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The Sustainable Development Goals link access to higher education, particularly for non-traditional populations, as a way to fight poverty and ensure prosperity. This article examines the experiences of several under-researched categories of non-traditional students who attend Community Colleges and Technical Vocational Education and Training (TVET) Colleges in multiple jurisdictions worldwide. The article begins to fill in the gap with comparative data on how these institutions advance equity, diversity, and inclusion through access to higher education. The implications of Community Colleges and TVET are analyzed using the lens of Neo-Liberalism and the Capabilities Narrative. The study extends the scope of the inquiry into the contributions these institutions make to sustainable development. The article uses a comparative multi-case study approach to examine the Community Colleges and TVET Colleges in different jurisdictions worldwide.

Based on a systematic literature review, we demonstrate that college continuing education in Quebec is poorly represented in colleges' specialized publications and generally absent from the field of educational research, despite its importance in the field of professional and technical training. We first describe the context of adult college education and training in Quebec and demonstrate its significance as a distinct training sector. We then present findings from our exhaustive literature review. Using these results, we show that despite its role in adult education, college continuing education in Quebec remains an unexplored research area. To conclude, we present hypotheses that may explain this lack of visibility and suggest potential research avenues on a subject that merits greater consideration.

Background: Levels of care deemed as inappropriate generate moral distress among nurses and other intensive care professionals. Inappropriate levels of care and related moral distress are frequently broached as individual and psychological phenomena, reduced to how individuals feel and think about specific cases. However, this tends to obscure the complex context in which these situations occur, and on which healthcare professionals can act. There is thus a need for a more contextual and team-level lens on inappropriate levels of care. Research objective: This study aims to explore and understand the issue of inappropriate levels of care in an intensive care unit (ICU) through a contextual and team-level lens. Research design: Semi-structured interviews were conducted with nurses, respiratory therapists, and intensivists. Thematic analysis focused on understanding the causes and consequences of inappropriate levels of care, as well as potential avenues for improvement. This study is part of a 5-phase participatory living lab project on inappropriate levels of care conducted in the ICU of a Montreal (Quebec, Canada) hospital. This paper relates the initial phases of the project, focusing on understanding the issue, with reported events spanning from June 2022 to May 2023. Ethical considerations: Ethics approval was sought and granted by the Research Ethics Board of the CIUSSS de l'Est-de-l'Île-de-Montréal. Findings/Discussion: Five broad themes intrinsically related to the phenomenon of inappropriate levels of care were explored with and by participants: (1) the process of determining levels of care, (2) the distinction between appropriate and inappropriate levels of care, (3) causes of inappropriate levels of care, (4) consequences of inappropriate levels of care and (5) potential avenues for improvement. Conclusion: This research provides a comprehensive understanding of inappropriate levels of care in the ICU and emphasizes the relevance of team-level explorations of complex ethical issues. [ABSTRACT FROM AUTHOR]

Background: Direct-acting antivirals (DAAs) for hepatitis C virus (HCV) were approved in Canada in 2013. By 2018, treatment restrictions had been lifted in all provinces, making DAAs universally accessible. Here, we aim to assess progress toward HCV elimination in the DAA era (2014–2022) within the Canadian Co-infection Cohort. Methods: The CCC is a multisite open cohort of people living with HIV-HCV coinfection with cohort visits scheduled biannually. We calculated annual cure rates overall by province and key population: gay bisexual and other men who have sex with men, people who inject drugs, and Indigenous peoples. Results: Among the 952 participants eligible for DAAs, 65% (n = 623) were cured and 3% (n = 26) achieved late clearance without treatment by the end of the study period. Of the 35% (n = 303) who were not cured, 46% (n = 138) were lost to follow-up, 31% (n = 95) died, and 23% (n = 70) had insufficient data to determine their cure status. Annual cure rates increased from 2014 to 2019 and then decreased across the cohort and in all key populations. From 2015 to 2018, gay bisexual and other men who have sex with men had the highest cure rates, but by 2019 people who inject drugs and Indigenous peoples caught up. Annual cure rates dropped in all provinces with the onset of the COVID-19 pandemic (after 2019). Conclusions: Universal accessibility of DAAs was an important step toward HCV elimination among people living with HIV-HCV coinfection, but this is not sufficient alone. Efforts are needed to re-engage those who remain uncured and reduce mortality in people living with HIV-HCV coinfection. [ABSTRACT FROM AUTHOR]

Depression is common among people living with HCV and HIV, which contributes to health services utilization (HSU). It is unknown whether successful HCV treatment affects this. We examined depressive symptoms and HSU in people co-infected with HIV-HCV and their association with sustained virologic response (SVR) during the direct-acting antiviral era. We predicted depressive symptoms by a random forest classifier in the Canadian Co-infection Cohort. HSU was measured by inpatient and out-patient visits in the previous six months. We fit zero-inflated negative binomial models. Of the 1153 HCV RNA+participants, 530 were treated and of them, 95% achieved SVR. Without SVR, inpatient and out-patient visits were 17% and 5% higher among those with depressive symptoms than those without respectively; with SVR, this association disappeared. SVR was associated with 24% fewer inpatient visits. Thus, depressive symptoms were associated with a modest increase in HSU, and SVR appears to attenuate this effect. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) pandemic has led to important challenges in health and education service delivery. Aims: The present study aimed to document: (i) changes in the use of telepractice by speech-language pathology (SLP) professionals in Quebec since the start of the COVID-19 outbreak; (ii) perceptions of the feasibility of telepractice by SLPs; (iii) barriers to the use of telepractice; and (iv) the perceptions of SLP professionals regarding the main issues of telepractice. Methods & Procedures: An online survey with closed and open, Likert scale and demographic questions was completed by 83 SLPs in Quebec in June and July 2020. Outcomes & Results: The survey responses showed that within the cohort responding, telepractice use has increased significantly as a response to the COVID-19 pandemic. Most respondents planned to continue using telepractice after the pandemic ends. In addition, the respondents considered telepractice to be adequate for many clinical practices but less so for others (e.g., swallowing disorders, hearing impairment). Most of the reported barriers to the use of telepractice concerned technological problems and a lack of clinical materials for online use. Confidentiality and privacy issues were also raised. Conclusions & Implications: SLP professionals rapidly took advantage of existing technologies in their clinical settings to cope with the pandemic's effects on service delivery. The discrepancy between their perceptions and the evidence in the literature for some practices and populations strengthens the need for more information and education on telepractice.

Background: The term progressive apraxia of speech (PAOS) is used to describe speakers presenting with isolated or dominant apraxia of speech in the context of a neurodegenerative syndrome, including primary progressive apraxia of speech (PPAOS) and dominant progressive apraxia of speech (DAOS), respectively. Its motor speech profile has been increasingly explored in the last decade, but description remains vague and very English oriented, although the effect of speakers' language on motor speech phenotypes is increasingly recognized. Although some studies suggest that speakers presenting with isolated PAOS (PPAOS) versus dominant PAOS with concomitant aphasia (DAOS) should be differentiated, distinct characteristics of the two presentations are unclear. Furthermore, a careful description of their clinical presentation in languages other than English is required. Aims: To describe the motor speech characteristics of Quebec French-speaking participants with prominent PAOS and to explore the communication profile of those presenting more specifically with isolated PAOS (PPAOS), and with dominant PAOS and concomitant aphasia (DAOS). Methods & Procedures: A thorough effort to recruit all speakers presenting with PAOS in the larger population areas of the province of Quebec was conducted over a 3-year span. A total of nine participants with PAOS (pwPAOS; PPAOS = 5, DAOS = 4) underwent a comprehensive language and motor speech assessment, and a cognitive screening. Their performance was compared with 30 matched healthy controls. Outcomes & Results: As a group, pwPAOS differed from healthy speakers on all acoustic and perceptual measures. The PPAOS and PAOS subgroups were similar on several measures, but participants from the PPAOS subgroup tended to perform better on articulatory measures and maximum speech rate tasks. Conclusions & Implications: This study provides an in-depth analysis of motor speech characteristics of PAOS in Quebec French speakers and adds further evidence for the differentiation of PPAOS and DAOS. Combining simple perceptual and acoustic analyses represent a promising approach to distinguish the two variants and identify treatment targets.

Objective: There are numerous reports of people substituting medical cannabis (MC) for medications. Our obejctive was to investigate the degree to which this substitution occurs among people with rheumatic conditions. Methods: In a secondary analysis from a cross‐sectional survey conducted with patient advocacy groups in the US and Canada, we investigated MC use and medication substitution among people with rheumatic conditions. We subgrouped by whether participants substituted MC for medications and investigated differences in perceived symptom changes and use patterns, including methods of ingestion, cannabinoid content (cannabidiol vs delta‐9‐tetrahydrocannabinol [THC]), and use frequency. Results: Among 763 participants, 62.5% reported substituting MC products for medications, including nonsteroidal anti‐inflammatory drugs (54.7%), opioids (48.6%), sleep aids (29.6%), and muscle relaxants (25.2%). Following substitution, most participants reported decreases or cessation in medication use. The primary reasons for substitution were fewer adverse effects, better symptom management, and concerns about withdrawal symptoms. Substitution was associated with THC use and significantly higher symptom improvements (including pain, sleep, anxiety, and joint stiffness) than nonsubstitution, and a higher proportion of substitutors used inhalation routes than those who did not. Conclusion: Although the determination of causality is limited by our cross‐sectional design, these findings suggest that an appreciable number of people with rheumatic diseases substitute medications with MC for symptom management. Inhalation of MC products containing some THC was most commonly identified among those substituting, and disease characteristics did not differ by substitution status. Further study is needed to better understand the role of MC for symptom management in rheumatic conditions. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Development Studies is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background The cascade of care, commonly used to assess HIV and hepatitis C (HCV) health service delivery, has limitations in capturing the complexity of individuals' engagement patterns. This study examines the dynamic nature of engagement and mortality trajectories among people with HIV and HCV. Methods We used data from the Canadian HIV-HCV Co-Infection Cohort, which prospectively follows 2098 participants from 18 centers biannually. Markov multistate models were used to evaluate sociodemographic and clinical factors associated with transitioning between the following states: (1) lost-to-follow-up (LTFU), defined as no visit for 18 months; (2) reengaged (reentry into cohort after being LTFU); (3) withdrawn from the study (ie, moved); (4) death; otherwise remained (5) engaged-in-care. Results A total of 1809 participants met the eligibility criteria and contributed 12 591 person-years from 2003 to 2022. LTFU was common, with 46% experiencing at least 1 episode, of whom only 57% reengaged. One in 5 (n = 383) participants died during the study. Participants who transitioned to LTFU were twice as likely to die as those who were consistently engaged. Factors associated with transitioning to LTFU included detectable HCV RNA (adjusted hazards ratio [aHR], 1.37; 95% confidence interval [CI], 1.13–1.67), evidence of HCV treatment but no sustained virologic response result (aHR, 1.99; 95% CI, 1.56–2.53), and recent incarceration (aHR, 1.94; 95% CI, 1.58–2.40). Being Indigenous was a significant predictor of death across all engagement trajectories. Interpretation Disengagement from clinical care was common and resulted in higher death rates. People LTFU were more likely to require HCV treatment highlighting a priority population for elimination strategies. [ABSTRACT FROM AUTHOR]

This exploratory study aimed to evaluate the preferences, expectations, and sense of safety of blind or visually impaired persons regarding three types of pedestrian phasing with audible pedestrian signals configurations that exist in Quebec City (Canada). These include: 1) exclusive phasing with non-directional audible pedestrian signals; 2) exclusive phasing with directional audible pedestrian signals; and 3) concurrent phasing with directional audible pedestrian signals. Thirty-two blind or visually impaired persons were asked to complete a survey. Their preferences and expectations regarding audible pedestrian signals were documented through a series of simulations. Their sense of safety regarding the three existing configurations were also documented. Subsequently, semi-directed, individual interviews with 11 of the individuals who had completed the survey were conducted to build off the collected information. No formal consensus regarding many of the issues discussed were established as participants' responses varied too significantly. However, findings suggest that the exclusive phasing with directional audible pedestrian signals configuration is perceived to be the safest option by the participants. This study may have practical implications on the design of intersections (e.g., selection of a type of pedestrian phasing with audible pedestrian signal) and the training of blind or visually impaired pedestrians. The addition of audible pedestrian signals to pedestrian signals heightens the sense of safety of blind or visually impaired persons. This study may have practical implications on the design of intersections with audible pedestrian signals and the selection of a type of audible pedestrian signals based on intersection characteristics. Since many participants reported a lower sense of safety when faced with concurrent phasing, it is recommended that more intensive orientation and mobility interventions be provided to blind or visually impaired pedestrians who use this type of traffic signals. Educating road users about blind or visually impaired pedestrians appears also essential. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To assess whether remote physical exercise interventions helped maintain function in daily life, level of physical activities, basic mobility and frailty status in pre-disabled seniors during the first Covid-19 lockdown. Design: This is an interventional study conducted from May 2020 to May 2021. Setting: Community-dwelling older adults in 2 Canadian cities. Participants: 84 pre-disabled seniors. Intervention: 12-week physical exercise programs (1 hour/ 3 times/ week) in kinesiologist-guided groups using Zoom or phone-supervised individual booklet-based home-program (n=44) vs. Control (usual life habits; n=40). Measurements: Functional status in daily activities (OARS scale); Daily level of aerobic (TAPA-1) and strengthening/flexibility (TAPA-2) physical activities; Basic mobility abilities (SPPB: balance, lower limbs strength, walking speed; Timed Up-and-Go) and Frailty (SOF index) were assessed at baseline and at 3, 6, 9 and 12-month follow-ups. Results: The participants' mean age was 78.5 ± 7.2 and 76.5 % were women. There was a group * time effect for the OARS scale (p=0.02), the TAPA-1 (p=0.06) and the TAPA-2 (p=0.007) scores. For these outcomes, scores significantly improved during the first 3 months of follow-up and then stabilised in the intervention group whereas they remained constant in the control group over time. There was an overall time effect for the SPPB (p=0.004), the 4-m walking speed (p=0.02) and for the SOF index (p=0.004), with no between-group differences. Finally, no effect was observed for the TUG. Conclusion: Remote home-based physical exercise interventions and monitoring during the first Covid-19 lockdown seemed to have helped maintain seniors' level of physical activities without impacting on basic mobility abilities. Further studies are needed to identify parameters of remote exercise programs that can improve daily function and mobility in this population. [ABSTRACT FROM AUTHOR]

Efficient adaptation strategies to climate change require the estimation of future impacts and the uncertainty surrounding this estimation. Over- or underestimating future uncertainty may lead to maladaptation. Hydrological impact studies typically use a top-down approach in which multiple climate models are used to assess the uncertainty related to the climate model structure and climate sensitivity. Despite ongoing debate, impact modelers have typically embraced the concept of "model democracy", in which each climate model is considered equally fit. The newer Coupled Model Intercomparison Project Phase 6 (CMIP6) simulations, with several models showing a climate sensitivity larger than that of Phase 5 (CMIP5) and larger than the likely range based on past climate information and understanding of planetary physics, have reignited the model democracy debate. Some have suggested that "hot" models be removed from impact studies to avoid skewing impact results toward unlikely futures. Indeed, the inclusion of these models in impact studies carries a significant risk of overestimating the impact of climate change. This large-sample study looks at the impact of removing hot models on the projections of future streamflow over 3107 North American catchments. More precisely, the variability in future projections of mean, high, and low flows is evaluated using an ensemble of 19 CMIP6 general circulation models (GCMs), 5 of which are deemed hot based on their global equilibrium climate sensitivity (ECS). The results show that the reduced ensemble of 14 climate models provides streamflow projections with reduced future variability for Canada, Alaska, the Southeast US, and along the Pacific coast. Elsewhere, the reduced ensemble has either no impact or results in increased variability in future streamflow, indicating that global outlier climate models do not necessarily provide regional outlier projections of future impacts. These results emphasize the delicate nature of climate model selection, especially based on global fitness metrics that may not be appropriate for local and regional assessments. [ABSTRACT FROM AUTHOR]

Foreign accent syndrome (FAS) is an acquired neurologic disorder in which an individual suddenly and unintentionally speaks with an accent which is perceived as being different from his/her usual accent. This study presents an acoustic-phonetic description of two Quebec French-speaking cases. The first speaker presents a perceived accent shift to Acadian French (French spoken in the easternmost provinces of Canada), whereas the second acquired an accent identified as Germanic. Speech seems affected by constraints on the coordination of articulatory gestures, expressed by distortions in the production of segments. These distortions do not necessarily result from changes in suprasegmental settings (slow speech rate and isochronous syllable pattern were observed) but may cause the disappearance of markers used for Quebec French accent recognition. Reported speech characteristics are comparable to those of speakers with apraxia of speech (AOS) but symptoms are relatively mild and somewhat similar to the speech of foreign speakers. For this reason, the position that FAS may be a mild form or subtype of AOS, as maintained by other authors, should be seriously considered. (Contains 4 tables and 2 figures.)

Background: To promote regular physical activity (PA) among children and adolescents, authors recommend that physical education (PE) teachers offer their students programmes that would allow them to be physically active outside PE classes. However, such programmes are rarely rigorously assessed and it is recommended that further studies be undertaken to better understand characteristics of interventions that render children and adolescents more physically active. Aims: The purposes of this study were (a) to examine the effectiveness of a PA intervention, the team pentathlon, and (b) to examine whether the impact of team pentathlon was different for boys and girls. Method: Four primary school PE teachers and eight 5th grade elementary classes (two for each PE teacher: one experimental and one control) took part in the study. Overall, 86 students (44 girls; 42 boys) experienced team pentathlon in addition to their regular PE classes whereas 82 students (41 girls; 41 boys) simply attended their regular PE classes. The research design included: (a) a 3-week baseline measure of the physical activity volume (PAV) for both the experimental group (EG) and the control group (CG); (b) the implementation of a 5-week intervention programme and weekly PAV measures for the EG (weeks 4 to 8) and periodic PAV measures for the CG (weeks 4, 6 and 8); (c) a 2-week recess for both groups (weeks 9 and 10); (d) PAV measures for both groups during weeks 11 and 12. PAV was computed in terms of pentathlon hours (PH), meaning the actual number of activity hours reported by students, corrected according to the intensity (energy cost) of the practiced physical activities. A repeated measures ANOVA was performed to see if there was a difference between the experimental and control groups, between boys and girls and between the four repeated measures. Non-parametric analyses were performed to see if there was any significant difference between reported volumes of physical activity for each PE teacher's classes. Results: Overall the results showed that control students' level of activity remained stable while experimental students were significantly more physically active at the time of the pentathlon implementation as well as three weeks after the end of the intervention programme. In both experimental and control groups, girls accumulated less pentathlon hours each week than boys. Results also showed that the regular practice of PA, outside of PE classes, varied between schools, both in control and experimental conditions. At times, the weekly volume of physical activity also varied greatly among students from the same classes. Conclusion: Team pentathlon brought about a greater volume of physical exercise among ten- and eleven-year-old children. Although girls reported a slightly larger raw volume of physical activity per week than boys, they accumulated lower pentathlon hour values due to their choice of less intense activities. Finally, the results also showed that regular PA, outside PE classes, may vary from one school to another or even among students from the same class. (Contains 4 tables, 3 notes and 4 figures.)

Afterschool and community science programs have become widely recognized as important sanctuaries for science learning for low-income urban youth and as offering them with "missing opportunities." Yet, more needs to be known about how youth, themselves, perceive such opportunities. What motivates youth to seek out such opportunities in the nonschool hours? How do youth describe the doing and talking of science in such programs? Given such descriptions, how do youth perceive the role of these programs in their lives? This paper relies on stories from three youth drawn from a multisited ethnographic study, one site being an afterschool girls-only science program at the elementary level in Canada and the other an Upward Bound Math and Science program in the USA. The paper concludes with a discussion about the ways these programs offered youth a meaningful way to relate to science in concordance with their own lived experiences, resulting in "I will" and "I can" attitudes and a sense of hope for the future within which science becomes a tool for action.

Objective: Understanding how medical cannabis (MC) use is integrated into medical practice for rheumatic disease management is essential. We characterized rationale for MC use, patient–physician interactions around MC, and MC use patterns among people with rheumatic conditions in the US and Canada. Methods: We surveyed 3406 participants with rheumatic conditions in the US and Canada, with 1727 completing the survey (50.7% response rate). We assessed disclosure of MC use to health care providers, MC authorization by health care providers, and MC use patterns and investigated factors associated with MC disclosure to health care providers in the US versus Canada. Results: Overall, 54.9% of US respondents and 78.0% of Canadians reported past or current MC use, typically because of inadequate symptom relief from other medications. Compared to those in Canada, fewer US participants obtained MC licenses, disclosed MC use to their health care providers, or asked advice on how to use MC (all P values <0.001). Overall, 47.4% of Canadian versus 28.2% of US participants rated their medical professionals as their most trusted information source. MC legality in state of residence was associated with 2.49 greater odds of disclosing MC use to health care providers (95% confidence interval: 1.49‐4.16, P < 0.001) in the US, whereas there were no factors associated with MC disclosure in Canada. Our study is limited by our convenience sampling strategy and cross‐sectional design. Conclusion: Despite widespread availability, MC is poorly integrated into rheumatic disease care, with most patients self‐directing use with minimal or no clinical oversight. Concerted efforts to integrate MC into education and clinical policy is critical. [ABSTRACT FROM AUTHOR]

During the past two decades, international development non-government organizations (INGOs) have proliferated in the global North. In Canada, there are ∼1350 registered INGOs—of which, 950 were established in 2000 or later, 1192 receive no federal government funding, 1202 have annual revenues under CAD one million dollars, and 709 have no full-time employees. This new wave of Small and Medium Organizations (SMOs) epitomises the decentralisation of global development as private aid has surpassed Official Development Assistance funding. Yet, recent studies suggest SMOs have a short lifespan and fail to progress beyond service provision representing the first evolutionary stage of INGO maturation. Our study combines surveys (n: 95) and interviews (n: 18) with Canadian SMOs to explore growth aspirations along with their challenges and strategies to increase revenue. Our results show that nearly all Canadian SMOs desire organisational growth, and pursue diverse funding sources and innovative strategies to increase revenue. However, for SMOs, growth means doing more of the same thing—they are committed to improving the living conditions of their target population—which contradicts best practices to scale up INGO impact and may necessitate alternative organisational evolutionary guides for SMOs operating in this emerging development niche. [ABSTRACT FROM AUTHOR]

Background: People Who Use Drugs (PWUD) have lower vaccination uptake than the general population, and disproportionately experience the burden of harms from vaccine-preventable diseases. We conducted a national qualitative study to: (1) identify the barriers and facilitators to receiving COVID-19 vaccinations among PWUD; and (2) identify interventions to support PWUD in their decision-making. Methods: Between March and October 2022, semi-structured interviews with PWUD across Canada were conducted. Fully vaccinated (2 or more doses) and partially or unvaccinated (1 dose or less) participants were recruited from a convenience sample to participate in telephone interviews to discuss facilitators, barriers, and concerns about receiving COVID-19 vaccines and subsequent boosters, and ways to address concerns. A total of 78 PWUD participated in the study, with 50 participants being fully vaccinated and 28 participants partially or unvaccinated. Using thematic analysis, interviews were coded based on the capability, opportunity, and motivation-behavior (COM-B) framework. Results: Many partially or unvaccinated participants reported lacking knowledge about the COVID-19 vaccine, particularly in terms of its usefulness and benefits. Some participants reported lacking knowledge around potential long-term side effects of the vaccine, and the differences of the various vaccine brands. Distrust toward government and healthcare agencies, the unprecedented rapidity of vaccine development and skepticism of vaccine effectiveness were also noted as barriers. Facilitators for vaccination included a desire to protect oneself or others and compliance with government mandates which required individuals to get vaccinated in order to access services, attend work or travel. To improve vaccination uptake, the most trusted and appropriate avenues for vaccination information sharing were identified by participants to be people with lived and living experience with drug use (PWLLE), harm reduction workers, or healthcare providers working within settings commonly visited by PWUD. Conclusion: PWLLE should be supported to design tailored information to reduce barriers and address mistrust. Resources addressing knowledge gaps should be disseminated in areas and through organizations where PWUD frequently access, such as harm reduction services and social media platforms. [ABSTRACT FROM AUTHOR]

Oat (Avena sativa L.) is the main species used as a companion crop when establishing perennial forages in eastern Canada, and, although other annual species are used, they have not been systematically evaluated. A field study was conducted across five environments to contrast the use of six annual species (berseem clover, Trifolium alexandrinum L.; forage peas, Pisum sativum L.; annual ryegrass, Lolium multiflorum Lamarck; oat; Japanese millet, Echinochloa esculenta [A. Braun] H. Scholz; sudangrass, Sorghum × drummondii [Nees ex. Steud.] Millsp. & Chase) as companion crops for the establishment of alfalfa (Medicago sativa L.)‐timothy (Phleum pratense L.) mixtures. The control treatment consisted of the perennial species seeded without companion crop. Treatments were seeded at three dates and evaluated during the seeding and post‐seeding years. The performance of the six companion crops evaluated herein varied depending on the seeding date and the environment. For a mid‐May to early June seeding total seeding year forage mass was greatest with use of oat, Japanese millet, or sudangrass as companion crops; for a mid‐June to late June seeding with Japanese millet or sudangrass; and for a late July to early August seeding with oat or Japanese millet. These species, however, reduced in some environments seeding year alfalfa or timothy mass compared to a control seeded without a companion crop. Such reduction was also observed in some environments in the first post‐seeding year. Companion crop choice to establish alfalfa–timothy mixtures needs to take into consideration seeding date and forage needs on the short term versus the long term. Core Ideas: Oat is the main companion crop used to establish perennial forages, others can be used but information is limited.Use of oat, Japanese millet, or sudangrass as companion crop produce the greatest seeding year total forage mass.Most productive companion crop species resulted in 19%–31% reduction in first post‐seeding year forage mass.Use of berseem clover, annual ryegrass, and peas minimally impacted seeding and post‐seeding year forage mass.Selection of companion crops must consider seeding date and short‐ and long‐term forage needs. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Foreign Policy Journal (CFPJ) is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose Training represents a considerable portion of research activities and is vastly different for each clinical trial. This variation is partially explained by the lack of detailed regulations surrounding training procedures, which hinders the ability of investigational drug service (IDS) staff to plan their workload. The aim of this study was to quantify the workload associated with trial-specific training of IDS staff. The secondary aim was to identify the factors associated with training complexity. Methods A retrospective study was carried out in the IDS of a mother and child university hospital. Trial-specific documents on which the pharmacy staff was trained were analyzed. Workload was calculated by measuring reading time. The readability of each document was determined by the Flesch Reading Ease score. The complexity of the trials was established using the scoring method of Calvin-Lamas et al. The influence of the following factors on training was assessed by analysis of variance: sponsor type, research phase, and research focus by medical specialty. Results A total of 93 clinical trials and 433 documents were included. Investigator's brochures were the longest (a mean [SD] of 107 [46] pages; P < 0.0001) and most difficult documents to read (mean [SD] readability score, 25.5 [4.4]; P < 0.0001). Trials with industry sponsors required a significantly longer overall reading time (mean [SD], 12.26 [6.72] hours; P < 0.0001). On average, a mean (SD) of 9.42 (7.16) hours of reading were necessary to train one employee for a clinical trial. Conclusion This study is the first to document reading time necessary for training of IDS staff. The training workload varied by sponsor type, while the research phase and medical specialty had little impact. IDS units would benefit from a tool that could identify complex trials. [ABSTRACT FROM AUTHOR]

The absence of disease modifying treatments for amyotrophic lateral sclerosis (ALS) is in large part a consequence of its complexity and heterogeneity. Deep clinical and biological phenotyping of people living with ALS would assist in the development of effective treatments and target specific biomarkers to monitor disease progression and inform on treatment efficacy. The objective of this paper is to present the Comprehensive Analysis Platform To Understand Remedy and Eliminate ALS (CAPTURE ALS), an open and translational platform for the scientific community currently in development. CAPTURE ALS is a Canadian-based platform designed to include participants' voices in its development and through execution. Standardized methods will be used to longitudinally characterize ALS patients and healthy controls through deep clinical phenotyping, neuroimaging, neurocognitive and speech assessments, genotyping and multisource biospecimen collection. This effort plugs into complementary Canadian and international initiatives to share common resources. Here, we describe in detail the infrastructure, operating procedures, and long-term vision of CAPTURE ALS to facilitate and accelerate translational ALS research in Canada and beyond. [ABSTRACT FROM AUTHOR]

Background Depression is common in people with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), with biological and psychosocial mechanisms at play. Direct acting antivirals (DAA) result in high rates of sustained virologic response (SVR), with minimal side-effects. We assessed the impact of SVR on presence of depressive symptoms in the HIV-HCV coinfected population in Canada during the second-generation DAA era (2013–2020). Methods We used data from the Canadian CoInfection Cohort (CCC), a multicenter prospective cohort of people with a HIV and HCV coinfection, and its associated sub-study on food security. Because depression screening was performed only in the sub-study, we predicted Center for Epidemiologic Studies Depression Scale-10 classes in the CCC using a random forest classifier and corrected for misclassification. We included participants who achieved SVR and fit a segmented modified Poisson model using an interrupted time series design, adjusting for time-varying confounders. Results We included 470 participants; 58% had predicted depressive symptoms at baseline. The median follow-up was 2.4 years (interquartile range [IQR]: 1.0–4.5.) pre-SVR and 1.4 years (IQR: 0.6–2.5) post-SVR. The pre-SVR trend suggested depressive symptoms changed little over time, with no immediate level change at SVR. However, post-SVR trends showed a reduction of 5% per year (risk ratio: 0.95 (95% confidence interval [CI]:.94–.96)) in the prevalence of depressive symptoms. Conclusions In the DAA era, predicted depressive symptoms declined over time following SVR. These improvements reflect possible changes in biological pathways and/or better general health. If such improvements in depression symptoms are durable, this provides an additional reason for treatment and early cure of HCV. [ABSTRACT FROM AUTHOR]

The intracratonic Paleoproterozoic Nonacho Basin, deposited on the western margin of the Rae craton, contains historic polymetallic (i.e., U, Cu, Fe, Pb, Zn, Ag) occurrences spatially associated with its unconformable contact with underlying crystalline basement rocks and regionally occurring faults. This study presents the paragenesis, mineral chemistry and geochemistry of uranium mineralized rocks and minerals of the MacInnis Lake sub-basin of the Nonacho Basin, to evaluate the style and relative timing of uranium mineralization. Mineralization is restricted to regionally occurring deformation zones, and post-dates widely spread and pervasive albitization and more local Ba-rich K-feldspar alteration of host rocks. Uranium mineralized rocks show elevated concentration of Cu, Ag and Au relative to variably altered host rocks. Microscopic and compositionally heterogeneous altered uraninite occurs (i) as overgrowths on partially dissolved Cu-sulphides with magnetite in chlorite ± quartz, calcite veins, and (ii) with minor uranophane in hematite-sericite-chlorite ± quartz breccia and stockwork. Both uraninite types are Th poor (<0.09 wt.% ThO2) and variably rich in SO4 (up to 2.26 wt.%), suggesting a low-temperature hydrothermal origin in a relatively oxidized environment. Rare-earth element (+Y) concentrations in type-i uraninite are high, up to 9.5 wt.% Σ(REE+Y)2O3 with CeN/YN values > 1, similar to REE compositions of uraninite in metasomatic iron and alkali-calcic systems (MIAC), including low-temperature hematite-type IOCG-deposits (e.g., Olympic Dam, Gawler Craton, Australia) and albitite-hosted uranium deposits (e.g., Southern Breccia, Great Bear Magmatic Zone, Canada, and Gunnar Deposit, Beaverlodge District, Canada). Both uraninite types are variably rich in Ba (up to 3 wt.% BaO), a geochemical marker for MIAC systems, provided by the dissolution of earlier secondary Ba-rich K-feldspar. Chemical U-Th-Pb dating yields resetting ages of <875 ± 35 Ma for type-ii uraninite-uranophane, younger than strike-slip movement along regional structures of the basin that are spatially associated with the uranium occurrences. We suggest that MacInnis Lake uranium occurrences formed from oxidized hydrothermal fluids along previously altered (albitized, potassically altered) regional-scale faults. Uranium minerals precipitated on earlier Fe-rich sulfides (chalcopyrite, bornite), which acted as a redox trap for mineralization, in low-temperature (~310–330 °C, based on Al-in-chlorite thermometry) breccias and stockwork zones, late in a metasomatic iron and alkali-calcic alteration system. [ABSTRACT FROM AUTHOR]

Background: Many people living with HIV struggle to consistently adhere to antiretroviral therapy, fail to achieve long-term virologic control and remain at risk for HIV-related disease progression, development of resistance and may transmit HIV infection to others. Objective: To determine if switching from current multi-tablet (curART) to single-tablet antiretroviral therapy (abacavir/lamivudine/dolutegravir; ABC/3TC/DTG), both combined with individualized adherence support, would improve HIV suppression in non-adherent vulnerable populations. Methods: TriiADD was an investigator-initiated randomized, multicentre, open label study. HIV+ adults with documented non-adherence on curART were randomized in a 1:1 ratio to immediately switch to ABC/3TC/DTG or to continue curART. Both arms received adherence support. The primary outcome was the proportion of participants in each arm with HIV RNA < 50 copies/mL 24 weeks after randomization. Results: In total, 50 people were screened and 27 randomized from 11 sites across Canada before the trial was stopped early due to slow recruitment. Participants were predominantly from ethnocultural communities, Indigenous people and/or had a history of injection drug use. The proportion achieving HIV RNA < 50 copies/mL at week 24 was 4/12 (33%) in the curART arm vs 7/13 (54%) in the ABC/3TC/DTG arm; median Bayesian risk difference, 5% (95% CrI, − 17 to 28%) higher for those randomized to ABC/3TC/DTG. We encountered difficulties with recruitment of participants without prior drug resistance, retention despite intensive support, reliably measuring adherence and in overcoming entrenched adherence barriers. Conclusion: Results of our trial are consistent with a slight improvement in viral suppression in a vulnerable population when a single tablet regimen is combined with patient-level adherence support. Beyond treatment simplicity and tolerability, tailored interventions addressing stigma and social determinants of health are still needed. The numerous challenges we encountered illustrate how randomised trials may not be the best approach for assessing adherence interventions in vulnerable populations. [ABSTRACT FROM AUTHOR]

This study examines how unique audience segments within the Canadian population think and act toward climate change, and explores whether and how the level of audience engagement moderates the effect of various messages on support for climate policy. Drawing on a random probability sample of Canadian residents (N = 1207) conducted in October 2017, we first identify and describe five distinct audiences that vary in their attitudes, perceptions and behaviours with respect to climate change: the Alarmed (25%), Concerned (45%), Disengaged (5%), Doubtful (17%) and Dismissive (8%). We then explore how each segment responds to different messages about carbon pricing in Canada. We find that messages alluding to earmarking (i.e., "Invest in solutions") or leveling the playing field for alternative energy sources (i.e., "Relative price") increase support for a higher carbon price among the population as a whole. However, these messages decreased support for carbon pricing among more engaged audiences (e.g., Alarmed) when a low carbon price was specified to the respondent. Meanwhile, the "Relative price" is the only message that increased policy support among less engaged audiences–the Concerned and the Doubtful. In addition to highlighting the importance of tailoring and targeting messages for differently engaged segments, these results suggest that communicating around the specific consequences of carbon taxes for the prices of some goods may be a fruitful way to enhance support for carbon taxes among relatively less engaged audiences. [ABSTRACT FROM AUTHOR]

While telemedicine is seen as an emerging practice that will outlast the COVID-19 pandemic, it can reduce health services for those with limited internet and technological devices access or sufficient literacy. The aim of this study was to explore the feasibility of using telehealth with people who inject drugs (PWID). A survey on availability and accessibility of different methods of communication was administered to a sample of PWID from an ongoing longitudinal cohort in Montréal, Canada. Among the 96 respondents, phone calls were generally considered acceptable (89.6%) although availability was low (50%). Acceptability and availability of social media were 26% and 41.7%, respectively. Internet-based communication applications were considered acceptable to use for telehealth in 28.1% of participants, even if not frequently available (8.3%). Telehealth is an acceptable form of treatment for PWID, but may be challenging due to low availability of phone or internet access. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Fisheries & Aquatic Sciences is the property of Canadian Science Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To describe the real‐world treatment persistence (defined as the continuation of medication for the prescribed treatment duration), demographics and clinical characteristics, and treatment patterns for patients prescribed erenumab for migraine prevention in Canada. Background: The effectiveness of prophylactic migraine treatments is often undermined by poor treatment persistence. In clinical trials, erenumab has demonstrated efficacy and tolerability as a preventive treatment, but less is known about the longer term treatment persistence with erenumab. Methods: This is a real‐world retrospective cohort study where a descriptive analysis of secondary patient data was conducted. Enrollment and prescription data were extracted from a patient support program for a cohort of patients prescribed erenumab in Canada between September 2018 and December 2019 and analyzed for persistence, baseline demographics, clinical characteristics, and treatment patterns. Descriptive analyses and unadjusted Kaplan–Meier (KM) curves were used to summarize the persistence and dose escalation/de‐escalation at different timepoints. Results: Data were analyzed for 14,282 patients. Median patient age was 47 years, 11,852 (83.0%) of patients were female, and 9443 (66.1%) had chronic migraine at treatment initiation. Based on KM methods, 71.0% of patients overall were persistent to erenumab 360 days after treatment initiation. Within 360 days of treatment initiation, it is estimated that 59.3% (KM‐derived) of patients who initiated erenumab at 70 mg escalated to 140 mg, and 4.4% (KM‐derived) of patients who initiated at 140 mg de‐escalated to 70 mg. Conclusions: The majority of patients prescribed erenumab remained persistent for at least a year after treatment initiation, and most patients initiated or escalated to a 140 mg dose. These results suggest that erenumab is well tolerated, and its uptake as a new class of prophylactic treatment for migraine in real‐world clinical practice is not likely to be undermined by poor persistence when coverage for erenumab is easily available. [ABSTRACT FROM AUTHOR]

The egg parasitoid Trichogramma spp. (Hymenoptera: Trichogrammatidae) is a widely used biocontrol agent against lepidopteran pests. Historically, Trichogramma were deployed either by plane or by using cardboard cards on which parasitized eggs are glued and manually installed at sites. Plane deployment is costly and card installation is time consuming, but the use of Trichogramma has been shown to be efficient against several pests. In 2016 and 2017, a research project investigated the potential use of unmanned aerial system for distributing Trichogramma as biocontrol agents against two major pests: an agricultural pest of maize, the European corn borer, Ostrinia nubilalis (Hübner) (Lepidoptera: Crambidae), and a forest pest, the eastern spruce budworm, Choristoneura fumiferana (Clemens) (Lepidoptera:Tortricidae). Exposure duration of parasitized eggs to field conditions (temperature, predation, etc.) in maize fields influenced the Trichogramma's emergence rate, suggesting that timing of parasitoid releases with their emergence is essential. Although parasitism of naturally occurring eggs in maize fields could not be compared due to the low density of the European corn borer, parasitism of sentinel eggs by Trichogramma was more prominent in plots with unmanned aircraft systems (UAS)-releases compared to control plots. For spruce budworm, treatment with Trichogramma increased egg parasitism and there was no difference between the deployment by UAS and by Trichocards. We discuss these results in the context of pest biology and management. We also discuss the advantages and shortcomings of both methods and offer insights into where future work might go to further leverage the use of UAS in managing these important pests. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Fisheries & Aquatic Sciences is the property of Canadian Science Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A new coronavirus strain known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide. This virus is the causative agent for coronavirus disease 2019 (COVID-19) and spreads primarily through human-to-human transmission via infected droplets and aerosols generated by infected persons. Although COVID-19 is a respiratory virus, the potential for transmission of SARS-CoV-2 via food is considered theoretically possible and remains a concern for Canadian consumers. We have conducted an exposure assessment of the likelihood of exposure of SARS-CoV-2 in Canadian food sources at the time of consumption. This article describes the exposure routes considered most relevant in the context of food contamination with SARS-CoV-2, including contaminated food of animal origin, other contaminated fresh foods, fomites, and SARS-CoV-2–contaminated feces. The likelihood of foodborne infection of SARS-CoV-2 via the human digestive tract also was considered. Our analysis indicates that there is no evidence that foodborne transmission of SARS-CoV-2 has occurred, and we consider the likelihood of contracting COVID-19 via food and food packaging in Canada as low to remote. Adherence to safe food practices and cleaning procedures would in any case prevent a potential foodborne infection with SARS-CoV-2. Our analysis shows no evidence of foodborne transmission of SARS-CoV-2. The likelihood of contracting COVID-19 via food or food packaging is low to remote. Following safe food practices mitigates the likelihood of SARS-CoV-2 transmission. [ABSTRACT FROM AUTHOR]

Background Noninvasive markers of liver fibrosis such as aspartate aminotransferase-to-platelet ratio (APRI) and transient elastography (TE) have largely replaced liver biopsy for staging hepatitis C virus (HCV). As there is little longitudinal data, we compared changes in these markers before and after sustained virologic response (SVR) in human immunodeficiency virus (HIV)-HCV coinfected patients. Methods Participants from the Canadian Coinfection Cohort study who achieved SVR after a first treatment with either interferon/ribavirin or direct acting antivirals (DAAs), with at least 1 pre- and posttreatment fibrosis measure were selected. Changes in APRI or TE (DAA era only) were modeled using a generalized additive mixed model, assuming a gamma distribution and adjusting for sex, age at HCV acquisition, duration of HCV infection, and time-dependent body mass index, binge drinking, and detectable HIV RNA. Results Of 1981 patients, 151 achieved SVR with interferon and 553 with DAAs; 94 and 382 met inclusion criteria, respectively. In the DAA era, APRI increased (0.03 units/year; 95% credible interval (CrI): −.05,.12) before, declined dramatically during, and then changed minimally (−0.03 units/year; 95% CrI: −.06,.01) after treatment. TE values, however, increased (0.74 kPa/year; 95% CrI:.36, 1.14) before treatment, changed little by the end of treatment, and then declined (−0.55 kPa/year; 95% CrI: −.80, −.31) after SVR. Conclusions TE should be the preferred noninvasive tool for monitoring fibrosis regression following cure. Future studies should assess the risk of liver-related outcomes such as hepatocellular carcinoma according to trajectories of fibrosis regression measured using TE to determine if and when it will become safe to discontinue screening. [ABSTRACT FROM AUTHOR]

Background: A successful lung cancer screening program requires a patient cohort at sufficient risk of developing cancer who are willing to participate. Among other factors, a patient's lung cancer risk perception may inform their attitudes toward screening and smoking cessation programs.Research Question: This study analyzed data from the Pan-Canadian Early Detection of Lung Cancer (PanCan) Study to address the following questions: Which factors are associated with the perception of lung cancer risk? Is there an association between risk perception for lung cancer and actual calculated risk? Is there an association between risk perception for lung cancer and the intent to quit smoking? Are there potential targets for lung cancer screening awareness?Study Design and Methods: The PanCan study recruited current or former smokers aged 50 to 75 years who had at least a 2% risk of developing lung cancer over 6 years to undergo low-dose screening CT. Risk perception and worry about lung cancer were captured on a baseline questionnaire. Cumulative logistic regression analysis was used to assess the relationship between baseline risk variables and both lung cancer risk perception and worry.Results: Among the 2,514 individuals analyzed, a higher perceived risk of lung cancer was positively associated with calculated risk (P = .032). Younger age, being a former smoker, respiratory symptoms, lower FEV1, COPD, and a family history of lung cancer were associated with higher perceived risk. Conversely, a consistent relationship between calculated risk and worry was not identified. There was a positive association between risk perception and lung cancer worry and reported intent to quit smoking.Interpretation: Individuals' lung cancer risk perception correlated positively with calculated risk in a screening population. Promotion of screening programs may benefit from focusing on factors associated with higher risk perception; conversely, harnessing worry seemingly holds less value. [ABSTRACT FROM AUTHOR]

Introduction: Prenatal maternal distress has a negative impact on the course of pregnancy, fetal development, offspring development, and later psychopathologies. The study aimed to determine the extent to which the coronavirus disease 2019 (COVID-19) pandemic may aggravate the prenatal distress and psychiatric symptomatology of pregnant women.Material and Methods: Two cohorts of pregnant volunteer women were evaluated, one that was recruited before the COVID-19 pandemic (n = 496) through advertisements in prenatal clinics in Quebec, Canada, from April 2018 to March 2020; the other (n = 1258) was recruited online during the pandemic from 2 April to 13 April 2020. Prenatal distress and psychiatric symptomatology were measured with the Kessler Distress Scale (K10), Post-traumatic Checklist for DSM-5 (PCL-5), Dissociative Experiences Scale (DES-II), and Positive and Negative Affect Schedule (PANAS).Results: The 1754 pregnant women (Mage  = 29.27, SD = 4.23) were between 4 and 41 gestational weeks (M = 24.80, SD = 9.42), were generally educated (91.3% had post-high-school training), and financially well-resourced (85.3% were above the low-income cut-off). A multivariate analysis of covariance controlling for age, gestational age, household income, education, and lifetime psychiatric disorders showed a large effect size (ES) in the difference between the two cohorts on psychiatric symptoms (Wilks' λ = 0.68, F6,1400  = 108.50, P < .001, partial η2  = 0.32). According to post-hoc analyses of covariance, the COVID-19 women reported higher levels of depressive and anxiety symptoms (ES = 0.57), dissociative symptoms (ES = 0.22 and ES = 0.25), symptoms of post-traumatic stress disorder (ES = 0.19), and negative affectivity (ES = 0.96), and less positive affectivity (ES = 0.95) than the pre-COVID-19 cohort. Women from the COVID-19 cohort were more likely than pre-COVID-19 women to present clinically significant levels of depressive and anxiety symptoms (OR = 1.94, χ2 [1] = 10.05, P = .002). Multiple regression analyses indicated that pregnant women in the COVID-19 cohort having a previous psychiatric diagnosis or low income would be more prone to elevated distress and psychiatric symptoms.Conclusions: Pregnant women assessed during the COVID-19 pandemic reported more distress and psychiatric symptoms than pregnant women assessed before the pandemic, mainly in the form of depression and anxiety symptoms. Given the harmful consequences of prenatal distress on mothers and offspring, the presently observed upsurge of symptoms in pregnant women calls for special means of clinical surveillance. [ABSTRACT FROM AUTHOR]

Background: Recruitment to clinical trials is suboptimal, increasing costs, and delaying the potential implementation of clinical advances. Among other barriers, the lack of marketing experience among trialists may limit recruitment. In this observational study, in the context of the Pan-Canadian Early Detection of Lung Cancer Trial, we assessed the value of a motivational survey of study participants in planning a tailored advertising campaign and analysed the value of individual components of advertising in generating telephone calls to the study and recruited subjects. Methods: The Pan-Canadian Early Detection of Lung Cancer Trial was a single arm study assessing risk modelling for lung cancer screening by low-dose computed tomography scan and autofluorescence bronchoscopy. Individuals were recruited to eight sites across Canada without a central marketing plan. On contact with the study, individuals reported how they heard about the study according to a predefined list. One site, the Juravinski Cancer Centre, worked with a marketing expert to develop a survey to assess participant motivations, source of study awareness, and personal habits. The survey was used to develop a media campaign for recruitment. Media events were collected from all sites. The primary analysis assessed the number of telephone contacts and recruited subjects associated with various media factors. Individual print media characteristics were assessed for their effect on recruitment. Results: At all sites, 7059 individuals contacted the study, and 2537 were eligible and recruited. Among 52 individuals completing the Juravinski Cancer Centre survey, motivation included concern for personal risk of lung cancer (71%), followed by desire to contribute to a cure (67%), followed by personal knowledge of a person with lung cancer (50%). Most reported hearing of the study from the newspaper (58%) despite no print ad yet being distributed. With survey input, a newsprint campaign was executed. The number of media events varied by site (median: 13, range: 3–28). Among all recruits, 56.4% reported referral by newspaper followed by family/friend (14%). Telephone contacts and recruited subjects per event varied significantly by site, while unpaid media events appeared superior to paid events. Print media characteristics associated with increased telephone contacts and recruitment included use of a rational appeal (vs a mixed rational–emotional), less use of white space, and larger headline font. Conclusion: A survey of trial candidates provides useful information regarding personal motivation, media use, and lifestyle. Unpaid media events appear superior in generating recruitment, while print media may be superior to radio and television in selecting eligible recruits. The utility of individual print media characteristics appears to differ from the commercial advertising literature. Further research on marketing in clinical trials is encouraged to improve recruitment (ClinicalTrials.gov registration: NCT00751660, https://clinicaltrials.gov/ct2/show/NCT00751660). [ABSTRACT FROM AUTHOR]

Background: Life expectancy (LE) and health expectancy have increased throughout much of the world. However, these gains have not been shared equally across all population groups. Socioeconomic disparities exist, though varied methodologies and data sources have made it difficult to ascertain changes over time in Canada. Methods: The 1996 and 2011 Canadian Census Health and Environment Cohorts, with a five-year mortality follow-up, were used to estimate the LE of the household population at ages 25 and 65, according to individual-level education and income. Health status was measured by the Health Utilities Index Mark 3 instrument in two national population health surveys and was used to adjust LE to estimate health-adjusted life expectancy (HALE). Disparities in LE and HALE, and differences between cohorts, were examined. Results: LE, HALE and the ratio of HALE to LE were greater at higher levels of education or income. A stepwise gradient was also observed by level of education within and across income quintiles, with people in the lowest combined education and income categories at the greatest disadvantage. Disparities were wider in the 2011 cohort compared with the 1996 cohort, but not necessarily to the same extent for both sexes or at different ages. Interpretation: In Canada, education-related and income-related disparities in life and health expectancy persist and may be wider than they were in the past. This underscores the importance of ongoing data development for routine monitoring of trends in mortality and morbidity, which can, in turn, inform policy development and planning to advance health equity. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Surgery is the property of CMA Impact Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Using different time frames or time scales, such as short term, medium term, and long term, this article considers if the 1969 Official Languages Act was a turning point for Canadians. If opponents to official bilingualism believed that the Official Languages Act was definitely a turning point at the time, this is not the case when using a medium-term scale. The passage of the Act demonstrates that this was part of the federal government's broader strategy of changing Canadian symbols. The long-term scale provides another interpretation since Indigenous languages and rights have been ignored. [ABSTRACT FROM AUTHOR]

This study employed the Academic Learning Time model to describe the behavior of moderately mentally handicapped students in their physical education classes. The concept of academic learning time (ALT) is defined as the proportion of time a student is engaged in a task related to the learning objectives and is experiencing an appropriate success rate. Subjects were 29 students randomly selected from five adapted-P.E. groups (three elementary and two secondary) in three Quebec City region schools. A French version of the ALT observation system developed by Siedentop, Tousignant, and Parker (1982) was used to code the students' behavior in P.E. classes. The results reveal that, on the average, only 63 % of the time officially allocated to P.E. within the school curriculum was actually used for teacher/student interaction. Moreover, 21% of this 63 % was spent organizing the learning activities, 4% in explaining the tasks, and the remaining 75% in motor activities. However, although the number of students in a group varied from five to nine, on the average individuals were successfully motor engaged only 16% of the time and spent 50% of the time waiting. [ABSTRACT FROM AUTHOR]

Background: Over the past century, life expectancy at birth in Canada has risen substantially. However, these gains in the quantity of life say little about gains in the quality of life. Methods: Health-adjusted life expectancy (HALE), an indicator of quality of life, was estimated for the household and institutional populations combined every four years from 1994/1995 to 2015. Health status was measured by the Health Utilities Index Mark 3 instrument in two national population health surveys, and was used to adjust life expectancy. The percentage of the population living in health-related institutions was estimated based on the Census of Population. Attribute-deleted HALE was calculated to determine how various aspects of health status contributed to the differences between life expectancy and HALE. Results: HALE has increased in Canada. Greater gains among males have narrowed the gap between males and females. The ratio of HALE to life expectancy changed little for males, and a marginal improvement was observed for females aged 65 or older. Mobility problems and pain, the latter mainly among females, accounted for an increased share of the burden of ill health over time. Exclusion of the institutional population significantly increased the estimates of HALE and yielded higher ratios of HALE to life expectancy. Interpretation: Although people are living longer, the share of years spent in good functional health has remained fairly constant. Data for both the household and institutional populations are necessary for a complete picture of health expectancy in Canada. [ABSTRACT FROM AUTHOR]

Background: Development of intraoperative techniques and blood management strategies in liver resection, and the multidisciplinary nature of perioperative transfusion decision making, creates an opportunity for practice variation. The aim of this study was to describe the current practices in perioperative blood management and explore differences between surgeons and anesthesiologists.Study Design and Methods: A Web-based survey was developed, piloted, and circulated to Canadian liver surgeons and anesthesiologists. The survey focused on management of preoperative anemia, blood conservation strategies, estimation of blood loss, and transfusion decision making in a multidisciplinary setting.Results: A total of 198 physicians received the survey, with 117 responding (59%). Most responding surgeons (67%) perform more than 20 liver resections per year, while most responding anesthesiologists (90%) take part in fewer than 20. Anesthesiologists most commonly stated that preoperative anemia is managed by someone else (38%), while surgeons most commonly reported "no specific treatment" (45%). The most common intraoperative blood conservation technique used is administration of antifibrinolytics (63% used them at least occasionally). The most important factor for anesthesiologists when deciding on an intraoperative transfusion was hemoglobin value (47%); for surgeons, it was patient hemodynamics (33%). Compared to when they started their career, 60% of respondents felt that they were less likely to transfuse a patient now.Conclusion: The results of our survey provide insights into current transfusion practice and decision making in liver resection, including a comparison between anesthesiologist and surgeon transfusion behavior. Management of preoperative anemia, increased use of intraoperative blood conservation techniques, and improved communication between providers were identified as targets for quality improvement. [ABSTRACT FROM AUTHOR]