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This paper reports the findings of a Canada based multi-institutional study designed to investigate the relationships between admissions criteria, in-program assessments, and performance on licensing exams. The study's objective is to provide valuable insights for improving educational practices across different institutions. Data were gathered from six medical schools: McMaster University, the Northern Ontario School of Medicine University, Queen's University, University of Ottawa, University of Toronto, and Western University. The dataset includes graduates who undertook the Medical Council of Canada Qualifying Examination Part 1 (MCCQE1) between 2015 and 2017. The data were categorized into five distinct sections: demographic information as well as four matrices: admissions, course performance, objective structured clinical examination (OSCE), and clerkship performance. Common and unique variables were identified through an extensive consensus-building process. Hierarchical linear regression and a manual stepwise variable selection approach were used for analysis. Analyses were performed on data set encompassing graduates of all six medical schools as well as on individual data sets from each school. For the combined data set the final model estimated 32% of the variance in performance on licensing exams, highlighting variables such as Age at Admission, Sex, Biomedical Knowledge, the first post-clerkship OSCE, and a clerkship theta score. Individual school analysis explained 41-60% of the variance in MCCQE1 outcomes, with comparable variables to the analysis from of the combined data set identified as significant independent variables. Therefore, strongly emphasising the need for variety of high-quality assessment on the educational continuum. This study underscores the importance of sharing data to enable educational insights. This study also had its challenges when it came to the access and aggregation of data. As such we advocate for the establishment of a common framework for multi-institutional educational research, facilitating studies and evaluations across diverse institutions. This study demonstrates the scientific potential of collaborative data analysis in enhancing educational outcomes. It offers a deeper understanding of the factors influencing performance on licensure exams and emphasizes the need for addressing data gaps to advance multi-institutional research for educational improvements.

There is an expectation that health professions schools respond to priority societal health needs. This expectation is largely based on the underlying assumption that schools are aware of the priority needs in their communities. This paper demonstrates how open-access, pan-national health data can be used to create a reliable health index to assist schools in identifying societal needs and advance social accountability in health professions education. Using open-access data, a psychometric evaluation was conducted to examine the reliability and validity of the Canadian Health Indicators Framework (CHIF) conceptual model. A non-linear confirmatory factor analysis (CFA) on 67 health indicators, at the health-region level (n = 97) was used to assess the model fit of the hypothesized 10-factor model. Reliability analysis using McDonald's Omega were conducted, followed by Pearson's correlation coefficients. Findings from the non-linear CFA rejected the original conceptual model structure of the CHIF. Exploratory post hoc analyses were conducted using modification indices and parameter constraints to improve model fit. A final 5-factor multidimensional model demonstrated superior fit, reducing the number of indicators from 67 to 32. The 5-factors included: Health Conditions (8-indicators); Health Functions (6-indicators); Deaths (5-indicators); Non-Medical Health Determinants (7-indicators); and Community & Health System Characteristics (6-indicators). All factor loadings were statistically significant (p < 0.001) and demonstrated excellent internal consistency ([omega]>0.95). Many schools struggle to identify and measure socially accountable outcomes. The process highlighted in this paper and the indices developed serve as starting points to allow schools to leverage open-access data as an initial step in identifying societal needs.

Background: Although the Canadian Consensus Guidelines for Primary Care of Adults with Intellectual and Developmental Disabilities recommends conducting periodic health checks in primary care, uptake is lacking. This study seeks to understand factors influencing the conduct of periodic health checks and identify what needs to change to increase them. Method: Qualitative data from five stakeholder groups (adults with intellectual and developmental disabilities, primary care providers, administrative staff, family, disability support workers) was guided by the Behaviour Change Wheel and the Theoretical Domains Framework to identify barriers and 'what needs to change' to support periodic health checks. Results: Stakeholders (n = 41) voiced multiple barriers. A total of 31 common and 2 unique themes were identified plus 33 items 'needing to change'. Conclusion: Despite barriers, stakeholders saw merit in periodic health checks as a preventative and equitable healthcare offering for adults with intellectual and developmental disabilities. Results will inform future intervention development steps.

This research examines the impact of the biographies of generalist elementary school pre-service teachers (PSTs) on their experiences of Canadian physical education teacher education (PETE), and how these biographies shape self-confidence and self-perceived competence as physical educators. The phenomenological case study took place in a Canadian university faculty of education involving 112 PSTs taking a mandatory 36 h methods course in PETE. Research indicates that the majority of elementary school physical education (PE) classes in Canada are taught predominantly by non-specialist classroom teachers (Fletcher & Mandigo, 2013. The primary schoolteacher and physical education: a review of research and implications for Irish physical education. "Irish Educational Studies," 31(3), 363-376. doi:10.1080/03323315.2012.710063; Freak & Miller, 2017. Magnifying pre-service generalist teachers' perceptions of preparedness to teach primary school physical education. "Physical Education and Sport Pedagogy," 22(1), 51-70. doi:10.1080/17408989.2015.1112775; Fletcher, Mandigo & Kosnik, 2013. Elementary classroom teachers and physical education change in teacher-related factors during pre-service teacher education. Physical Education and Sport Pedagogy, 18(2), 169-183. doi:10.1080/17408989.2011.649723). While generalist teachers may be required to teach PE, they often cite negative attitudes towards the subject based on their past personal experiences as students. These biographies can have a significant impact on how beginning PE teachers approach practice (Hyndman, B. P., & Pill, S.; (2016). The Influences on Teaching Perspectives of Australian Physical Education Teacher Education Students: The First-Year Influences on Teaching Perspectives Exploratory (FIT-PE) Study. "Australian Journal of Teacher Education," 41(5), 99-118. doi:10.14221/ajte.2016v41n5.7; Hyndman, B. P. (2017). Perceived social-ecological barriers of generalist pre-service teachers towards teaching physical education: Findings from the GET-PE study. "Australian Journal of Teacher Education," 42(7), 26-46. doi:10.14221/ajte.2017v42n7.3; Wrench, A. (2017). Spaces and physical education pre-service teachers' narrative identities. "Sport, Education and Society," 22(7), 825-838. doi:10.1080/13573322.2015.1094046; Ladwig et al, 2018). Results indicated that PSTs who had negative experiences in PE also stated that they had significant fear in teaching PE, while PSTs who had positive past experiences indicated that they had greater self-confidence and self-perceived competence. Findings indicated that a non-competitive, inclusive pedagogical approach had a positive effect on supporting PSTs to develop greater self-confidence and self-perceived competence.

In 2020, the global number of refugees reached record levels, pressuring asylum countries to determine more effective methods for facilitating integration. This article explores an array of stakeholder practices towards refugees in Surrey and Greater Vancouver, Canada. It is based on questionnaires and interviews that elicit the perceptions and struggles of 40 settlement workers, health and mental health professionals, Members of Parliament, educators, librarians, scholars and grassroots organisations, who work with refugees. The findings show that stakeholders often feel isolated, 'working in silos' and wasting time and money due to uncoordinated services and a lack of interagency communication. They feel it is also unreasonable to expect Government-Assisted Refugees (GARs) to learn English and complete job training in preparation for independent living within 1 year of support. Both refugee adults and children suffer from high levels of trauma, often compounded by interrupted or no schooling. Since education is essential to refugee success, I argue that teachers play a role in filling the gap, often uniquely positioned to form ongoing, safe and trusting relationships with refugee students and their families. For many teachers, it is an ethos of care, compassion and social justice acquired in teacher education programmes that increases refugee resilience, sense of belonging and wellbeing. This article identifies what new collaborations between teachers and other stakeholders might accomplish, including communication back to government policymakers. Recommendations encompass initiating online registries of services and low-cost housing in neighbourhoods where community schools and services are interlinked, possibly achieving holistic care for all refugees.

Drawing on a review of international higher education (IHE) policies, priorities, and literature from the USA, Canada, Australia, and the UK over the course of a 16-year period (2000-2016), this article identifies a strong scholarly and policy preoccupation with the urgency of the global knowledge economy and cognate discourses of 'Asia Pacific century', an emerging economic and geopolitical configuration that is considered threatening to the historic and ideological Western superiority in IHE relations. As such, the export commodification and transnationalization of higher education of the last decade is conceptualized as Western responses to an increasingly Asia-driven global economic order. This, we suggest, is an analytical lens which approaches time--as in knowledge economic time--and space--as in the West and Asia--in rather absolute, contained, and hierarchized terms, overlooking how both the West's coming to terms with postcolonial Asia, and the postcolonial Asian states' desire for Western knowledge and modernity re-cast broader transnational inequities established by colonial practices. In contrast, the concept of 'spacetime entanglement' is proposed to develop a necessary analysis as well as a critique of the transnationalization of capitalist colonial relations via discourses and practices of contemporary IHE.

Purpose: Domestic abuse (e.g., family violence) occurs globally and increases the risk for lifelong adverse health outcomes for all members involved. Although victims of domestic abuse often refrain from seeking support due to various reasons (e.g., fear), health centers such as emergency departments (EDs) can serve as outlets for assistance. The Domestic Abuse Response Team (DART) is a program working collaboratively with a regional hospital center in Alberta, Canada, uniquely providing immediate, expert, and patient-oriented services (e.g., safety plans) to domestic abuse victims within the ED. This study aimed to evaluate the DART program by: (1) using administrative data to characterize ED and DART patient characteristics and (2) examining staff perceptions about DART's operations, effectiveness, challenges, and improvements. Methods: A mixed-methods approach was used to collect data from April 1st, 2019 to March 31st, 2020. Quantitative data consisted of descriptive statistics on patient and staff characteristics and qualitative data was collected through two surveys to determine perceptions of the DART program. Results: Approximately 60% of ED patients were screened for domestic abuse and 1% were referred to DART, of which 86% were female. All referrals received support within an hour and were provided patient-oriented assistance. Qualitative data revealed that the DART program offers important support to patient victims, increases comfort around dealing with domestic abuse, and decreases ED staff workloads. Conclusions: The DART program offers valuable support to domestic abuse victims. Staff reported that DART is effective in providing victims with immediate care and services while also supporting ED staff. [ABSTRACT FROM AUTHOR]

As populations in small and medium-sized Canadian communities steadily decline, migration is increasingly seen as the solution. While government programs promoting migration to smaller centres exist at both the federal and provincial levels, the long-term integration of newcomers to smaller communities remains a challenge. This tendency could be connected to the notable social, economic and political differences that have been described between larger and smaller centres which can be overlooked by theories of integration derived from empirical work conducted in larger, heavily urban centres. This article explores three theories of integration – assimilation, transnationalism and the whole-of-community approach – and their applicability to the study of small centres medium-sized centres. It suggests that the whole-of-community’s emphasis on local context, multilevel governance and dynamic view of culture provides a useful framework for theorizing integration in small centres and develops a sketch of factors relevant to their study in the Canadian context. [ABSTRACT FROM AUTHOR]

Universities and institutions of higher education are facing economic pressures to sustain large classes, while simultaneously maintaining the quality of the online learning environment (Deming et al., 2015). Digital learning environments require significant pedagogical shifts on the part of the teacher. This paper is a qualitative examination of the nature of teaching in the digital age, and the significant changes facing teachers in the 21st century. The authors describe key features of quality distance pedagogy that were exhibited during 12 weeks of a synchronous undergraduate course held in Adobe Connect. The central research questions are: (1) How can problem-based learning pedagogy enable instructors to form smaller cohesive groups of students that take greater responsibility for their own learning?; (2) What strategies can be used by teachers to develop communities of practice and inquiry?; (3) How can an instructor in a large virtual class co-create the level of social capital that is required to build and maintain the relationships that are a necessary condition for a high quality learning experience?; and (4) What are the perceptions of teachers about the challenges and benefits of facilitating a high quality problem based learning environment through invisible pedagogy? The research is grounded in literature through the work of Cousins and Bissar (2012), Kaufman (2013), Badge, Saunders and Cann (2012), Flavin (2012) and McNeill, Gosper and Xu (2012). These authors examine how teachers and learners adapt to the digital age. In addition, more recent work by Bowers and Kumar (2015), Hoadley (2016), Deming et al. (2015) and Gunduz et al. (2016) are examined. In these digital spaces, teachers become facilitators, guides, collaborators and learners themselves, thus making traditional pedagogy virtually invisible. Further, the paper uses qualitative semi-structured interviews of two assistant professors who instructed the two groups of undergraduate students. The teachers identify challenges and successes to using problem based learning as a tool for attaining 21st century learning outcomes in digital learning spaces.

Satellite data are effective for mapping wildfires, particularly in remote locations where monitoring is rare. Geolocated fire detections can be used for enhanced fire management and fire modelling through daily fire progression mapping. Here we present the Canadian Fire Spread Dataset (CFSDS), encompassing interpolated progressions for fires >1,000 ha in Canada from 2002–2021, representing the day-of-burning and 50 environmental covariates for every pixel. Day-of-burning was calculated by ordinary kriging of active fire detections from the Moderate Resolution Imaging Spectroradiometer and the Visible Infrared Imaging Radiometer Suite, enabling a substantial improvement in coverage and resolution over existing datasets. Day of burning at each pixel was used to identify environmental conditions of burning such as daily weather, derived weather metrics, topography, and forest fuels characteristics. This dataset can be used in a broad range of research and management applications, such as retrospective analysis of fire spread, as a benchmark dataset for validating statistical or machine-learning models, and for forecasting the effects of climate change on fire activity. [ABSTRACT FROM AUTHOR]

This paper, one of a series, reports the results of a survey of 413 children in Grades Three to Six on inclusive education in a school district in rural Alberta, Canada. The aims of the study were to examine the views of children regarding their experience in schools claiming to be inclusive, situated within a jurisdiction which also claims to be inclusive, and to try and identify any demographic differences in responses. The study found that the school district under examination was generally doing a good job of inclusion in the eyes of the students, and that there were little differences in this view between groups of children identified with exceptionality, and those who were not. Future areas of study include the addition of a qualitative aspect to the examination of student views. (Contains 2 tables.)

This paper identifies and explores emergent themes in inclusive PE in the specific context of pre-service teacher preparation programs. Fully inclusive PE encompasses four areas: knowledge and curricula related to ability and disability, teacher attitudes, pre-service teacher education and a reframing of our understandings of multiple perspectives on physical literacy. Fully accessible PE involves material and attitudinal conditions configured to render these programs actually usable by all those whose 'inclusion' is intended. Access is, indeed, conceptually implied in 'inclusion', however, in practice the latter can easily become more of a slogan naming an aspiration than a realizable state of affairs. Unless an organization or individual brings a universal commitment to access, attitudinal barriers may prevent full inclusion from becoming a reality. The paper uses qualitative case study methodology to examine pre-service teacher education students' preconceptions about 'dis'ability and analyses heuristically how pre-service teachers pre-conceived notions of ability and disability may be challenged through an intervention. 21C PE programs can move towards an emphasis on inclusive activities which are not based on traditional conceptions of physical competence, size, shape, appearance and ability, but instead focus on how all bodies can develop fundamental movement skills, functional fitness and physical literacy. The author challenges pre-service students to address issues of accessibility, normative notions of ability, body equity, social justice and inclusion, as well as the need for multiple definitions of physical literacy. The paper is a case study of the specific phenomenon of 'broadening student teachers' understandings of ability and disability in PE' as a necessary condition for preparing students to work in schools where full inclusion may not have been integral to PE policies, programs and practices.

This paper, the first in a series on inclusive education in a rural Canadian school district, reports an attempt to develop a succinct, common cross-age scale to measure student views on important school-related aspects of inclusive education. A lengthy scale, previously developed for use in a different study, was administered to 855 children in Grades One to Twelve in a school district in rural Alberta, Canada. A succinct 12-item scale was produced, addressing four of five conceptual areas thought to be important to inclusive education from a student's perspective, and within the Canadian educational context. This scale has been named the Student Perceptions of Inclusion in Rural Canada (SPIRC) scale. Future areas of study include the addition of a component addressing sentiments towards disability and inclusion in the newly refined scale. (Contains 6 tables.)

Introduction: From the advancement of treatment of pediatric cancer diagnosis, the five-year survival rate has increased significantly. However, the adverse consequence of improved survival rate is the second malignant neoplasm. Although previous studies provided information on the incidence and risk of SMN in long term survivors of childhood cancer, there is still scarce information known for short term (< 5 years) prognosis. This study aims to assess the incidence, characteristics, management, and outcome of children who develop SMN malignancies within 5 years of diagnosis of their initial cancer. Method: This is a retrospective cohort study of early Second Malignant Neoplasms (SMN) in pediatric oncology patients. The Cancer in Young People - Canada (CYP-C) national pediatric cancer registry was used and reviewed pediatric patients diagnosed with their first cancer from 2000-2015. Results: A total of 20,272 pediatric patients with a diagnosis of a first malignancy were analyzed. Of them, 0.7% were diagnosed with a SMN within the first 5 years following their first cancer diagnosis. Development of a SMN impacted survival, shown by an inferior survival rate in the SMN cohort (79.1%) after three years compared to that of the non-SMN cohort (89.7%). Several possible risk factors have been identified in the study including the use of epipodophyllotoxins, exposure to radiation, and hematopoietic stem cell 169 transplant. Discussion: This is the first national study assessing the incidence, 170 characteristics, risk factors and outcome of early SMN in Canadian children 171 from age 0-15 from 2000-2015. [ABSTRACT FROM AUTHOR]

Changes in digital technology, increasing volume of data collection, and advances in methods have the potential to unleash the value of big data generated through the education of health professionals. Coupled with this potential are legitimate concerns about how data can be used or misused in ways that limit autonomy, equity, or harm stakeholders. This consensus statement is intended to address these issues by foregrounding the ethical imperatives for engaging with big data as well as the potential risks and challenges. Recognizing the wide and ever evolving scope of big data scholarship, we focus on foundational issues for framing and engaging in research. We ground our recommendations in the context of big data created through data sharing across and within the stages of the continuum of the education and training of health professionals. Ultimately, the goal of this statement is to support a culture of trust and quality for big data research to deliver on its promises for health professions education (HPE) and the health of society. Based on expert consensus and review of the literature, we report 19 recommendations in (1) framing scholarship and research through research, (2) considering unique ethical practices, (3) governance of data sharing collaborations that engage stakeholders, (4) data sharing processes best practices, (5) the importance of knowledge translation, and (6) advancing the quality of scholarship through multidisciplinary collaboration. The recommendations were modified and refined based on feedback from the 2022 Ottawa Conference attendees and subsequent public engagement. Adoption of these recommendations can help HPE scholars share data ethically and engage in high impact big data scholarship, which in turn can help the field meet the ultimate goal: high-quality education that leads to high-quality healthcare. [ABSTRACT FROM AUTHOR]

There is an expectation that health professions schools respond to priority societal health needs. This expectation is largely based on the underlying assumption that schools are aware of the priority needs in their communities. This paper demonstrates how open-access, pan-national health data can be used to create a reliable health index to assist schools in identifying societal needs and advance social accountability in health professions education. Using open-access data, a psychometric evaluation was conducted to examine the reliability and validity of the Canadian Health Indicators Framework (CHIF) conceptual model. A non-linear confirmatory factor analysis (CFA) on 67 health indicators, at the health-region level (n = 97) was used to assess the model fit of the hypothesized 10-factor model. Reliability analysis using McDonald's Omega were conducted, followed by Pearson's correlation coefficients. Findings from the non-linear CFA rejected the original conceptual model structure of the CHIF. Exploratory post hoc analyses were conducted using modification indices and parameter constraints to improve model fit. A final 5-factor multidimensional model demonstrated superior fit, reducing the number of indicators from 67 to 32. The 5-factors included: Health Conditions (8-indicators); Health Functions (6-indicators); Deaths (5-indicators); Non-Medical Health Determinants (7-indicators); and Community & Health System Characteristics (6-indicators). All factor loadings were statistically significant (p < 0.001) and demonstrated excellent internal consistency (ω >0.95). Many schools struggle to identify and measure socially accountable outcomes. The process highlighted in this paper and the indices developed serve as starting points to allow schools to leverage open-access data as an initial step in identifying societal needs. [ABSTRACT FROM AUTHOR]

Although broadleaf tree species of the boreal biome have a lower flammability compared to conifers, there is a period following snow melt and prior to leaf flush (i.e., greenup), termed the "spring window" by fire managers, when these forests are relatively conducive to wildfire ignition and spread. The goal of this study was to characterize the duration, timing, and fire proneness of the spring window across boreal Canada and assess the link between these phenological variables and the incidence of springtime wildfires. We used remotely sensed snow cover and greenup data to identify the annual spring window for five boreal ecozones from 2001 to 2021 and then compared seasonality of wildfire starts (by cause) and fire‐conducive weather in relation to this window, averaged over the 21‐year period. We conducted a path analysis to concomitantly evaluate the influence of the spring window's duration, the timing of greenup, and fire‐conducive weather on the annual number and the seasonality of spring wildfires. Results show that the characteristics of spring windows vary substantially from year to year and among geographic zones, with the interior west of Canada having the longest and most fire‐conducive spread window and, accordingly, the greatest springtime wildfire activity. We also provide support for the belief that springtime weather generally promotes wind‐driven, rather than drought‐driven wildfires. The path analyses show idiosyncratic behavior among ecozones, but, in general, the seasonality of the wildfire season is mainly driven by the timing of the greenup, whereas the number of spring wildfires mostly responds to the duration of the spring window and the frequency of fire‐conducive weather. The results of this study allows us to better understand and anticipate the biome‐wide changes projected for the northern forests of North America. [ABSTRACT FROM AUTHOR]

This paper is one of a series of papers examining inclusive education in the context of a rural Canadian school district that has adopted a philosophy of inclusion. The results of a survey of 438 parents on their views about aspects of inclusive education at their youngest child's school are reported. The results indicate that the majority of parents were generally positive in their views about and experiences with the inclusive school environment and links to the local community; however, parents were by no means unanimous in their level of comfort with inclusive education. Tensions were found to exist, and differences in the experience of parents of children who had identified exceptionalities were evident. This study points to the paucity of research on parents and inclusive education and provides some direction for future work in the area. (Contains 3 tables.)

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Background Half of Canadians living in long-term care (LTC) homes will fall each year resulting in consequences to independence, quality of life, and health. The objective in this study was to analyze factors that contribute to, or are protective against, falls in Canadian LTC homes. Methods We analyzed of a retrospective cohort of a stratified random sample of Canadian LTC homes in Western Canada from 2011-2017. We accessed variables from the RAI-MDS 2.0 to assess the association of the dependent variable "fall within the last 31-180 days" with multiple independent factors, using generalized estimating equation models. Results A total of 28,878 LTC residents were analyzed. Factors found to increase the odds of falling were other fractures (OR 3.64 [95% confidence interval; CI 3.27, 4.05]), hip fractures (OR 3.58 [3.27, 3.93]), moderately impaired cognitive skills (OR 2.45 [2.28, 2.64]), partial support to balance standing (OR 2.44 [2.30, 2.57]), wandering (OR 2.31 [2.18, 2.44]). Conclusion A range of factors identified were associated with falls for people living in LTC homes. Individual physical ability represented the largest group of independent factors contributing to falls. Residents who experience any fracture or an acute change in behaviour, mobility, or activities of daily living (ADL) should be considered at increased risk of falls. [ABSTRACT FROM AUTHOR]

Objective: To provide the initial installment of a living guideline that will provide up-to-date guidance on the pharmacological management of patients with rheumatoid arthritis (RA) in Canada.Methods: The Canadian Rheumatology Association (CRA) formed a multidisciplinary panel composed of rheumatologists, researchers, methodologists, and patients. In this first installment of our living guideline, the panel developed a recommendation for the tapering of biologic and targeted synthetic disease-modifying antirheumatic drug (b/ts DMARD) therapy in patients in sustained remission using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach, including a health equity framework developed for the Canadian RA population. The recommendation was adapted from a living guideline of the Australia & New Zealand Musculoskeletal Clinical Trials Network.Results: In people with RA who are in sustained low disease activity or remission for at least 6 months, we suggest offering stepwise reduction in the dose of b/tsDMARD without discontinuation, in the context of a shared decision, provided patients are able to rapidly access rheumatology care and reestablish their medications if needed. In patients where rapid access to care or reestablishing access to medications is challenging, we conditionally recommend against tapering. A patient decision aid was developed to complement the recommendation.Conclusion: This living guideline will provide contemporary RA management recommendations for Canadian practice. New recommendations will be added over time and updated, with the latest recommendation, evidence summaries, and Evidence to Decision summaries available through the CRA website (www.rheum.ca). [ABSTRACT FROM AUTHOR]

Non‐renewable resource extraction contributes greatly to degradation of wildlife habitats in boreal landscapes. In western Canada, oil and gas exploration and extraction have left a dense network of linear disturbances (seismic lines) and abandoned well pads that have fragmented boreal forest. Among multiple ecological effects, these disturbances have increased predator access to the preferred habitat of some wildlife taxa, most notably boreal woodland caribou, resulting in population declines. Restoration of seismic lines and abandoned well pads is a critical activity to improve the recovery of woodland caribou populations. We present a linear programming model that optimally allocates restoration efforts to maximize the access of caribou to nearby undisturbed habitat in a fragmented landscape. We applied the model to examine restoration scenarios in the Cold Lake First Nations area in northeastern Alberta, Canada, which includes caribou habitat but also areas of active oil and gas extraction. The model depicts the landscape as a network of interconnected habitat patches and combines three network flow sub‐problems. The first sub‐problem enforces the spatial connectivity of the remaining network of unrestored sites. The second sub‐problem maximizes access to suitable habitat from the restored locations and the third sub‐problem ensures the allocation of restoration activities in as few spatially contiguous restoration projects as possible. The approach is generalizable and applicable to assist restoration planning in other resource extraction regions and for other taxa. [ABSTRACT FROM AUTHOR]

The article discusses the results of a study on the influence of caffeinated energy drinks on healthy adults' cardiovascular response during exercise. Topics mentioned include the significance of the study on people with hypertension, a description of exercise and intervention characteristics, and the range of ectopic beats and heart rate during the exercise.

Objective: To develop best practice statements for the provision of virtual care in adult and pediatric rheumatology for the Canadian Rheumatology Association's (CRA) Telehealth Working Group (TWG).Methods: Four members of the TWG representing adult, pediatric, university-based, and community rheumatology practices defined the scope of the project. A rapid literature review of existing systematic reviews, policy documents, and published literature and abstracts on the topic was conducted between April and May 2021. The review informed a candidate set of 7 statements and a supporting document. The statements were submitted to a 3-round (R) modified Delphi process with 22 panelists recruited through the CRA and patient advocacy organizations. Panelists rated the importance and feasibility of the statements on a Likert scale of 1-9. Statements with final median ratings between 7-9 with no disagreement were retained in the final set.Results: Twenty-one (95%) panelists participated in R1, 15 (71%) in R2, and 18 (82%) in R3. All but 1 statement met inclusion criteria during R1. Revisions were made to 5/7 statements following R2 and an additional statement was added. All statements met inclusion criteria following R3. The statements addressed the following themes in the provision of virtual care: adherence to existing standards and regulations, appropriateness, consent, physical examination, patient-reported outcomes, use in addition to in-person visits, and complex comanagement of disease.Conclusion: The best practice statements represent a starting point for advancing virtual care in rheumatology. Future educational efforts to help implement these best practices and research to address identified knowledge gaps are planned. [ABSTRACT FROM AUTHOR]

Objective: To examine the Canadian pediatric rheumatology workforce and care processes.Methods: Pediatric rheumatologists and allied health professionals (AHPs) participated. A designee from each academic center provided workforce information including the number of providers, total and breakdown of full-time equivalents (FTEs), and triage processes. We calculated the clinical FTE (cFTE) available per 75,000 (recommended benchmark) and 300,000 (adjusted) children using 2019 census data. The national workforce deficit was calculated as the difference between current and expected cFTEs. Remaining respondents were asked about ambulatory practices.Results: The response rate of survey A (workforce information) and survey B (ambulatory practice information) was 100% and 54%, respectively. The majority of rheumatologists (91%) practiced in academic centers. The median number of rheumatologists per center was 3 (IQR 3) and median cFTE was 1.9 (IQR 1.5). The median cFTE per 75,000 was 0.2 (IQR 0.3), with a national deficit of 80 cFTEs. With the adjusted benchmark, there was no national deficit, but there was a regional maldistribution of rheumatologists. All centers engaged in multidisciplinary practices with a median of 4 different AHPs, although the median FTE for AHPs was ≤ 1. Most centers (87%) utilized a centralized triage process. Of 9 (60%) centers that used an electronic triage process, 6 were able to calculate wait times. Most clinicians integrated quality improvement practices, such as previsit planning (67%), postvisit planning (68%), and periodic health outcome monitoring (36-59%).Conclusion: This study confirms a national deficit at the current recommended benchmark. Most rheumatologists work in multidisciplinary teams, but AHP support may be inadequate. [ABSTRACT FROM AUTHOR]

Objective: To compare clinical characteristics and treatment of patients with rheumatoid arthritis (RA) across 4 Canadian cohorts.Methods: The 4 longitudinal cohorts included the following: the Canadian Early Arthritis Cohort (CATCH; n = 2878), Ontario Best Practices Research Initiative (OBRI; n = 3734), RHUMADATA (Quebec, n = 2890), and the Rheum4U Precision Health Registry (Calgary, Alberta, n = 709). Data were from cohort inception (range 1998-2016) to 2020. Clinical characteristics and drug treatments were summarized descriptively.Results: In total, 10,211 patients with RA were included. The percentage of patients who entered the cohort with early RA (2 yrs of disease at enrollment) ranged from 29% (Rheum4U) to 100% (CATCH). Mean age (55 yrs), sex (74% female), and seropositivity (69%) were similar between cohorts. At the time of initial disease-modifying antirheumatic drug (DMARD) use, median Disease Activity Score in 28 joints (DAS28) varied, ranging from 2.99 (Rheum4U) to 5.19 (CATCH), but were more similar at the time of the first DMARD switch (range 3.57-5.03), first biologic (bDMARD) or targeted synthetic DMARD (tsDMARD) use (range 4.01-4.67), and second bDMARD or tsDMARD (range 3.71-4.39). The initial DMARD was most commonly methotrexate, either in monotherapy (32%, range 18-40%) or dual therapy (34%, range 29-42%). The first DMARD switch was to another DMARD monotherapy in 20% (range 10-32%), dual therapy in 49% (range 39-56%), and bDMARD or tsDMARD in 24% (range 15-28%). The first bDMARD was an anti-tumor necrosis factor in 79% (range 78-82%).Conclusion: Canadian RA cohorts demonstrate some heterogeneity in treatment, which could reflect differences in inclusion criteria, calendar year, or regional differences. This project is a first step toward conducting harmonized analyses across Canadian RA cohorts. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has had a major impact on access to health care resources. Our objective was to estimate the impact of the COVID-19 pandemic on the incidence of childhood cancer in Canada. We also aimed to compare the proportion of patients who enrolled in clinical trials at diagnosis, presented with metastatic disease or had an early death during the first 9 months of the COVID-19 pandemic compared with previous years.Methods: We conducted an observational study that included children younger than 15 years with a new diagnosis of cancer between March 2016 and November 2020 at 1 of 17 Canadian pediatric oncology centres. Our primary outcome was the monthly age-standardized incidence rates (ASIRs) of cancers. We evaluated level and trend changes using interventional autoregressive integrated moving average models. Secondary outcomes were the proportion of patients who were enrolled in a clinical trial, who had metastatic or advanced disease and who died within 30 days. We compared the baseline and pandemic periods using rate ratios (RRs) and 95% confidence intervals (CIs).Results: Age-standardized incidence rates during COVID-19 quarters were 157.7, 164.6, and 148.0 per million, respectively, whereas quarterly baseline ASIRs ranged between 150.3 and 175.1 per million (incidence RR 0.93 [95% CI 0.78 to 1.12] to incidence RR 1.04 [95% CI 0.87 to 1.24]). We found no statistically significant level or slope changes between the projected and observed ASIRs for all new cancers (parameter estimate [β], level 4.98, 95% CI -15.1 to 25.04, p = 0.25), or when stratified by cancer type or by geographic area. Clinical trial enrolment rate was stable or increased during the pandemic compared with baseline (RR 1.22 [95% CI 0.70 to 2.13] to RR 1.71 [95% CI 1.01 to 2.89]). There was no difference in the proportion of patients with metastatic disease (RR 0.84 [95% CI 0.55 to 1.29] to RR 1.22 [0.84 to 1.79]), or who died within 30 days (RR 0.16 [95% CI 0.01 to 3.04] to RR 1.73 [95% CI 0.38 to 15.2]).Interpretation: We did not observe a statistically significant change in the incidence of childhood cancer, or in the proportion of children enrolling in a clinical trial, presenting with metastatic disease or who died early during the first 9 months of the COVID-19 pandemic, which suggests that access to health care in pediatric oncology was not reduced substantially in Canada. [ABSTRACT FROM AUTHOR]

Linear disturbances from geological exploration (i.e., seismic lines) have an extensive footprint across much of Canada's western boreal forest; however, how seismic lines interact with subsequent wildfire remains poorly understood. We assessed whether wildfires effectively mitigate the footprint of seismic lines by promoting forest recovery. We evaluated the forest structure of legacy seismic lines burned in 2001 and 2002 by comparing them against adjacent unburned control plots, using metrics derived from airborne laser scanning (ALS) data collected between 2007 and 2009. ALS metrics identified persistent differences in vegetation height and structure between seismic lines and adjacent forest controls, 7–9 years post-fire. Median canopy height was 2.90 m lower on upland seismic lines and 1.94 m lower on lowland seismic lines than on adjacent controls, corresponding to a 21% and 25% height reduction, respectively. Field surveys revealed greater graminoid and nonvascular plant cover, and lower tall-tree cover and dead vegetative matter, on seismic lines, in comparison with controls. Our results show that tree recovery remains significantly delayed on most upland and lowland burned seismic lines in our study area, and that additional management efforts or longer timescales may be required to restore these fragmented landscapes. [ABSTRACT FROM AUTHOR]

The article presents Caffeinated energy drinks in the Canadian context, and the health risk assessment with a focus on cardiovascular effects. Topics discussed include caffeinated energy drinks (CEDs) currently sold under Temporary Marketing Authorizations must meet strict eligibility criteria; and these criteria, which include compositional and labelling requirements, were developed based on the outcome of a health risk assessment conducted by Health Canada (HC) in 2013.

Asynchronous discussion technologies offer the advantage of providing time for reflection essential for higher order cognitive thinking. In the context of a ten-week graphic design foundations course in the Digital Graphic Design program at Vancouver Community College, this advantage provides an avenue for advancing critical discussion of design work. Garrison, Anderson and Archer's (2000) Community of Inquiry (COI) model is applied in tandem with the design process to develop a blended approach to the traditional critique. The appropriate alignment of curriculum and faculty and student interactions to the environments best suited is determined. Guiding principles and learning objectives and tasks are developed to support cognitive, social and teaching presences essential to foster critical discourse in asynchronous discussion environments. (Contains 10 tables and 2 figures.)

There is an increasing number of younger adults with disabilities becoming residents of long-term care (LTC) homes across Atlantic Canada. Moving younger adults into LTC is less-than-ideal and presents an immediate challenge for LTC homes to meet the unique health-related needs of younger residents. This study explored the lived experiences of younger residents in a Nova Scotian LTC setting in terms of their long-term health and aging-in-place needs. Guided by the social-ecological model, this study gathered first-person experiences through photovoice and interview methods. Eleven residents, aged 36 to 60 years, illustrated how their health and aging processes were affected by multiple interacting individual, interpersonal, and environmental factors. Participants identified how they wished to be supported within LTC to improve comprehensive health services. This study demonstrates that younger LTC residents can, and should, be part of the planning for their own specialized healthcare and housing to support positive health and aging. There are many factors that influence the experience of living and aging in long-term care homes for younger adults with disabilities. These factors relate to the resident as an individual, their relationships while living in long-term care, and the environment of the long-term care home as a place to live. Younger long-term care residents need to be involved in the decisions being made on how to improve their experiences living in long-term care homes over time. There are different ways that younger residents can be involved in these decisions. For example, taking and presenting photographs to long-term care managers to show their issues and concerns as well as illustrate the possible opportunities to make long-term care homes a better place for them to live. [ABSTRACT FROM AUTHOR]

In 2007, Canada expanded the Temporary Foreign Worker Program (TFWP) to include service and hospitality sectors. By 2010, more migrants entered Canada with temporary visas than as permanent residents. While some found employment in hospitality and tourism, most were concentrated in the fast food sector. Working transnationally, this paper uses Tim Hortons' concurrent global expansion and its arrival in the Philippines as a case study of the global mobilities and intersecting pathways of capital and labour. Drawing on the theoretical contributions of feminist political economy, it illustrates how the aspirations and mobilities of the Filipino workers at the centre of this study are organized in the service of capital; capital, in this example, as represented by the globally ambitious Tim Hortons' parent corporation, Restaurant Brands International (RBI) and, more specifically, the Brazilian American global investment firm that owns and manages RBI, 3G Capital, as well as by the efforts and objectives of franchise holders. [ABSTRACT FROM AUTHOR]

Objective: To elucidate the essential elements of high-quality rheumatoid arthritis (RA) care in order to develop a vision statement and a set of strategic objectives for a national RA quality framework.Methods: Focus groups and interviews were conducted by experienced qualitative researchers using a semistructured interview or focus group guide with healthcare professionals, patients, clinic managers, healthcare leaders, and policy makers to obtain their perspectives on elements essential to RA care. Purposive sampling provided representation of stakeholder types and regions. Recorded data was transcribed verbatim. Two teams of 2 coders independently analyzed the deidentified transcripts using thematic analysis. Strategic objectives and the vision statement were drafted based on the overarching themes from the qualitative analysis and finalized by a working group.Results: A total of 54 stakeholders from 9 Canadian provinces participated in the project (3 focus groups and 19 interviews). Seven strategic objectives were derived from the qualitative analysis representing the following themes: (1) early access and timeliness of care; (2) evidence-informed, high-quality care for the ongoing management of RA and comorbidities; (3) availability of patient self-management tools and educational materials for shared decision making; (4) multidisciplinary care; (5) patient outcomes; (6) patient experience and satisfaction with care; and (7) equity, the last of which emerged as an overarching theme. The ultimate vision obtained was "ensuring patient-centered, high-quality care for people living with rheumatoid arthritis."Conclusion: The 7 strategic objectives that were identified highlight priorities for RA quality of care to be used in developing the National RA Quality Measurement Framework. [ABSTRACT FROM AUTHOR]

Objective: To conduct a needs assessment and environmental scan to support optimal transition from pediatric to adult rheumatology care in Canada.Methods: This initiative involved 3 phases: (1) a survey-based needs assessment of adult and pediatric rheumatologist members of the Canadian Rheumatology Association to identify perceived infrastructure, educational needs, and national resources to support transition care; (2) an environmental scan, through semistructured interviews, of existing rheumatology transition service care models and challenges in care delivery; and (3) a focus group to prioritize national activities.Results: The needs assessment survey was completed by 65 members, with 66% agreeing that a national approach to transition care was needed. Semistructured interviews reflecting activities at 9 transition care sites were conducted, and they identified candidate models of care, including direct transfer, progressive transfer, and shared care models. Challenges and needs experienced in these care models reflected resource and infrastructure needs, poor availability of mechanisms to support parents and youth through the transition process, and the need for evaluation to support quality improvement. The focus group and prioritization activity was attended by 26 participants, with each having the ability to cast 3 votes. "Supporting patient education for transition to adult rheumatology health care system" (n = 17 votes) and "advocacy activities to access allied health support, including funding" (n = 10 votes) emerged as the top priorities for national initiatives.Conclusion: We have identified priorities in education and advocacy for advancing transition care in Canada that require participation of pediatric and adult rheumatology providers, patients, and arthritis stakeholders in the interest of advancing transition care outcomes. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to develop a patient-centered quality measurement framework to address a predefined vision statement and 7 strategic objectives for rheumatoid arthritis (RA) care that was developed in prior qualitative work with arthritis stakeholders.Methods: One hundred forty-seven RA-related performance measures (PMs) were identified from a systematic review. A candidate list of 26 PMs meeting predefined criteria and addressing the strategic objectives previously defined was then assessed during a 3-round (R) modified Delphi. Seventeen panelists with expertise in RA, quality measurement, and/or lived experience with RA rated each PM on a 1-9 scale based on the items of importance, feasibility, and priority for inclusion in the framework during R1 and R3, with a moderated discussion in R2. PMs with median scores ≥ 7 on all 3 items without disagreement were included in the final set, which then underwent public comment.Results: Twenty-one measures were included in the final framework (15 PMs from the Delphi and 6 published system-level measures on access to care and treatment). The measures included 4 addressing early access to care and timely diagnosis, 12 evidence-based care for RA and related comorbidities, 1 addressing patient participation as an informed partner in care, and 4 on patient outcomes.Conclusion: The proposed framework builds upon existing measures capturing early access to care and treatment in RA and adds important PMs to promote high-quality RA care and outcome measurement. In the next phase, the authors will test the framework in clinical practice in addition to addressing certain areas where no suitable PMs were identified. [ABSTRACT FROM AUTHOR]

Background: The ongoing COVID-19 pandemic has spread across 188 countries and claimed over 300,000 lives so far. Despite strong public health messaging and strict community restrictions in Canada, misconceptions and high-risk behaviours such as mass public gatherings have contributed to its spread across the country. Local data on the knowledge, attitudes, and practices from high-case areas could inform public health messaging during the current unprecedented pandemic. Study Objective: To collate and describe the knowledge, attitudes, and practices of highly affected Canadian communities related to the COVID-19 pandemic and to evaluate factors associated with risky behaviours in order to inform public health policies and communication. Methods and Study Design: Information on COVID-19 knowledge, attitudes, and practices was collected via online convenience sampling from 1,593 Canadians between 6 to 26 April, 2020. The high outbreak provinces of Alberta and Ontario were targeted. Findings: While knowledge of COVID-19 transmission and prevention was high (mean knowledge score of 10.5/12 (88%)), a significant minority of respondents (32%) expressed at least one attitude resistant to public messaging that could hamper containment efforts: visiting crowded places other than grocery stores or pharmacies, close encounters with non-household members, and intention not to isolate if having mild flu symptoms, or known COVID-19 exposure. Factors associated with these risky behaviours included low COVID-19 knowledge (OR 1.2 (95% CI 1.1-1.3), p=0.0057), feeling not worried (OR 2.9 (95% CI 2.2-3.9), p<0.001), and feeling uninformed about the pandemic (OR 1.6 (95% CI 1.1-2.3), p=0.030). Respondents reported high acceptance of a potential vaccine (93%) and endorsed a wide-spread vaccination strategy (81%). Interpretation: Low levels of knowledge and worry regarding COVID-19 may be key contributors to resistance against public health messaging. A potential vaccine, if made available to the general public, would likely be widely accepted. [ABSTRACT FROM AUTHOR]

The top priority of fire management agencies in Canada is to protect human life and property. Here we investigate if decades of aggressive fire suppression in the boreal biome of Canada has reduced the proportion of recently burned forests (RBF; <30 years) near human communities, and thereby inadvertently increased the risk of wildfire. We measured the percentage of RBF, which are usually less flammable than older forests, up to a 25-km radius around communities compared to that in the surrounding regional fire regime zone. Our analysis of 160 communities across boreal Canada shows that 54.4% exhibited a deficit or lack of RBF, whereas only 15.0% showed a surplus. Overall, a majority (74.4%) of communities are surrounded by a low (≤10%) proportion of RBF, indicating a higher vulnerability of those communities to wildfire. These findings suggest that suppression policies are increasing flammability in the wildland–urban interface of boreal Canada. A primary element of modern wildfire management is to aggressively suppress small fires before they become large, but benefits can be offset by the fact that these practices promote older forests that are more 'flammable'. Here the authors show that this downside puts numerous human communities at elevated risk of fires in boreal Canada. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to describe the prevalence and incidence of ADHD medication prescribing, by age and gender, from 2005 to 2015 in Canadian primary care. Method: A population-based retrospective cohort study was conducted to evaluate the prescribing of ADHD medications between 2005 and 2015 using electronic medical record data. Yearly prevalence and incidence of ADHD medication prescribing were calculated for preschoolers (up to 5 years old), school-aged children (6-17 years old), and adults (18-65 years old) along with a description of the types of ADHD medications prescribed between 2005 and 2015. Results: Between 2005 and 2015, there was a 2.6-fold increase in the prevalence of ADHD medication prescribing to preschoolers, a 2.5-fold increase in school-aged children, and a fourfold increase in adults. There was a corresponding rise in incidence of prescribing although this rise was moderate and estimates were much lower compared with prevalence. The most commonly prescribed medication was Methylphenidate (65.0% of all ADHD medications prescribed). Conclusion: Although the prevalence of ADHD has remained stable over time, this study found an increase in the prescribing of ADHD medications in all age groups between 2005 and 2015. Incidence of new prescriptions was small relative to prevalence, suggesting that longer term treatments are being adopted. [ABSTRACT FROM AUTHOR]

Child abuse prevention expertise is sufficiently important to warrant its acquisition during pre-service teacher education training. Teacher training can address primary abuse prevention in the context of child growth and development or parenting courses. Such studies would lead to and necessitate the creation of non-punitive methods of classroom management. (JHZ)

Automobiles are ubiquitous objects of private consumption and their meaning and use are shaped by different aspects of identity, including gender. The gender dimensions of automobility associated with particular types of vehicles have not been extensively researched. This article studies pickup trucks and masculinities in relation to home and work in the industrial construction sector in Newfoundland and Labrador, Canada. There, like in much of North America, trucks have become the most commonly purchased new vehicles over the last decade. Their widespread popular appeal contrasts with their historical development for manual labour gendered as masculine, such as farming and fishing, in rural places and environments conducive to such labour. Drawing on interviews with construction industry actors and workers, the article shows how new, expensive trucks have come to reflect the hegemonic masculinity at male-dominated industrial construction projects, while also showing how the meanings and uses of trucks are complex and contested. Trucks are understood to be functional for work and driving, but they are also status symbols, often used only sparingly for commuting, masculinized domestic work and leisure activities. The article unpacks the new and expanding popularity of the truck and its positioning in practice in relation to masculinities, work, and to the landscape in a place-based gender regime. In doing so, it contributes to efforts to contextualize masculinities in place, while also revealing how they are related to gender constructs in other places and at other scales. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To validate our previously developed 16 plasma-protein biomarker panel to differentiate between transient ischaemic attack (TIA) and non-cerebrovascular emergency department (ED) patients. METHOD: Two consecutive cohorts of ED patients prospectively enrolled at two urban medical centers into the second phase of SpecTRA study (training, cohort 2A, n = 575; test, cohort 2B, n = 528). Plasma samples were analyzed using liquid chromatography/multiple reaction monitoring-mass spectrometry. Logistic regression models which fit cohort 2A were validated on cohort 2B. RESULTS: Three of the panel proteins failed quality control and were removed from the panel. During validation, panel models did not outperform a simple motor/speech (M/S) deficit variable. Post-hoc analyses suggested the measured behaviour of L-selectin and coagulation factor V contributed to poor model performance. Removal of these proteins increased the external performance of a model containing the panel and the M/S variable. CONCLUSIONS: Univariate analyses suggest insulin-like growth factor-binding protein 3 and serum paraoxonase/lactonase 3 are reliable and reproducible biomarkers for TIA status. Logistic regression models indicated L-selectin, apolipoprotein B-100, coagulation factor IX, and thrombospondin-1 to be significant multivariate predictors of TIA. We discuss multivariate feature subset analyses as an exploratory technique to better understand a panel’s full predictive potential. [ABSTRACT FROM AUTHOR]

The population of Elliot Lake in Northern Ontario, Canada is old and getting older, and small and getting smaller. It is Canada's most severely shrinking city and is home to the nation's third oldest population. In 2017, the city published a five-year Age-Friendly Action Plan to improve Elliot Lake in eight domains, including health care and transportation. This study assesses older adult access to health care facilities via Elliot Lake's existing public transportation service. We outlined the geography of health care facilities in Elliot Lake and determined that the community's two main health care facilities were not within walking distance of most neighbourhoods with large older adult populations. Through a buffer analysis, we demonstrated that 76% of older adults live within 150 m of a bus stop, while 96% live within 400 m of a bus stop. Using the novel Older Persons Walking and Transit Audit, we found that the city's inconsistent use of age-friendly features along walking routes and at bus stops, such as bus shelters, sidewalks, and adequate lighting, discourages older adult public transportation use and creates barriers to accessing health care. Finally, we developed municipal-level recommendations to improve health care access via public transportation in Elliot Lake. • The Older Persons Walking and Transit Audit was created to evaluate transit access. • 76% of older adults in Elliot Lake live within 150 m of a bus stop. • Age-friendly features were not consistently implemented across Elliot Lake. [ABSTRACT FROM AUTHOR]

Household, journey-to-work, and workplace dynamics intersect and are diverse and changing. These intersections contribute to gendered, classed, and racialized divisions of labour at home, at work, and on the road. Research on journeys-to-work has generally focused on journeys that happen daily, follow similar routes, at similar times, and involve travel to a single, fixed workplace. Time geography has shared some of this focus in its attention to fixity and constraints that shape these kinds of movements in time and space. However, change and disruption in home lives, journeys-to-work and in the location and scheduling of work are widespread. Feminist intersectional rhythmanalysis may be better equipped to address these. This article draws on insights from a body of Canadian research captured here in the form of 5 vignettes that describe intersecting home, work, environmental and employment-related geographical mobility (E-RGM) rhythms and some of their consequences across diverse groups, sectors and contexts. The vignettes are derived from research among trucking, construction, seafood processing, homecare, and precariously employed urban immigrant workers. We focus on groups engaging in complex, extended and often changing E-RGM to and within work. The vignettes highlight ways diverse gendered, classed and some racialized spatio-temporal rhythms of work, E-RGM, weather and seasons, and household lives intersect to disrupt and, as we move through the vignettes, increasingly constrain the capacity of these diverse groups of workers and their households to achieve even fragile synchronicities, reflecting the extension of coercion beyond the workplace into life at home and work-related mobilities. [ABSTRACT FROM AUTHOR]

This paper contributes to the growing literature on the political economy of migration management. Based on ethnographic research in Manila in 2016, we explore the contradictory entrepreneurial character of IOM Philippines in its multi-stranded global migration management activities. As a major labour export country with a history of fractious politics over state reliance on migration, partly in response to neoliberalisation, the Philippines represents an ideal field site for examining triple-win migration and development scenarios. By way of example, we analyse how IOM's global mission is represented in pre-departure programming for select visa-ready migrants destined for Canada. Such sessions occur in an increasingly competitive environment and exemplify the rescaling of migration management initiatives concerned to gain maximum advantage from labour export and import (for states and capital), while grooming a disciplined migrant labour force. On Canada's part, neoliberalisation and justin- time immigration priorities seek greater efficiencies from duly disciplined migrant arrivals. Here, we see the IOM's signature history of protection and aid for vulnerable and displaced persons maintained in tension with its facilitating role in perpetuating the structured inequalities of global capitalism. IOM's entrepreneurial activities in the governance gaps and market places of migration are, we argue, best summed up as labour brokerage by another name. [ABSTRACT FROM AUTHOR]

ARRAY(0x562b02106808) [ABSTRACT FROM AUTHOR]

Background: The objectives of this study were to describe the impact of trial enrollment at diagnosis on event-free and overall survival in paediatric acute lymphoblastic leukaemic (ALL) using a population-based approach.Methods: We conducted a retrospective cohort study that included children newly diagnosed with ALL between 1 and 14 years of age. The data source was the Cancer in Young People in Canada (CYP-C) national paediatric cancer population-based database. We conducted univariate and multiple Cox proportional hazards models.Results: There were 2569 children with ALL; 1408 (54.8%) were enrolled on a clinical trial at initial diagnosis. Event-free survival at 5 years was 89.8%±0.9 vs 84.1%±1.2. (P<0.0001) for those enrolled and not enrolled on a clinical trial, respectively. Overall survival at 5 years was higher for those enrolled (94.1%±0.7) vs not enrolled (90.5%±1.0; P=0.001). In a model that adjusted for demographic, leukaemic and socioeconomic factors, enrollment on trials was significantly associated with better event-free survival (hazard ratio (HR) 0.67, 95% confidence interval (CI) 0.47-0.95; P=0.023), but not overall survival (HR 0.69, 95% CI 0.44-1.08; P=0.102).Conclusions: Event-free survival was significantly better in children with ALL enrolled on a clinical trial. Future research should identify barriers to clinical trial enrollment for children with ALL. [ABSTRACT FROM AUTHOR]

Objectives: The increasing cost of clinical laboratory testing is a challenge in our health care system. This study aims to calculate the annual clinical laboratory test costs attributed to patients in a major Canadian city and to correlate them to their sociodemographic variables.Methods: Retrospective cohort study involving patients who received clinical chemistry, hematology, and microbiology tests in 2011 in Calgary, Canada (n = 610,409). Test volumes were obtained from a laboratory informatics database. Total expenditures per patient were calculated using estimated test costs and then combined with the 2011 Canadian Census Household Survey results to infer sociodemographic correlates.Results: While more women received laboratory testing (58.4%), men had slightly higher testing costs per capita. Except for Chinese, visible minority and Aboriginal populations had higher testing costs. There was an inverse correlation between testing cost and household income, and accordingly, higher costs were found in those without postsecondary education and the unemployed. Furthermore, hotspot mapping revealed the geographical distribution of patient test costs within the city.Conclusions: There is variation in testing costs for patients among different sociodemographic variables. [ABSTRACT FROM AUTHOR]

Background: Primary objective was to describe the proportion of children newly diagnosed with cancer enrolled on a therapeutic clinical trial. Secondary objectives were to describe reasons for non-enrollment and factors associated with enrollment on trials.Methods: In this retrospective cohort study, we included children newly diagnosed with cancer between 0 and 14 years of age and diagnosed from 2001 to 2012. We used data from the Cancer in Young People in Canada (CYP-C) national pediatric cancer population-based database. CYP-C captures all cases of pediatric cancer (0-14 years) diagnosed and treated at one of the 17 tertiary pediatric oncology centers in Canada. Non-enrollment was evaluated using univariate and multiple logistic regression analysis.Results: There were 9204 children with cancer included, of whom 2533 (27.5%) were enrolled on a clinical trial. The most common reasons cited for non-enrollment were lack of an available trial (52.2%) and physician choice (11.2%). In multiple regression, Asian and Arab/west Asian race were associated with lower enrollment (P = 0.006 and P = 0.032 respectively). All cancer diagnoses were more likely to be enrolled compared to astrocytoma and children with acute lymphoblastic leukemia had an almost 18-fold increased odds of enrollment compared to astrocytoma (P < 0.0001). Greater distance from the tertiary care center was independently associated with non-enrollment (P < 0.0001).Conclusions: In Canada, 27.5% of children with cancer are enrolled onto therapeutic clinical trials and lack of an available trial is the most common reason contributing to non-enrollment. Future research should better understand reasons for lack of trial availability and physician preferences to not offer trials. [ABSTRACT FROM AUTHOR]

Background and Objectives: In our family medicine residency program, we have established a culture of guided self-assessment through a systematic approach of direct observation of residents and documentation of formative feedback. We have observed that our residents have become more accurate in self-assessing their clinical performance. The objective of this study was to examine whether this improved accuracy extended to residents' self-assessment of their medical knowledge and clinical reasoning on the In-Training Examination (ITE).Methods: In November each year, residents in their first (PGY1) and second (PGY2) years of residency take the ITE (240 multiple-choice questions). Immediately before and right after taking the ITE, residents complete a questionnaire, self-assessing their knowledge and predicting their performances, overall and in eight high-level domains. Consented data from residents who took the ITE in 2009-2015 (n=380, 60% participation rate) were used in the Generalized Estimating Equations analyses.Results: PGY2 residents outperformed PGY1 residents; Canadian medical graduates consistently outperformed international medical graduates; urban and rural residents performed similarly overall. Residents' pre-post self-assessments were in line with residents' actual performance on the overall examination and in the domains of Adult Medicine and Care of Surgical Patients. The underperforming residents in this study accurately predicted both pre- and post-ITE that they would perform poorly.Conclusion: Our findings suggest that the ITE operates well in our program. There was a tendency among residents in this study to appropriately adjust their self-assessment of their overall performance after completing the ITE. Irrespective of the residency year, resident self-assessment was less accurate on individual domains. [ABSTRACT FROM AUTHOR]