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Purpose: Within minutes, our group, who had no prior introduction, began to learn the value of emerging from a relational space of (re)presenting and (re)storying our experiences. "I" became "We", which became "Us" Design/methodology/approach: Recently, the seventh bi-annual conference of the World Federation for Teacher Education 2023 focused on the theme of "Re-imagining Teacher Education: From Words to Action." During the session on métissage as methodology, participants from four different countries, three ethnic backgrounds and gender and sexual differences were invited into dialogue to explore the nuances of our identities, academic positions and life experiences. Findings: Doing métissage as novices, our subsequent discussion problematized the perpetuation of procedural narratives that contested the Cartesian cuts of methodological normalcy. Originality/value: Sharing our stories of self in our group we referenced how institutional frameworks had shaped and were reconstructing contexts for our being and belonging in the academy. In our narrating vulnerability we were once again located in telling relations to do with identity, power and social being. Jones (2015, p. 8) has asked. "Other than dry academic reports, how can we retell these stories in sensitive and ethical ways to wider audiences? How do the stories themselves inspire creativity in retelling them? How can we involve participants in the retelling of their stories?"

This paper outlines the design, development, and preliminary usability study of a system comprising (1) a web-based Indigenous lesson-creation interface and (2) an accompanying mobile app for studying the lessons. The Nisotak project was developed in response to the need for the preservation of Indigenous languages and to support reconciliation within Canada. In this paper, the authors discuss the technological aspects of the project and the less tangible decision-making that helped navigate software development in ways that support and honour Indigenous languages, Indigenous knowledge, and Indigenous people while, at the same time, making space for non-Indigenous allies. The key decisions that guided this project included privileging the target language(s), accommodating multiple dialects, creating an easy-to-use and engaging interface for non-technical users, and designing for easy transfer of ownership and management. Finally, the authors share the results of a small usability study.

This study examines the lived experiences of seven internationally diverse scholars from Canada, the United States, New Zealand, and Australia to answer the question: how do we make meaning of our collective boundary crossing experiences across disciplines and positions within SoTL? Our positions range from graduate student, faculty, and academic developers, to department chair and centre director. We conducted a phenomenological study, based on narratives of experience, and drew on Wenger-Trayner and Wenger-Trayner's (2015) theoretical framework that explores the features of a landscape of practice. Guided by this framework, we analyze our boundary crossings and brokering across the "diverse, political and flat" features of the SoTL landscape. Our collective findings highlight the critical role brokers play in facilitating boundary crossings. Brokering is precarious, bringing people together, building trusting relationships, and developing legitimacy while negotiating deadlocks, bureaucracy, authorities, and a multitude of challenges. Brokers, we found, require strength and resilience to mobilise, influence, and drive change in the landscape to transform existing practices or create new ones. We suggest that our analytical process can be used as a tool of analysis for future research about how brokers influence the SoTL landscape of practice and how brokering enhances SoTL development, support, and leadership.

Objective: Nonsuicidal self-injury (NSSI) is a commonly occurring, yet historically poorly understood, mental health concern among post-secondary students. The present study sought to identify the current knowledge needs of university stakeholders to inform training efforts around effective NSSI response and student support on university campuses. Participants: Participants were 1,762 university students, staff, and student-staff (77% female) from seven universities in Canada, the USA, New Zealand, and Australia. Methods: Methods: Participants completed an online survey about their attitudes and knowledge of both general mental health and NSSI. Results: University stakeholders reported significantly greater stigma toward NSSI than mental illness in general. Student-staff reported greater perceived knowledge and comfort, and demonstrated greater knowledge of NSSI, than students and staff. Conclusions: Findings underscore the need for additional training and resources to reduce stigma and increase knowledge about NSSI on university campuses internationally.

The focus of this qualitative study is upon 15 Grade 12 students situated in an English Communications (ECM) classroom in rural Nova Scotia and the impact a daily classroom circle had upon their academic engagement. ECM is intended for students who may require further support to develop their skills as readers, writers, and language users as they enter the job market or community colleges. There is no formal curriculum for ECM, and often the demographics of such classrooms are comprised of some of the province's most vulnerable populations. In this paper, we demonstrate the impact the daily classroom circle had upon late adolescents' understanding of themselves as thinkers with ideas to share. Overall, we see this study as significant for teachers in high-poverty contexts, particularly the importance of using a classroom circle as a consistent space to communicate elevated expectations for students who have experienced academic struggles.

Tier 1 school mental health programs for middle school youth often focus on healthy relationships promotion. However, the vast majority of these programs take a gender- and race-neutral approach (i.e., content that does not focus on the way that gender, race, and ethnicity intersect to shape relationships and mental health). Embedding these intersections into Tier 1 programs is critical to equitably advancing mental health for middle school youth. This article specifically explores associations between participation in a Tier 1 gender-transformative healthy relationships program and friendship quality for Ethnocultural boys. Data were drawn from 278 White and Ethnocultural boys who participated in the program in 2016-2017 or 2017-2018 in a Western Canadian province. Data were analyzed using three-level multilevel models. In these data, we found that Ethnocultural boys who participated in WiseGuyz reported improved friendship quality with their closest same-sex friend following the end of the program. We also found that Ethnocultural boys who reported a positive change in male role norms related to emotional restriction reported significant improvements to friendship quality from pre- to post-test. Findings suggest the importance of embedding equity into Tier 1 school mental health programming through a specific focus on intersections between gender, race, and ethnicity.

This paper is based on a three-year study that has a dual purpose: firstly, to create a program to attend to the health and wellness of Aboriginal children and youth, and secondly, to narratively inquire into the experiences of the children and youth who participate in the wellness program. In an attempt to disrupt intervention type models that position Aboriginal youth as at-risk, or in-deficit, we pose questions around how wellness programming and research begin in different commitments when we see Aboriginal youth as knowledge holders.

A narrative approach was adopted to explore the experiences of 13 women who pursued academic careers. Analysis of the personal reflective narratives uncovered themes common to the participants, also the authors of this study, which focused on striving to have work-life balance, personal and professional costs associated with being unwell, and the impact of academic work on families. Findings highlighted suggestions for being well in academia such as choose to engage in work and leisure activities that are enjoyable and maintain relationships. Suggestions for universities included: provide clear promotion and tenure processes, examine workload expectations, promote wellness, and facilitate mentorship.

In the face of declining human-ecological systems, as well as intercultural and interspecies trauma, we are currently witnessing a renaissance of activist-orientated environmental education. In Canada, this work is increasingly viewed as part of a broader healing response of "DEEP" reconciliation work between Indigenous and non-Indigenous Peoples, and ultimately humankind and the planet. This article locates these themes of healing human-ecological trauma and Indigenous-non-Indigenous relationships, within the work of the International Resilience Network (IRN)--a community of practice which aims to collectively impact social-ecological resilience, in part through transformative pedagogical practices which simultaneously support Indigenous resurgence and develop epistemological and relational solidarity between Indigenous and non-Indigenous Peoples. Through our story of the IRN's inaugural summit, we share our learnings of such pedagogical practices amidst the tensions and paradoxes inherent within a decolonizing agenda.

Our group of early- and mid-career women faculty members in a mid-sized Canadian university examined the peer review process and our experiences of being reviewed. Using post-structural feminist literature, we theorised how subjectivities are shaped by the pressures of neoliberal incursions into university work. The impact of peer review can be severe and feel highly personal. The peer review system contains assumptions that create conditions for misuse: that reviewers have expertise and that notions of quality scholarly work are shared; that they will be supportive and intellectually ethical; and that they will encourage innovation. We engaged with what it feels like to be reviewed through using collaborative autoethnography as a methodology, and narrative and poetic inquiry as data as well as methods of analysis. We found that how a writer received a review depended on the amount of respect and collegiality in the reviewer's language. Uninformed critical review comments appeared to be particularly damaging. We also found the obscure nature of the process meant that misunderstandings characterised our experiences. Many of us suffered feelings of powerlessness, a homogenisation of writing style, and a decrease in creativity. However, we also found solace and agency in sharing our stories. We shared our experiences within a relational holding space drawing on an ethic of care where well-being flourished, and in which there was an equality of respect, dignity, and mutual concern. We argue this perspective has potential to be applied more broadly to review processes.

This article provides a 10-year review by the test developers of the Canadian English Language Benchmark Assessment for Nurses (CELBAN™). From 2004 to 2014, the development, implementation, national administration, and operations of CELBAN and CELBAN-related products and services were the responsibility of the test developers and team at the Canadian English Language Assessment Services (CELAS) Centre at Red River College, Winnipeg, Manitoba. The CELAS Centre team experienced both challenges and opportunities during this 10-year period. As CELBAN expands, and in light of its current profile as a high stakes language assessment tool, a time for reflection and review is warranted. This retrospective review of CELBAN provides an overview of its history, administration, operations, and growth, as well as challenges experienced and lessons learned by the CELAS Centre team. Further research and development ideas are also posited by the CELBAN test developers.

This paper presents the findings of a research project that sought to interrogate the possibilities of digital storytelling as a pathway towards a more complete understanding of treaties and the treaty relationship in western Canada. This research is situated in the province of Saskatchewan, where treaty education (that is, education about the history of the numbered treaties signed between First Nations people and the British Crown, as well as the subsequent history of the treaty relationship) has been mandatory for almost a decade. The paper details a two-year journey alongside elementary educators as they used digital storytelling to take up treaty education in their classrooms. We present an overview of the research project as well as the narratives of a teacher, a researcher, and a Cree knowledge keeper, all of whom were involved in and reflected on the research journey. We consider the research findings alongside these narratives in order to explore the possibilities that digital storytelling might offer as we, as a Canadian nation, move towards reconciliation with Aboriginal people within a Canadian context of ongoing colonialism.

Chatbots are "computer agents that can interact with the user" in a way that feels like human-to-human conversation.1 While the use of chatbots for reference service in academic libraries is a topic of interest for both library professionals and researchers, little is known about how they are used in library reference service, especially in academic libraries in Canada. This article aims to fill this gap by conducting a web-based survey of 106 academic library websites in Canada and analyzing the prevalence and characteristics of chatbot and live chat services offered by these libraries. The authors found that only two libraries were using chatbots for reference service. For live chat services, the authors found that 78 libraries provided this service. The article discusses possible reasons for the low adoption of chatbots in academic libraries, such as accessibility, privacy, cost, and professional identity issues. The article also provides a case study of the authors' institution, the University of Calgary, which integrated a chatbot service in 2021. The article concludes with suggestions for future research on chatbot use in libraries. [ABSTRACT FROM AUTHOR]

In recent years, the pressure for educators to cultivate civic participation among Canada's apathetic youth voters has been mounting. Between 1998 and 2007, a national wave of curriculum reform introducing or enhancing civic engagement education occurred at the secondary level. In this study, we explore the role and place of civic engagement in the Canadian university curriculum. We have chosen to focus on curriculum in political science programs because calls to increase civic engagement originated with the goal of increasing participation in voting by young people, and because civic engagement is widely espoused as a central value in the discipline of political science. We report the findings of a national survey of politics instructors and their course syllabi regarding civic engagement as an intended learning outcome. Our analysis of the survey data involved a comparison of instructor responses with the assessment activities identified on their course syllabi. By analyzing the real and imagined audience(s) and purpose(s) of course assignments, we find that students are required to complete assignments that situate them within academic contexts involving academic purposes and audiences. The apparent conflict between civic education outcomes and academic assessment tasks relates to broader conversations about the purposes of political science education and higher education in general.

Justice after sexual assault is often understood and enacted through the criminal legal system such that the outcomes are binary (i.e., justice is achieved or not achieved). Previous research indicates that survivors have specific wants and needs following an assault in order to experience justice, which may or may not align with current practices. We conducted a critical interpretive synthesis of 5 databases to create a sampling frame of 4,203 records; the final analysis included 81 articles, book chapters, and policy documents. Results indicate that justice is an individualized and dynamic process which may include the experience of voice, connectedness, participating in a process, accountability, and prevention. The experiences of safety and control are central to each of these domains. Survivors may seek and enact these justice domains through several avenues, including the criminal justice and legal systems, restorative justice, medical/mental health spaces, activism, art, and social media. Existing actors within currently available justice systems, including legal, medical, and mental health personnel should encourage survivors to identify and define their own experience of justice, including locating helpful behaviors rooted in safety and control, and resist a binary model of justice. Extant systems should therefore be flexible and accessible to help survivors realize their preferred modes of justice. [ABSTRACT FROM AUTHOR]

Background: As nonsuicidal self‐injury (NSSI) has become an increasing public health concern, the last few years have seen the emergence of efforts to address NSSI recovery. Although many recovery efforts adopt a medical view of self‐injury and focus on cessation of the behaviour, recovery can mean many different things to different people. In this study, we provide initial empirical validation of the self‐injury recovery framework, by assessing whether different recovery profiles exist. Methods: Our sample comprised 733 participants with lived experience of NSSI (M age = 24.54, sd = 6.39). Participants completed self‐report measures of constructs related to NSSI recovery and NSSI characteristics. Results: Using latent profile analysis, we identified six unique profiles reflecting differences in thoughts/urges to self‐injure, self‐efficacy, social support, optimism, coping, underlying adversities, perceptions of scarring, disclosure, resilience and self‐compassion. Multivariate analyses of variance confirmed these profiles differed according to NSSI characteristics such as frequency of NSSI, a self‐assessment of recovery, the desire to self‐injure or avoid self‐injury and the number of people disclosed to. Limitations: A homogenous sample and cross‐sectional design limit generalisability of our findings across populations and across time. Conclusions: Our findings reinforce that recovery can take many different forms, with different factors being relevant to different individuals. Adopting a person‐centred approach that centres an individual's lived experience and emphasises what is important to them in the recovery process offers opportunities for more empathic responses to self‐injury and better outcomes for individuals who self‐injure. [ABSTRACT FROM AUTHOR]

Nurses are at the forefront of providing health education for the general public and are leaders in developing health education programs for all ages. Research has shown that the pediatric population often experience anxiety surrounding common medical procedures. However, evidence-based health education has been shown to enhance self-management, increase knowledge, and decrease anxiety in the pediatric population. One such successful evidence-based health education approach designed for the pediatric population is the Teddy Bear Clinic. The purpose of this article is to report on the efficacy of a nursing student-led Teddy Bear Clinic designed to increase the awareness of common medical equipment and procedures in the pre-school pediatric population. This quality improvement project used a program evaluation design to assess the children's knowledge of common medical procedures and equipment. Participants were a convenience sample of 16 children aged 3–5 years old, attending one daycare center in a large city in Atlantic Canada. Findings showed that after participation in the clinic, the pre-schoolers reported a high level of knowledge of common medical equipment and procedures. This project shows that a Teddy Bear Clinic run by senior nursing students can promote community partnerships and enhance health knowledge in pre-school children. [ABSTRACT FROM AUTHOR]

This is an interpretive-descriptive analysis of responses to 41 open ended questionnaires returned by academics working beyond normal retirement age. The sample consisted mainly of academics from the United Kingdom, Australia, and New Zealand. The research addressed the question of what motivates some academics to continue working beyond the "usual" retirement age. The main motivation for continuing was strong interest and commitment, particularly to research and writing. Some also gave social, financial, and other reasons for continuing. Those not in full time employment described barriers, including finance and facilities and the support that they needed to maintain their activities. In most countries institutional and government policies made it possible for them to stay involved academically even if it meant making a personal effort. Most of them would have liked better support or recognition from their universities. The results suggest that universities should more actively support older academics in continuing activity.

Research suggests that spiritual transformation, a change in the way a person considers the sacred, can change medical outcome (Pargament, 2006). Psychometric studies have failed to identify specific factors, but qualitative reports detail an experience that can be reliably shown to have an impact. We report on the development of a rubric for quantifying levels of spiritual transformation. Narrative analysis techniques were used to quantify levels of spiritual transformation from participants' life stories, experience with traditional healers, and subsequent medical status. A quantification rubric was developed and 111 assistants rated the stories after a three-hour training session. Inter-observer reliability was 0.87 (95% CI, 0.72 to 0.97, p less than 0.001). Findings suggest it is possible to develop reliable coding scenarios that independent raters can follow to use in research to quantifiably assess spiritual transformation. (Contains 1 footnote.)

In working to build a better, more just future, post-secondary institutions play a crucial role in shaping the students of today and tomorrow. Many institutions already employ a number of innovative programs aimed at broadening students' horizons. We can now look forward to seeing these initiatives grow. As students, we outline our views on some of the challenges and possible avenues for change in post-secondary education. Efforts to strengthen student leadership, optimize experiential learning, and develop a more holistic educational approach are important. Current challenges to post-secondary education lie within aspects of accessibility, funding, relationship disconnect, and segregated educational approaches. Strengths and challenges encountered within post-secondary education can frame learning boundaries to be deconstructive or constructive. Both boundary modalities can play important roles in designing the future of post-secondary education in Canada.

The null hypothesis test used in differential item functioning (DIF) detection tests for a subgroup difference in item-level performance--if the null hypothesis of "no DIF" is rejected, the item is flagged for DIF. Conversely, an item is kept in the test form if there is insufficient evidence of DIF. We present frequentist and empirical Bayes approaches for implementing statistical equivalence testing for DIF using the Mantel-Haenszel (MH) DIF statistic. With these approaches, rejection of the null hypothesis of "DIF" allows the conclusion of statistical equivalence, a more stringent criterion for keeping items. In other words, the roles of the null and alternative hypotheses are interchanged in order to have positive evidence that the DIF of an item is small. A simulation study compares the equivalence testing approaches to the traditional MH DIF detection method with the Educational Testing Service classification system. We illustrate the methods with item response data from the 2012 Programme for International Student Assessment.

Canada is one of many representative democracies with low youth representation in parliament of the age cohorts 30 years or under, 35 years or under, and 40 years or under. While most research tries to examine structural- or party-level factors responsible for youth's low presence in politics, our study is interested in politicians' perspectives. Are candidates and elected officials aware of youth's low presence in the Canadian House of Commons? Do they find this dearth of representation problematic, and if so, what remedies do they suggest to alleviate the situation? We try to answer these questions through original survey research of candidates and elected representatives of the 2019 and 2021 Canadian general elections. Our results reveal interesting patterns. Most of the surveyed are aware that youth representation is lacking behind youth's distributive share of the population in Canada. However, only a minority of the survey respondents finds this problematic. Interestingly, there is also not enough support for proactive measures such as youth quotas or term limits to increase youth representation in the House of Commons. [ABSTRACT FROM AUTHOR]

There is an urgent need to develop an international competency and capability framework to support standardization of education and roles in advanced practice physiotherapy (APP). This need arose due to the rapid growth of the APP model of care, implemented out of necessity in the absence of agreement as to the competencies and capabilities or formal education required for the roles. This study explores the views and perceptions of practitioners and key stakeholders on a draft competency and capability framework for advanced practice physiotherapists. The purpose of this study was to: 1) gather feedback from key stakeholders (advanced practice physiotherapists, researchers, and leaders) on a draft competency and capability framework and 2) use that feedback to revise and improve the draft framework. Qualitative study using a series of four multi-national online focus groups. Thematic analysis was conducted according to Braun and Clarke. Sixteen participants from the United Kingdom, Ireland, Canada, Australia, and New Zealand participated in the study. Five themes were generated after data analysis: clinical expert, experienced communicator, strong leader, collaborator, and knowledge creator). A modified competency and capability framework was developed based on feedback from the focus groups and input from subject matter experts (SMEs). This study provides a modified core competency and capability framework comprising 24 competencies grouped under six domains. This study is a step toward international standardization of advanced practice physiotherapy based on a commonly agreed framework for the education and training of advanced practice physiotherapists. [ABSTRACT FROM AUTHOR]

In this article, the authors explore how mobile learning can complement the Certificate of Indigenous Languages program at the University of Saskatchewan in Western Canada. Through the FRAME model analysis, the authors extract salient cultural, pedagogical, environmental, and technological characteristics that should be considered in the development of mobile learning tools and approaches for Cree language teachers. It is hoped that this article will stimulate a dialogue amongst designers and Indigenous groups regarding language sustainability through mobile learning. The article concludes with key findings: the need to follow protocols, to establish good relationships, and to design for areas of low/no bandwidth. Finally, the examination of current Indigenous language learning methods provides ideas for the development of much needed "apps" appropriate for Cree learners and teachers.

The current prostate cancer (PCa) screen test, prostate-specific antigen (PSA), has a high sensitivity for PCa but low specificity for high-risk, clinically significant PCa (csPCa), resulting in overdiagnosis and overtreatment of non-csPCa. Early identification of csPCa while avoiding unnecessary biopsies in men with non-csPCa is challenging. We built an optimized machine learning platform (ClarityDX) and showed its utility in generating models predicting csPCa. Integrating the ClarityDX platform with blood-based biomarkers for clinically significant PCa and clinical biomarker data from a 3448-patient cohort, we developed a test to stratify patients' risk of csPCa; called ClarityDX Prostate. When predicting high risk cancer in the validation cohort, ClarityDX Prostate showed 95% sensitivity, 35% specificity, 54% positive predictive value, and 91% negative predictive value, at a ≥ 25% threshold. Using ClarityDX Prostate at this threshold could avoid up to 35% of unnecessary prostate biopsies. ClarityDX Prostate showed higher accuracy for predicting the risk of csPCa than PSA alone and the tested model-based risk calculators. Using this test as a reflex test in men with elevated PSA levels may help patients and their healthcare providers decide if a prostate biopsy is necessary. [ABSTRACT FROM AUTHOR]

A marine protected area (MPA) network of multiple reserves can protect biodiversity across space, but to be effective, network configuration should support dispersal among MPAs as well as spillover to unprotected habitats. The ability of MPAs to function as an interacting network of populations connected by dispersal, however, is difficult to estimate at broad spatial scales, and therefore, connectivity is often not integrated in MPA design. Here, we simulate passive larval dispersal using a biophysical model to estimate potential transboundary network connectivity of MPAs in western Canada and United States. Drift time was varied to represent generic functional groups of nearshore species with planktonic larvae and sedentary adult stages. We found that MPAs potentially act as an interacting network and meet connectivity design criteria for nearshore invertebrate species, many MPAs (65%–90%) possibly exchange individuals, and a third of larvae from MPAs (25%–32%) source areas of the unprotected coast. This analysis provides a first approximation of multispecies connectivity to inform ongoing transboundary MPA design, and it can be used as a foundation for future model development. [ABSTRACT FROM AUTHOR]

Background: Research demonstrates sustained return to work (RTW) by individuals on medical leave is influenced by personal and job resources and job demands. Relatively few studies have been conducted in the workers' compensation context that is known to have longer absence durations for RTW. Aims: This study sought to illuminate workers' experience as they returned to work following a work injury that was either psychological in nature or involved more than 50 days of disability, with a focus on the co-worker, supervisor, and employer actions that supported their return. Methods: Workers in Saskatchewan, Canada, with a work-related psychological or musculoskeletal injury, subsequent disability, and who returned to work in the last three years, were invited to complete an online survey comprising of freetext questions. Thematic analysis was used to explore participants' experiences. Results: Responses from 93 individuals were analysed. These revealed that persistent pain, emotional distress, and loss of normal abilities were present during and beyond returning to work. Almost two-thirds indicated that the supervisors' and co-workers' support was critical to a sustained return to work: their needs were recognized and they received autonomy and support to manage work demands. By contrast, one-third indicated that the support they expected and needed from supervisors and employers was lacking. Conclusions: Workers returning to work lacked personal resources but co-workers' and supervisors' support helped improve confidence in their ability to RTW. Supervisors and employers should acknowledge workers' experiences and offer support and autonomy. Likewise, workers can expect challenges when returning to work and may benefit from cultivating supportive relationships with co-workers and supervisors. [ABSTRACT FROM AUTHOR]

The declaration of brain death (BD), or death by neurological criteria (DNC), is medically and legally accepted throughout much of the world. However, inconsistencies in national and international policies have prompted efforts to harmonize practice and central concepts, both between and within countries. The World Brain Death Project was published in 2020, followed by notable revisions to the Canadian and US guidelines in 2023. The mission of these initiatives was to ensure accurate and conservative determination of BD/DNC, as false-positive determinations could have major negative implications for the medical field and the public's trust in our ability to accurately declare death. In this Review, we review the changes that were introduced in the 2023 US BD/DNC guidelines and consider how these guidelines compare with those formulated in Canada and elsewhere in the world. We address controversies in BD/DNC determination, including neuroendocrine function, consent and accommodation of objections, summarize the legal status of BD/DNC internationally and discuss areas for further BD/DNC research. This Review reviews changes introduced into the US brain death/death by neurological criteria (BD/DNC) guidelines in 2023 and compares these guidelines with those formulated elsewhere in the world. The authors highlight controversies and legal challenges in BD/DNC determination and discuss future research priorities. Key points: Brain death (BD), or death by neurological criteria (DNC), has been a medically and legally accepted formulation of death throughout the world for more than half a century. Guideline updates are intended to strengthen the methods and practice of BD/DNC determination; these include the World Brain Death Project (WBDP) in 2020, the Canadian guideline update in 2023, and the US combined paediatric and adult guidelines from multiple societies in 2023. New guidance has emerged for BD/DNC determination in several challenging circumstances, including hypothermia, carbon dioxide retention, primary infratentorial injury, extracorporeal membrane oxygenation and pregnancy. Guidelines continue to emphasize a meticulous and systematic approach, erring on the conservative side, to reduce the possibility of false-positive BD/DNC determination. Acceptable ancillary tests, which are only to be used when a complete clinical evaluation is not possible or safe, comprise tests of cerebral blood flow, such as four-vessel catheter angiography, radionuclide perfusion scintigraphy and transcranial Doppler ultrasonography (in adults only). EEG is no longer accepted as an ancillary test, and the most recent US guidelines and the WBDP do not permit the use of CT angiography. [ABSTRACT FROM AUTHOR]

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Medical cannabis (MC) may offer therapeutic benefits for children with complex neurological conditions and chronic diseases. In Canada, parents, and caregivers frequently report encountering barriers when accessing MC for their children. These include negative preconceived notions about risks and benefits, challenges connecting with a knowledgeable healthcare provider (HCP), the high cost of MC products, and navigating MC product shortages. In this manuscript, we explore several of these barriers and provide recommendations to decision-makers to enable a family-centered and evidence-based approach to MC medicine and research for children. [ABSTRACT FROM AUTHOR]

Background: The need for new therapies to improve survival and outcomes in pediatric oncology along with the lack of approval and accessible clinical trials has led to "out‐of‐trial" use of innovative therapies. We conducted a retrospective analysis of requests for innovative anticancer therapy in Canadian pediatric oncology tertiary centers for patients less than 30 years old between 2013 and 2020. Methods: Innovative therapies were defined as cancer‐directed drugs used (a) off‐label, (b) unlicensed drugs being used outside the context of a clinical trial, or (c) approved drugs with limited evidence in pediatrics. We excluded cytotoxic chemotherapy, cellular products, and cytokines. Results: We retrieved data on 352 innovative therapy drug requests. Underlying diagnosis was primary CNS tumor 31%; extracranial solid tumor 37%, leukemia/lymphoma 22%, LCH 2%, and plexiform neurofibroma 6%. RAS/MAP kinase pathway inhibitors were the most frequently requested innovative therapies in 28% of all requests followed by multi‐targeted tyrosine kinase inhibitors (17%), inhibitors of the PIK3CA‐mTOR‐AKT pathway (8%), immune checkpoints inhibitors (8%), and antibody drug conjugates (8%). In 112 out of 352 requests, innovative therapies were used in combination with another anticancer agent. 48% of requests were motivated by the presence of an actionable molecular target. Compassionate access accounted for 52% of all requests while public insurance was used in 27%. Mechanisms of funding varied between provinces. Conclusion: This real‐world data collection illustrates an increasing use of "out‐of‐trial" innovative therapies in pediatric oncology. This new field of practice warrants further studies to understand the impact on patient trajectory and equity in access to innovative therapies. [ABSTRACT FROM AUTHOR]

Traditionally in Canada, attention to political or civic education has been at the primary- or secondary-school level. This study focuses on the place of civic engagement in introductory Canadian politics and government university courses in Canada by surveying instructors on their attitudes and approaches to civic engagement in the classroom. Surveying 28 instructors from across the country from large and small, English and French institutions, we compared survey results to collected course syllabi from the participants. In our study, we found that there is a clear disconnect between what instructors believe is the most effective way to foster civic engagement and what they are assigning their students to complete for course requirements.

In 2002/2003, the National Epidemiologic Database for the Study of Autism in Canada started capturing information on children diagnosed with autism in different regions of the country. Based on data collected through 2008 in Newfoundland and Labrador and 2010 in Prince Edward Island and Southeastern Ontario, the estimated average annual percent increases in prevalence among children 2-14 years of age ranged from 9.7% (95% CI 7.8-11.6) to 14.6% (95% CI 11.3-18.0). Differential in-migration and identification of previously undetected cases may have contributed in part to the increases observed, but we cannot rule out the possibility of a true increase in incidence, particularly given the lack of a leveling-off of prevalence among the 6- to 9-year olds.

The Violence Risk Scale (VRS) uses ratings of static and dynamic risk predictors to assess violence risk, identify targets for treatment, and assess changes in risk following treatment. The VRS was rated pre- and posttreatment on a sample of 150 males, mostly high-risk violent offenders many with psychopathic personality traits. These individuals attended a high-intensity institution-based cognitive-behavioral-oriented violence reduction treatment program in Canada and were then followed up for approximately 5 years postrelease to determine court adjudicated community violent recidivism. VRS scores significantly predicted violent recidivism. Measurements of risk reduction using dynamic VRS predictors were significantly correlated with reduction of violent recidivism after controlling for various potential confounds. The results suggest that, in a high-risk group of offenders with significant psychopathic traits, the VRS demonstrated predictive validity and the dynamic predictors can be used to assess treatment progress, which is linked to a specific criterion variable, thus, fulfilling the criteria for causal dynamic predictors set forth by Kraemer et al. Appended are Violence Risk Scale Static and Dynamic Items and Brief Item Descriptions. (Contains 4 tables, 2 figures, and 4 notes.)

Indigenous worldviews remain at the margins of education, science, and sustainability efforts. The emergence of sustainable science holds promise as a means of advancing deep sustainability and recentering Indigenous knowledge. Transformative learning's engagement with sustainable science has the potential to play an integral role in this paradigmatic shift which necessitates a broader legitimation of our ecology as a deeply interconnected living system. An important part of this project is learner-centred critical onto-epistemological inquiry--the critical study of one's own reality and implications for ecological relationship. Drawing on Intuitive Inquiry and Kaupapa Maori research, this article illuminates the partial decolonization of my own Life-World and arrival at a deepened sense of ecological relationship. Initially focusing on "the dreaming," it integrates my visceral experiences of the land and Indigenous constructions of reality through interviews with Ngai Te Rangi and Plains Cree elders. The implications for transformative learning and sustainability are discussed.

Purpose: To examine national trends in the adoption and use of the LI-RADS Treatment Response Algorithm. Methods: Members of the Society of Abdominal Radiology (SAR) Disease-Focused Panel (DFP) on LI-RADS Treatment Response (LR-TR) of hepatocellular carcinoma (HCC) developed a 15-question survey which was distributed to radiologists at academic and private practice institutions around the USA and Canada. The survey focused on HCC-related practice patterns as well as the adoption and use of the LR-TR algorithm. Results: Of 122 surveys distributed, a total of 76 radiologists responded (62%). Responders were predominantly from academic centers (85%). Nearly all (96%) participate in multidisciplinary hepatic tumor boards and most (67%) have an active liver transplant program. All responders' institutions perform locoregional therapy for HCC, including radiation-based therapy (TARE and SBRT). There was a preference for use of MRI over CT for follow-up after locoregional therapy. All responders were aware of the LR-TR algorithm and nearly all (92%) used the system in routine practice. Radiologists expressed a need for more visual aids related to the LR-TR system. Multiple respondents requested additional clarity within the LR-TR algorithm regarding the evolution of post-treatment radiation changes over time. Conclusion: Most survey participants use the LR-TR algorithm after locoregional therapy for HCC. Future iterations of the algorithm may benefit from increased clarity regarding response after radiation-based therapies. Educational materials should include more visual aids to improve reader understanding. [ABSTRACT FROM AUTHOR]

Early visual deprivation impairs some, but not all, aspects of face perception. We investigated the possible developmental roots of later abnormalities by using a face detection task to test infants treated for bilateral congenital cataract within 1 hour of their first focused visual input. The seven patients were between 5 and 12 weeks old ("n" = 3) or older than 12 weeks ("n" = 4). Like newborns, but unlike visually normal age-matched controls, the patients looked preferentially toward "config" (three squares arranged as facial features) over its inverted version and none of the older patients preferred a positive-contrast face over the negative-contrast version. We conclude that postnatal changes in face perception are experience-dependent, and that interference with their typical development may contribute to later deficits in face processing. (Contains 1 table, 1 figure and 1 note.)

Nonsuicidal self-injury (NSSI) is a significant issue among college students but few resources are available to college mental health professionals. This article consolidates extant knowledge on NSSI from the empirical and clinical literature, including common NSSI characteristics (rates, methods, demographics, and concomitants), intrapersonal and social functions, and NSSI's relation to suicide. Practical strategies for assessing NSSI among students are presented, as are empirically informed treatments. With this knowledge, college mental health professionals will have a theoretical and practical understanding of NSSI and will be better equipped to work with students who self-injure.

Designing for the needs of people with impairments has rarely been a significant feature of urban planning theory and education. Given the role of urban planners as shapers of the built environment and public policy, the prevalence of negative and misinformed attitudes among planners toward impaired populations has been highlighted as requiring study. This paper reports on the effectiveness of lecture-based awareness training and active impairment simulation activities with regard to their respective influence on the attitudes of urban planning students toward people with impairments. Using an established attitude assessment instrument (the Attitudes Toward Disablement Scale), pre and post-awareness training data were collected from 200 urban planning students. Results suggest that awareness training can result in significant attitude changes while, contrary to published literature and prior assumptions, impairment simulations have a moderate effect on student attitudes. The paper concludes with recommendations for planning education and professional practice. (Contains 3 tables.)

University instructors were surveyed to determine the requirements for their literary braille courses. Twenty-one instructors provided information on the textbooks they used; how they determined errors; reading proficiency requirements; and other pertinent information, such as methods of assessing mastery of the production of braille using a Perkins brailler, slate and stylus, and Perky Duck. (Contains 2 tables.)

This study reports the results of a five-year follow-up survey of private-pay outdoor behavioral healthcare (OBH) programs operating in the United States and Canada. A total of 65 of 102 programs identified as meeting certain characteristics responded to the survey and identified themselves as an OBH program that utilizes a clinical treatment model that primarily uses wilderness expeditions. The goal of the study was to determine industry trends by comparing the results of this study to results generated in a 2001 survey of OBH programs. An additional goal of the study was to discuss the findings in the context of recent reports on OBH and related programs concerning program management and practice. Key findings indicate that the number of OBH programs operating appears to have increased since 2001, and that the clear majority of these programs are state-licensed and half are accredited. Family involvement in programming has decreased, as has the number of families receiving co-pay to help alleviate the costs of treatment. Field instructor training and qualifications, supervision, and oversight of daily treatment and program operation, and drug detoxification practices at admission are all issues that warrant further investigation. A conclusion is made that care should be taken by policy makers and others when making broad generalizations that implicate all OBH treatment programs, when it appears that most programs are licensed, have licensed clinicians on staff, and adhere to best practices in treatment as identified by a variety of agency and association standards.

There has been little evidence to support the hypothesis that diagnostic substitution may contribute to increases in the administrative prevalence of autism. We examined trends in assignment of special education codes to British Columbia (BC) school children who had an autism code in at least 1 year between 1996 and 2004, inclusive. The proportion of children with an autism code increased from 12.3/10,000 in 1996 to 43.1/10,000 in 2004; 51.9% of this increase was attributable to children switching from another special education classification to autism (16.0/10,000). Taking into account the reverse situation (children with an autism code switching to another special education category (5.9/10.000)), diagnostic substitution accounted for at least one-third of the increase in autism prevalence over the study period.

This article, detailing the implications of "ethics drift" for critical work in the academy, reports on an ethics challenge to a non-research-based scholarly text. It analyzes how General Research Ethics Boards (GREBs) can threaten academic freedom when they lack a clear definition of "human subject" research, fail to distinguish between empirical research using humans and scholarly engagement of important social/political issues within human contexts, and overstep the limits of their jurisdiction when they agree to arbitrate on scholarship that ought to be resolved through open debated rather than administrative mechanisms. The article emphasizes that in public democratic institutions, those who contribute to decisions and policies, whether through formal process or by informal tacit ideology, are acting not as individuals but as functionaries of the institution and must bear public accountability and its attendant critiques. The article ends with a recommendation for arms-length oversight of the workings of GREBs. (Contains 14 notes.)

There is considerable controversy over reasons for observed increases in the prevalence of autism spectrum disorders. We examined trends in British Columbia education database coding of children with autism from 1996 to 2004. There was a significant linear increase in autism prevalence. The proportion of children identified by age 6 increased significantly from 1996 to 1999. When we calculated prevalence assuming onset prior to age 3, previously unidentified cases, particularly among girls in 1996 and 1997, accounted for substantial increases in estimated prevalence. The magnitude of under-identification decreased from 1996 to 2000, and rose slightly in 2001. Analyses of prevalence trends must take into account effects of earlier age at identification and inclusion of previously undetected cases on prevalence estimates.

Background: Avoidable disparities in health outcomes persist in Canada despite substantial investments in a publicly funded health care system that includes preventive services. Our objective was to provide preventive care recommendations that promote health equity by prioritizing effective interventions for people experiencing disadvantages. Methods: The guideline was developed by a primary care provider–patient panel, with input from a patient-partner panel with diverse lived experiences. After selecting priority topics, we searched for systematic reviews and recent randomized controlled trials of screening and other relevant studies of screening accuracy and management efficacy. We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to develop recommendations and followed the Appraisal of Guidelines for Research and Evaluation (AGREE II) reporting guidance. We managed competing interests using the Guideline International Network principles. The recommendations were externally reviewed by content experts and circulated for endorsement by national stakeholders. Recommendations: We developed 15 screening and other preventive care recommendations and 1 policy recommendation on improving access to primary care. We recommend prioritized outreach for colorectal cancer screening starting at age 45 years and for cardiovascular disease risk assessment, to help address inequities and promote health. Specific interventions that should be rolled out in ways that address inequities include human papillomavirus (HPV) self-testing, HIV self-testing and interferon-γ release assays for tuberculosis infection. Screening for depression, substance use, intimate partner violence and poverty should help connect people experiencing specific disadvantages with proven interventions. We recommend automatic connection to primary care for people experiencing disadvantages. Interpretation: Proven preventive care interventions can address health inequities if people experiencing disadvantages are prioritized. Clinicians, health care organizations and governments should take evidence-based actions and track progress in promoting health equity across Canada. [ABSTRACT FROM AUTHOR]