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This article is an enquiry into the voluntary and part-time nature, as well as the Britishness, of the Canadian militia, especially the Non-Permanent Active Militia (NPAM), in an interwar 'nation-in-arms'. Major-General Maurice Pope's insights are revisited through the eyes of regimental histories, print media, memoirs and other sources. After reviewing the role of voluntarism, unpaid service and improved training, three themes will be considered. The first is a type of training known as close-order drill, singled out by Joseph Pope as a mark of English-speaking regimental culture. The creation in 1937 of a Canadian Guards brigade, part of a wider Guards tradition across the British World, ties into a second theme briefly considered: NPAM participation in the royal tour of 1939 in communities across Canada, which merits a more detailed study. Third, there follows a case study of one exemplary but lesser-known interwar officer in Ottawa, Lieutenant-Colonel Edward Lisle of the Governor General's Foot Guards, who, like so many men across the country, as well as his civilian day-job, pursued a lifelong part-time army career as a reserve unit officer and realist contributor to the Canadian Defence Quarterly. [ABSTRACT FROM AUTHOR]

Objectives: Increasing numbers of older people are living longer, often alone, in their own homes. Services and products that enable older people to remain safely in their own homes are required. The My Smart Home project recruited 30 community-dwelling people aged 65+ to co-design a package of technology to address their individual goals for safety and security at home. The technology package, up to the value of $4000, included installation of health monitoring, communication and entertainment devices, and security alarms, with 6 hours of technology coaching. Methods: Participants completed the Personal Wellbeing Index (PWI), the Australian Quality of Life-8 Dimensions (AQoL-8D) and the Canadian Occupational Performance Measure (COPM) at baseline, and after 4 weeks' use of the technology package. Semi-structured interviews were also used to qualitatively understand the challenges, enablers and outcomes of the project with respect to safety and security in the home. Results: Significant improvements in PWI (p < 0.01), AQoL-8D (p < 0.001) and COPM for goal performance (p < 0.001) and goal satisfaction (p < 0.001) were reported. Participants also reported feeling safer and more secure in their own homes. Common barriers to adoption of technology, cost, integration with already-owned technology and lack of confidence were overcome with this technology and coaching package. Conclusions: An individualised package of technology, with coaching, that supports older people to realise their personal goals with technology resulted in improved well-being, quality of life and sense of safety and security in community-dwelling older people. Ultimately, this should support a longer and better quality of life at home. [ABSTRACT FROM AUTHOR]

This study examined the frequency of sexual assault experiences in a sample of university women to understand the conditions under which sexual assault occurs, and compare alcohol and drug consumption patterns on the likelihood of experiencing sexual victimization. While patterns of victimization have been examined in American contexts, research on contemporary Canadian contexts is scant at present. We found that roughly 58% of the 377 university women in our sample attending one of three large Western Canadian universities in British Columbia reported having been sexually assaulted. These women reported a total of 528 incidents of sexual assault, with 56% of these involving substance-related nonpenetrative sex acts; 312 incidents were substance-related and 216 involved forcible sexual assault. The likelihood of sexual assault victimization was the highest among participants who identified as a sexual minority, consumed marijuana, and reported greater severity of recent alcohol consumption. The present research aims to inform sexual assault prevention and education efforts to reduce occurrences of victimization. [ABSTRACT FROM AUTHOR]

Background: Substantial health inequities exist for Indigenous Peoples in Canada. The remote and distributed population of Canada presents unique challenges for access to and use of surgery. To date, the surgical outcome data for Indigenous Peoples in Canada have not been synthesized.Methods: We searched 4 databases to identify studies comparing surgical outcomes and utilization rates of adults of First Nations, Inuit or Métis identity with non-Indigenous people in Canada. Independent reviewers completed all stages in duplicate. Our primary outcome was mortality; secondary outcomes included utilization rates of surgical procedures, complications and hospital length of stay. We performed meta-analysis of the primary outcome using random effects models. We assessed risk of bias using the ROBINS-I tool.Results: Twenty-eight studies were reviewed involving 1 976 258 participants (10.2% Indigenous). No studies specifically addressed Inuit or Métis populations. Four studies, including 7 cohorts, contributed adjusted mortality data for 7135 participants (5.2% Indigenous); Indigenous Peoples had a 30% higher rate of death after surgery than non-Indigenous patients (pooled hazard ratio 1.30, 95% CI 1.09-1.54; I2 = 81%). Complications were also higher for Indigenous Peoples, including infectious complications (adjusted OR 1.63, 95% CI 1.13-2.34) and pneumonia (OR 2.24, 95% CI 1.58-3.19). Rates of various surgical procedures were lower, including rates of renal transplant, joint replacement, cardiac surgery and cesarean delivery.Interpretation: The currently available data on postoperative outcomes and surgery utilization rates for Indigenous Peoples in Canada are limited and of poor quality. Available data suggest that Indigenous Peoples have higher rates of death and adverse events after surgery, while also encountering barriers accessing surgical procedures. These findings suggest a need for substantial re-evaluation of surgical care for Indigenous Peoples in Canada to ensure equitable access and to improve outcomes.Protocol Registration: PROSPERO-CRD42018098757. [ABSTRACT FROM AUTHOR]

Background: The scope of practice of general surgeons in Canada is highly variable. The objective of this study was to examine the demographic characteristics of general surgeons in Canada and compare surgical procedures performed across community sizes and specialties.Methods: Data from the Canadian Institute for Health Information's National Physician Database were used to analyze fee-for-service (FFS) care provided by general surgeons and other providers across Canada in 2015/16.Results: Across 8 Canadian provinces, 1669 general surgeons provided FFS care. The majority of the surgeons worked in communities with more than 100 000 residents (71%), were male (78%), were aged 35-54 years (56%) and were Canadian medical graduates (76%). Only 7% of general surgeons practised in rural areas and 14% in communities with between 10 000 and 50 000 residents. Rural communities were significantly more likely to have surgeons who were international medical graduates or who were older than 65 years. The surgical procedures most commonly performed by general surgeons were hernia repairs, gallbladder and biliary tree surgery, excision of skin tumours, colon and intestine resections and breast surgery. Many general surgeons performed procedures not listed in their Royal College of Physicians and Surgeons of Canada training objectives.Conclusion: Canadian general surgeons provide a wide array of surgical services, and practice patterns vary by community size. Surgeons practising in rural and small communities require proficiency in skills not routinely taught in general surgery residency. Opportunities to acquire these skills should be available in training to prepare surgeons to meet the care needs of Canadians. [ABSTRACT FROM AUTHOR]

This systematic review assessed the current evidence base of substance use prevention programs for Indigenous adolescents in the USA, Canada, Australia and New Zealand. The authors investigated (a) the outcomes, type, setting and context of prevention programs; (b) the common components of beneficial prevention programs; and (c) the methodological quality of evaluations of included prevention programs. The authors searched eight peer-reviewed and 20 grey literature databases for studies published between 1 January 1990 and 31 August 2017. Data extracted included type of program (culturally adapted, culture-based or unadapted), the setting (school, community, family or multi-setting), delivery (computerised or traditional), context (Indigenous-specific or multi-cultural environment) and common components of the programs. Program evaluation methodologies were critically appraised against standardised criteria. This review identified 26 eligible studies. Substance use prevention programs for Indigenous youth led to reductions in substance use frequency and intention to use; improvements in substance-related knowledge, attitudes and resistance strategies; and delay in substance use initiation. Key elements of beneficial programs included substance use education, skills development, cultural knowledge enhancement and community involvement in program development. Five programs were rated as methodologically strong, seven were moderate and fourteen were weak. Prevention programs have the potential to reduce substance use among Indigenous adolescents, especially when they are developed in partnership with Indigenous people. However, more rigorously conducted evaluation trials are required to strengthen the evidence base. [ABSTRACT FROM AUTHOR]

This research examined media coverage of breast cancer (n = 145) and heart disease and stroke (n = 39) news articles, videos, advertisements, and images in a local Canadian context through quantitative and thematic content analyses. Quantitative analysis revealed significant differences between coverage of the diseases in placement, survivors as a source of information, health agency, human interest stories, citation of a research study, the inclusion of risk statistics, discussion of preventative behaviors, and tone used. The thematic analysis revealed themes that characterized a "typical" breast cancer survivor and indicated that "good" citizens and businesses should help the cause of breast cancer. Themes for heart disease and stroke articulated individual responsibility and the ways fundraising reinforced femininity and privilege. Findings provide insight on how these diseases are framed in local Canadian media, which might impact an individual's understanding of the disease. [ABSTRACT FROM AUTHOR]

Computer-mediated communication (CMC) is often used to initiate, maintain, or terminate intimate relationships and recently, such platforms have been considered an outlet for sexual communication. This has led to the emerging trend of sending sexually suggestive messages via computer devices in what is known as ''sexting.'' The current study expands the definition of sexting to include different types of sext content (i.e., non-sexters, less explicit, explicit, and very explicit) and modes of transmission (e.g., cell phone, social networking). Our primary goal was to determine whether sexting behaviours, risky health behaviours, attitudes and subjective norms, sensation seeking, and motivations for sexting differ across separate sexter groups (N= 511). Individuals who had never sent a sext message were classified as non-sexters (n= 117), those who had sent sexy word-based messages were classified as less explicit sexters (n= 135), semi-nude photo or video senders were classified as explicit sexters (n= 87), and individuals who had sent fully nude photos or videos were classified as very explicit sexters (n= 172). Results revealed that participants who report very explicit forms of sexting had higher positive attitudes toward sexting and engaged in riskier sexual behaviours relative to explicit, less explicit and non-sexters. In general, sexters perceived more social pressure to engage in sexting and demonstrated a higher need for sensation seeking compared to non-sexters. Higher rates of alcohol consumption were found among the very explicit and explicit sexter groups compared to less explicit and non-sexters. [ABSTRACT FROM AUTHOR]

Medical oncology is a subspecialty of internal medicine that deals with tumours originating in all organ systems.1 Medical oncologists provide systemic therapy with either palliative or curative intent for large numbers of cancer patients. An emphasis on providing patient-centred care closer to home, coupled with population aging and distribution, is shifting demand for cancer care services from larger urban hospitals to regional centres in local communities. The majority of medical oncologists in Canada are concentrated in larger regional centres, often in close proximity to radiation oncology units.5 Historically, it has proven difficult to recruit new oncology graduates to the community oncology milieu, and this difficulty threatens to impede close-to-home access to cancer services in many parts of the country. However, differences between academic and community oncology practice are steadily being eroded through improved communications technology and distributed medical education.3 This article profiles a number of dynamic nonacademic medical oncology practices across Canada to provide an up-to-date view of the realities of community oncology practice. Based on leading practices, it also presents a hypothetical optimal community oncology practice model. [ABSTRACT FROM AUTHOR]

It is usually assumed that the flag debate of 1964 was about replacing an outmoded British vision of Canada with the distinctive Canadianism of the Maple Leaf. In fact, the debate was not between "British" and "Canadian," but between rival interpretations of Canadianism. Britishness and Canadianness were interpenetrated in both flags. Even if the overt Britishness of the Red Ensign was downgraded, the new flag was a less dramatic break with the past than is commonly thought. If it was not explicitly British in appearance, the new flag remained the product of a British world. In its design and implementation by a small Anglo-Celtic cadre in the government—with the country deeply divided and non-British groups largely sidelined—the Maple Leaf is, in some ways, the legacy of a very British coup. [ABSTRACT FROM AUTHOR]

A series of political memos from the 1950s and 1960s reveal in striking detail how the major political parties competed for the allegiance of ethnic minority voters. Political courtship helped integrate new Canadians into civic life, and in particular, into Canada's British parliamentary system with its voting blocs, interest groups, and networks resembling patron-client relationships. The historiography has neglected the foundational contribution of ethnic courtship to this story. In turn, a misunderstood aspect of ethnic integration has been the role of ethnic voices in the flag debate of 1964, when the country is presumed to have adopted a more "inclusive" flag. Some Anglo-Canadian nationalists assumed that immigrants and "ethnics" could not relate to Canada's Britishness. But some could, and the record reveals a complex nexus between ethnic political participation, changes in the symbolic order, and the emergence of multiculturalism. [ABSTRACT FROM AUTHOR]

Abstract: Contemporary trauma to the elderly, its severity and associated mortality and morbidity in 111 United States and Canadian trauma centers are described. Three-thousand eight-hundred thirty-three (3,833) trauma patients age 65 years or older are compared to 42,944 injured patients under age 65. Although both groups had ≡ measures of injury severity, the older group had higher case fatality and complication rates and longer hospital stays. The results raise important questions regarding the triage, acute care, accurate prediction of outcome, and hospital reimbursement for the elderly injured patient, with implications for care evaluation, quality assurance, and the long-term viability of trauma centers and systems of care. (Am J Public Heath 1989; 79:1278-1282.) INSET: HRSA Provides Financial Aid to Disadvantaged Students in the. [ABSTRACT FROM AUTHOR]

Background: The implementation of trauma systems in many high-income countries over the last 50 years has led to important reductions in injury mortality and disability in many healthcare jurisdictions. Injury organizations including the American College of Surgeons and the Trauma Association of Canada as well as the World Health Organization provide consensus-based recommendations on resources and processes for optimal injury care. Many hospitals treating trauma patients seek verification to demonstrate that they meet these recommendations. This process may be labeled differently across jurisdictions. In Canada for example, it is called accreditation, but it has the same objective and very similar modalities. The objective of the study described in this protocol is to systematically review evidence on the effectiveness of trauma center verification for improving clinical processes and patient outcomes in injury care. Methods: We will perform a systematic review of studies evaluating the association between trauma center verification and hospital mortality (primary outcome), as well as morbidity, resource utilization, and processes of care (secondary outcomes). We will search CINAHL, EMBASE, HealthStar, MEDLINE, and ProQuest databases, as well as key injury organization websites for gray literature. We will assess the methodological quality of studies using the Risk Of Bias In Non-randomized Studies – of Interventions (ROBINS-I) assessment tool. We are planning to conduct a meta-analysis if feasible based on the number of included studies and their heterogeneity. We will evaluate the quality of cumulative evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group methodology. Discussion: This review will provide a synthesis of the body of evidence on trauma center verification effectiveness. Results could reinforce current verification modalities and may suggest ways to optimize them. Results will be published in a peer-reviewed journal and presented at an international clinical conference. Systematic review registration: PROSPERO CRD42018107083. [ABSTRACT FROM AUTHOR]