Search

Geriatric emergency management (GEM) nursing has emerged as a critical response to the increasing number of emergency department (ED) visits by older people, particularly in North America and specifically in Canada. This demographic often presents with complex medical conditions and atypical disease manifestations. The GEM programme, implemented in Ontario, Canada, aims to provide targeted assessment and establish community connections for frail older individuals, helping prevent their decline and loss of independence. There is a significant demand for specialised wound care services in EDs and frontline ED staff have a limited capacity to provide these. Advanced wound management was integrated into the GEM nursing scope of practice in an initiative. Patients who received wound care from GEM nurses and clinical nurse specialists had positive outcomes; those treated by GEM nurses had shorter wait times. Although the wound care role requires additional training and adds to the GEM nurse workload, the advantages appear substantial. Merging geriatric-focused care with specialist wound management may significantly benefit the care and satisfaction of older people attending the ED, as well as improve patient flow in the ED. This initiative requires further consideration by healthcare leaders and policymakers. [ABSTRACT FROM AUTHOR]

This paper utilizes a conceptual analysis and targeted literature review to explore public administrative collaboration models in the context of Canadian fire department interagency relationships. It proposes that effective emergency planning and response links are formed and maintained by the use of thoughtful and tailored communication. Numerous working examples of stakeholder relationships for fire departments are explored including other first responding organizations, various government levels, non-governmental organizations (NGOs), media and the public — including special considerations for specific subsets of the population. Operational recommendations are made based on the review of numerous public management and administration research for the creation of effective interagency relationships. These recommendations, while based in Canada, could easily be adapted to analogous fire departments or other first responding organizations internationally. [ABSTRACT FROM AUTHOR]

This paper outlines the context of emergency management in Canada and identifies some of the key factors that have contributed to public emergency preparedness initiatives reaching a saturation point. Readers will gain insight and actionable suggestions from the proposed Community Resiliency Framework. Readers will learn how emergency management agencies can engage and collaborate authentically with communities and leverage existing preparedness initiatives with new methodologies to increase community resiliency. [ABSTRACT FROM AUTHOR]

Background: Every year, people in Canada are evacuated due to wildland fires to avoid death, injury, and illness from fire and smoke events. Aims: In this paper, we provide an overview of evacuations recorded in the Canadian Wildland Fire Evacuation Database between 1980 and 2021. Methods: Our analysis covers evacuations in Canada from 1980 to 2021. We provide summary statistics including number of evacuations and evacuees, evacuation duration, seasonality, evacuation causes, community types, structure losses, and fatalities. We also investigate temporal and spatial patterns. Key results: Between 1980 and 2021, there were 1393 wildland fire evacuation events with 576,747 people evacuated. During this period, there was an overall increase in frequency of evacuations, number of evacuees, and duration of events. Structure loss occurred during 194 evacuation events, with 4105 homes burned. We estimate wildland fire evacuations cost at least CAD3.7 billion (excluding structural losses), jumping to CAD4.6 billion if we include productivity losses. Indigenous peoples are disproportionately impacted in wildfire evacuations compared to the general Canadian population. Conclusions: Wildland fire evacuations continue to occur across Canada and are increasing. Implications: The findings from this study give us a better understanding of the characteristics of wildland fire evacuations, which can help guide emergency management. This paper summarises data on wildland fire evacuations in Canada between 1980 and 2021. There were 1393 wildland fire evacuation events with 576,747 people evacuated, costing approximately CAD4.6 billion CDN including productivity losses. [ABSTRACT FROM AUTHOR]

Competing Interests: Competing interests: None declared.

Past major earthquakes have demonstrated that a significant proportion of existing residential buildings are vulnerable to seismic hazards, resulting in economic and social losses. The assessment of earthquake‐induced losses is crucial for devising strategies aimed at enhancing seismic resilience through mitigation plans and emergency response measures. This study intends to provide an analytical methodology for evaluating economic losses for existing residential concrete shear wall buildings in Eastern Canada seismic zones based on Canadian‐compatible seismic capacity parameters. A sampled data set related to residential buildings in Montreal was analyzed and statistical distributions were developed that represent the proportion of buildings in different seismic design code levels and number of stories. Vulnerability analyses were performed, which involved estimating buildings' response under seismic hazard inputs according to the 2020 National Building Code of Canada and conducting loss assessment for structural components, nonstructural displacement‐sensitive components, nonstructural acceleration‐sensitive components, and contents. The results of vulnerability analyses in terms of loss ratio curves showed that the seismic performance varies between mid‐rise and high‐rise concrete shear wall buildings with different seismic design code levels, and nonstructural displacement‐sensitive components exerted the most significant influence on overall economic losses among building components. In addition, a comparison was conducted between Canadian‐compatible economic loss ratio curves and those developed based on the standard seismic capacity parameters in the Hazus technical manual and differences in predicted loss ratios were discussed. The developed loss ratio curves can be integrated into regional scale loss assessment tools for rapid estimation of earthquake‐induced economic losses for concrete shear wall buildings as a function of seismic intensity. [ABSTRACT FROM AUTHOR]

Provides a methodology for selection of an expert support system (ESS) in an emergency management training environment. A decision matrix construct for selection of an ESS for casualty disposition training at Emergency Preparedness Canada is presented, and four system options of simulation models that deal with emergency management are described. (40 references) (LRW)

The climate crisis significantly impacts the health and well-being of older adults, both directly and indirectly. This issue is of growing concern in Canada due to the country's rapidly accelerating warming trend and expanding elderly population. This article serves a threefold purpose: (i) outlining the impacts of the climate crisis on older adults, (ii) providing a descriptive review of existing policies with a specific focus on the Canadian context, and (iii) promoting actionable recommendations. Our review reveals the application of current strategies, including early warning systems, enhanced infrastructure, sustainable urban planning, healthcare access, social support systems, and community engagement, in enhancing resilience and reducing health consequences among older adults. Within the Canadian context, we then emphasize the importance of establishing robust risk metrics and evaluation methods to prepare for and manage the impacts of the climate crisis efficiently. We underscore the value of vulnerability mapping, utilizing geographic information to identify regions where older adults are most at risk. This allows for targeted interventions and resource allocation. We recommend employing a root cause analysis approach to tailor risk response strategies, along with a focus on promoting awareness, readiness, physician training, and fostering collaboration and benchmarking. These suggestions aim to enhance disaster risk management for the well-being and resilience of older adults in the face of the climate crisis. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to investigate how training or exercises are assessed in local government emergency management organisations. Design/methodology/approach – An investigative review of the resources available to emergency managers across North America and within New Zealand, for the evaluation and monitoring of emergency management training and exercises was conducted. This was then compared with results from a questionnaire based survey of 48 local government organisations in Canada, USA, and New Zealand. A combination of closed and open ended questions was used, enabling qualitative and quantitative analysis. Findings – Each organisation's training program, and their assessment of this training is unique. The monitoring and evaluation aspect of training has been overlooked in some organisations. In addition, those that are using assessment methods are operating in blind faith that these methods are giving an accurate assessment of their training. This study demonstrates that it is largely unknown how effective the training efforts of local government organisations are. Research limitations/implications – Further study inspired by this paper will provide a clearer picture of the evaluation of and monitoring of emergency management training programs. These results highlight that organisations need to move away from an ad hoc approach to training design and evaluation, towards a more sophisticated and evidence-based approach to training needs analysis, design, and evaluation if they are to maximise the benefits of this training. Originality/value – This study is the first investigation to the authors' knowledge into the current use of diverse emergency management training for a range of local government emergency offices, and how this training impacts the functioning of the organisation's emergency operations centre during a crisis. [ABSTRACT FROM AUTHOR]

The Canadian Prairies are a major grain production region, producing most of the wheat for export in Canada. Global warming and the associated changes in extreme precipitation and temperature events pose significant risks to agriculture on the Canadian Prairies. Compound hazards can cause higher crop failure than isolated events, especially in the main grain production regions in western Canada. To achieve informed climate risk management, it is critical to characterize the threats posed by compound hazards in current and future climates in western Canada. In this study, return periods of events were computed to assess the potential changes in the hotspots for agriculturally relevant compound events in western Canada using two convection‐permitting climate simulations: current (CTL) climate and future climate under the RCP8.5 scenario based on a pseudo‐global‐warming (PGW) approach. Specifically, our study analyzed agricultural drought, low precipitation, heatwaves, and cool waves related to cool‐season crops. The results showed the overall good performance of the CTL simulation in capturing spatial patterns of these compound events in western Canada. In the current climate, droughts and heatwaves co‐occur mostly in southeastern parts of the prairies. Under the RCP8.5 scenario, they are likely to increase in frequency and expand to cover the major croplands of western Canada. This study provides information that policymakers in the fields of climate change adaptation and agricultural disaster management will find useful. [ABSTRACT FROM AUTHOR]

Managing oncologic emergencies is a fundamental competency for radiation oncology trainees and is evaluated through an entrustable professional activity (EPA) in the competency-by-design curriculum. Simulation-based learning has been extensively studied in medical education as an effective learning strategy to support achieving specific clinical skill goals. This study aims to evaluate the effectiveness of virtual cases in improving trainee knowledge and readiness to assess oncologic emergencies. Three virtual patient modules simulating common oncologic emergencies encountered throughout residency training in radiation oncology were developed using a simulation-based online learning platform. These modules include spinal cord compression, superior vena cava syndrome, and tumor-induced hemorrhage. Clinical vignettes were designed to mimic the clinical presentation and evolution of a patient exhibiting signs and symptoms of these common oncologic emergencies. Each module consisted of pre- and post-module questions compared to assess immediate knowledge acquisition. Questions focused on physical examination, imaging interpretation, staging, anatomy, epidemiology, differential diagnosis, prognostication, radiation planning, communication skills, and pertinent literature. We recruited radiation oncology residents from across Canada to participate over a 6-month period from June to December 2021. A total of 13 radiation oncology trainees across Canada (PGY2-6) completed 32 virtual patient scenarios. The modules were completed by junior residents (PGY2-3) 24 times and by senior residents (PGY4-6) 8 times. For all residents, the mean pre-module completion score was 66% (range 60-71%). Mean pre-module completion scores were 65% (range 63-68%) and 69% (range 50-80%) for junior and senior residents, respectively. Mean post-module completion scores were higher, at 92% (range 89-95%) for all residents, 92% (range 90-94%) and 91% (range 88-95%) for junior and senior residents, respectively. Pre-module completion scores were lowest for the tumor-induced hemorrhage scenario, identifying a potential knowledge gap. Resident feedback was unanimously positive, and residents reported that these online modules were useful for their learning. Online virtual patient modules can be used as complementary learning and assessment tools in the management of different oncologic emergencies. There is a significant improvement in knowledge acquisition after completion of each module, and this improvement is seen across all years of residency. Overall, residents find this learning method useful. [ABSTRACT FROM AUTHOR]

Canadian municipal governments are expected to play a central role in emergency management, which involves developing policies and programs to cope with emergencies and their impacts. But although all communities face potential emergencies, the quality of municipal emergency planning varies considerably from one community to another. This suggests that some municipal decision-makers have recognized emergencies as a problem and have prioritized this issue relative to others competing for attention and resources. This article examines policy-making in municipal emergency management through the lens of the Multiple Streams framework, an analytical model that explains how problems are recognized, how and why they are added to the decision agenda, and how they are matched with policy solutions. Sommaire : Les gouvernements municipaux canadiens sont supposés jouer un rôle essentiel dans la gestion des urgences, ce qui implique l'élaboration de politiques et de programmes pour faire face aux urgences et à leurs répercussions. Mais alors que toutes les collectivités font face à des urgences éventuelles, la qualité de la planification des urgences à l'échelle municipale varie considérablement d'une collectivitéà une autre. Cela laisse entendre que certains décisionnaires municipaux ont reconnu les urgences comme étant un problème et ont accordé la prioritéà cette question par rapport à d'autres rivalisant pour obtenir de l'attention et des ressources. Le présent article examine l'élaboration de politiques dans le domaine de la gestion des urgences dans une municipalité par le biais du cadre Sources multiples, un modèle analytique qui explique comment les problèmes sont reconnus, comment et pourquoi ils sont ajoutés au programme de décisions, et quelles sont les solutions en matière de politiques pour les résoudre. [ABSTRACT FROM AUTHOR]

Objectives: Despite evidence-based clinical practice guidelines for the emergency management of asthma, substantial treatment variation exists. Our objective was to assess compliance with the Canadian Association of Emergency Physicians (CAEP)/Canadian Thoracic Society (CTS) Asthma Advisory Committee's ‘Guidelines for the emergency management of asthma in adults’ in the emergency department (ED) of a university-affiliated tertiary care teaching hospital. Methods: This retrospective study was conducted in a Canadian inner city adult ED. Investigators reviewed all ED records for the period from Jan. 1, 2001, to Dec. 31, 2001, and identified adult pa- tients (i.e., >18 years of age) with a primary ED diagnosis of asthma. Hospital records were then reviewed to document compliance with the CAEP/CTS asthma guidelines. Descriptive statistics, in- cluding means, standard deviations and frequencies were used to summarize information. Results: Overall compliance with the guidelines was 69.6%, (95% confidence interval, 64.7%–74.5%), but compliance ranged from 41.4% for severe asthma, 67.1% for moderate asthma, and 88.6% for mild asthma. Interobserver reliability for compliance assessment was excellent. Conclusions: Despite publication and dissemination of evidence-based guidelines for the management of acute asthma in adults, guideline compliance at a university-affiliated, inner city, tertiary care teaching hospital ED is suboptimal. [ABSTRACT FROM AUTHOR]

Research in the field of emergency management indicates that pre-disaster mitigation can significantly reduce the costs of post-disaster reconstruction and recovery. Yet, it is often difficult for disaster mitigation advocates to garner the support of policy- and decision-makers, who tend to focus on other community concerns. Interest in disaster mitigation tends to be highest during the period immediately following a major disaster, when public attention focuses on vulnerabilities that must be addressed through policy. The "focusing event" of 11 September 2001 highlighted the vulnerability of a large urban area to disaster, in this case human-induced. The event had a significant impact on federal emergency management in Canada and the United States and shaped the nature of mitigation policy in the following year. [ABSTRACT FROM AUTHOR]

Introduction: Febrile neutropenia is one of the most severe oncological emergencies associated with the treatment of cancer. Patients with febrile neutropenia are at grave risk of developing life-threatening sepsis unless there is rapid initiation of treatment. The aim of this study was to evaluate the quality of ED care of patients with febrile neutropenia using the 3 quality dimensions of safety, effectiveness, and timeliness of care., Methods: A retrospective review of all available records of adult cancer patients with febrile neutropenia who presented to 1 urban emergency department in Atlantic Canada was conducted over 5 years., Results: Examining the 9 quality indicators of the 431 patients included in the study identified areas for improvement in each of the 3 dimensions. More than one third of the participants were unsafely discharged from the emergency department despite the severity of their conditions. Patients in the study were not seen promptly by the physician and did not receive timely treatment during different phases of their visit. Most importantly, the delay in antibiotic administration presented a major risk for this population., Discussion: Aspects of care provided to this cohort of febrile neutropenia patients were inconsistent with the recommended evidence. Strengthening ED care is necessary to reduce the gap between evidence-based and actual care. Quality initiatives can be implemented to improve care to become safer, effective, and timely. Nurses who are in direct contact with the patients and who are actively involved in every single process of the health care system are well positioned to lead this change., (Crown Copyright © 2020. Published by Elsevier Inc. All rights reserved.)

Purpose: COVID-19 impact on the population's mental health has been reported worldwide. Predicting healthcare workers' mental health and life stress is needed to proactively plan for future emergencies. Design: Statistics Canada has surveyed Canadian healthcare workers and those working in healthcare settings to gauge their perceived mental health and perceived life stress. Setting: A cross-sectional survey of healthcare workers in Canada. Subjects: A sample of 18,139 healthcare workers respondents. Analysis: Eight algorithms, including Logistic Regression, Random Forest (RF), Naive Bayes (NB), K Nearest Neighbours (KNN), Adaptive boost (AdaBoost), Multi-layer perceptron (MLP), XGBoost, and LightBoost. AUC scores, accuracy and precision were measured for all models. Results: XGBoost provided the highest performing model AUC score (AUC = 82.07%) for predicting perceived mental health, and Random Forest performed the best for predicting perceived life stress (AUC = 77.74%). Perceived health, age group of participants, and perceived mental health compared to before the pandemic were found to be the most important 3 features to predict perceived mental health and perceived stress. Perceived mental health compared to before the pandemic was the most important predictor for perceived life stress. Conclusion: Our models are highly predictive of healthcare workers' perceived mental health and life stress. Implementing scalable, non-expensive virtual mental health solutions to address mental health challenges in the workplace could mitigate the impact of workplace conditions on healthcare workers' mental health. [ABSTRACT FROM AUTHOR]

The article provides an overview of various extreme weather events that occurred in 2023. It attributes the global heat to El Niño and global warming, resulting in record-breaking temperatures and droughts in some areas. The year began with extreme heat and cold, accompanied by major flooding in Africa, the Philippines, and New Zealand. The article also mentions the "Zombie Cyclone" that caused heavy rain, high winds, and flooding as it traveled from Indonesia to Madagascar and Mozambique. It further discusses Canada's historic wildfire season, extreme summer heat in North America and Asia, and other notable events such as record-breaking temperatures in Algeria, Morocco, and Albania, scorching temperatures in China, historic flooding in the eastern Mediterranean, deadly monsoon flooding in South Asia, Hurricane Otis in Mexico, and storms in Europe causing flooding and power outages. The article concludes by mentioning the forecasted dissipation of El Niño in 2024, which may result in lower global temperatures. [Extracted from the article]

Background: Anaphylaxis due to unknown trigger (AUT) is anaphylaxis not explained by a proved or presumptive cause or stimulus at the time of the reaction. Research describing the management and follow-up of AUT is limited., Objective: To assess and compare the demographic and clinical characteristics and the management of adult and pediatric AUT cases across Canada., Methods: Participants were identified between 2011 and 2018 in emergency departments at 8 centers across Canada as part of the Cross-Canada Anaphylaxis Registry. A standardized form documenting the reaction and management in children and adults was completed. Patients were contacted for follow-up to determine assessment by an allergist., Results: A total of 295 AUT cases (7.5%) were recruited among 3,922 cases of anaphylaxis. In the prehospital setting, children (adjusted odds ratio [aOR], 1.20; 95% CI, 1.05-1.37) and those with a known food allergy (aOR, 1.14; 95% CI, 1.02-1.28) were more likely to receive treatment with epinephrine. Children were also more likely to be assessed by an allergist after their reaction (aOR, 1.43; 95% CI, 1.13-1.81) and were more likely to have an identified trigger for their reaction (aOR, 1.35; 95% CI, 1.07-1.70). Among patients contacted for follow-up, food was identified as the cause of reaction in 11 of 76 patients. A new food allergy was diagnosed in 4 patients (2 children and 2 adults)., Conclusions: Our findings highlight important differences between management and follow-up of adult and pediatric AUT cases. It is crucial to follow up all cases of AUT and establish appropriate treatment and management guidelines., (Copyright © 2018 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)

Historically, governmental responses to homelessness in Canada have defaulted to the most basic of services such as food and shelter. Even under exceptional circumstances, such as the current coronavirus pandemic, governments still demonstrate reluctance to guarantee permanent, adequate and affordable housing to all. In this policy review we argue that this pattern suggests that reticence is an apt term for describing homelessness responses in Canada and that this condition is rooted in the continued dominance of liberalism in Canadian society. [ABSTRACT FROM AUTHOR]

Disaster risk reduction is central to managing the risks of climate change at global, national, and sub-national levels. The operationalization of disaster risk reduction, however, has been met with challenges that have restricted successful policy implementation. Drawing from document analyses and Delphi studies with government practitioners, this article examines the policy context for disaster risk reduction in Canada and Australia and investigates the state of flood and drought planning and preparedness. Results are organized around two central themes: risk (ownership and sensitivity) and engagement (stakeholder involvement and capacity-building). The findings show that public policies on disaster risk reduction in Canada and Australia reflect international discourse that advocates for a whole-of-society, risk-sensitive, and risk-informed approach. However, implementing this approach in household planning and preparedness, cross-sector planning and policy integration, terminology, and socio-cultural representation, has been hampered by several factors. Government practitioners in both countries argued that while disaster risk reduction and climate risk management continue to evolve in multi-level governance, policy implementation is constrained by the legacies of past governance arrangements that have enabled disaster risk creation and accumulation. The results presented herein suggest a need for institutional reform that better reflects the holistic and systemic relationships between disaster risk, climate change, and other policy problems. We argue that disaster risk reduction and climate risk management policies require bridging governance arrangements between these and related policy domains to foster effective multi-level implementation. Key policy insights Implementing disaster risk reduction has been inconsistent, exacerbating exposure to climate change and increasing socio-economic vulnerabilities to disaster impacts. Managing climate and disaster risk requires a holistic approach that targets vulnerable groups, tackles underlying drivers of risk, and builds capacities to support disaster risk reduction. Although disaster risk reduction and climate risk management policies continue to evolve, implementation is hindered by legacy governance arrangements that favour economic growth over sustainable, climate-sensitive disaster risk management. Transformation through the integration of disaster risk reduction and human development offers potential pathways to reduce vulnerabilities via a holistic disaster risk and climate policy approach. [ABSTRACT FROM AUTHOR]

Reducing flood risk through disaster planning and risk management requires accurate estimates of exposure, damage, casualties, and environmental impacts. Models can provide such information; however, computational or data constraints often lead to the construction of such models by aggregating high‐resolution flood hazard grids to a coarser resolution, the effect of which is poorly understood. Through the application of a novel spatial classification framework, we derive closed‐form solutions for the location (e.g., flood margins) and direction of bias from flood grid aggregation independent of any study region. These solutions show bias of some key metric will always be present in regions with marginal inundation; for example, inundation area will be positively biased when water depth grids are aggregated and volume will be negatively biased when water surface elevation grids are aggregated through averaging. In a separate computational analysis, we employ the same framework to a 2018 flood and successfully reproduce the findings of our study‐region‐independent derivation. Extending the investigation to the exposure of buildings, we find regions with marginal inundation are an order of magnitude more sensitive to aggregation errors, highlighting the importance of understanding such artifacts for flood risk modelers. Of the two aggregation routines considered, averaging water surface elevation grids better preserved flood depths at buildings than averaging of water depth grids. This work provides insight into, and recommendations for, aggregating grids used by flood risk models. Key Points: Through a novel framework, we show analytically that hazard grid aggregation leads to bias of key metrics independent of any study regionThis aggregation is shown to always positively bias inundation area when water depth grids are aggregatedFor example, aggregating from 1 to 512 m resolution resulted in a doubling of the inundated area for a 2018 flood in Canada [ABSTRACT FROM AUTHOR]

The degree to which exercises improve the collaboration among different organizations during an emergency is under debate. This study aims to contribute to the scarce research on this topic by giving insight into the perceived effects of exercises on collaboration, learning, usefulness and interorganizational trust. In particular, this quantitative study looked into the differences between the effects of tabletop and full‐scale exercises. A questionnaire assessing collaboration, learning, usefulness and trust—the CLUT instrument—was developed. Data were collected from 173 full‐time emergency management personnel in Norway and Canada. Usefulness, learning and collaboration outcomes were perceived to be high for both types of exercises, but full‐scale exercises were perceived to have greater learning and usefulness outcomes than tabletop exercises. Stronger relationships were identified between the perceived effects on learning and usefulness, collaboration and trust in tabletop compared to full‐scale exercise, whereas the relationship between the perceived effects upon collaboration and trust was stronger in full‐scale exercises. Multiple regression analysis showed that the variables used to measure exercise usefulness can better predict tabletop exercise outcomes. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has increased physician burnout beyond high baseline levels. We aimed to determine whether pandemicrelated factors contribute to physician burnout beyond known organizational factors. This was a cross-sectional survey of Canadian physicians using a convenience sample. Eligible participants included any physician currently holding a license to practice in Canada. Responses were gathered from May 13 to 12 June 2020. Risk factors measured included the newly developed Pandemic Experiences and Perceptions Scale (PEPS) subscales, contact with virus, pandemic preparation, and provincial caseload. The primary outcome was the Maslach Burnout Inventory (MBI). The primary outcome was completed by 309 respondents. Latent profile analysis found 107 (34.6%) respondents were burned out. In multivariate analysis, exhaustion was independently associated with PEPS adequacy, risk perception, and worklife subscales (adjusted R2 = 0.236, P < 0.001). Cynicism was associated with exhaustion, and PEPS worklife (adjusted R2 = 0.543, P < 0.001). Efficacy was associated with cynicism, PEPS worklife, and active cases (adjusted R2 = 0.152, P < 0.001). Structural equation modelling showed statistically significant direct paths between PEPS areas of worklife and all MBI subscales. Contact with virus, preparation, and PEPS risk perception added to the prediction of MBI exhaustion. Among a sample of Canadian physicians during the COVID-19 pandemic, adequacy of resources, risk perception, and quality of worklife were associated with burnout indices. To mitigate physician burnout organizations should work to improve working conditions, ensure adequate resources, and foster perceived control of risk of transmission. [ABSTRACT FROM AUTHOR]

Background: Since the start of the COVID-19 pandemic in Canada, the cannabis industry has adapted to public health emergency orders which had direct and indirect consequences on cannabis consumption. The objective of this scoping review was to describe the patterns of consumption and cannabis-related health and safety considerations during the COVID-19 pandemic in Canada. Methods: For this scoping review, we searched four electronic databases supplemented with grey literature. Peer-reviewed or pre-print studies using any study design and grey literature reporting real-world data were included if published in English between March 2020 and September 2021 and focused on cannabis and COVID-19 in Canada. A content analysis was performed. Results: Twenty-one studies met the inclusion/exclusion criteria. Study designs included cross-sectional surveys (n = 17), ecological study (n = 1), conceptual paper (n = 1), longitudinal study (n = 1), and prospective cohort study (n = 1). Most were conducted solely in Canada (n = 18), and the remaining included global data. Our content analysis suggested that cannabis consumption during the pandemic varied by reasons for use, consumers' age, gender, and method of consumption. Health and safety impacts due to the COVID-19 pandemics included increased mental illness, increased emergency visits, and psychosocial impacts. Discussion: This scoping review suggested that the impact of the pandemic on cannabis consumption in Canada is more complex than simplistic assumptions of an increase or decrease in consumption and continues to be difficult to measure. This study has explored some of those complexities in relation to reasons for use, age, gender, method of consumption, and health impacts. This scoping review is limited by focusing on the breadth compared to depth. Conclusions: Legalizing nonmedical use of cannabis in Canada in 2018 has had its challenges of implementation, one of which has been the changing context of the society. The findings of this study can help inform cannabis policy updates in Canada as the country is reaching its fifth year of legalizing nonmedical use of cannabis. [ABSTRACT FROM AUTHOR]

How to improve coordination between formal and unaffiliated or spontaneous volunteers after emergencies is currently an international question with a high profile. Drawing on international disaster management literature and experiences and recent crisis events in Canada, our analysis examines four Canadian case studies to show that the inclusion of citizens in EM is becoming indispensable, as simultaneously as the frequency and intensity of natural disasters are seen to be growing due to climate change, and citizens are increasingly presenting their labour and resources as assets to be drawn on in emergency and postemergency situations. In this context, Canadian municipalities are starting to better manage the unpredictability of spontaneous citizen volunteering in emergencies by building anticipatory structures of networked governance for integrating diverse, pre‐existing, and in some cases, pre‐identified groups of citizens as volunteers in emergency management functions. Additionally, as the role of voluntary service organizations is becoming elevated in emergency response and recovery in Canada, these organizations can prospectively play the role of brokers to help emergency management agencies access and manage community‐based networks of voluntary resources. [ABSTRACT FROM AUTHOR]

In the spring of 2020, remote Indigenous communities in the far northwestern region of Saskatchewan, Canada, experienced a COVID-19 outbreak that required the collaboration of local leaders, Indigenous governments, and other multi-sectoral organizations. This study shares the stories of those involved in the response and illustrates the challenges, successes, and recommendations for future emergency preparedness. A total of 22 participants were interviewed from the impacted communities, government agencies, and organizations in public health, public safety, and law enforcement between May and August of 2021. Qualitative interviews were analyzed using thematic analysis resulting in the following themes: 1) Challenges, 2) Consequences, 3) Successes, and 4) Recommendations. A final knowledge translation event was held with key stakeholders, including public health professionals and community members, to co-create final recommendations for future public health responses in remote Indigenous communities. Our findings underscored the importance of community leadership, local investment, public health preparedness, and relationship-building between organizations and jurisdictions. Lessons and recommendations from these stories can be applied to future pandemic preparedness in the province. [ABSTRACT FROM AUTHOR]

The article discusses the response by the Lennox and Addington County General Hospital (LACGH) rural community clinic in Greater Napanee, Ontario to the COVID-19 pandemic. Among the steps taken are administrative coordination, active and passive screening, and the creation of a COVID-19 Assessment Centre (CAC). Also cited are the use of personal protective equipment (PPE) and changes to emergency medicine and resuscitation strategies.

Over the last decade, youth have been acknowledged as agents of change in the fight against climate change, and more recently in disaster risk reduction. However, there is a need for improved opportunities for youth to participate and have their voices heard in both contexts. Our Photovoice study explores youth perceptions of the capability of youth to participate in disaster risk reduction and climate change action. We conducted six focus groups from February 2019 to June 2019 with four teenaged youth participants in Ottawa, Canada, hosting two virtual Photovoice exhibitions in 2021. Our results highlight 11 themes across a variety of topics including youth as assets, youth-adult partnerships, political action on consumerism, social media, education, accessibility, and art as knowledge translation. We provide four calls to action, centering youth participation and leadership across all of them, to guide stakeholders in how to improve disaster risk reduction and climate change initiatives by meaningfully including youth as stakeholders. [ABSTRACT FROM AUTHOR]

Responding to disastrous wildfires traversing geographical scales requires multi‐actor collaboration to address a series of interdependent operational tasks. While this type of distributed collective action problem is salient across governance contexts, less is known about if and how collaboration helps individual actors effectively address their tasks. Applying a novel network‐centric method to wildfire responder networks in Canada and Sweden, this study shows that when actors working on the same tasks collaborate, and/or when one actor addresses two interdependent tasks, effectiveness increases. The number of collaborative ties an actor has with others does not enhance effectiveness. Furthermore, when the chain of command is unclear, and/or when actors lack recent disaster management experience and/or pre‐existing collaborative relationships, effectiveness only increases if multiple actors collaborate over multiple interdependent tasks. The results have implications for disaster response agencies, and they provide valuable insights for collaborative responses to significant societal and environmental challenges. [ABSTRACT FROM AUTHOR]

In the article, the authors discuss the intrinsic social dilemmas that emerged during the COVID-19 pandemic and pandemic planning, as well as the invisibility of the personal support workers (PSW) despite the key role they play in healthcare systems. Also cited are the gendered dynamics of risks that were seen during the pandemic, and how the pandemic showed the limits of biomedicine and the fragility of the for-profit healthcare systems.

Summary: This qualitative study examined the COVID-19 pandemic as experienced by healthcare-based social workers in relation to practice, and personal and professional impacts of providing care in this context, with recommendations for pandemic preparedness and response. A total of 12 focus groups were convened between June 2020 and March 2021, comprising 67 hospital social workers across multiple hospitals and other care facilities in western Canada. Findings: Based on an Interpretive Description approach, themes emerged reflecting practice shifts; increased work and changing roles; imposed restrictions; problems in communication and decision-making; distress, fear, and demoralization; and co-existing silver linings amid challenges. Applications: The COVID-19 pandemic has substantially impacted social workers and their delivery of service. Addressing concerns through proactive responsiveness, both during and beyond the pandemic, are important in nurturing patient-centered care and a supported workforce. Along with that of interdisciplinary colleagues in health care, social workers' practice has been profoundly impacted by the COVID-19 pandemic. This article explores the experiences of social workers in healthcare settings during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Despite well-documented increased demands and shortages of personal protective equipment (PPE) during previous disease outbreaks, health systems in Canada were poorly prepared to meet the need for PPE during the COVID-19 pandemic. In the primary care sector, PPE shortages impacted the delivery of health services and contributed to increased workload, fear, and anxiety among primary care providers. This study examines family physicians' (FPs) response to PPE shortages during the first year of the COVID-19 pandemic to inform future pandemic planning. Methods: As part of a multiple case study, we conducted semi-structured qualitative interviews with FPs across four regions in Canada. During the interviews, FPs were asked to describe the pandemic-related roles they performed over different stages of the pandemic, facilitators and barriers they experienced in performing these roles, and potential roles they could have filled. Interviews were transcribed and a thematic analysis approach was employed to identify recurring themes. For the current study, we examined themes related to PPE. Results: A total of 68 FPs were interviewed across the four regions. Four overarching themes were identified: 1) factors associated with good PPE access, 2) managing PPE shortages, 3) impact of PPE shortages on practice and providers, and 4) symbolism of PPE in primary care. There was a wide discrepancy in access to PPE both within and across regions, and integration with hospital or regional health authorities often resulted in better access than community-based practices. When PPE was limited, FPs described rationing and reusing these resources in an effort to conserve, which often resulted in anxiety and personal safety concerns. Many FPs expressed that PPE shortages had come to symbolize neglect and a lack of concern for the primary care sector in the pandemic response. Conclusions: During the COVID-19 pandemic response, hospital-centric plans and a lack of prioritization for primary care led to shortages of PPE for family physicians. This study highlights the need to consider primary care in PPE conservation and allocation strategies and to examine the influence of the underlying organization of primary care on PPE distribution during the pandemic. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic highlighted and exacerbated inequities in health for structurally marginalised Canadians. Their location on society's hierarchies constrained their ability to access healthcare and follow recommended health behaviours. The aim of this article is to identify, from the perspective of marginalised populations, factors influencing the acceptance or rejection of COVID-19 countermeasures by structurally marginalised Canadians. Interviews were conducted with Canadians 18 + who identified as Black (n = 8), First Nations, Métis, or Inuit (n = 7) and low-income (<40,000 annual household income) (n = 8) between August and December 2021. Measures were said to impact well-being and interfere with revenue generating activities. Longstanding unfavourable living and environmental conditions as they relate to structural marginalisation was said to fuel anger toward the government and lead to a greater reluctance to accept countermeasures. Participants described concerns about government decisions being made without considering their unique contexts, or knowledge of the experiences of the population for whom these decisions were being made. Effective proactive action from government is important to foster trust with marginalised populations to support acceptance of health information and address growing inequities. Action that demonstrates government competence and commitment to the interests of marginalised populations is critical. [ABSTRACT FROM AUTHOR]

This article analyzes discourses of preparedness and public safety in the context of the colonial history of emergency measures in Canada. An argument is made for how current measures of pandemic preparedness produce the social responsibilization of public health. [ABSTRACT FROM AUTHOR]

COVID-19 prompted an abundance of independent and collaborative quick response disaster research (QRDR) initiatives globally. The 2020 federal COVID-19-driven granting opportunities initiated the first official QRDR effort in Canadian history, engaging social scientists to rapidly address the pandemic-related societal influences. This study aims to portray the landscape of this nascent social science QRDR workforce through the first round of federal COVID-19-specific grant recipients. A case study approach was employed to analyze 337 social science projects with 1119 associated researchers, examining the demographic structure of these COVID-19-driven social science researchers and their research projects' characteristics. Accordingly, the findings are presented through the following two streams: (1) From a researcher perspective, this case study describes researcher typology, geographic location, primary discipline, and educational background, highlighting the diverse characteristics of social sciences researchers, and uneven research development across Canada. (2) From a research project perspective, this case study identifies and synthesizes research project subjects, themes, collaborations, and Canadian distinctions, emphasizing the need for galvanizing cooperation and focusing on uniquely Canadian contexts. The case study illustrates challenges associated with data curation that pose barriers to developing a nuanced understanding of the Canadian social science community COVID-19 research landscape. Consequently, the case study develops three recommendations to improve QRDR development in Canada: promoting information transparency, dissemination, and updates; improving hazards and disaster research workforce evaluation; and enhancing multi-stakeholder cooperation. [ABSTRACT FROM AUTHOR]

This paper presents a review of historical and latest insights into rock fall hazard temporal variability associated with weather. Reviewed research expands several locations around the world; however, focus has been on the recent advances in western Canada and from the author's experience. The recent research reviewed has provided new insights into the relationships between weather and rock fall occurrences and the recent focus on probabilistic approaches appears to be the way forward for rock fall hazard management. This paper also references some statistical tools for quantification of weather–rock fall relationships that allows better understanding of the stochastic nature of the phenomena. A decisive strength of how these methodologies are developing lies in the fact that adoption of probabilistic tools allows direct translation into rock fall hazard quantification that reflects its temporal variability. When coupled with weather forecasting, these tools can provide real-time forecasting of rock fall hazard. Moreover, some of these tools provide a way forward for forecasting the effects of climate change on rock fall hazards. [ABSTRACT FROM AUTHOR]

Background: Following the SARS pandemic, jurisdictions around the world began developing ethical resource allocation frameworks for future pandemics-one such framework was developed by Thompson and colleagues. While this framework offers a solid backbone upon which decision-makers can rest assured that their work is driven by rigorous ethical processes and principles, it fails to take into account the nuanced experiences and interests of children and youth (i.e., young people) in a pandemic context. The current COVID-19 pandemic offers an opportunity to re-examine this framework from young people's perspectives, informed by advances in childhood ethics and children's rights.Main Body: In this paper, we revisit the Thompson et al. framework and propose adaptations to the ethical processes and values outlined therein. This work is informed by expertise in clinical ethics and literature related to impacts of COVID-19 and other pandemics on the health and well-being of children around the world, though with particular attention to Canada. During the processes of drafting this work, stakeholders were consulted-aligned with the approach used by Thompson and colleagues-to validate the interpretations provided. We also propose a new principle, namely practicability, to indicate the complex balance between what is possible and what is convenient that is required in ethically sound decisions in the context of services affecting young people. We outline and discuss the strengths and limitations of our work and indicate next steps for scholars in the areas of childhood studies and child health.Conclusion: Efforts to ensure frameworks are truly child-inclusive should be the status-quo, so pandemic impacts and policy implications can be considered in advance of emergency preparedness contexts. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists 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.)

From an out-of-province/state and international post-secondary student perspective, this article (a) explores mass email risk communication facilitation during the COVID-19-triggered campus-wide evictions in Canada and the United States; and (b) develops relative recommendations to improve mass email risk communication strategies for future emergency response. Investigating mass email risk communication-related impacts on students in a tertiary educational context has revealed a significant deficit in emergency response research, practice, and policymaking. Mandatory temporary university and college closures during the COVID-19 first wave provided an opportunity to address this research and practice deficit, as most Canadian and American universities/colleges administered their eviction communication via daily mass email chains. Through a phenomenological lens, this study interviewed twenty out-of-province/state and international students, ten from each country respectively, to examine student eviction experiences associated with intensive mass email risk communication. This research identified four factors linked to mass email risk communication: email chain characteristics, student interpretation, interdepartmental cooperation, and frontline voices. Synthesizing these findings, four evidence-based recommendations were developed: to efficiently convey risk information to students, to understand student perceptions and to inform their behaviors, to enhance interdepartmental cooperation, and to enable mutual dialogue in decision making. These recommendations could assist post-secondary institutions, and other organizations, in strengthening their mass email risk communication strategies and advancing organizational emergency response plans for future extreme events. [ABSTRACT FROM AUTHOR]

Using the example of a large exercise programme developed by the government of Canada in preparation for several large special events in 2010, this article provides an argument as well as recommended practical strategies for incorporating a realistic simulated public response to an emergency event, to be utilised by both government organisations and the private sector. [ABSTRACT FROM AUTHOR]

Almost every year, First Nations are evacuated in Canada because of wildfire proximity and smoke. Dynamics of wildfires, and remote locations, unique sociocultural characteristics, and limited emergency management resources present challenges for evacuation organizers and residents. This study explores how Dene Tha' First Nation evacuated their Taché community in July 2012 due to wildfire smoke and how the evacuation process affected evacuees. Interviews were completed with 31 evacuation organizers and residents to examine the factors that helped and hindered the evacuation process. Lack of information about the nearby wildfire, smoke, and evacuation of the nearby small community of Zama City, combined with a generic evacuation plan, delayed and posed challenges during the evacuation of this Dene Tha' community. Strong leadership and its role in community organizing, keeping families together, providing the social support they needed, and using familiar host communities, demonstrated and contributed to the community's resilience during the evacuation. Measures to improve evacuations and emergency management in the community and other First Nations in Canada are identified and discussed. [ABSTRACT FROM AUTHOR]

Context: The potential for disasters and public health emergencies is increasing globally, requiring expertise and capacity to mitigate and manage such events. Individuals with prior international disaster response represent an essential source of expertise to support disaster response in their home countries. Objective: The objective of this study was to explore the experiences of healthcare personnel involved in international emergency response regarding their perceptions of the individual attributes and collective team capacities during disaster response and how this may benefit disaster management in Canada. Study design and analysis: This descriptive qualitative research study consisted of semi-structured interviews with key informants. Interviews were audio-recorded and transcribed. Conventional content analysis was performed on the transcripts, and themes were developed. Setting: Interviews were either conducted over the phone or in person. Population studied: Participants were delegates involved with the Canadian Red Cross medical response team, and who acted in a clinical or technical (physicians, surgeons, nurses) or administrative role (team leaders, administrators) within the last 5 years. Instrument: Semi structured interview guide was designed and piloted. It included open ended questions that explored participants' experience on medical emergency response team and related lessons learned in terms of skills and capacities acquired. Outcome measures: Participant narratives of individual skills and team capacities acquired during disaster response and how these skills and capacities can be applied domestically in Canada. Results: Eighteen key informants provided perspectives on individual attributes acquired during international deployments, (ex; agility, stress management), and team capacities developed, including collaboration and conflict management. Key informants included nurses, physicians, technicians, and administrators and described these experiences as highly relevant to the domestic context. Conclusions: Canadian physicians and healthcare workers involved with international disaster response have already acquired essential capacities, and this experience can be vital to building efficient disaster response teams. These findings complement the CanMEDS roles and can inform course design, competency and curriculum development for family medicine and primary care professional training programs related to disaster response. [ABSTRACT FROM AUTHOR]