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A survey of 357 final-year preservice teachers at a small Canadian university found that male and female participants did not differ in mathematics achievement or time elapsed since taking a mathematics course, but women had significantly greater mathematics anxiety and reported less positive beliefs about mathematics utility and more negative experiences with mathematics instruction in high school than men. (Contains 43 references.) (SV)

An Ontario study of 68 caregivers of persons with Alzheimer's disease revealed that those respondents living in more remote areas of northwestern Ontario expressed greater needs for information, education, and social support; experienced significantly more difficulties with morale; and employed coping strategies that reflected an inadequate social support system. Contains 31 references. (LP)

This paper reviews the cultural and historical context of mainstreaming students with disabilities in the United States and contrasts this with a proposed model for Canadian integration. Mainstreaming and integration are seen as reflecting different social dynamics and cultural traditions, and the administrative and research implications of the two models are discussed. (Author/JDD)

The Pediatric Endocrine Society (PES) was initially established in 1972 as the Lawson Wilkins Pediatric Endocrine Society (LWPES), by some of Wilkins' former fellows. As the society grew from its 37 founding members and Dr. Wilkins' influence faded, the name of the society was changed in 2010 and now counts about 1,500 members, mostly from the US and Canada. Pediatric endocrine training programs headed by (LW)PES members have welcomed fellows from throughout the world, many of whom have gone on to leadership positions in their home countries. Starting in 1981, the (LW)PES has collaborated with pediatric endocrine societies around the world in quadrennial meetings, fostering collaborations, transfer of ideas, devising joint practice guidelines, and enjoying one another's fellowship and counsel. The PES presently has committees and special interest groups concerned with all aspects of pediatric endocrinology, assuring that our clinical and academic resources reflect both breadth and depth. To celebrate our 50th anniversary, selected members have written the historical manuscripts featured in this special issue of Hormone Research in Pediatrics. These historical reviews delve into the origins of our specialty, sometimes deep into antiquity, provide useful background information, and illustrate the kinds of intellectual struggles that have led to the development of contemporary pediatric endocrinology, worldwide. [ABSTRACT FROM AUTHOR]

The terminal Mesoproterozoic was a period of widespread tectonic convergence globally, culminating in the amalgamation of the Rodinia supercontinent. However, in Laurentia, long-lived orogenesis on its eastern margin was punctuated by short-lived extension that generated the Midcontinent Rift ca. 1110-1090 Ma. Whereas this cratonic rift basin is typically considered an isolated occurrence, a series of new depositional ages demonstrate that multiple cratonic basins in northern Laurentia originated around this time. We present a Re-Os isochron date of 1087.1 ± 5.9 Ma from organic-rich shales of the Agu Bay Formation of the Fury and Hecla Basin, which is one of four closely spaced cratonic basins spanning from northeastern Canada to northwestern Greenland known as the Bylot basins. This age is identical, within uncertainty, to ages from the Midcontinent Rift and the Amundsen Basin in northwestern Canada. These ages imply that the late Mesoproterozoic extensional episode in Laurentia was widespread and likely linked to a common origin. We propose that significant thermal anomalies and mantle upwelling related to supercontinent assembly centered around the Midcontinent Rift influenced the reactivation of crustal weaknesses in Arctic Laurentia beginning ca. 1090 Ma, triggering the formation of a series of cratonic basins. [ABSTRACT FROM AUTHOR]

Background: The secondary fracture prevention gap in the osteoporosis field has been previously described as a 'crisis'. Closing this gap is increasingly important in the context of accumulating evidence showing that an incident fragility fracture is associated with an increased risk of subsequent fracture within 1-2 years, known as imminent fracture risk. The objective of this study was to use health services data to characterize the time between index fragility fractures occurring at different osteoporotic sites and subsequent fractures.Methods: This retrospective observational study used de-identified health services data from the publicly funded healthcare system in Ontario, the largest province of Canada. Patients aged > 65 with an index fragility fracture occurring between 2011 and 2015 were identified from the ICES Data Repository using International Classification of Diseases (ICD)-10 codes. We examined median time to subsequent fragility fractures for osteoporotic fracture sites until the end of follow-up (2017). BMD assessment and use of osteoporosis therapies following index fracture were also characterized.Results: Among 115,776 patients with an index fragility fracture, 17.8% incurred a second fragility fracture. Median time between index and second fracture occurring at any site was 555 days (interquartile range: 236-955). For each index fracture site examined, median time from index to second fracture was < 2 years. The proportion of patients with BMD assessment was 10.3% ≤1 year prior to and 16.4% ≤1 year post index fracture. The proportion of patients receiving osteoporosis therapy was 29.8% ≤1 year prior, 34.6% ≤1 year post, and 25.9% > 3 years post index fracture.Conclusions: This cohort of Canadian patients aged > 65 years who experienced a fragility fracture at any site are at imminent risk of experiencing subsequent fracture within the next 2 years and should be proactively assessed and treated. [ABSTRACT FROM AUTHOR]

The rise of animals occurred during an interval of Earth history that witnessed dynamic marine redox conditions, potentially rapid plate motions, and uniquely large perturbations to global biogeochemical cycles. The largest of these perturbations, the Shuram carbon isotope excursion, has been invoked as a driving mechanism for Ediacaran environmental change, possibly linked with evolutionary innovation or extinction. However, there are a number of controversies surrounding the Shuram, including its timing, duration, and role in the concomitant biological and biogeochemical upheavals. Here we present radioisotopic dates bracketing the Shuram on two separate paleocontinents; our results are consistent with a global and synchronous event between 574.0 ± 4.7 and 567.3 ± 3.0 Ma. These dates support the interpretation that the Shuram is a primary and synchronous event postdating the Gaskiers glaciation. In addition, our Re-Os ages suggest that the appearance of Ediacaran macrofossils in northwestern Canada is identical, within uncertainty, to similar macrofossils from the Conception Group of Newfoundland, highlighting the coeval appearance of macroscopic metazoans across two paleocontinents. Our temporal framework for the terminal Proterozoic is a critical step for testing hypotheses related to extreme carbon isotope excursions and their role in the evolution of complex life. [ABSTRACT FROM AUTHOR]

Thirty-seven kindergarten children were interviewed regarding their contact with, knowledge of, and beliefs about animals. Results provided support to the study's major hypothesis which states that young children's beliefs about animals would be egocentric and subjective. (Author/MP)

Copyright of Canadian Journal of Plant Science is the property of Canadian Science Publishing 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.)

The article discusses Nuu-chah-nulth whalers and whaling in Barkley Sound, British Columbia (B.C.), heavily referencing zooarchaeology and whalebone remains. An overview Nuu-chah-nulth's hunting of humpback and grey whales, including in regard to humpback whales' migrations to feed on herring, is provided.

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

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

Copyright of Canadian Journal of Animal Science is the property of Canadian Science Publishing 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.)

The article discusses the management of asthma in adults in Canada. It states that asthma remains the common chronic disease of young adults which can be initially treated by using low-dose inhaled corticosteroids. It notes that a combination therapy with long-acting ß2-agonists and a single inhaler corticosteroids is the best treatment choice. It suggests that patients with asthma must have a regular check-up with the doctor and proper inhaler technique should be reviewed.

The article presents information on a survey commissioned by the Canadian Consulate office in Buffalo, New York to study the impact of the Canada-U.S. border trade on those companies located within the Niagara Bi-National Region. A total of 225 companies from Canada and 236 from the U.S. agreed to participate. All 461 of these firms were either exporters or importers, or both. Eighty percent of these U.S. and Canadian firms were cither exporting or importing shipments worth less than 35 million in 2004. The survey found that security-related trade irritants are present across firms of all sizes.

Collaboration between anthropologists and the Canoe Creek and High Bar First Nations resulted in the excavation and identification of a radiocarbon-dated 5,000-year-old human burial, one of only six Middle Period burials now known from three Canadian Plateau sites. The burial appears to have been an isolated mortuary occurrence but with a pattern of body disposition similar to China Lake (EiRm-7) and Pritchard (EeQw-21). Osteological analysis indicated an elderly female (sex confirmed by molecular testing) with age-related pathological changes. A comprehensive comparative review of known Canadian Plateau human remains, included in this study, revealed an individual of relatively short stature with strongly developed upper limbs. Stable isotope analysis (carbon and nitrogen) pointed to a predominantly terrestrial diet likely based on hunting, with a moderate intake of marine protein, presumably salmon. Testing for mitochondrial DNA indicated haplogroup A, which is widespread in living Native Americans. Comparative mtDNA data suggest long-standing genetic continuity in the pacific Northwest, but with evidence for a genetically diverse population in existence at 5000 BP. [ABSTRACT FROM AUTHOR]

The continental scaup population (Lesser [Aythya affinis] and Greater [A. marila] combined) has declined markedly since 1978. One hypothesis for the population decline states that reproductive success has decreased because female scaup are arriving on breeding areas in poorer body condition than they did historically (i.e. spring condition hypothesis). We tested one aspect of that hypothesis by comparing body mass and nutrient reserves (lipid, protein, and mineral) of Lesser Scaup at four locations (Louisiana, Illinois, Minnesota, and Manitoba) between the 1980s and 2000s. We found that mean body mass and lipid and mineral reserves of females were 80.0, 52.5, and 3.0 g higher, respectively, in the 2000s than in the 1980s in Louisiana; similarly, body mass and lipid and mineral reserves of males were 108.8, 72.5, and 2.5 g higher, respectively. In Illinois, mean body mass and lipid reserves of females were 88.6 and 56.5 g higher, respectively, in the 2000s than in the 1980s; similarly, body mass and lipid and mineral reserves of males were 80.6, 76.0, and 2.7 g higher, respectively. Mean body mass of females were 58.5 and 58.9 g lower in the 2000s than in the 1980s in Minnesota and Manitoba, respectively; mean body mass of males, similarly, were 40.7 g lower in Minnesota. Mean lipid reserves of females in the 2000s were 28.8 and 27.8 g lower than those in the 1980s in Minnesota and Manitoba, respectively. Mean mineral reserves of females in the 2000s were 3.2 g lower than those in the 1980s in Manitoba. Consequently, females arriving to breed in Manitoba in the 2000s had accumulated lipid reserves for 4.1 fewer eggs and mineral reserves for 0.8 fewer eggs than those arriving to breed there in the 1980s. Accordingly, our results are consistent with the spring condition hypothesis and suggest that female body condition has declined, as reflected by decreases in body mass, lipids, and mineral reserves that could cause reductions in reproductive success and ultimate... [ABSTRACT FROM AUTHOR]

This paper examines the export characteristics of Canadian firms in the commercial geographic information systems (GIS) industry. Evidence from a sample of 351 Canadian GIS companies suggests that export success correlates positively with a wide range of organizational variables, including R&D spending, external collaboration (alliances with complementary firms), recourse to government support systems, and occupational structure (in-house technical skills). A notable finding is that company size plays no discernible role in export performance. If anything, very small firms exhibit better export performance than their larger counterparts. A further finding is that some of the strongest predictors of export involvement pertain to the extent to which GIS firms exploit government programs and/or other public initiatives in areas that relate to foreign sales development. A regression analysis based on predictor variables from a two-group discriminant model (exporters versus non-exporters) reveals that export success is strongly influenced by in-house research effort, foreign travel, external collaboration, and product customization. [ABSTRACT FROM AUTHOR]

Since 1999, use of electronic calls has been legal for hunting lesser snow geese (Chen caerulescens caerulescens; hereafter snow geese) during special seasons or times of day when other waterfowl species could not be hunted in prairie Canada. Prior to expanding the use of electronic calls for hunting snow geese during fall hunting seasons, effects of these calls on nontarget goose species must be examined. Accordingly, we examined the vulnerability of Canada (Branta canadensis) and white-fronted geese (Anser albifrons) (dark geese) to electronic snow goose calls and 3 goose decoy sets (dark, mixed, and white) during the 1999 fall hunting seasons in Manitoba and Saskatchewan. Canada geese were 2.3 times more likely to fly within gun range (P<0.001) and the mean. number killed/hour/hunter was 2.5 times greater (P=0.043) during control periods when hunters were silent or used traditional calling methods (i.e., hand-held and voice calls) than when hunters used electronic snow goose calls. Flock response and kill rate for Canada geese declined as proportions of white decoys increased in decoy sets (P<0.001). White-fronted geese were 1.8 times more likely to fly within gun range (P=0.050) and the mean number killed/hour/hunter was 5.0 times greater (P=0.022) during control periods than during periods when electronic snow goose calls were used. Flock response for white-fronted geese also declined as the proportion of white decoys increased in decoy sets (P<0.001). The legalization of electronic snow goose calls during fall hunting seasons in prairie Canada should not result in increased harvest of nontarget dark geese. [ABSTRACT FROM AUTHOR]

Our objective was to determine the availability and utilization of urodynamic investigations by gynecologists in the preoperative evaluation of women with urinary incontinence. Gynecologists in the UK, USA, Australia, New Zealand and Canada were asked what urodynamic investigations were required for four clinical scenarios. Analysis was restricted to frequent operators. Urodynamic investigations were available to 70% of frequent operators. For uncomplicated stress incontinence, cystometry was utilized by 72% of subspecialists and 44% of generalists ( P<0.001) who had access to urodynamic investigations. For stress incontinence and straining to void, uroflowmetry was utilized by 73% of subspecialists and 46% of generalists ( P<0.001) who had access to urodynamic investigations. We concluded that many gynecologists who frequently operate for female urinary incontinence do not have access to urodynamic investigations or do not utilize urodynamic investigations, or utilize investigations in a way that may be inadequate for the clinical problem. There are differences in utilization between subspecialists and generalists that are not explained by access. These observations could be explained by poor understanding or a lack of belief in the value of urodynamic investigations. [ABSTRACT FROM AUTHOR]

The article presents the author's opinion on the alleged existence of racial profiling at the Toronto Police Services. In any event, racial profiling is thus the profiling based upon one characteristic: race. The two important factors that come out of this analysis of racial profiling are that the phenomenon must involve police decision making based upon race and that the police activity involved is aimed at identifying criminals. If police activity is stepped-up in response to community concerns about local drug pushers or local speeders and that community is economically disadvantaged and is more heavily populated with visible minorities, the statistics will be skewed towards more police-minority interactions. In other words, good science demands that researchers carefully distinguish between situations in which the police are using race and where they are finding race. The principal defect in the newspaper Toronto Star's approach is that it assumed the validity of the data collection and the appropriateness of the data's use for its purposes. The point is that statistical disparity--even if it truly existed--is relatively meaningless and in now way justifies the leap to claims of racial profiling against a police force expressly committed to intolerance of any racial bigotry.

Presents archaeological insights into the antiquity, species preferences and cultural importance of whales to the aboriginal Nuu-chah-nulth (Nootkan) of Barkley Sound, British Columbia. Archaeological sites in Nuu-chah-nulth, Dididaht and Makah territories; Evidences suggesting the antiquity of whale use and whale hunting; Implications of settlement pattern and social system on whale species exploited by Nootka Indians.

Examines the issue of optimal tariffs for a small economy trading with a large economy in Canada. Framework of the study; Inability of small countries to affect world prices; Effect of the non-zero trade tax pre-commitment of small countries to the optimal trade tax of large countries.

ABSTRACT This paper examines the competitive characteristics of small and medium-sized manufacturing firms (SMFs) in a Canada-U.S. cross-border region (the Niagara Frontier). Particular attention is given to the innovation and business performance of comparably-sized firms on both sides of the border. The results of two firm-level surveys are presented. A comparative analysis of the two groups suggests that Canadian SMFs exhibit significantly stronger export and innovation performance than their U.S. counterparts. The results also suggest that U.S. firms face tougher competitive difficulties arising from specific national and regional circumstances, including shortages of skilled labor, higher corporate tax rates, rising import competition, and a more complex regulatory environment. The implications of the empirical results are discussed in the context of policy options for regional economic development in crossborder zones such as the Niagara Frontier [ABSTRACT FROM AUTHOR]

Examines the comparison of Ross' Geese and Lesser Snow Geese nests in Karrak Lake, Northwest Territories, Canada. Reference to the design of the Ross' Geese's nest; Information on the effect the design of the nests have on embryonic development; Indepth look at the differences in the nests.

Animal Care Committees (ACCs) at Canadian universities and research centers operate under the aegis of the Canadian Council on Animal Care (CCAC) and its guidelines for the humane care and treatment of animals in teaching, research, and testing. All Canadian universities have at least one active committee. The committees are expected to assume an educative role beyond the provision of information concerning housing, maintenance, and appropriate conditions for the treatment of animals in research. This includes critical examination of the serious ethical issues involved in animal research within the context of the principles and practices endorsed by the CCAC. One-day animal care courses provided by ACCs at three Canadian universities are described. Comparisons are made between the content and structure of curricula and the ways these relate to the teaching and research mandate in each institution, focusing particularly on the teaching of ethics in each course. The implications for heightening awareness of ethical issues in animal research and improving the effectiveness of these courses are discussed. [ABSTRACT FROM AUTHOR]

The article examines the use of a critical care outreach or medical emergency team (MET) in Canada. The aims of a MET is for the early recognition of a deteriorating patient and the subsequent response and evaluation by a designated team with the necessary expertise, experience and resources. The duration of MET implementation and control periods may vary, as well as the daily availability of the team. The members of the team may include nurses and junior doctors.

Simple Summary: Canadian grasslands are recognized for providing high quality forage for grazing livestock and wildlife. The study was conducted on a re-established pasture in a Western Canadian semi-arid climate to investigate the effect of pasture species mixture and grazing management on pasture productivity, animal performance, and soil carbon sequestration. Pasture productivity and animal response were independent of pasture mixture but affected by grazing management. Average pasture dry matter productivity was greater with deferred-rotational grazing while pasture quality and animal gain were higher with continuous grazing. Soil carbon change varied with pasture seed mixture and grazing management interaction where pasture with 7-species mixture under continuous grazing had the lowest soil carbon gain. The objective of the study was to determine the effect of type of pasture mix and grazing management on pasture productivity, animal response and soil organic carbon (SOC) level. Pasture was established in 2001 on 16 paddocks of 2.1 ha that had been primarily in wheat and summer fallow. Treatments consisted of a completely randomized experimental design with two replicates: two pasture mixes (7-species (7-mix) and 12-species (12-mix)) and two grazing systems (continuous grazing (CG) and deferred-rotational grazing (DRG)). Pasture was stocked with commercial yearling Angus steers (Bos Taurus, 354 ± 13 kg) between 2005 and 2014. All pastures were grazed to an average utilization rate of 50% (40% to 60%). Average peak and pre-grazing pasture dry matter (DM) yield and animal response were independent of pasture seed mixture but varied with grazing management and production year. Average peak DM yield was 26.4% higher (p = 0.0003) for pasture under DRG relative to CG (1301 kg ha−1). However, total digestible nutrient for pasture under DRG was 4% lower (p < 0.0001) as compared to CG (60.2%). Average daily weight gain was 18% higher (p = 0.017) for CG than DRG (0.81 kg d−1), likely related to higher pasture quality under CG. Soil carbon sequestration was affected by seed mixture × grazing system interaction (p ≤ 0.004). Over the fourteen years of production, pasture with 7-mix under CG had the lowest (p < 0.01) average SOC stock at 15 cm (24.5 Mg ha−1) and 30 cm depth (42.3 Mg ha−1). Overall, the results from our study implied that increasing species diversity for pasture managed under CG may increase SOC gain while improving animal productivity. [ABSTRACT FROM AUTHOR]

• Olivine, opx, cpx, and garnet from peridotite xenoliths contain 2 – 224 ppm H 2 O. • Metasomatism by kimberlitic melt that evolved during ascent through the lithosphere. • Xenoliths with high H in olivine preferentially sampled kimberlite travel zones. Whether hydrogen incorporated in nominally anhydrous mantle minerals plays a role in the strength and longevity of the thick cratonic lithosphere is a matter of debate. In particular, the percolation of hydrogen-bearing melts and fluids could potentially add hydrogen to the mantle lithosphere, weaken its olivines (the dominant mineral in mantle peridotite), and cause delamination of the lithosphere's base. The influence of metasomatism on hydrogen contents of cratonic mantle minerals can be tested in mantle xenoliths from the Slave Craton (Canada) because they show extensive evidence for metasomatism of a layered cratonic mantle. Minerals from mantle xenoliths from the Diavik mine in the Lac de Gras kimberlite area located at the center of the Archean Slave craton were analyzed by FTIR for hydrogen contents. The 18 peridotites, two pyroxenites, one websterite and one wehrlite span an equilibration pressure range from 3.1 to 6.6 GPa and include samples from the shallow (≤145 km), oxidized ultra-depleted layer; the deeper (∼145–180 km), reduced less depleted layer; and an ultra-deep (≥180 km) layer near the base of the lithosphere. Olivine, orthopyroxene, clinopyroxene and garnet from peridotites contain 30–145, 110–225, 105–285, 2–105 ppm H 2 O, respectively. Within each deep and ultra-deep layer, correlations of hydrogen contents in minerals and tracers of metasomatism (for example light over heavy rare-earth-element ratio (LREE/HREE), high-field-strength-element (HFSE) content with equilibration pressure) can be explained by a chromatographic process occurring during the percolation of kimberlite-like melts through garnet peridotite. The hydrogen content of peridotite minerals is controlled by the compositions of the evolving melt and of the minerals and by mineral/melt partition coefficients. At the beginning of the process, clinopyroxene scavenges most of the hydrogen and garnet most of the HFSE. As the melt evolves and becomes enriched in hydrogen and LREE, olivine and garnet start to incorporate hydrogen and pyroxenes become enriched in LREE. The hydrogen content of peridotite increases with decreasing depth, overall (e.g., from 75 to 138 ppm H 2 O in the deep peridotites). Effective viscosity calculated using olivine hydrogen content for the deepest xenoliths near the lithosphere-asthenosphere boundary overlaps with estimates of asthenospheric viscosities. These xenoliths cannot be representative of the overall cratonic root because the lack of viscosity contrast would have caused basal erosion of lithosphere. Instead, metasomatism must be confined in narrow zones channeling kimberlite melts through the lithosphere and from where xenoliths are preferentially sampled. Such localized metasomatism by hydrogen-bearing melts therefore does not necessarily result in delamination of the cratonic root. [ABSTRACT FROM AUTHOR]

In order to examine the relationship between linguistic background and nonverbal intelligence, two groups of Canadian native children, one bilingual and the other monolingual, were administered tests of verbal ability and nonverbal intelligence. The bilingual group was found superior on a test of nonverbal intelligence, however, no difference was obtained between the groups with respect to English vocabulary level. The results are interpreted as showing general support for a transfer-accretion model for the development of intelligence and abilities [ABSTRACT FROM AUTHOR]

Focuses on the use of Archean Slave craton for investigating lithosphere formation and evolution in northwestern Canada. Result of the deep probing magnetotelluric survey; Conduction of a tectonic process; Discovery of economic diamondiferous kimberlite pipes.

Aims: To estimate the rate of non-vitamin K oral anticoagulant (NOAC) dosing that is lower- and higher-than-recommended and to describe the reasons for NOAC dose discordance with Health Canada prescribing information., Methods: The OPTIMAL AF Programme was an observational cohort quality assessment initiative in which primary and specialty care physicians in eight provinces provided a snapshot of their anticoagulated non-valvular atrial fibrillation (NVAF) patients through either an electronic medical record (EMR) system or standardised, paper-based data collection methods., Results: Data on 1681 NVAF patients receiving oral anticoagulation (OAC) for stroke prevention was provided by 102 physicians. A NOAC was prescribed in 1379 patients (8%). The standard recommended dose was prescribed in 849 (76%) and reduced dose in 264 (24%). Concordance of the reduced dose with Health Canada prescribing information occurred in 154 patients (58%). The standard dose was concordant in 805 (95%). The main reasons for the use of discordant reduced doses were age of 80 years or more, elevated creatinine, prior bleeding or dose recommended by specialist., Discussion and Conclusion: The vast majority of Canadian patients meeting the Canadian Cardiovascular Society (CCS) guideline recommendations for OAC to decrease AF-related stroke risk were receiving product monograph-concordant NOAC dosing (85%). Nonetheless, this highlights the fact that an important proportion of patients were prescribed doses that are discordant and opportunities remain to improve NOAC dosing to optimise stroke prevention., (© 2020 John Wiley & Sons Ltd.)

Hypertension Canada's 2020 guidelines for the prevention, diagnosis, risk assessment, and treatment of hypertension in adults and children provide comprehensive, evidence-based guidance for health care professionals and patients. Hypertension Canada develops the guidelines using rigourous methodology, carefully mitigating the risk of bias in our process. All draft recommendations undergo critical review by expert methodologists without conflict to ensure quality. Our guideline panel is diverse, including multiple health professional groups (nurses, pharmacy, academics, and physicians), and worked in concert with experts in primary care and implementation to ensure optimal usability. The 2020 guidelines include new guidance on the management of resistant hypertension and the management of hypertension in women planning pregnancy., (Copyright © 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

Objectives: To assess the policy utility of national cause of death (COD) data of six high-income countries with highly developed health information systems., Methods: National COD data sets from Australia, Canada, Denmark, Germany, Japan and Switzerland for 2015 or 2016 were assessed by applying the ANACONDA software tool. Levels, patterns and distributions of unusable and insufficiently specified "garbage" codes were analysed., Results: The average proportion of unusable COD was 18% across the six countries, ranging from 14% in Australia and Canada to 25% in Japan. Insufficiently specified codes accounted for a further 8% of deaths, on average, varying from 6% in Switzerland to 11% in Japan. The most commonly used garbage codes were Other ill-defined and unspecified deaths (R99), Heart failure (I50.9) and Senility (R54)., Conclusions: COD certification errors are common, even in countries with very advanced health information systems, greatly reducing the policy value of mortality data. All countries should routinely provide certification training for hospital interns and raise awareness among doctors of their public health responsibility to certify deaths correctly and usefully for public health policy.

Background: In non-endemic countries, malaria risk is addressed by selectively testing or deferring at-risk donors. These policy decisions were made using a variety of decision-making frameworks prior to the development of the Alliance of Blood Operators Risk Based Decision-Making Framework. It is unclear whether the range of items assessed in the decision-making process would be increased if the Framework were used. We compared assessments considered in France, England and Australia for decisions to implement selective testing, plus donor selection criteria (Canada and the USA included) with those recommended by the Framework., Materials and Methods: Elements of the Framework were identified: the intervention, safety threat, availability threat, donor impact, financial implications, risk communication, stakeholder and regulatory aspects. Decisions about selective testing and donor selection criteria were analysed separately. Assessments were compared against elements of the Framework and the level of concern for considerations rated., Results: Sufficiency of the blood supply (plus safety in France) were the drivers for selective testing; main trade-offs were high operational impact and cost. In three donor criteria examples, transfusion-transmitted malaria cases prompted the change. Social concerns were high in France and Australia, political/regulatory concerns influenced decisions in France, Australia and Canada, while sufficiency was a consideration in Canada and the USA. Decision trade-offs involved moderate operational impact., Discussion: The assessments considered in each country were generally consistent with the assessments recommended by the Framework. When data supported quantified risk assessment, safety and operational feasibility had the greatest weight. When risk was not well defined, contextual factors such as social and political concern had greater weight.

Background: Physicians treating nonvalvular atrial fibrillation (AF) assess stroke and bleeding risks when deciding on anticoagulation. The agreement between empirical and physician-estimated risks is unclear. Furthermore, the association between patient and physician sex and anticoagulation decision-making is uncertain., Methods: We pooled data from 2 national primary care physician chart audit databases of patients with AF (Facilitating Review and Education to Optimize Stroke Prevention in Atrial Fibrillation and Coordinated National Network to Engage Physicians in the Care and Treatment of Patients with Atrial Fibrillation Chart Audit) with a combined 1035 physicians (133 female, 902 male) and 10,927 patients (4567 female and 6360 male)., Results: Male physicians underestimated stroke risk in female patients and overestimated risk in male patients. Female physicians estimated stroke risk well in female patients but underestimated the risk in male patients. Risk of bleeding was underestimated in all. Despite differences in risk assessment by physician and patient sex, > 90% of patients received anticoagulation across all subgroups. There was modest agreement between physician estimated and calculated (ie, CHADS 2 score) stroke risk: Kappa scores were 0.41 (0.35-0.47) for female physicians and 0.34 (0.32-0.36) for male physicians., Conclusions: Our study is the first to examine the association between patient and physician sex influences and stroke and bleeding risk estimation in AF. Although there were differences in agreement between physician estimated stroke risk and calculated CHADS 2 scores, these differences were small and unlikely to affect clinical practice; further, despite any perceived differences in the accuracy of risk assessment by sex, most patients received anticoagulation., (Copyright © 2018 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

This national chart audit of 7,019 patients with nonvalvular atrial fibrillation (AF) from 735 primary care physician practices sought to examine the management of Canadian patients with AF through an evidence-based, guideline-recommended approach. The appropriate use of oral anticoagulants (OACs) in this patient population and the potential factors guiding OAC choice were examined. Suboptimal dosing was seen. In patients on warfarin, 30.9% had not achieved a time in therapeutic range (TTR) in excess of 65% and, despite current Canadian guideline recommendations, were continued on warfarin rather than one of the novel OACs. In patients who received no antithrombotic therapy, 65.5% met criteria for treatment with an OAC. In addition, 62.8% of patients who were treated with acetylsalicylic acid monotherapy met guideline criteria for the use of an OAC. In those patients treated with an OAC, 24.8% were not on the recommended dose based on the product monograph or, if on warfarin, had a TTR <65%. Of the patients on novel OACs (NOACs), 7.4% of patients were underdosed, whereas overdosing was seen in 4.3%. Factors that may have contributed to dosing outside recommendations included underestimation of stroke risk, overestimation of bleed risk, compliance concerns, and lack of provincial reimbursement. In conclusion, significant correctable gaps remain in optimal treatment for stroke prevention in AF., (Copyright © 2016 Elsevier Inc. All rights reserved.)

The objectives of this national chart audit (January to June 2013) of 6,346 patients with atrial fibrillation (AF; ≥18 years without a significant heart valve disorder) from 647 primary care physicians were to (1) describe the frequency of stroke and bleed risk assessments in patients with nonvalvular AF by primary care physicians, including the accuracy of these assessments relative to established predictive indexes; (2) outline contemporary methods of anticoagulation used; and (3) report the time in the therapeutic range among patients prescribed warfarin. An annual stroke risk assessment was not undertaken in 15% and estimated without a formal risk tool in 33%; agreement with CHADS2 score estimation was seen in 87% of patients. Major bleeding risk assessment was not undertaken in 25% and estimated without a formal risk tool in 47%; agreement with HAS-BLED score estimation was observed in 64% with physician overestimation in 26% of patients. Antithrombotic therapy included warfarin (58%), dabigatran (22%), rivaroxaban (14%), and apixaban (<1%). Among warfarin-treated patients, the median international normalized ratio was 2.4 and time in therapeutic range (TTR) was 73%; however, the TTR was <50% in 845 (25%), 50% to 69% in 674 (20%), and ≥70% in 1,827 (55%) patients. In conclusion, we describe a contemporary real-world elderly population with AF at important risk for stroke. There is apparent overestimation of bleeding risk in many patients. Warfarin was the dominant stroke prevention treatment; however, the suggested TTR target was achieved in only 55% of these patients., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Antiplatelet agents are a cornerstone of therapy for patients with atherosclerotic vascular disease. There is presently a lack of comprehensive guidelines focusing on the use of antiplatelet drugs in patients currently manifesting or at elevated risk of cardiovascular disease. The Canadian Antiplatelet Therapy Guidelines Committee reviewed existing disease-based guidelines and subsequently published literature and used expert opinion and review to develop guidelines on the use of antiplatelet therapy in the outpatient setting. This full document has been summarized in an Executive Summary published in the Canadian Journal of Cardiology and may be found at http://www.ccs.ca/. Antiplatelet therapy appears to be generally underused, perhaps in part because of a lack of clear, evidence-based guidance. Here, we provide specific guidelines for secondary prevention in patients discharged from hospital following acute coronary syndromes, post-percutaneous coronary intervention, post-coronary artery bypass grafting, patients with a history of transient cerebral ischemic events or strokes, and patients with peripheral arterial disease. Issues related to primary prevention are also addressed, in addition to special clinical contexts such as diabetes, heart failure, chronic kidney disease, pregnancy/lactation, and perioperative management. Recommendations are provided regarding pharmacologic interactions that may occur during combination therapy with warfarin, clopidogrel and proton-pump inhibitors, or acetylsalicylic acid and nonsteroidal anti-inflammatory drugs, as well as for the management of bleeding complications., (Copyright © 2011. Published by Elsevier Inc.)

Background: IgE-mediated peanut allergy is a complex trait with strong heritability, but its genetic basis is currently unknown. Loss-of-function mutations within the filaggrin gene are associated with atopic dermatitis and other atopic diseases; therefore, filaggrin is a candidate gene in the etiology of peanut allergy., Objective: To investigate the association between filaggrin loss-of-function mutations and peanut allergy., Methods: Case-control study of 71 English, Dutch, and Irish oral food challenge-positive patients with peanut allergy and 1000 non peanut-sensitized English population controls. Replication was tested in 390 white Canadian patients with peanut allergy (defined by food challenge, or clinical history and skin prick test wheal to peanut ≥ 8 mm and/or peanut-specific IgE ≥ 15 kUL(-1)) and 891 white Canadian population controls. The most prevalent filaggrin loss-of-function mutations were assayed in each population: R501X and 2282del4 in the Europeans, and R501X, 2282del4, R2447X, and S3247X in the Canadians. The Fisher exact test and logistic regression were used to test for association; covariate analysis controlled for coexistent atopic dermatitis., Results: Filaggrin loss-of-function mutations showed a strong and significant association with peanut allergy in the food challenge-positive patients (P = 3.0 × 10(-6); odds ratio, 5.3; 95% CI, 2.8-10.2), and this association was replicated in the Canadian study (P = 5.4 × 10(-5); odds ratio, 1.9; 95% CI, 1.4-2.6). The association of filaggrin mutations with peanut allergy remains significant (P = .0008) after controlling for coexistent atopic dermatitis., Conclusion: Filaggrin mutations represent a significant risk factor for IgE-mediated peanut allergy, indicating a role for epithelial barrier dysfunction in the pathogenesis of this disease., (Copyright © 2011 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.)

Background: Preterm birth is the leading cause of perinatal morbidity and mortality. Risk factors for preterm birth include a personal or familial history of preterm delivery, ethnicity and low socioeconomic status yet the ability to predict preterm delivery before the onset of preterm labour evades clinical practice. Evidence suggests that genetics may play a role in the multi-factorial pathophysiology of preterm birth. The All Our Babies Study is an on-going community based longitudinal cohort study that was designed to establish a cohort of women to investigate how a women's genetics and environment contribute to the pathophysiology of preterm birth. Specifically this study will examine the predictive potential of maternal leukocytes for predicting preterm birth in non-labouring women through the examination of gene expression profiles and gene-environment interactions., Methods/design: Collaborations have been established between clinical lab services, the provincial health service provider and researchers to create an interdisciplinary study design for the All Our Babies Study. A birth cohort of 2000 women has been established to address this research question. Women provide informed consent for blood sample collection, linkage to medical records and complete questionnaires related to prenatal health, service utilization, social support, emotional and physical health, demographics, and breast and infant feeding. Maternal blood samples are collected in PAXgene™ RNA tubes between 18-22 and 28-32 weeks gestation for transcriptomic analyses., Discussion: The All Our Babies Study is an example of how investment in clinical-academic-community partnerships can improve research efficiency and accelerate the recruitment and data collection phases of a study. Establishing these partnerships during the study design phase and maintaining these relationships through the duration of the study provides the unique opportunity to investigate the multi-causal factors of preterm birth. The overall All Our Babies Study results can potentially lead to healthier pregnancies, mothers, infants and children.

Environmental investigations have been conducted at 23 military firing ranges in the United States and Canada. The specific training facilities most frequently evaluated were hand grenade, antitank rocket, and artillery ranges. Energetic compounds (explosives and propellants) were determined and linked to the type of munition used and the major mechanisms of deposition.