021, we conducted semi-structured virtual focus groups (3) and in-depth interviews (11) with a diverse group of sexual health service providers (n = 18) including frontline workers, public health workers, sexual health nurses, physicians, and sexual health educators across Ontario. As part of a larger community-based research study, data collection and analysis were led by three Peer Researchers and a Community Advisory Board was consulted throughout the research process. Transcripts were transcribed verbatim and analysed with NVivo software following grounded theory. Results: Service providers identified the reallocation of public health resources and staff toward COVID-19 management, and closures, reduced hours, and lower in-person capacities at sexual health clinics as the causes for a sharp decline in access to sexual health testing services. Virtual and self-sampling interventions for STBBI testing were adopted to increase service capacity while reducing risks of COVID-19 transmission. Participants suggested that alternative models of testing were more convenient, accessible, safe, comfortable, cost-effective, and less onerous compared to traditional clinic-based models, and that they helped fill the gaps in testing caused by the pandemic. Conclusions: Acceptability of virtual and self-sampling interventions for STBBI testing was high among service providers, and their lived experiences of implementing such services demonstrated their feasibility in the context of Ontario. There is a need to approach sexual health services as an essential part of healthcare and to sustain sexual health services that meet the needs of diverse individuals. [ABSTRACT FROM AUTHOR]

The prospects and challenges of boundary-spanning public value co-creation are one of the quintessential features of public management in the current age of complexity. This paper argues that boundary-spanning takes on a heightened salience in multilevel jurisdictions where actors must not only navigate the horizontal contours of inter-organizational relations but also vertical tiers of jurisdiction in pursuit of joint action. Drawing insights from the multilevel governance literature, and using Canada's recent Innovation Superclusters Initiative as case study, the paper sheds some light on how public managers and policy entrepreneurs navigate strategically across boundaries in federal and other multitiered systems. [ABSTRACT FROM AUTHOR]

The article focuses on the AmeriDendro 2022 conference held in Montréal, Canada, aiming to rebuild the tree-ring community after pandemic-related disruptions. Topics include recognition of excellence in dendrochronology through awards, emphasizing contributions to the field, and student awards for outstanding research, as well as detailing the scientific program's workshops, presentations, and activities.

Drug-resistant tuberculosis (TB) is a major global health challenge in part because there are fewer effective treatments and these treatments have been prolonged and more toxic. The evidence base for more effective, shorter, standardized treatments is evolving rapidly. Herein, we report the first case of pre-extensively drug-resistant pulmonary TB treated with a novel six-month all oral bedaquiline, pretomanid and linezolid (BPaL) regimen in Canada. Recent clinical trial data supporting BPaL therapy is presented in the context of current and evolving clinical guidelines. In this article, we highlight significant implementation challenges and make recommendations for what needs to be addressed to ensure safe programmatic use of BPaL in Canada. Key recommendations include the development of infrastructure for timely access to novel TB drug susceptibility testing, streamlining access to novel TB drugs, and cautious use of such drugs in collaboration with care teams with expertise in drug-resistant TB management. [ABSTRACT FROM AUTHOR]