Search

Positive academic climates are critical to helping students thrive, and kindness innovations might enhance these climates. This conceptual paper's purpose is to share insights from a consensus building event focused on fostering relationships and knowledge-sharing among an international group of multidisciplinary students, faculty, and staff who explored ways to bring a kindness framework into post-secondary education. Participants underscored kindness as critical for students' experiences and university culture, and identified several levels of influence requiring intervention focus. Ideas and strategies emerging from the event might serve to encourage student-led kindness initiatives and prompt university personnel to integrate kindness into post-secondary institutions.

Dr. Marilyn A. Ray, nurse scholar and retired United States Air Force (USAF) veteran and former flight nurse, began her nursing scholarship in Canada. She was influenced by the experiences and interprofessional scholarly ideas that she encountered along her career trajectory. Her early love of the air and space led her to the United States Air Force Nurse Corps, where she served as a flight nurse during the Vietnam war era, followed by leadership positions in nursing education, administration, practice, and research. Dr. Ray's contributions to nursing knowledge includes two nursing theories and a caring inquiry methodology. Dr. Ray is helping to create a new caring science certificate program at Florida Atlantic University, Christine E. Lynn College of Nursing. In this column, Dr. Ray shares the story of her scholarly influences and how they helped her care for her husband and gain insight into her contributions to nursing knowledge development. [ABSTRACT FROM AUTHOR]

Background: Risk factors for aquaporin-4 (AQP4+) antibody neuromyelitis optica spectrum disorder (NMOSD) are not well-established. Objective: To investigate demographic and environmental factors associated with NMOSD using a validated questionnaire and case–control design. Methods: We enrolled patients with AQP4 + NMOSD through six Canadian Multiple Sclerosis Clinics. Participants completed the validated Environmental Risk Factors in Multiple Sclerosis Study (EnvIMS) questionnaire. Their responses were compared to those of 956 unaffected controls from the Canadian arm of EnvIMS. We calculated odds ratios (ORs) for the association between each variable and NMOSD using logistic regression and Firth's procedure for rare events. Results: In 122 participants (87.7% female) with NMOSD, odds of NMOSD in East Asian and Black participants were ⩾8 times that observed in White participants. Birthplace outside Canada was associated with an increased risk of NMOSD (OR = 5.5, 95% confidence interval (CI) = 3.6–8.3) as were concomitant autoimmune diseases (OR = 2.7, 95% CI = 1.4–5.0). No association was observed with reproductive history or age at menarche. Conclusion: In this case–control study, risk of NMOSD in East Asian and Black versus White individuals was greater than that observed in many previous studies. Despite the preponderance of affected women, we did not observe any association with hormonal factors such as reproductive history or age at menarche. [ABSTRACT FROM AUTHOR]

This article reports on the findings of a larger study that explored urban Indigenous providers' experiences with contracting in mental health and addictions care. The study was undertaken with seven Indigenous and one non-Indigenous non-profit organizations based in diverse large and mid-size cities (off reserve) in British Columbia, Canada. Indigenous and critical theoretical perspectives provided the lens for this ethnographic inquiry. In-depth interviews were the primary data source. Participants' narratives provide an account of the ideological embeddedness of contracting and how a New Public Management operates to perpetuate colonial power imbalances and structural barriers to culturally safe and equity-oriented care within urban Indigenous communities. Policy and practice implications for government funders are discussed. [ABSTRACT FROM AUTHOR]

Aims: This study aims to understand factors contributing to nonpublication and publication bias in clinical trials in Canada. Methods: Qualitative interviews were conducted between March 2019 and April 2021 with 34 participants from the Canadian provinces of Alberta, British Columbia and Ontario, including 17 clinical trial investigators, 1 clinical research coordinator, 3 research administrators, 3 research ethics board members and 10 clinical trial participants. We conducted a thematic analysis involving coding of interview transcripts and memo‐writing to identify key themes. Results: Several factors contribute to nonpublication and publication bias in clinical trial research. A core theme was that reporting practices are shaped by incentives within the research system taht favour publication of positive over negative trials. Investigators are discouraged from reporting by experiences or perceptions of difficulty in publishing negative findings but rewarded for publishing positive findings in various ways. Trial investigators more strongly associated positive clinical trials than negative trials with opportunities for industry and nonindustry funding and with academic promotion, bonuses and recognition. Research institutions and ethics boards tended to lack well‐resourced, proactive policies and practices to ensure trial findings are reported in registries or journals. Conclusion: Clinical trial reporting practices in Canada are shaped by incentives favouring reporting of positive over negative trials, such as funding opportunities and academic promotion, bonuses and recognition. Research institutions could help change incentives by adopting performance metrics that emphasize full reporting of results in journals or registries. [ABSTRACT FROM AUTHOR]

Objective: The literature that has examined healthcare access and needs of the multiple sclerosis (MS) population is limited. Currently, no research has engaged healthcare providers delivering services to this population to examine their perspectives on the provision of MS care in Canada. We aimed to summarize what good MS care should look like according to Canadian healthcare providers working with people with MS, and to identify the supports and resources required, within their care setting, to enable this standard of care. Methods: A qualitative descriptive approach was taken to analyze data from participants who responded to additional open-ended survey questions, within a larger "MS Models of Care Survey" targeting Canadian healthcare providers working with persons with MS. Results: Currently, a gap exists between what healthcare providers working with persons with MS believe MS care should encompass and what they are able to offer. Participants emphasized that their MS clinics are currently understaffed and patient-to-provider ratios are high, leaving very little time to address the array of healthcare concerns their patients present with. The healthcare providers overwhelmingly described that moving toward multidisciplinary team-based MS care that includes appropriate numbers of MS-trained neurologists, nurses, physiotherapists, occupational therapists, and mental health providers working within one location would be their prioritized approach to comprehensively managing MS care. This model of care enables all professionals to effectively coordinate care and use their time efficiently by only focusing on their area of expertise, all while meeting the needs of their patient in one setting, reducing wait-times and improving overall care. Conclusion: To meet the care needs of Canadians with MS, the healthcare system must consider standardizing and funding multidisciplinary team-based MS clinics, comparable to Stroke units, which continue to show favorable health outcomes after years of implementation. [ABSTRACT FROM AUTHOR]

Objective: Little work has evaluated integrated models of care in multiple sclerosis (MS) and the composition of MS care teams across Canada is largely unknown. We aimed to gather information regarding existing models of MS care across Canada, and to assess the perceptions of health care providers (HCPs) regarding the models of care required to fully meet the needs of the person with MS. Methods: We conducted an anonymous online survey targeting Canadian HCPs working in MS Clinics, and neurologists delivering MS care whether or not they were based in an MS Clinic. We queried the types of HCPs delivering care within formal MS Clinics, wait times for HCPs, the perceived importance of different types of HCPs for good quality care, assessments conducted, and whether clinic databases were used. We summarized survey responses using descriptive statistics. Results: Of the 716 HCPs to whom the survey was distributed, 100 (13.9%) people responded. Of the 100 respondents, 85 (85%) indicated that their clinical practice included people with MS and responded to specific questions about clinical care. The most common types of providers within MS Clinics with integrated models of care were neurologists and MS nurses. Of 23 responding MS Clinics, 10 (43.5%) indicated that there were not enough neurologists, and 16 (69.6%) indicated that there were not enough non-neurologist HCPs to provide adequate care. More than 50% of clinics reported wait times exceeding 3 months for physiatrists, physiotherapists, psychiatrists, psychologists, neuropsychologists and urologists; in some clinics wait times for these providers exceeded 1 year. Multiple disciplines were identified as important or very important for delivering good quality MS care. Over 90% of respondents thought it was important for neurologists, nurse practitioners, MS nurses and psychiatrists to be co-located within MS Clinics. Conclusion: Canadian HCPs viewed the ideal MS service as being multidisciplinary in nature and ideally integrated. Efforts are needed to improve timely access to specialized MS care in Canada, and to evaluate how outcomes are influenced by access to care. [ABSTRACT FROM AUTHOR]

Background: Selective dorsal rhizotomy (SDR) is a neurosurgical intervention to reduce spasticity in children with cerebral palsy. Parents researching SDR for their child may be influenced by framing of SDR in news media articles they read. This study examined framing of SDR in English‐language news media. Methods: Content analysis of English‐language news media articles including the search term 'rhizotomy' in the Factiva database published July 2015 to July 2018 in online or print form in Canada, New Zealand, Australia, United States of America and the United Kingdom. Results: One hundred and eighty‐six articles were identified describing 91 different children (45 male), almost all with cerebral palsy, median age 4 years old. One hundred and twenty‐six articles were written prior to surgery; in many articles, SDR surgery involved travel overseas and/or fundraising. SDR was described universally in positive terms with little discussion of risks. Content of articles variably included the specialized nature of SDR, parental frustration with their local health system and their hope for positive outcomes. There was geographical variation in both numbers of articles and content. Conclusions: SDR is a common focus in cerebral palsy news media articles in some countries. Framing in these articles supports SDR as a beneficial and specialized procedure and may lead families to believe they need to work outside their local health systems. As news media are likely an important influence on families' attitudes to SDR, clinicians should be aware of this influence. [ABSTRACT FROM AUTHOR]

Exposure to violence is recognized as a major health concern among adolescent populations. The evidence base that links religious involvement with risks for child violence is inconsistent. In a national analysis involving a weighted sample of 24,307 young people, we studied the perpetration of violence (fighting and bullying), as well as victimization by violence (bullying only), among young people who were affiliated with religious groups. One in four young Canadians reported involvement in such groups. Study findings confirmed some unique patterns among this group. First, these religiously involved children reported the same or greater levels of perpetration of violence than other children. Second, religiously involved children reported the same or greater levels of experiencing victimization from violence. Third, religious involvement appeared to protect against engagement in certain overt risk-taking behaviors, but not violence. These patterns were consistent even after adjustment for family, community, socioeconomic, and school-related determinants. If religious communities are to fulfill mandates that foster the protection and nurturing of children into healthy relationships, violence is best addressed using evidence-based strategies. Development of such effective preventive strategies requires the incorporation of contemporary evidence about the distribution, determinants, and possible effects of violence in such groups. Findings from our study suggest that a silence around the issue of violence may in fact be true in the context of some Canadian religious communities. Yet, if these communities make an intentional commitment to protecting children from violence and promoting healthy relationships, and are willing to learn from evidence-based practices that have shown to protect children from participating in and experiencing violent and victim behaviors, perhaps these disturbing trends could be reversed. This message is germane for all levels of leadership in Canadian religious communities. [ABSTRACT FROM AUTHOR]

Purpose: While there is literature that examines factors associated with low participation in cancer screening among Canadian ethnic groups, there is limited understanding of black visible minorities, particularly Somalis. Thus, the purpose of this study is to synthesize knowledge pertaining to the perceptions, beliefs and barriers of Somali women and men toward screening for breast, cervical and colorectal cancers in countries such as Canada. Design/methodology/approach: The scoping review methodology was used to search for peer-reviewed articles that explicitly examined perceptions, beliefs and barriers among Somalis toward screening for breast, cervical and colorectal cancers in developed countries. The following electronic databases were searched without time frame restrictions, namely, OVID Medline, Embase, CINHAL, PubMed, Scopes and ProQuest. A total of 402 peer-reviewed articles were identified and screened. Three articles were identified through reference list screening (one eligible) and consultation with experts in the networks (two eligible). In total, 12 studies met the inclusion criteria for synthesis. Thematic analysis was used to analyze the selected articles for key themes and the synthesis was informed by the socio-ecological model. Findings: The majority of studies originated from the USA and focused primarily on Somali women and cervical cancer screening. Themes that emerged from the literature include individual-level negative experiences and socio-cultural perceptions/beliefs; community-level barriers in cancer screening; and systemic challenges in navigating the health-care system. Many of the studies focused on individual and community-level determinants of cancer screening, with little attention to systemic level determinants. Other gaps identified include factors influencing Somali men's low participation in cancer screening; limited studies on colorectal cancer and Somali women; and specific cancer-screening barriers faced by Somalis within the Canadian context. Originality/value: The findings of the review reveal multiple cancer screening challenges for Somali communities and the gained insights should inform both health and social care practitioners and policymakers. [ABSTRACT FROM AUTHOR]

A successful national sport organization, Synchro Canada, was described in terms of three structural characteristics (formalization, centralization, and complexity) and five processes (activities to ensure resources, work flow. control, identification, and homeostatic activities) based on evidence from documents and, to a limited extent, from interviews. Eighty-five subjects from four constituent groups (administrators, judges, coaches, and athletes) responded to a questionnaire that assessed their perceptions regarding contributions of the selected organizational characteristics to Synchro Canada's overall effectiveness. The analyses showed that the organization's structures and processes were consistent with the literature in organization theory. From an overall perspective, the respondents perceived the structural and process characteristics as contributing to overall effectiveness. However, the coaches as a subgroup viewed the dimensions of activities to ensure resources, control activities, and centralization as detracting from effectiveness. [ABSTRACT FROM AUTHOR]

Background: Due to racism, xenophobic nationalism, acculturation pressures and patriarchal social relations, Asian men in Western societies may be particularly susceptible to negative experiences and beliefs regarding mental illness and treatment services. Aims: We examine factors associated with stigma toward mental illness among Asian men in Canada. Methods: Between 2013 and 2017, 428 self-identified Asian men living in proximity to Vancouver, Canada, were recruited and completed self-administered questionnaires assessing social stigma and self-stigma. The degree to which these variables were associated with the men’s sociodemographic characteristics was analyzed. Results: Multivariable regression revealed that social stigma was significantly predicted by age, immigration, employment status and experience with mental illness. Together, these variables accounted for 12.36% of variance in social stigma. Interaction terms were added to the regression models to examine whether the effects of immigration on social stigma varied by age and experience with mental illness, but none of the interaction terms were statistically significant. Among the 94 Asian men identified as living with mental illness, self-stigma was predicted by age, immigration and employment status, which together accounted for 14.97% of variance in self-stigma. Conclusion: These results offer new knowledge about the factors predicting stigma toward mental illness among Asian men in Western societies. [ABSTRACT FROM AUTHOR]

Background Physical activity ( PA) is beneficial for all people, yet people affected by multiple sclerosis ( MS) find regular PA challenging. These people may include individuals with the disease who have moderate-to-severe disability and their family caregivers. For researchers and clinicians to effectively promote PA among caregiver/care-recipient dyads with moderate-to-severe MS, a comprehensive understanding of the shared PA experiences of these dyads would be beneficial. Objective We explored shared experiences of caregiver/care-recipient dyads affected by moderate-to-severe MS about PA and directions for intervention. Methods Six focus groups with 23 people with moderate-to-severe MS and 12 family caregivers were conducted. Data were analysed using a constant comparative approach. Results Three major themes emerged as follows: (i) PA is a continuum, (ii) cycle of disengagement and (iii) cycle of adjustment. The first theme captured the dyads understanding that PA falls along a continuum ranging from highly structured to unstructured activities. Cycle of disengagement captured the experiences of dyads engaging in little or no PA. These dyads perceived internal and external issues as drivers of the cycle of disengagement, while availability of supportive programmes and services or people helped the dyads to break out of the cycle. When the cycle of disengagement was broken, the dyads described moving towards the cycle of adjustment, where they were able to learn skills and take action to incorporate PA into daily routines. Conclusion This research highlights the need to adopt an integrative approach that acknowledges the caregiver/care-recipient dyad with moderate-to-severe MS as a focus for PA intervention. [ABSTRACT FROM AUTHOR]

The impact of visual and visual-cognitive impairments on fitness to drive in persons with multiple sclerosis (PwMS) are not well studied. We quantified visual correlates of fitness to drive in 30 PwMS. PwMS completed visual ability and visual attention assessments, and a standardized on-road assessment, and were compared with 145 older volunteer drivers. PwMS (vs. older volunteer drivers) made more total (W = 12,139, p = .03) and critical driving errors (predictive of crashes) in adjustment to stimuli (W = 11,352, p < .0001), vehicle positioning (W = 11,449, p < .0001), and wide lane turns (W = 9,932, p < .0001). PwMS who failed (vs. passed) made more total (W = 325, p = .04), adjustment to stimuli (W = 321.5, p = .02), and gap acceptance errors (W = 333, p = .03). For PwMS, adjustment to stimuli errors moderately correlated with visual acuity (ρ = .50, p = .006), and gap acceptance errors moderately correlated with visual processing speed (ρ = .40, p = .03). Visual-cognitive impairments may be indicative of critical driving errors and help identify PwMS at-risk for fitness to drive. [ABSTRACT FROM AUTHOR]

Purpose: Migrant and refugee women are at risk of negative sexual and reproductive health (SRH) outcomes due to low utilisation of SRH services. SRH is shaped by socio-cultural factors which can act as barriers to knowledge and influence access to healthcare. Research is needed to examine constructions and experiences of SRH in non-English-speaking migrant and refugee women, across a range of cultural groups. Method: This qualitative study examined the constructions and experiences of SRH among recent migrant and refugee women living in Sydney, Australia, and Vancouver, Canada. A total of 169 women from Afghanistan, Iraq, Somalia, South Sudan, Sudan, India, Sri Lanka and South America participated in the study, through 84 individual interviews, and 16 focus groups comprised of 85 participants. Thematic analysis was used to analyse the data. Results: Three themes were identified: 'women's assessments of inadequate knowledge of sexual and reproductive health and preventative screening practices', 'barriers to sexual and reproductive health' and 'negative sexual and reproductive health outcomes'. Across all cultural groups, many women had inadequate knowledge of SRH, due to taboos associated with constructions and experiences of menstruation and sexuality. This has implications for migrant and refugee women's ability to access SRH education and information, including contraception, and sexual health screening, making them vulnerable to SRH difficulties, such as sexually transmissible infections and unplanned pregnancies. Conclusion: It is essential for researchers and health service providers to understand socio-cultural constraints which may impede SRH knowledge and behaviour of recent migrant and refugee women, in order to provide culturally safe SRH education and services that are accessible to all women at resettlement irrespective of ethnicity or migration category. [ABSTRACT FROM AUTHOR]

In Australia and Canada, the sexual health needs of migrant and refugee women have been of increasing concern, because of their underutilization of sexual health services and higher rate of sexual health problems. Previous research on migrant women's sexual health has focused on their higher risk of difficulties, or barriers to service use, rather than their construction or understanding of sexuality and sexual health, which may influence service use and outcomes. Further, few studies of migrant and refugee women pay attention to the overlapping role of culture, gender, class, and ethnicity in women's understanding of sexual health. This qualitative study used an intersectional framework to explore experiences and constructions of sexual embodiment among 169 migrant and refugee women recently resettled in Sydney, Australia and Vancouver, Canada, from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, India, and South America, utilizing a combination of individual interviews and focus groups. Across all of the cultural groups, participants described a discourse of shame, associated with silence and secrecy, as the dominant cultural and religious construction of women's sexual embodiment. This was evident in constructions of menarche and menstruation, the embodied experience that signifies the transformation of a girl into a sexual woman; constructions of sexuality, including sexual knowledge and communication, premarital virginity, sexual pain, desire, and consent; and absence of agency in fertility control and sexual health. Women were not passive in relation to a discourse of sexual shame; a number demonstrated active resistance and negotiation in order to achieve a degree of sexual agency, yet also maintain cultural and religious identity. Identifying migrant and refugee women's experiences and constructions of sexual embodiment are essential for understanding sexual subjectivity, and provision of culturally safe sexual health information in order to improve well-being and facilitate sexual agency. [ABSTRACT FROM AUTHOR]

Objective: Recovery from mental illness is influenced by one's social location along multiple dimensions of identity, such as race, class, gender, age, and ability, and by how these social locations are expressed through structural and institutional barriers. This project was developed using an intersectional policy analysis framework designed to promote equity across identity locations--called the multistrand method--to examine the potential use of self-directed care financing approaches in the Canadian mental health system. Method: A panel of 16 diverse stakeholders came together 4 times at structured 6-hr meetings to examine the evidence for self-directed care and explore its application in the Canadian context. Telephone interviews with evidence panel members were conducted to assess their perceptions of the group process and outcomes. Results: Our analysis revealed ways that intersecting strand locations might differentially influence the degree of choice and recovery experienced by self-directed care participants. Individualized resource allocation, draining financial resources from ethnically specific services, unevenness in acceptance of the recovery orientation, and paucity of service options in different geographical regions were identified as contexts in which self-directed care policies could promote inequity. However, greater peer involvement in the model's implementation, use of indigenous community supports, purchase of material goods by economically disenfranchised persons, and access to services from ethnically diverse clinicians in the private sector were identified as equity-promoting model features. Conclusion and Implications for Practice: By couching their analysis at the level of unique socially-situated perspectives, the group developed detailed policy recommendations and insights into both the potential and limitations of self-directed care. The knowledge gained from our project can be used to develop uniquely Canadian self-directed care models tailored to promote recovery through empowerment and self-determination across intersecting identity strand locations. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the impact of Motivational Interviewing (MI)-via-Co-Active Life Coaching (CALC) on: smoking behaviours, personal competency as well as changes in perceptions of identity, smoking, quitting and the intervention itself among young adults (aged 19-25 years) in Canada. A mixed methods intent-to-treat approach was taken; the impact of 8-10 MI-via-CALC sessions on smoking behaviour and personal competency of 40 young adult smokers was examined through both questionnaires and individual interviews over 1 year. The immediate-intervention group received MI-via-CALC starting right after enrolment, whereas the waitlist-intervention group was placed on a waitlist for 3 months and then received the intervention. The immediate-intervention group decreased significantly from baseline to post-intervention in smoking behaviours, including the number of cigarettes smoked per day and cigarette dependency; and increased significantly in personal competency, including self-esteem and self-efficacy compared with the waitlist-intervention group. Moreover, 27.5% of participants after receiving the intervention were smoke-free at 12-month post-intervention follow-up. Additionally, qualitative themes pertaining to perceptions of identity, smoking, quitting and the intervention and their changes over time were described and were consistent with quantitative findings. Together, the high cessation rate for the entire study as well as the significant decreases in smoking behaviours and increases in personal competency of the intervention group compared with the waitlist group underscore the impact on behaviour change. MI-via-CALC offers a theoretically grounded, practical and efficacious cessation strategy for young adult smokers. [ABSTRACT FROM AUTHOR]

This is an exact reprint of an article published in 1978 in Volume 16 of the Alberta Law Review. It is the story of the last appeal to go from Canada to the Judicial Committee of the Privy Council, as told by the late Justice Morrow of the Supreme Court of Alberta Appellate Division. This article not only describes the background to a historically significant case that went through the Appellate Division, but also provides the unique perspective of one of its former members. As noted in the original abstract, "[t]he material contained in the reported decisions is interesting but it is hoped the reader will find that the story back of the reports is even more interesting." [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the English phonological skills of English language learners (ELLs) over 5 time points. Method: Sound class accuracy, whole-word accuracy, percentage of occurrence of phonological patterns, and sociolinguistic correlational analyses were investigated in 19 ELLs ranging in age from 5;0 (years; months) to 7;6. Results: Accuracy across all samples was over 90% for all sound classes except fricatives and increased for all sound classes across time. Whole-word accuracy was high and increased across time. With the exception of cluster reduction, stopping, and final consonant deletion, the frequency of occurrence for phonological patterns was less than or equal to 5% at every time point. Sociolinguistic variables such as age of arrival, age of exposure, and age were significantly related to phonological skills. Conclusions: The results were consistent with the hypotheses outlined in Flege's (1995) speech learning model in that the phonological skills of ELLs increased over time and as a function of age of arrival and time. Thus, speech-language pathologists (SLPs) also should expect phonological skills in ELLs to increase over time, as is the case in monolingual children. SLPs can use the longitudinal and connected-speech results of this study to interpret their assessments of the phonological skills of ELLs. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Issues / Thèmes Canadiens is the property of Association for Canadian Studies 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.)

Abstract: Objectives: To examine the use and cost of health-care services in British Columbia, Canada, before and after public drug coverage for tiotropium bromide. Methods: A time series analysis was performed using data from British Columbia''s centralized administrative health-care databases. Linear regression on data from a stable 3-year prepolicy period was used to predict future use of inhaled anticholinergic (IAC) medications, visits to physicians, emergency hospitalizations, and costs. For each use measure, we estimated the policy effect as the difference between observed use in the postpolicy period and predicted use obtained from the prepolicy period. Results: In total, over the 2.5-year period after public coverage, tiotropium use increased by 24.4% more than predicted (95% confidence interval [CI] 23.9%–24.8%). Visits to physicians were unchanged, but there were between 596 and 948 more emergency admissions for chronic obstructive pulmonary disease, and between 582 and 1940 more hospital admissions of any kind than were predicted from prepolicy data. Total cost of inhaled IAC medications increased slightly more than predicted, by between an additional CDN$1.30 million and CDN$1.71 million, but total out-of-pocket spending by patients on IAC medications was reduced by between CDN$2.83 million and CDN$3.11 million because of public coverage. Hospital costs were between CDN$3.88 million and CDN$12.93 million greater than anticipated based on prepolicy data. Conclusions: Public drug plan coverage for tiotropium in British Columbia reduced out-of-pocket costs for patients and their private insurers. Before versus after time series analysis did not show a reduction in hospitalizations or physician visits, or costs associated with those services. [Copyright &y& Elsevier]

Using findings from two studies conducted in British Columbia, Canada, that examined income and employment supports for people with psychiatric disabilities we argue that economic security is essential for mental health recovery, and that supported employment and social enterprise models are well suited to support these goals. We contend that the aims and values underlying neo-liberalism, with its attendant welfare state restructuring, undermine the progressive vision of recovery and the practice of citizenship for people with psychiatric disabilities. [ABSTRACT FROM AUTHOR]

Provincially mandated credential assessment services within Canada have collaborated to develop quality assurance principles and mechanisms for recognizing foreign educational credentials. The quality assurance framework specifies the standards and criteria for good practice in the assessment of foreign credentials. Provincially mandated assessment services that adhere to these quality assurance criteria are eligible for membership in The Alliance of Credential Evaluation Services of Canada (the Alliance). This quality assurance framework has the potential to be refined and expanded to include a broad range of organizations involved in foreign credential recognition. [ABSTRACT FROM AUTHOR]

The article discusses the cultural studies and national identities that are present in both Canada and Mexico, followed by a comparison of the two cases. The author proposes a comparative cultural study of the two countries. There is a lack of evidence that link the two countries, partly because of the extreme differences between the two countries, geographically, politically, and economically. The reason for completing a study on these two countries is important, however, as it is a way to study the effects of globalization after the start of a new age of bilateral trade between Canada and Mexico.

An introduction is presented which discusses the editor-in-chief's retirement from his tenure at the journal and the hiring of Carly Adams to become the journal's new chief editor.

Discusses social and historical antecedents which brought about the emergence of elder abuse and neglect in Canada. Public and private responses to elder abuse; Historical view on competing constructions about the needs of elderly people; Legislation aimed at protecting the aged.

This article deals with various challenges on the cultural studies of Canadian sociology and anthropology at the beginning of the 1990s. It is instructive also to compare in more detail the different ways in which the concept of cultural studies has appealed to researchers in the humanities, anthropology and sociology. In the cases of the humanities and cultural anthropology, some might argue that, as in the case of feminist and Francophone Quebec scholars, people have from the beginning been doing cultural studies anyway. Such a statement is misleading, however, because it risks falling back on a common sense definition of cultural studies as just any kind of cultural analysis when in fact it has its origins in various oppositional challenges to conventional forms of cultural theory and research. But it is important to stress the disciplinary-specific character of those crises and contradictions. Within the humanities, for example, the move toward cultural studies took the form of appropriating new theories outside literature and has been characterized by a concern with the extrinsic as well as intrinsic aspects of texts, stress upon the material and institutional foundations of cultural production and reception, and a redefinition of the objects of inquiry as any form of cultural expression, including popular forms.

The article focuses on the increasing trend of employment equity planning in Canada's public sector. It discusses several reasons for the increasing importance of employment equity planning as a management tool including the gap between male and female wages and minimal representation of women in various occupations. It stresses on the need for strong executive commitment and organizational coordination for the successful implementation of the plans. It mentions the observations of the Royal Commission on Equality in Employment report and presents its key points related to the employment equity. Also mentioned are various components of employment equity including non-sexist communications among employees, gender-balanced selection panels, and strict sexual harassment policies.

The article discusses the Fort McMurray wildfire which occurred in northeastern Alberta in Canada on May 1, 2016. It states that the wildfire was human-caused that spread rapidly and developed into a raging crown fire, making the 90,000 residents of the city and surrounding area to evacuate when the fire grew out of control, jumped several rivers and headed toward downtown.

• Lung function and nutrition prior to CFTR modulator therapy was significantly lower in people with CF in south Africa compared to Canada. • Disparities in outcomes are likely due to different socioeconomic conditions, inferior quality of healthcare in SA and early-life determinants of health. • Global disparities in CF outcomes between high and low to middle income countries are likely to widen in future as CFTR modulators rapidly become standard of care in only high-income countries. Outcomes of cystic fibrosis (CF) differ between low-middle income and high-income countries, but comparative data are lacking. We compared South African (SA) and Canadian CF outcomes to explore what disparities existed prior to access of CFTR modulators in Canada. A cross-sectional study of SA and Canadian CF registries data for period 1 January to 31 December 2018. CF registry data were harmonised between countries to compare lung function and nutrition outcomes. Poor nutrition was defined as BMIz-score < -1 in children and < 18.5 kg/m2 in adults. Standardised mean difference (SMD) >10 was considered significant. After excluding Canadians on CFTR modulators and lung transplant recipients, data on 4049 Canadian and 446 SA people was analysed. Compared to Canada, people in SA were younger (median age 15.8 years vs. 24.1 years: SMD 52) with fewer males (47.8% vs 54.2%; SMD 12.5) and White (70.9% vs. 93.3%; SMD 61.3). Class I-III CFTR mutation frequency was similar in SA (n = 384, 86.1%) and Canada (n = 3426, 84.9%). After adjusting for age, gender, diagnosis age, genotype, P.aeruginosa infection and pulmonary treatments, FEV1pp was 8.9% lower (95% CI 6.3% to 11.4%) and poor nutrition 1.7-fold more common (OR 1.70; 95% CI 1.19–2.41) in SA compared to Canada. Lung function and nutrition was significantly lower in SA compared to Canada. Global disparities in CF outcomes between high and low-middle income countries are likely to widen as CFTR modulators are rapidly scaled up in only high-income countries. [ABSTRACT FROM AUTHOR]

Analyzing health care administrative data and findings from focus groups of people with multiple sclerosis (MS) and family caregivers revealed a complex pattern of service use and need that contributes to nursing home entry for people with MS. Preventing or delaying this entry will require a multipronged approach. [ABSTRACT FROM AUTHOR]

This section offers news briefs on provincial, regional and territorial library associations in Canada as of 2008. The 2009 annual conference of the British Columbia Library Association (BCLA) is scheduled from April 16 to 18. The Library Association of Alberta (LAA) formed a partnership with the Writers Guild of Alberta and the Education Institute for the pilot project, "Wired Writers: Author Talks With a Twist." The Chesley Friends of the Library of Bruce County, Ontario has received the 2008 Gabriele Schreiber Friends of the Library Award.

This report provides a brief description of the Khumbu region of Nepal, its people, and the availability of dental treatment in this remote area. It also highlights Canadian involvement in the training of dental staff who provide treatment in a new clinic in the region. [ABSTRACT FROM AUTHOR]