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Given a growing digital economy with complex problems, demands are being made for education to address computational thinking (CT)--an approach to problem solving that draws on the tenets of computer science. We conducted a comprehensive content analysis of the Ontario elementary school curriculum documents for 44 CT-related terms to examine the extent to which CT may already be considered within the curriculum. The quantitative analysis strategy provided frequencies of terms, and a qualitative analysis provided information about how and where terms were being used. As predicted, results showed that while CT terms appeared mostly in Mathematics, and concepts and perspectives were more frequently cited than practices, related terms appeared across almost all disciplines and grades. Findings suggest that CT is already a relevant consideration for educators in terms of concepts and perspectives; however, CT practices should be more widely incorporated to promote 21st century skills across disciplines. Future research would benefit from continued examination of the implementation and assessment of CT and its related concepts, practices, and perspectives.

Objective: Rib fractures lead to altered breathing mechanics, impaired gas exchange, and in some patients to respiratory failure. Multimodal analgesia has become one of the pillars of management; however, barriers toward widespread adoption remain. We reviewed the trends in multimodal pain management strategies and their drivers over a 10-year period at a lead trauma hospital in Canada. Methods: This is a cross-sectional study in which demographic, injury, pharmacological, as well as outcome data were collected for all adult patients admitted with rib fractures. Data were collected retrospectively and the study period was divided into three eras (2011–2014; 2015–2018; 2019–2022). Multimodal pain management was defined as either patient-controlled (PCA) or regional analgesia (epidural or continuous plane block) in combination with acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs). All patients received pro re nata (PRN) narcotics. Data were stratified based on rib fracture severity, age, and intubation on arrival. Results: We identified 2586 patients with rib fractures (mild non-flail 32.6%; moderate non-flail 50.2%; flail 17.2%). The use of standing acetaminophen and NSAIDs increased over time for all groups. Regional analgesia use increased while PCA use reduced, particularly in the flail group. Only 7% of flail patients intubated on arrival received regional analgesia. Among those not intubated on arrival, only 35% of flail and 23% of non-flail patients received multimodal pain management. Over time, multimodal pain management decreased in the non-flail group due to a reduction in PCA use without an equal rise in regional anesthesia. Those without multimodal pain management were older and the mechanism of injury was more likely a fall. Among those with a flail, who were non-intubated at presentation, only 31% of those aged >65 received multimodal pain regimens compared to 45% in those ≤65y. Conclusions: Although multimodal pain management strategies have improved over time, a large proportion of patients, even among those with flail chest, still do not receive multimodal pain management. Elderly patients, at highest risk of adverse outcomes, were less likely to receive multimodal pain management strategies and should be the target of performance improvement initiatives. [ABSTRACT FROM AUTHOR]

Aims and Background: The spleen is the most frequently injured solid organ after blunt trauma and a trial non-operative management (NOM) has become the standard of care in hemodynamically stable patients. It remains uncertain which patients are at increased risk of non-operative management failure (NOMF) at initial presentation. We explored whether clinical variables including the contemporary rotational thromboelastography (ROTEM) parameters are predictive of NOMF. Materials and Methods: Data for all adult patients with a blunt splenic injury was collected retrospectively at St. Michael's Hospital in Toronto, Canada between 2005 and 2021. Those who underwent a splenectomy within 4 hours of presentation were classified as direct operative management (OM), while those who had a splenectomy after 4 hours of observation were classified as NOM failure. Vital signs on arrival and injury characteristics were collected. Logistic regression was used to identify predictors of OM and predictors of NOM failure. Results: Seven hundred and seventeen patients were identified with splenic injury during our study period. The median Injury Severity Score (ISS) was 27 (IQR 17–36), and 19% (n = 134) had a shock index of 1 or more. One hundred and eleven (15.5%) underwent direct operative management. A shock index above 1 and increasing spleen injury severity were strong predictors of patients undergoing direct OM. The remaining 606 patients underwent NOM of which 59% (n = 357) of these were admitted to the ICU. NOM failure occurred in 7.4% (n = 45) with a median time to NOM failure of 23 (IQR 8–72) hours. The American Association for the Surgery of Trauma (AAST) spleen injury severity was the major factor significantly associated with NOM failure. Conclusions: The only major predictor of NOMF available on arrival is increased spleen injury grade. Other clinical variables such as age, vital signs on arrival, and bloodwork were not significantly able to predict NOM failure. Additional investigation is required to identify novel predictors of NOM failure. [ABSTRACT FROM AUTHOR]

Purpose: Massively bleeding trauma patients often arrive to intensive care units hypothermic. Active warming blankets have shown promise in reducing hypothermia in the pre-hospital setting, but less is known about their in-hospital use. The aim of this pilot evaluation was to understand the feasibility of the Ready-Heat® blanket in a level 1 trauma centre to improve the management of hypothermia in massively bleeding trauma patients. Methods: This was a prospective, observational, feasibility study of 15 patients performed at a single level 1 trauma centre. Patients were eligible for enrollment if they presented to the trauma bay and a massive hemorrhage protocol was activated. Primary outcome measures (feasibility) included: blanket applied to the patient; temperature recording in the trauma bay, and next phase or final phase of care; and blanket remaining on patient upon arrival to the subsequent phase of care.Secondary outcome measures (safety) included skin irritation and cold discomfort. Use of the Ready-Heat® blanket was considered feasible if 10 of 15 patients met all four criteria for feasibility. Results: The Ready-Heat® blanket was placed on all patients with mean time to blanket application of 24 (± 13.4) minutes. Thirteen patients (86.7%) met all four criteria for feasibility. Initial challenges were identified in the first five patients including proper blanket application, keeping the blanket on the patient through subsequent phases of care, and failure to obtain temperature recordings. Conclusion: The Ready-Heat® blanket proves feasible for this patient population. A larger study focusing on hypothermia prevention and treatment is warranted. Trial registration number: NCT04399902. Date of registration: May 22, 2020. [ABSTRACT FROM AUTHOR]

Twenty teachers working in elementary and secondary schools were interviewed from 2 school districts in southern Ontario, Canada about their understanding and use of particular formative assessment strategies. Analysis of the interviews followed a constant comparison method and revealed a variety of emerging themes. Results suggested an imbalance in the use of formative assessment methods associated with improvements in student learning and achievement. Many teachers noted tensions in utilizing particular formative assessment strategies such as peer assessment and self-assessment. The discussion focuses on the implications for teacher education reform and in-service professional development so that greater synergy between formative assessment research and practice can be obtained in contemporary classrooms.

Summary: During World War II, Charles H. Best utilized Charles R. Drew's plasma isolation and drying technique to lead Canada's initiative to provide dried serum as a means of primary resuscitation for British casualties on the frontlines. Serum was likely utilized over plasma for its volume expansion properties without the risk of clotting during prolonged storage. We reconstituted dried serum from 1943 and discovered intact albumin, as well as anti‐thrombin, plasminogen, protein C and protein S activity. Proteomic analysis identified 71 proteins, most prominent being albumin, and positive for hepatitis B by serological testing. Transmission of blood‐borne diseases ended the programme, until modern advances in testing and pathogen reduction revived this technology. We tested the latest iteration of Canadian freeze‐dried plasma (FDP), which was stored for 4 years, and demonstrated that its clotting capacity remained equivalent to fresh frozen plasma. We recommend that FDP is a strong alternative to contemporary prehospital resuscitation fluids (e.g. normal saline/lactated Ringer's) in managing prehospital haemorrhage where whole blood is unavailable. [ABSTRACT FROM AUTHOR]

Peatlands store approximately one-half of terrestrial soil carbon and one-tenth of non-glacial freshwater. Some of these important ecosystems are located near heavy metal emitting smelters. To improve the understanding of smelter impacts and potential recovery after initial pollution controls in the 1970s (roughly 50 years of potential recovery), we sampled peatlands along a distance gradient of 134 km from a smelter in Sudbury, Ontario, Canada, an area with over a century of nickel (Ni) and copper (Cu) mining activity. This work is aimed at evaluating potential shifts in bacterial and archaeal community structures in Sphagnum moss and its underlying peat within smelter-impacted poor fens. In peat, total Ni and Cu concentrations were higher (0.062–0.067 and 0.110–0.208 mg/g, respectively) at sites close to the smelter and exponentially dropped with distance from the smelter. This exponential decrease in Ni concentrations was also observed in Sphagnum. 16S rDNA amplicon sequencing showed that peat and Sphagnum moss host distinct microbiomes with peat accommodating a more diverse community structure. The microbiomes of Sphagnum were dominated by Proteobacteria (62.5%), followed by Acidobacteria (11.9%), with no observable trends with distance from the smelter. Dominance of Acidobacteria (32.4%) and Proteobacteria (29.6%) in peat was reported across all sites. No drift in taxonomy was seen across the distance gradient or from the reference sites, suggesting a potential microbiome recovery toward that of the reference peatlands microbiomes after decades of pollution controls. These results advance the understanding of peat and Sphagnum moss microbiomes, as well as depict the sensitivities and the resilience of peatland ecosystems. [ABSTRACT FROM AUTHOR]

Background: Patients with scleroderma require a lifetime of treatment and frequent contacts with rheumatologists and other health care professionals. Although publicly funded health care systems in Canada cover many costs, patients may still face a substantial financial burden in accessing care. The purpose of this study was to quantify out-of-pocket costs borne by people with scleroderma in Canada and compare this burden for those living in large communities and smaller communities. Methods: We analyzed responses to a Web-based survey of people living in Canada with scleroderma. Respondents reported annual out-of-pocket medical, travel and accommodation and other nonmedical costs (2019 Canadian dollars). We used descriptive statistics to describe travel distance and out-of-pocket costs. We used a 2-part model to estimate the impact on out-of-pocket costs of living in a large urban centre (≥ 100 000 population), compared with smaller urban centres or rural areas (< 100 000 population). We generated combined mean estimates from the 2-part models using predictive margins. Results: The survey included 120 people in Canada with scleroderma. The mean, annual, total out-of-pocket costs were $3357 (standard deviation $5580). Respondents living in smaller urban centres and rural areas reported higher mean total costs ($4148, 95% confidence interval [CI] $3618-$4680) and travel or accommodation costs ($1084, 95% CI $804-$1364) than those in larger urban centres (total costs $2678, 95% CI $2252-$3104; travel or accommodation costs $332, 95% CI $207-$458). Interpretation: Many patients with scleroderma incur considerable out-of-pocket costs, and this burden is exacerbated for those living in smaller urban centres and rural areas. Health care systems and providers should consider ways to alleviate this burden and support equitable access to care. [ABSTRACT FROM AUTHOR]

Purpose : Like most Western armies, obesity affects Canadian Armed Forces (CAF) personnel. Bariatric surgery is an effective treatment for obesity. However, this is not yet accepted for active-duty soldiers in most countries. The CAF have approved bariatric surgery since 2005. Our aim is to assess weight loss, resolution of obesity-related comorbidities, and impacts of bariatric surgery on military careers. Materials and Methods: We retrospectively reviewed the perioperative data, long-term bariatric results, and military outcomes of 108 CAF active-duty military personnel who underwent bariatric surgery in Canada over a 61-month period. Results: The cohort was predominantly male (66.7%) with a mean preoperative body mass index (BMI) of 43.6 ± 5.8 kg/m2. Roux-Y gastric bypass was performed in 59 patients, sleeve gastrectomy in 29, and gastric banding in 20. All the surgeries were performed laparoscopically. The total body weight loss at the last follow-up visit was 22.5 ± 11.0%. Remission or improvement of hypertension was observed in 91.2%, diabetes in 85.7%, gastroesophageal reflux disorder (GERD) in 43.6%, sleep apnea in 43.1%, and dyslipidemia in 42.9%. One patient (0.9%) was medically released due to postoperative complications. Fifteen patients (13.9%) were deployed postoperatively. The combined deployable and possibly deployable statuses increased from 35.4% preoperatively to 47.9% postoperatively. Conclusion: This is the largest series of bariatric surgeries performed in active-duty military personnel. Bariatric surgery is effective and safe and improves deployability without impairing military careers. These results are relevant to the military of many industrialized countries. Bariatric surgery should be considered for all active-duty military personnel who meet surgical criteria for the treatment of obesity. [ABSTRACT FROM AUTHOR]

Mine remediation entails long-term risks associated with the containment and monitoring of dangerous materials. To date, research on mine remediation in Canada has focused primarily on technical fixes; little is known about the socio-political and colonial aspects of remediation. Using the Giant Mine in Yellowknife (Northwest Territories, Canada) as a case study, this research investigates the story of the Giant Mine 'Monster', how it was defined, how it has changed and how nearby communities will care for the mine in the future. Using a mixed-methods approach, this research combines literature reviews, archival analysis, key informant interviews and participant observation in analyzing the multiple experiences, practices and stories of the Giant Mine Remediation Project. Directed by the frameworks of ecological restoration, Indigenous environmental justice and science and technology studies theories of care, this research reveals that, by focusing on the technical containment of arsenic trioxide pollution, the Giant Mine Remediation Project sidelined community objectives for compensation, independent oversight and a perpetual care plan. However, through the ongoing activism of the Yellowknives Dene First Nations and community allies, the Giant Mine Monster is being creatively reframed as something to care for and live with for generations to come – a responsibility for mining wastes that settlers across Canada have yet to meaningfully reckon with. I argue that the Giant Mine case points to a critical reconceptualization of environmental remediation as an anti-colonial mechanism to (re)structure, or (re)mediate, relationships with both land and people. Without a community objectives based approach to remediation, such projects risk continuing systems of colonization, marginalization and environmental injustice. [ABSTRACT FROM AUTHOR]

In the face of global pressures of change and biodiversity loss, crop wild relatives (CWR) and wild‐utilized species (WUS) urgently require conservation attention. To advance conservation, we assembled a national inventory of CWR and WUS in Canada. To assess current ex situ conservation of these plant species, we gathered a virtual metacollection of accession data from botanical gardens and national genebanks. The inventory includes 779 CWR and WUS taxa (658 distinct species), with 263 (222 distinct species) that are related to food crops of national and global importance such as blueberry (Vaccinium corymbosum L.), apple (Malus domestica (Suckow) Borkh.), sunflower (Helianthus annuus L.), and saskatoon (Amelanchier spp.). Sixty‐one food crop relatives are prioritized for breeding potential, and sixteen due to conservation threats. Although most food crop CWR are represented in ex situ collections (91% of species), representation of within‐species diversity is low (median = 5% of Canadian ecogeographic types represented per species). Poor representation of within‐species diversity demands an integrative conservation strategy that emphasizes in situ protection, especially focusing on wild populations in Canada's southern ecoregions where diversity is concentrated. While genebank collections represent higher accession counts per species, botanical gardens include living collections of fruit crop relatives and other woody perennials that are well situated to raise broader awareness of CWR and WUS. To promote further conservation action, we present a web application that enables conservation planners and practitioners to identify local CWR and WUS and to identify within‐species ecogeographic types that are underrepresented in ex situ conservation systems. Core Ideas: Canada contains a rich diversity of crop wild relatives and wild‐utilized species, including many relatives of fruit crops.The 61 Canadian food crop wild relatives have high potential utility in crop breeding, and 17 are nationally imperiled.Living collections of woody‐perennial crop wild relatives and wild‐utilized species in botanical gardens complement ex situ conservation in genebanks.Conservation requires integrative strategy, with coordinated in situ action prioritizing Canada's southern regions.Display collections in gardens and new, online tools are situated to advance conservation by raising engagement. [ABSTRACT FROM AUTHOR]

This article reports on the peer review process of the College of Physicians and Surgeons of Ontario, the licensing and regulatory authority, and the effect of educational interventions on physicians identified to be in need. Since 1980, the college has assessed more than 175 random and targeted nonspecialist physicians each year. A structured remediation process has been employed for those in need. Extensive data files have been maintained by the college. A majority of physicians identified as needing improvement improved and maintained their improved performance. The simple structured interventions employed by the college demonstrate an educational intervention that produces practice improvement.

Background: Randomized clinical trial data show that early plasma transfusion may save lives among trauma patients. Supplying plasma in remote environments is logistically challenging. Freeze‐dried plasma (FDP) offers a possible solution. Study Design and Methods: A Terumo BCT plasma freeze‐drying system was evaluated. We compared pooled frozen plasma (FP) units with derived Terumo BCT FDP (TFDP) units and pooled COVID‐19 convalescent apheresis fresh‐frozen plasma (CC‐AFFP) with derived CC‐TFDP units. Parameters measured were: coagulation factors (F) II; V; VII; VIII; IX; XI; XIII; fibrinogen; Proteins C (PC) and S (PS); antithrombin (AT); α2‐antiplasmin (α2AP); ADAMTS13; von Willebrand Factor (vWF); thrombin–antithrombin (TAT); D‐dimer; activated complement factors 3 (C3a) and 5 (C5a); pH; osmolality; prothrombin time (PT); and activated partial thromboplastin time (aPTT). Antibodies to SARS‐CoV‐2 in CC‐AFFP and CC‐TFDP units were compared by plaque reduction assays and viral protein immunoassays. Results: Most parameters were unchanged in TFDP versus FP or differed ≤15%. Mean aPTT, PT, C3a, and pH were elevated 5.9%, 6.9%, 64%, and 0.28 units, respectively, versus FP. CC‐TFDP showed no loss of SARS‐CoV‐2 neutralization titer versus CC‐AFFP and no mean signal loss in most pools by viral protein immunoassays. Conclusion: Changes in protein activities or clotting times arising from freeze‐drying were <15%. Although C3a levels in TFDP were elevated, they were less than literature values for transfusable plasma. SARS‐CoV‐2‐neutralizing antibody titers and viral protein binding levels were largely unaffected by freeze‐drying. In vitro characteristics of TFDP or CC‐TFDP were comparable to their originating plasma, making future clinical studies appropriate. See editorial on page 257–260, in this issue [ABSTRACT FROM AUTHOR]

Despite clear evidence that formative assessment creates vantage points throughout the teaching-learning cycle for both teachers and students, research suggests that teachers are not taking advantage of the full cadre of formative assessment strategies available to them--particularly those that have been associated with improved student learning and achievement such as questioning techniques, feedback without grades, self-assessment, peer-assessment, and the formative use of summative assessment. When educators participate in sharing stories, take part in internal accountability practices, and build networked learning communities, the philosophy of assessment and school culture begins to move forward. Generating coherence and synergy between Ministries of Education, Education Faculties, school boards, and school policy is essential in order to successfully construct a medium where research results can influence practice. (Contains 9 endnotes.)

This essay examines the phenomenon of crossover fiction, that is, fiction that crosses from child to adult or adult to child audiences. Crossover literature may be addressed to a mixed-age audience by the author and / or publisher, or it may initially be written and / or published for a particular audience and subsequently appropriated by another in a process of 'cross-reading.' Various types of crossover fiction are examined : adult-to-child crossover fiction, rewritings for a different audience and child-to-adult crossover fiction. In addition, this article looks at the significant role that publishers and marketing strategies play in what is largely a marketing phenomenon. Crossover fiction has been seen by some as an essentially European phenomenon, but it is in fact an important, widespread and expanding global trend, as demonstrated in the author's book Crossover fiction: global and historical perspectives (2009). This essay uses examples from a Canadian corpus to explore the global phenomenon of crossover fiction. [ABSTRACT FROM AUTHOR]

Discusses problems of depository libraries such as volume of publications received, understaffing, subject and author/title access, currency of material, financing, and lack of theory and research. An "ideal" access system and an action program for its implementation are described. Four references are listed. (CHC)

Summary: Canadian universities faced a challenge with the return of a large cohort of battle-hardened students and faculty from the First World War. General Sir Arthur Currie, considered one of the few successful generals of the war, returned to a welcome of silence in Canada. McGill University exploited the opportunity to recruit him as its president. Currie oversaw a campaign of building construction and faculty development at McGill that also had a significant effect on the rest of Canada. Through his fostering of the Montreal Neurological Institute and the recruitment of Dr. Wilder Penfield, Currie facilitated the development of multidisciplinary medicine, which integrates clinical care with research — an aspiration still held by specialty medicine in Canada today. [ABSTRACT FROM AUTHOR]

Perhaps largely due to the successful campaigning of a number of pressure groups and social movements, but also due to the established position of related subjects within academia, there is a now almost routine consideration of class, ethnicity, gender and sexuality in relation to citizenship. Disability and the position of disabled people as “citizens” has not, however, received as much attention. It is the assertion of this article that this is a significant fact, for a consideration of disability in relation to citizenship provides useful insights into the strengths and weaknesses of some important theories of citizenship. Further, it demonstrates the need for an approach that takes account of the increasing uncertainty of groups such as disabled people towards their own identities and that conceives citizenship as being a process of “proactive engagement” towards a “reflexive position”. [ABSTRACT FROM AUTHOR]

The purpose of this study is to examine international publications in the field of theatre using bibliometric analysis methods. For this purpose, scientific articles published in the journals listed in Web of Science are analysed. A total of 8,047 articles published from 1975 to 2021are included in the analysis. Descriptive bibliometric analysis and social network mapping method are used to examine data. According to the analysis, the first three countries that have contributed the most to the field of theatre are the USA, England and Canada. In terms of citations, the most cited articles in the field are also published in the most cited journals in the field. Moreover, the most frequently cited books in the field are related to publications that improve the intellectual structure of the field. In terms of co-author citation analysis, our study shows that the most frequently cited authors are Shakespeare, Brecht, Boal, Schechner and Beckett. [ABSTRACT FROM AUTHOR]

Fuelled by forces of globalisation, China has gradually shifted from a centrally planned economy to the ‘socialist market economy’. This study examines changes in Chinese education under globalisation and market economy, focusing on the teaching and living conditions of teachers. The study reveals that the profound transformation of social and economic life has resulted in significant changes to education in China, as manifested in curriculum reform, increased disparity between rural and urban education, marginalisation of minority education and lack of accessible and affordable education for the children of migrant workers. The recent changes have also had tremendous impact on teachers in terms of their workload, payment, wellbeing, social status and teaching and living conditions. The study contextualises the concept of globalisation by examining its impact on China through marketisation and privatisation. Its analysis demonstrates a withdrawal of the state from provision and financing of public education. It also reveals a number of social injustices and inequities whose reduction and elimination require the Chinese government to take immediate and active measures. [ABSTRACT FROM AUTHOR]

Knowledge of total and bioavailable metal contents in soil is important for regional risk assessment and management. The main objective of the present study was to analyse the concentrations of metals in soils in two contrasting mining regions (Sudbury in Canada and Lubumbashi in DR-Congo). Genetic variation of plant populations was investigated to assess the potential impact of metal contamination on forest sustainability. The levels of copper, cobalt, zinc, arsenic, and lead were significantly higher (up to 200-fold) in mining sites in the Lubumbashi compared to the most highly contaminated Sudbury sites. The nickel content in soil samples from Lubumbashi was much lower compared to Sudbury region samples. Only 3.5% and 4 % of total copper and nickel, respectively, were phytoavailable, with values of 6%, 5.7%, 3.6%, and 5.4% for cobalt, magnesium, manganese, and zinc, respectively. There were significant positive correlations between total metal and phytoavailable metal concentrations for copper (r=0.99), nickel (r=0.86), cobalt (r=0.72), strontium (r=0.71), and zinc (r=0.66). Although genetic variation was high inPicea glaucapopulations from the Sudbury region, no association was found between metal contamination levels and genetic variation within and among theP. glaucapopulations. [ABSTRACT FROM PUBLISHER]

The Sudbury region in Canada is known for the mining and smelting of high-sulphide ores containing nickel, copper, iron and precious metals. Although reports provide information of metal levels in soil and plants, knowledge of genetic effects on plants growing in contaminated areas is limited. The main objective of this study was to characterise the level of genetic diversity in Pinus banksiana and Pinus resinosa populations from the Sudbury (Ontario) region using microsatellite markers. Soil samples were analysed for concentrations of metals. High levels of metal contents in soil were observed within short distances of the smelter compared with control sites. The level of genetic diversity was very low for P. resinosa populations and moderate for P. banksiana samples. Observed heterozygosity was fivefold higher in P. banksiana populations than P. resinosa populations studied. Overall, 17 and 24% of the total genetic diversity were attributed to differences among populations for P. banksiana and P. resinosa, respectively. In general, the inbreeding was significantly higher in P. resinosa populations than P. banksiana populations and gene flows were relatively low in both species. No significant trend of the levels of genetic diversity for metal contaminated and uncontaminated sites was found. [ABSTRACT FROM AUTHOR]

Several studies have reported high metal concentrations in soil within the vicinity of smelters in the Sudbury (Ontario) region. Continued investigation and monitoring of soil and vegetation are essential to the understanding of ecosystem recovery following the reduction of emissions from smelters and the establishment of a reforestation program. The concentrations of Cd, Co, Cu, Fe, Ni, and Zn, found in the present study were within the limits set by Ontario Ministry of Environment and Energy (OMEE) guidelines even in sites within the vicinity of the Falconbridge Smelters. The levels of these elements in black spruce ( Picea mariana) tissues were much lower and far below the toxic levels for vegetation. This is the first documented report of metal content in black spruce populations in the Sudbury region. [ABSTRACT FROM AUTHOR]

My first telescope arrived amidst two exciting events, the March 1997 Mars Opposition and Comet Hale Bopp. Mars became the first object I observed through a telescope of my own as I chased sucker holes in a broken cloudy sky. I would get one fleeting glimpse before the next cloud obscured the view, but I was able to observe the polar caps, Syrtis Major (I mistakenly thought this was the Mariner Valley) and some of the deserts. The thrill of seeing Martian polar caps for the first time is indescribable, and so reminiscent of our view of Earth one can’t help but imagine more similarities than differences between our worlds. But what are we looking at exactly when we see something on the surface of Mars? With Mars having reached opposition on 2020 October 13, and likely the best view from Canada until 2035, I thought now might be a good time to dig a little deeper. [ABSTRACT FROM AUTHOR]

Discusses the implementation of synchronous manufacturing at Pratt and Whitney Canada. Inclusion of the creation of a flexible and reliable manufacturing process; Focus on processing material as quickly as possible, based on customer orders; Avoidance of large work-in-process inventories and long production runs.

A 38 ha near-barren experimental catchment area near an abandoned Cu and Ni smelter in Sudbury, Canada was treated with 410 tons of coarse dolomitic limestone in 1994. An additional 54 tons of pelletized fine dolomite were added to 15 wetlands within the experimental catchment in 1995. The treatments significantly increased the pH and base cation concentrations in the outlet stream. Cu and Ni concentrations initially rose after the wetland treatment, but then declined to levels below those of the reference site. Bioassay tests revealed that the toxicity of the drainage water was greatly reduced by the liming, but some localized inputs of highly toxic groundwater still posed a problem for aquatic biota. The pH of surface water in the wetlands has been maintained at >6.0 for over 4 years. The wetland liming appeared to be highly effective at neutralizing drainage water, however there may be some adverse effects on wetland plant communities as a consequence. [ABSTRACT FROM AUTHOR]

Objectives: To quantify inconsistent self-reporting of chronic conditions between the baseline (2011–2015) and first follow-up surveys (2015–2018) in the Canadian Longitudinal Study on Aging (CLSA), and to explore methods to resolve inconsistent responses and impact on multimorbidity. Methods: Community-dwelling adults aged 45–85 years in the baseline and first follow-up surveys were included (n = 45,184). At each survey, participants self-reported whether they ever had a physician diagnosis of 35 chronic conditions. Identifiable inconsistent responses were enumerated. Results: 32–40% of participants had at least one inconsistent response across all conditions. Illness-related information (e.g., taking medication) resolved most inconsistent responses (>93%) while computer-assisted software asking participants to confirm their inconsistent disease status resolved ≤53%. Using these adjudication methods, multimorbidity prevalence at follow-up increased by ≤1.6% compared to the prevalence without resolving inconsistent responses. Discussion: Inconsistent self-reporting of chronic conditions is common but may not substantially affect multimorbidity prevalence. Future research should validate methods to resolve inconsistencies. [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]

Aphasia is an acquired communication disorder caused by a cerebral lesion, such as a stroke. People with aphasia can experience various difficulties that may involve speaking, listening, reading, or writing. These difficulties have multiple impacts on their expression of their needs, interests, and opinions. Accordingly, people with aphasia often encounter barriers and facilitators when using local services, which reduces their participation. For instance, grocery shopping or going to a coffee house can be challenging for them. Hence, this systematic review was conducted to synthetize the barriers and facilitators for people with aphasia when using local services. Following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines, five databases and Google Scholar were searched for the literature published through April 2024. A total of nine studies were included in the present work. The results highlight that most of the barriers to communicational access to local services are environmental ones related to other people or society. A few environmental facilitators were mentioned, but these were mainly a reflection of the barriers. Personal facilitators were noted, but people with aphasia said that they were insufficient for counterbalancing environmental barriers. The results highlight the need to raise awareness of aphasia. [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]

One of the key defining features of Westminster-type democracies is the acknowledgement of an official Opposition and a Leader of the Opposition typically referred to as a 'prime minister in waiting'. This article focuses on this crucial element of Westminster democracy and applies a gender perspective, looking into women Leaders of the Opposition in the UK, Canada, New Zealand, and Australia (1975–2022). As this inquiry reveals, there have been few and mostly short-lived women Leaders of the Opposition. Further, contrary to plausible assumptions, there have been more women Leaders of the Opposition from conservative than from left-wing parties. In particular, however, the office of Leader of the Opposition has, with few exceptions, not proven to be a springboard to the premiership. In fact, a majority of women prime ministers were 'takeover prime ministers', inheriting the office from a predecessor from their own party, rather than former Leaders of the Opposition, while many women Leaders of the Opposition were not even given the opportunity to lead their party into a national election campaign. The article discusses possible explanations for these patterns. [ABSTRACT FROM AUTHOR]

Background: Mild cognitive impairment (MCI) is commonly defined as a transitional subclinical state between normal aging and dementia. A growing body of research indicates that health behaviors may play a protective role against cognitive decline and could potentially slow down the progression from MCI to dementia. The aim of this study is to conduct a bibliometric analysis of literature focusing on health behaviors and MCI to summarize the factors and evidence regarding the influence of health behaviors on MCI. Methods: The study performed a bibliometric analysis by retrieving publications from the Science Citation Index and Social Sciences Citation Index subdatabases within the Web of Science Core Collection. Utilizing VOSviewer and CiteSpace software, a total of 2,843 eligible articles underwent co-citation, cokeywords, and clustering analyses. This methodology aimed to investigate the current status, trends, major research questions, and potential future directions within the research domain. Results: The bibliometric analysis indicates that research on healthy behaviors in individuals with MCI originated in 2002 and experienced rapid growth in 2014, reflecting the increasing global interest in this area. The United States emerged as the primary contributor, accounting for more than one-third of the total scientific output with 982 articles. Journals that published the most articles on MCI-related health behaviors included "Journal of Alzheimer's Disease," "Neurobiology of Aging," "Frontiers in Aging Neuroscience," and other geriatricsrelated journals. High-impact papers identified by VOSviewer predominantly cover concepts related to MCI, such as diagnostic criteria, assessment, and multifactorial interventions. Co-occurrence keyword analysis highlights five research hotspots in health behavior associated with MCI: exercise, diet, risk factors and preventive measures for dementia, cognitive decline-related biomarkers, and clinical trials. Conclusion: This study provides a comprehensive review of literature on health behavior in individuals with MCI, emphasizing influential documents and journals. It outlines research trends and key focal points, offering valuable insights for researchers to comprehend significant contributions and steer future studies. [ABSTRACT FROM AUTHOR]

Background: Racism in the healthcare system has become a burgeoning focus in health policy-making and research. Existing research has shown both interpersonal and structural forms of racism limiting access to quality healthcare for racialised healthcare users. Nevertheless, little is known about the specifics of racism in the inpatient sector, specifically hospitals and rehabilitation facilities. The aim of this scoping review is therefore to map the evidence on racial discrimination experienced by people receiving treatment in inpatient settings (hospitals and rehabilitation facilities) or their caregivers in high-income countries, focusing specifically on whether intersectional axes of discrimination have been taken into account when describing these experiences. Methods: Based on the conceptual framework developed by Arksey and O'Malley, this scoping review surveyed existing research on racism and racial discrimination in inpatient care in high-income countries published between 2013 and 2023. The software Rayyan was used to support the screening process while MAXQDA was used for thematic coding. Results: Forty-seven articles were included in this review. Specifics of the inpatient sector included different hospitalisation, admission and referral rates within and across hospitals; the threat of racial discrimination from other healthcare users; and the spatial segregation of healthcare users according to ethnic, religious or racialised criteria. While most articles described some interactions between race and other social categories in the sample composition, the framework of intersectionality was rarely considered explicitly during analysis. Discussion: While the USA continue to predominate in discussions, other high-income countries including Canada, Australia and the UK also examine racism in their own healthcare systems. Absent from the literature are studies from a wider range of European countries as well as of racialised and disadvantaged groups other than refugees or recent immigrants. Research in this area would also benefit from an engagement with approaches to intersectionality in public health to produce a more nuanced understanding of the interactions of racism with other axes of discrimination. As inpatient care exhibits a range of specific structures, future research and policy-making ought to consider these specifics to develop targeted interventions, including training for non-clinical staff and robust, transparent and accessible complaint procedures. [ABSTRACT FROM AUTHOR]

Background: Self-rated health (SRH) is a globally recognized measure of health status. Both impaired sleep (IS) and the presence of multimorbidity are related to poorer SRH, but the precise nature of these associations remains unclear. This study explored the association between IS, multimorbidity, and SRH among Canadian adults. Method: We used 2017-18 Canadian Community Health Survey (CCHS) data for this study. The main variable of interest, self-rated health (SRH), measured participants' health on a 5-point Likert scale, later categorized as "good or better" vs. "fair or poor". The primary predictor, IS, was derived from two variables and categorized into four groups: no sleep issues; fewer sleeping hours (<7 hours) only; trouble sleeping only; and fewer hours & trouble sleeping. Multimorbidity was present (yes/no) if a participant indicated being diagnosed with two or more chronic conditions. Results: Just over one in ten Canadians reported fair/poor SRH and approximately one-quarter had multimorbidity or experienced few sleep hours in combination with trouble sleeping. The adjusted model indicated greater odds of fair/poor SRH associated with the 40-64 years age group, male sex, and lower socio-economic status. It also suggested the presence of multimorbidity (AOR= 4.63, 95% CI: 4.06-5.28) and a combination of fewer sleep hours and troubled sleep (AOR= 4.05, 95% CI: 2.86-5.74) is responsible for poor SRH. Forty-four percent of the total effect of IS on SRH was mediated by multimorbidity. Conclusion: This unique finding highlights the mediating role of multimorbidity, emphasizing the importance of addressing it alongside sleep issues for optimal health outcomes. [ABSTRACT FROM AUTHOR]