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Simple Summary: Oral cancers are associated with high mortality in advanced stages. Early diagnosis is associated with better patient outcomes, but this is challenging to achieve as benign lesions look similar to lesions of concern, and multiple biopsies may be required to ensure the most pathologic tissue is sampled. This work leverages a previously developed endoscopic imaging system and deep learning segmentation tool to provide measurements of subsurface changes in the first few millimeters of oral tissue. We present seven quantitative features that allow for rapid examination of tissue, which we propose may be useful for biopsy site or treatment margin selection. Optical coherence tomography is a noninvasive imaging technique that provides three-dimensional visualization of subsurface tissue structures. OCT has been proposed and explored in the literature as a tool to assess oral cancer status, select biopsy sites, or identify surgical margins. Our endoscopic OCT device can generate widefield (centimeters long) imaging of lesions at any location in the oral cavity—but it is challenging for raters to quantitatively assess and score large volumes of data. Leveraging a previously developed epithelial segmentation network, this work develops quantifiable biomarkers that provide direct measurements of tissue properties in three dimensions. We hypothesize that features related to morphology, tissue attenuation, and contrast between tissue layers will be able to provide a quantitative assessment of disease status (dysplasia through carcinoma). This work retrospectively assesses seven biomarkers on a lesion-contralateral matched OCT dataset of the lateral and ventral tongue (40 patients, 70 sites). Epithelial depth and loss of epithelial–stromal boundary visualization provide the strongest discrimination between disease states. The stroma optical attenuation coefficient provides a distinction between benign lesions from dysplasia and carcinoma. The stratification biomarkers visualize subsurface changes, which provides potential for future utility in biopsy site selection or treatment margin delineation. [ABSTRACT FROM AUTHOR]

Worldwide, policymakers, health system managers, practitioners and researchers struggle to use evidence to improve policy and practice. There is growing recognition that this challenge relates to the complex systems in which we work. The corresponding increase in complexity-related discourse remains primarily at a theoretical level. This paper moves the discussion to a practical level, proposing actions that can be taken to implement evidence successfully in complex systems. Key to success is working with, rather than trying to simplify or control, complexity. The integrated actions relate to co-producing knowledge, establishing shared goals and measures, enabling leadership, ensuring adequate resourcing, contributing to the science of knowledge-to-action, and communicating strategically.

Some ethical dilemmas are more prevalent or more complicated to resolve in rural practice. In this practice note, I share some of the reflections that have helped me to unpack some of the ethical complications of overlapping relationships and objectivity, community pressure and integrity, generalist practice and competency, interdisciplinary collaboration and confidentiality, and professional development and support in rural professional practice.

This article presents a review of the Canadian Academic English Language (CAEL) Assessment, a high stakes standardized test of the English language. It is a topic-based test that integrates listening, reading, writing and speaking. The test is designed to describe the level of English language proficiency of test takers planning to study at English-medium colleges and universities. The test has many positive qualities, including innovation, use of topics, and integration of skills as well as a professional and easy to navigate website. Its innovation in use of topics consistently throughout the test form is remarkable. In addition, the skills are truly integrated across the modalities. The integration is not abrupt, wherein, for example, listening finishes and writing begins but instead skills are revisited through the test. The effort and research involved in developing and operationalizing the test demonstrate a commitment to innovation in language testing and a sincere attempt to change the approach to the college entrance English language test. At the same time, the test has some weaknesses. Although the website is easy to navigate, the print materials are difficult to manage and the layout is often challenging to read. The task prompts for writing and speaking are more open-ended and less focused than those found on other large-scale tests of English, which may result in lack of consistent elicitation in future studies. The author concludes that while the careful design and intent of this test are admirable and represent a genuine effort to increase the validity of the English language admissions test for non-native speakers of English, additional validity and reliability studies must be carried out to support it. At the same time, this innovative approach to test should be recognized. With its many different types of tasks, the CAEL represents a clear alternative to the more common multiple-choice tests used for similar purposes. In addition, the philosophy behind the test reflects a respect for the test purpose and test taker. By developing integrated tasks, the test developers recognize the need for test tasks to reflect the academic context. Moreover, the instructions to test administrators reflect the ILTA Code of Practice in the reminder to treat examinees kindly and humanely.

Purpose: The purpose is to ascertain the state of sustainability in higher education (SHE) in Atlantic Canada (sustainability education/curriculum; research and scholarship; operations; faculty/staff development and rewards; community outreach and service; student opportunities; and institutional mission, structure and planning). Design/methodology/approach: All Association of Universities and Colleges of Canada (AUCC) member institutions in Atlantic Canada were sampled in 2005/2006 to examine sustainability performance. Data were collected using the sustainability assessment questionnaire (SAQ) and were triangulated with document, webpage, and additional survey research. Findings: The majority of higher education institutions in Atlantic Canada are engaged in sustainable development work, most notably in the area of curriculum. Sustainability research and scholarship is spread amongst faculty and students; many institutions have inter- or multi-disciplinary research structures to address sustainability questions across campus and in collaboration with community partners. Much unrealized potential remains within physical operations, faculty/staff development and rewards, and student opportunities. No single university emerges as the Atlantic Canadian SHE leader; Acadia University (Wolfville, Nova Scotia), St Francis Xavier University (Antigonish, Nova Scotia) and Mt Allison University (Sackville, New Brunswick) excel in a regional peers comparison. Research limitations/implications: The Atlantic Canada study commences a series of five regional SHE assessments in Canada. Practical implications: The study strengthens ongoing efforts for creative institutional solutions to reduce the ecological footprint of higher education institutions. It contributes to SHE knowledge transfer and capacity-building. Originality/value: The study is the first regional SHE performance assessment in Canada. It serves as a pilot study and strategic planning tool. (Contains 9 tables, 2 figures, and 2 notes.)

This study examined each of the 192 Member States of the United Nations to address three important questions: (1) how many countries have professionals who provide school psychology services; (2) which countries do and do not have school psychologists; (3) what evidence of school psychology is available in each country. Of the 192 Member States of the United Nations there was evidence of school psychology in 83. Furthermore, this study revealed evidence of: regulations that require school psychologists to be licensed, registered or credentialed in 29 countries; professional associations specifically for school psychologists in 39 countries; university preparation programs for school psychologists in 56 countries and doctoral preparation programs in school psychology in 19 countries. This study advances our knowledge of the profession of school psychology as of 2007. (Contains 2 tables.)

Sexual health education (SHE) is an important rehabilitation component for acute coronary syndrome (ACS) survivors but is not routinely provided. This study's purpose was to explore healthcare providers' experiences of providing SHE to ACS survivors in cardiac rehabilitation programs to identify best practices. This qualitative study used convenience sampling and an interpretive descriptive design. Inclusion criteria were a healthcare provider employed within a cardiac rehabilitation program in a Western Canadian province. Eight cardiac rehabilitation healthcare providers volunteered to participate. The first author conducted semi-structured, digitally recorded interviews that were transcribed verbatim. The interviews were guided by a semi-structured interview guide anchored in the strengths-based, sex positive guiding frameworks. A reflective journal and socio-demographic forms served as additional data sources. Data were analyzed using open, axial, and selective coding as well as constant comparative analysis. Credibility was ensured through peer-reviewed evaluation criteria. Eight healthcare providers participated in the study. Participants equated sexuality and sexual health with physical activity and physical health. Findings identified philosophical perspectives and several barriers and facilitators that impact SHE provision. Participants offered strategies that may be used in practice and their recommendations provide a beginning foundation to improve cardiac rehabilitation programs and the health of ACS survivors. Healthcare providers in cardiac rehabilitation programs described their SHE experiences as "just think of it as sexercise." Facilitation of SHE is important as previous studies found that SHE may reduce fear, depression, and anxiety and increase the return to sexual activity among ACS survivors. Sexual health doesn't need to be a taboo topic. Approach sexual health conversations by thinking of it as "sexercise". Don't let silos stop sexual health education – talk to your coworkers and patients about sexual health. Knowledge about sexual health, timing of sexual health education, and communication between care providers and patients are important factors in delivery of sexual health education. [ABSTRACT FROM AUTHOR]

The Neoproterozoic Jacobsville Sandstone outcrops along the south and east shores of Lake Superior, USA. It records intraplate deformation, some during its deposition and some afterwards, after the c. 1,100 Ma Midcontinent Rift (MCR) failed. Here we analyse 549 new detrital zircon ages from five sites, combined with prior data. Initially, local palaeo‐topography controlled the source material, including the MCR‐adjacent Penokean and Archaean rocks. With time the percentage of distal sources increased, including the c. 1,300–980 Ma Grenville orogeny and 1,480–1,360 Ma Granite‐Rhyolite Province. Sites near the Keweenaw fault contain a significant number of MCR‐age zircons, presumably uplifted to the surface, indicating fault motion during deposition. Only a relatively small percentage of 1,090–980 Ma Grenville‐age zircons from collisions to the east are present, suggesting that they were not efficiently transported to the Lake Superior area. This work is innovative in that it is the first to use detrital zircon geochronology to understand the internal stratigraphy of the Jacobsville Sandstone, whose provenance provides new information about the Neoproterozoic tectonic and sedimentary history of Laurentia. [ABSTRACT FROM AUTHOR]

Many innovative small and medium enterprises (SMEs) face unique challenges in protecting their intellectual property (IP). Potential theft of trade secrets is a key feature of these challenges, which arises often in the context of disputes related to employee mobility. Despite the risks these challenges pose, SMEs often confront significant resource barriers in protecting themselves from trade secret theft. The passage of a recent criminal law by the Canadian federal government, section 391 of the Criminal Code, creates a powerful new tool for innovative SMEs to report, investigate, and prosecute theft of trade secrets. It also comes with specific considerations and risks that innovative SMEs should examine and contemplate. This article explores strategies for SMEs in Canada to use section 391 to protect their trade secrets, navigate the legal environment during theft of a trade secret, and remediate such theft. [ABSTRACT FROM AUTHOR]

Background: Acute kidney injury (AKI) is a common complication in critically ill patients. Renal replacement therapy may be prescribed for patients in AKI and may be provided in the form of intermittent hemodialysis or continuous renal replacement therapy (CRRT). CRRT is suitable for unstable critically ill patients, as it involves a slow continuous process. An intense nursing workload is required for this procedure in addition to caring for a critically ill patient. Therefore, it is important to understand nursing practices. Purpose: A Canadian survey was conducted to gain insight into CRRT nursing practices. This article focuses on selected results pertaining to patient safety. Methods: The design for this study was descriptive using a survey. The target population was ICU nurse educators at Canadian teaching and community hospitals. Topics in the survey included: staff education, CRRT ordering and initiation practices, vascular access, filters and filter life, anticoagulation methods and safety concerns. Findings: One hundred and twenty-nine surveys were mailed out and 73 were returned for a response rate of 57%. In the return surveys, all provinces were represented, but not the territories. Of the 73 completed surveys, 36 (49%) of the hospitals used CRRT. The findings revealed that educators identified several safety concerns related to anticoagulation, vascular access, machine malfunction and medication errors. Conclusion: Specific strategies were identified related to safety concerns. Registered nurses need knowledge and expertise to care for patients on CRRT and are valuable members of the interprofessional team in ensuring patient safety. [ABSTRACT FROM AUTHOR]

The article focuses on cybersecurity policy of the U.S. and Canada. It presents ideas about how to handle cyber security policy by looking at the directions taken by the United States and Canadian governments. It also describes the history and nature of cyberspace and further discusses Internet policy of the U.S. and changes in computer network secirity with the advancement of computer technology.

In this study, we assessed the quality of publicly available cancer-related physical activity ( PA) information appearing on reputable sites from Canada and other English-speaking countries. A cross-sectional Internet search was conducted on select countries (Canada, USA, Australia, New Zealand, UK) using Google to generate top 50 results per country for the keywords ''physical activity' AND 'cancer''. Top results were assessed for quality of PA information based on a coding frame. Additional searches were performed for Canadian-based sites to produce an exhaustive list. Results found that many sites offered cancer-related PA information (94.5%), but rarely defined PA (25.2%). Top 50 results from each country did not differ on any indicator examined. The exhaustive list of Canadian sites found that many sites gave information about PA for survivorship (78.3%) and prevention (70.0%), but rarely defined (6.7%) or referenced PA guidelines (28.3%). Cancer-related PA information is plentiful on the Internet but the quality needs improvement. Sites should do more than mention PA; they should provide definitions, examples and guidelines. With improvements, these websites would enable healthcare providers to effectively educate their patients about PA, and serve as a valuable resource to the general public who may be seeking cancer-related PA information. [ABSTRACT FROM AUTHOR]

Background: Treatment with tamoxifen or chemotherapy reduces the risk of contralateral breast cancer (CBC). However, it is uncertain how long the protection lasts and whether the protective effect is modified by patient, tumor, or treatment characteristics.Methods: The population-based WECARE Study included 1521 cases with CBC and 2212 age- and year of first diagnosis-matched controls with unilateral breast cancer recruited during two phases in the USA, Canada, and Denmark. Women were diagnosed with a first breast cancer before age 55 years during 1985-2008. Abstraction of medical records provided detailed treatment information, while information on risk factors was obtained during telephone interviews. Risk ratios (RRs) and 95 % confidence intervals (CIs) for CBC were obtained from multivariable conditional logistic regression models.Results: Compared with never users of tamoxifen, the RR of CBC was lower for current users of tamoxifen (RR = 0.73; 95 % CI = 0.55-0.97) and for past users within 3 years of last use (RR = 0.73; 95 % CI = 0.53-1.00). There was no evidence of an increased risk of estrogen receptor-negative CBC associated with ever use of tamoxifen or use for 4.5 or more years. Use of chemotherapy (ever versus never use) was associated with a significantly reduced RR of developing CBC 1-4 years (RR = 0.59; 95 % CI = 0.45-0.77) and 5-9 years (RR = 0.73; 95 % CI = 0.56-0.95) after first breast cancer diagnosis. RRs of CBC associated with tamoxifen or with chemotherapy use were independent of age, family history of breast cancer, body mass index and tumor characteristics of the first breast cancer with the exception that the RR of CBC was lower for lobular histology compared with other histologies.Conclusion: Our findings are consistent with previous studies showing that treatment with tamoxifen or chemotherapy is associated with a lower risk of CBC although the risk reduction appears to last for a limited time period after treatment is completed. [ABSTRACT FROM AUTHOR]

Background. Acute kidney injury (AKI) is a common complication in critically ill patients. Renal replacement therapy is prescribed for as many as 70% of critically ill patients in AKI and may be provided in the form of intermittent or continuous dialysis including intermittent hemodialysis, sustained low-efficiency dialysis, and continuous renal replacement therapy (CRRT). CRRT is commonly used for unstable critically ill patients, as it involves a slow continuous process. The nursing work involved with CRRT is highly complex and the learning requirements are challenging; therefore, it is important to identify nursing practices. Purpose. A national survey was conducted to gain insight into CRRT nursing practices. Methods. The design for this study was descriptive using a survey. The target population for this survey was ICU nurse educators at Canadian teaching and community hospitals. Topics in the survey included staff education, CRRT ordering and initiation practices, vascular access, filters and filter life, fluids used, anticoagulation methods, adverse events, and greatest concerns. Findings. One hundred and twenty-nine surveys were sent out and 73 were returned for a response rate of 57%. Thirty-six hospitals used CRRT and of these, 73% had used CRRT for more than eight years. The findings revealed that educators identified achieving and maintaining competence as their greatest concern related to CRRT practices. Conclusion. The findings of this research revealed that consistent training programs were not the norm. The complexity of caring for patients on CRRT requires consideration of when to introduce to staff the technology and care of patients on CRRT and how to sustain their competence. [ABSTRACT FROM AUTHOR]

The coast of Conception Bay South (CBS), near the community of Manuels, is characterized by bluffs of Quaternary glaciofluvial sediment, and steep gravel and sand beaches and barachoix. As CBS is subject to winter storms which eat away at these materials, and the region has experienced a rapid growth in coastal development in recent years, coastal erosion is a concern. An open field bordered by a bluff (5 to 8 m high and 120 m long) at the end of Flats Road, Manuels, was chosen for geophysical surveys to determine the nature of the subsurface. The three geophysical techniques used were ground penetrating radar (GPR), direct-current resistivity (DCR) and real-time kinetics GPS (RTK). DCR measures resistance to the flow of electrical current. High values are associated with bedrock or dry overburden, low values with damp overburden, and very low values with saline water. Air photographs from 2005 and 2021 were compared to assess the rates of erosion along the bluff. The GPR imaged the subsurface parallel to the bluff to a depth of 4 m and showed sediments with heterogeneous amounts of cobbles and boulders. A faint linear reflection at ~2 m depth correlated with a change in texture of the scarp face, visible from the beach. DCR profiles were taken both parallel and perpendicular to the bluff, imaging the subsurface to a depth of up to 21 m (13 m below sea level). They showed no sign of bedrock, but rather incursion of sea water into the sediments below sea level. Above sea level, a slab-like region of high resistivity, about 50 m x 50 m, corresponded to locations where the coastal erosion was slowest and the elevation was highest. This indicates that DCR may be a useful tool for assessing susceptibility to erosion in this environment. [ABSTRACT FROM AUTHOR]

Abstract: Retrogressive thaw slumps are one of the most dramatic thermokarst landforms in periglacial regions. This study investigates the impacts of one stable and two active thaw slumps on the geochemistry of streams in the Stony Creek watershed (Peel Plateau, NWT, Canada). The objective of this study is to elucidate the geochemical processes associated with ground ice ablation in retrogressive thaw slumps and the geochemical evolution of slump runoff to streams. This is accomplished by describing the geochemical composition of runoff across active mega-slumps, impacted and pristine tundra streams, as well as that of the ice-rich permafrost exposed in the slump headwalls. In the Stony Creek watershed, runoff derived from active and stable thaw slumps is characterized by a Ca(Mg)–SO4 geochemical facies with conductivity and solute concentrations approximately one order of magnitude higher than in pristine streams. The elevated solute concentrations in the slump runoff are directly related to thawing of highly weatherable Late Pleistocene age ice-rich and solute-rich permafrost exposed in the headwalls of slumps, which has solute concentrations nearly 100 times higher than those measured in the uppermost 1–2m (i.e., above the early Holocene thaw unconformity). An examination of ionic relations revealed a strong relation between Ca2+ and SO4 2− and (Ca2++Mg2+)–SO4 2−, suggestive that sulfate dissolution is the main process responsible for the geochemical composition of slump impacted streams. Thaw slumps significantly impact the geochemistry of streams, by increasing their solute load well above that of pristine streams along any reach of impacted streams. Unlike shallow active layer disturbances, the thaw slumps can degrade permafrost to depths of 10m or more and the impacts of abundant slump activity on stream geochemistry can be detected at the 10^2 km2 watershed-scale. [Copyright &y& Elsevier]

Engagement enhances learning, particularly for abstract and theoretical concepts. This article is an instructor reflection on student engagement with a case example of mobile learning for two differing senior undergraduate psychology courses, Theories of Counselling and Psychotherapy, and Ethics and Current Issues in Psychology. The instructor was experienced and the students were Canadian or Australian, respectively. The courses compared were delivered through an asynchronous online-enhanced distance model for a Canadian university and through a blended learning model for an Australian university. Issues with student engagement are explored through a review of informal and formal student feedback and instructor reflection. Although motivational instruction was a consistent factor in the course and instructional evaluations, this case example highlights the elusive nature of student engagement given the multiple factors involved in student expectations and needs and differing models of delivery for these undergraduate psychology courses. The author is left acknowledging only that different learning opportunities benefit the range of psychology students who may engage in them. [ABSTRACT FROM AUTHOR]

Rapid expansion in scientific knowledge, changes in medical practice, and greater demands from patients and society necessitate reform of the medical curriculum. In recognition of this, medical educators across the world have recommended the adoption of competence-based education. This is intended to increase the rigour and relevance of the curriculum, move students beyond a focus on the memorisation and regurgitation of scientific facts, and better enable them to understand scientific principles and apply them to the practice of medicine. Experience from 40 years' use of competence-based curricula across the world suggests that the uncritical application of this approach to the medical curriculum may not achieve its intended aims. There are valuable lessons to be learnt from the history of competence-based education. By taking on board these lessons, confronting the pitfalls of this approach, and devising new and creative solutions to the problems inherent in this methodology, medical educators can better achieve their aim of providing a strong foundation for the practice of medicine in the twenty-first century. It is only through such a strategy-rather than the uncritical adoption of this educational approach-that we will have real movement and progress both in competence-based education in general, and in its applications to medicine in particular. [ABSTRACT FROM AUTHOR]

Abstract: Energy sources such as oil, natural gas, and coal currently account for around 80% of the world’s primary energy consumption. Despite significant investments in renewable energy and energy efficiency, that Canada and others are making, the International Energy Agency (IEA) has forecast that as the global economy continues to grow, fossil fuels will continue to dominate the world’s energy supply for decades. Reconciling the world’s ongoing reliance on fossil fuels with the need to reduce greenhouse gas (GHG) emissions is then one of our greatest challenges. Canada is taking this challenge seriously with climate change policies that include enhancing our global leadership in advancing one of the most promising technologies for reducing GHG emissions from fossil fuel use: Carbon capture and storage (CCS). CCS is only one of several technologies that must be deployed and is not a ‘silver-bullet’ for meeting Canada’s target of reducing its GHG emissions by 17% from 2005 levels by 2020. Yet, CCS is one of the only technologies currently available for making emissions reductions from large-scale fossil fuel usage–and, thus, will be a critical component of the technology puzzle for Canada to meet its emissions reduction objectives. Canada has a number of key sectors where the deployment of CCS is needed and there are opportunities to advance the technology. These include coal-fired electricity plants, the oil sands, and natural gas processing (e.g. from the new development of shale gas) -though the opportunity and demand for advancing CCS technology also exists in other sectors such as chemicals, fertilizer, steel making, and cement. Federal and provincial governments in Canada are making substantial investments in CCS, committing upwards of $3 billion in public funding towards seven large-scale fully-integrated CCS demonstration projects. The federal ecoENERGY Technology Initiative announced $151 million for the initial engineering and/or pilot stages of seven potential demonstration projects in 2008. The 2009 federal budget created Clean Energy Fund, which included $610 million for CCS demonstrations. The Provinces of Alberta, Saskatchewan, and British Columbia have also committed funding for demonstrations, in particular $2 billion by Alberta. This public funding will leverage additional investment from industry, for projects that will each capture and store on the order of 1 million tonnes of CO2 per year, coming on-line starting in 2015 or sooner. This paper will provide an overview of Canada’s actions on advancing CCS deployment, with a focus on the CCS demonstration program and current R&D activities in Canada. [Copyright &y& Elsevier]

On 1 July 1961, the climatological day was redefined to end at 0600 UTC (coordinated universal time) at all synoptic (airport) stations in Canada. Prior to that, the climatological day ended at 1200 UTC for maximum temperature and 0000 UTC for minimum temperature. This study shows that the redefinition of the climatological day in 1961 has created a cold bias in the annual and seasonal means of daily minimum temperatures across the country while the means of daily maximum temperatures were not affected. Hourly temperatures taken at 121 stations for 1953–2007 are used to determine the magnitude of the bias and its spatial variation. It was found that the bias is more pronounced in the eastern regions; its annual mean varies from -0.2° in the west to -0.8°C in the east. Not all days are affected by this change in observing time, and the annual percentage of affected days ranges from 15% for locations in the west to 38% for locations in the east. An approach based on hourly values is proposed for adjusting the affected daily minimum temperatures over 1961–2007. The adjustment on any individual day varies from 0.5° to 12.5°C. The impact of the adjustment is assessed by examining the trends in the annual mean of the daily minimum temperatures for 1950–2007. Overall, with the adjustment, the trends are becoming either more positive or are reversing from negative to positive, and they have changed by as much as 1°C in numerous locations in the eastern regions. [ABSTRACT FROM AUTHOR]

Purpose - The purpose is to ascertain the state of sustainability in higher education (SHE) in Atlantic Canada (sustainability education/curriculum; research and scholarship; operations; faculty/staff development and rewards; community outreach and service; student opportunities; and institutional mission, structure and planning). Design/methodology/approach - All Association of Universities and Colleges of Canada (AUCC) member institutions in Atlantic Canada were sampled in 2005/2006 to examine sustainability performance. Data were collected using the sustainability assessment questionnaire (SAQ) and were triangulated with document, webpage, and additional survey research. Findings - The majority of higher education institutions in Atlantic Canada are engaged in sustainable development work, most notably in the area of curriculum. Sustainability research and scholarship is spread amongst faculty and students; many institutions have inter- or multi-disciplinary research structures to address sustainability questions across campus and in collaboration with community partners. Much unrealized potential remains within physical operations, faculty/staff development and rewards, and student opportunities. No single university emerges as the Atlantic Canadian SHE leader; Acadia University (Wolfville, Nova Scotia), St Francis Xavier University (Antigonish, Nova Scotia) and Mt Allison University (Sackville, New Brunswick) excel in a regional peers comparison. Research limitations/implications - The Atlantic Canada study commences a series of five regional SHE assessments in Canada. Practical implications - The study strengthens ongoing efforts for creative institutional solutions to reduce the ecological footprint of higher education institutions. It contributes to SHE knowledge transfer and capacity-building. Originality/value - The study is the first regional SHE performance assessment in Canada. It serves as a pilot study and strategic planning tool. [ABSTRACT FROM AUTHOR]

The article focuses on a conference organized by the authors, who are both members of Canada's Department of Foreign Affairs and International Trade, on the future of Iraq. It analyzes the backdrop to the initiative, describes how it developed, and highlights some of the conclusions of the exercise. According to the article, policy research allowed experts and practitioners to set their sights farther ahead, generating conclusions that Canada may use to influence the agendas of significant international actors.

This article presents an analysis of two sets of Canadian guidelines for therapy and counselling with women, one that was adopted by the Canadian Psychological Association (CPA) in 1980 and a new version that has just been developed. It shows how the issues and the context of Canadian feminist psychology have, and have not, changed in the intervening years. Although Canadian women have made some substantive gains within psychology and more generally, many systemic gender inequities remain. While the 1980 guidelines arose from a broad-based demand within the feminist community, the new guidelines were a response to a routine policy review by CPA. A primary goal of the 1980 guidelines was to challenge stereotypic assumptions about women. The current guidelines give practitioners direction about how to provide non-sexist therapy that is informed and recognizes the complex and diverse contexts of Canadian women's lives. [ABSTRACT FROM AUTHOR]

Samples of breast muscle from 32 species of waterfowl collected from 123 sites across Canada were analyzed for chlorobenzenes (CBz), chlordane-related compounds (CHL), hexachlorocyclohexanes (HCH), DDT, mirex, dieldrin, PCBs and mercury. ΣDDT, ΣCBz and ΣPCB were the compounds most frequently found above trace levels. ΣHCH and ΣMirex were detected the least often. Mercury was detected in all of the mergansers, over 50% of dabbling, bay and sea ducks, and in less than 2% of the geese analysed. The highest levels of contaminants were generally found in birds feeding at higher trophic levels such as sea ducks and mergansers. With the exception of a few samples of mergansers and long-tailed ducks from eastern Canada, which contained ΣPCB concentrations of 1.0–2.4 mg kg−1, ΣPCB levels were less than 1 mg kg−1 wet weight. Only one merganser from eastern Canada had a ΣDDT concentration (2.6 mg kg−1 ww) which was greater than 1 mg kg−1 ww. The highest ΣCHL (0.10 mg kg−1 ww) was also found in mergansers from eastern Canada. Levels of total mercury in breast muscle were either low (< 1 mg kg−1 ww) or below detection limits with the exception of a few samples of mergansers from eastern Canada which contained mercury concentrations of 1.0–1.5 mg kg−1 ww. Health Canada determined that the organochlorine and mercury levels found in samples of breast muscle of ducks and geese analysed in this study did not pose a health hazard to human consumers and therefore these waterfowl were safe to eat. [ABSTRACT FROM AUTHOR]

Background: There has been a growing recognition of the need for information about objective abnormalities in people with the fibromyalgia syndrome [FMS] and for an integrated approach to its diagnosis and management by primary care physicians. Objectives: To establish an expert consensus toward a working case definition of FMS and a working guide to its management for physicians in Canada. Methods: An Expert Subcommittee of Health Canada established the Terms of Reference and selected an Expert Medical Consensus Panel representing treating physicians, teaching faculty, and researchers. The editors prepared a draft document which was reviewed by the Panel members in preparation for the Consensus Workshop, which was held on March 30 to April 1, 2001. Subsequent writing assignments produced subdocuments on key topics relevant to the objectives. The subdocuments were then integrated into a submission document which was approved by each of the panel members. Results: The completed document is provided. It contains sections on a new approach to case definition, on proposed research to validate the new case definition, on a practical approach to assessment of severity, on empathetic management; and on what is known about pathogenesis. Conclusions: A consensus document was developed to assist clinicians in distinguishing FMS from other syndromes/illnesses that may present with body pain. It is intended that this document serve as a guide: to a better understanding of FMS; to a more reasoned approach to its management; and to further research on the clinical care of people with FMS. [ABSTRACT FROM PUBLISHER]

In this article, the author discusses the usefulness of the foreign policy review as a mechanism for re-calibrating Canadian foreign policy. The author focuses on a major review, arising from the defeat of the Progressive Conservative government in 1993 and the advent to power of a Liberal majority government that year. He observes that a Canadian government reluctance to do less of anything internationally leads to bland assurances like the promise to do more with less. In addition, the author describes the role of the prime minister and minister in the implementation of foreign policy.

Isolates of Phytophthora erythroseptica, causal agent of pink rot of potato, were obtained from diseased tubers collected in Prince Edward Island (PEI), Canada. In an in vitro assay of field and single-zoospore isolates, all isolates of the pathogen from PEI were sensitive to metalaxyl (EC50 < 0·5 µg mL-1), unlike moderately or highly resistant reference isolates obtained from Maine, USA. Allozyme-banding patterns at the glucose-6-phosphate isomerase (Gpi) locus were identical (91/91) for all isolates of P. erythroseptica examined from PEI and Maine, but could be used to distinguish isolates of P. erythroseptica from local isolates of Phytophthora infestans. Inoculation of potato tubers from plants treated with foliar applications of metalaxyl in the field indicated that compounds inhibitory to metalaxyl-sensitive isolates of P. erythroseptica were present in the periderm, even after 4 months' storage. By contrast, moderately or highly resistant isolates of the pathogen caused significantly (P ≤ 0·05) more disease than sensitive isolates in tubers from plants treated with metalaxyl. The effectiveness of metalaxyl in controlling pink rot in a particular region will depend on resistance levels of local populations of P. erythroseptica. Preventing the development and spread of resistant strains of P. erythroseptica will be critical in maintaining metalaxyl as an effective chemical for control of this pathogen. [ABSTRACT FROM AUTHOR]

The article offers information on the survey at executive development project conducted by representatives from the Canadian government, Institute of Public Administration of Canada (IPAC), and academics. A questionnaire was used to study several information related to public executives. The topic of the questionnaire revolves on the key to success of a public executive and the kind of systems that provincial organizations must have to support executive development. Assessing the answer of respondents from two hundred provinces in Canada, it is perceived that management development must be part of organizational programs and the needs of individual managers for career competence must be recognize at all time.

Intravenous access is a continuing challenge for nurses, and patients report dissatisfaction with multiple IV sticks. Typically, there are two options for IV access: traditional peripheral IV or central line placement. Often, peripherally inserted central catheter (PICC) lines are placed in patients with difficult or limited venous access. Midline IV catheters offer an additional alternative for patients with limited IV options and can be used for long-term IV therapy up to 29 days. While midline catheters have been available, our facility did not have a midline product and was not using them for IV therapy. A midline product trial was initiated, but there were concerns regarding confusion between midlines and PICC lines and possible misuse of midlines as peripherally inserted central catheters (PICCs). In order to address these concerns, a comprehensive education program was developed for nursing staff and physicians that delineated the differences and similarities between midlines and PICC lines. An IV Access Decision Algorithm was developed to guide clinicians in selecting the appropriate option. In addition to ordering a PICC or a midline, clinicians could consult the vascular access team to assess and recommend IV access. Over a six-month trial period, 150 midlines were placed. No TPN or medications requiring central line administration were given; however, Activase (Cathflo) was given twice in midlines misidentified as PICCs. Three physicians documented midlines as PICC lines and two nurses referred to midlines as PICC lines when troubleshooting, but there was no evidence that the midline was mistakenly used as a PICC. Midline IVs are a viable option for many patients but, as midline IVs become more common, more education is needed to ensure that midlines remain a safe alternative for TV access. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The management of prostate cancer (PCa) is rapidly evolving. Treatment and diagnostic options grow annually, however, high-level evidence for the use of new therapeutics and diagnostics is lacking. In November 2022, the Genitourinary Research Consortium held its 3rd Canadian Consensus Forum (CCF3) to provide guidance on key controversial areas for management of PCa. METHODS: A steering committee of eight multidisciplinary physicians identified topics for discussion and adapted questions from the Advanced Prostate Cancer Consensus Conference 2022 for CCF3. Questions focused on management of metastatic castration-sensitive prostate cancer (mCSPC); use of novel imaging, germline testing, and genomic profiling; and areas of non-consensus from CCF2. Fifty-eight questions were voted on during a live forum, with threshold for "consensus agreement" set at 75%. RESULTS: The voting panel consisted of 26 physicians: 13 urologists/uro-oncologists, nine medical oncologists, and four radiation oncologists. Consensus was reached for 32 of 58 questions (one ad-hoc). Consensus was seen in the use of local treatment, to not use metastasis-directed therapy for low-volume mCSPC, and to use triplet therapy for synchronous high-volume mCSPC (low prostate-specific antigen). Consensus was also reached on sufficiency of conventional imaging to manage disease, use of germline testing and genomic profiling for metastatic disease, and poly (ADP-ribose) polymerase (PARP) inhibitors for BRCA-positive prostate cancer. CONCLUSIONS: CCF3 identified consensus agreement and provides guidance on >30 practice scenarios related to management of PCa and nine areas of controversy, which represent opportunities for research and education to improve patient care. Consensus initiatives provide valuable guidance on areas of controversy as clinicians await high-level evidence. [ABSTRACT FROM AUTHOR]

INTRODUCTION: In patients with prostate cancer (PCa), the identification of an alteration in genes associated with homologous recombination repair (HRR) has implications for prognostication, optimization of therapy, and familial risk mitigation. The aim of this study was to assess the genomic testing landscape of PCa in Canada and to recommend an approach to offering germline and tumor testing for HRR-associated genes. METHODS: The Canadian Genitourinary Research Consortium (GURC) administered a cross-sectional survey to a largely academic, multidisciplinary group of investigators across 22 GURC sites between January and June 2022. RESULTS: Thirty-eight investigators from all 22 sites responded to the survey. Germline genetic testing was initiated by 34%, while 45% required a referral to a genetic specialist. Most investigators (82%) reported that both germline and tumor testing were needed, with 92% currently offering germline and 72% offering tissue testing to patients with advanced PCa. The most cited reasons for not offering testing were an access gap (50%), uncertainties around who to test and which genes to test, (33%) and interpreting results (17%). A majority reported that patients with advanced PCa (74-80%) should be tested, with few investigators testing patients with localized disease except when there is a family history of PCa (45-55%). CONCLUSIONS: Canadian physicians with academic subspecialist backgrounds in genitourinary malignancies recognize the benefits of both germline and somatic testing in PCa; however, there are challenges in accessing testing across practices and specialties. An algorithm to reduce uncertainty for providers when ordering genetic testing for patients with PCa is proposed. [ABSTRACT FROM AUTHOR]