Search

REDEVELOP is a graduate student training program funded by the NSERC-CREATE grant, starting in 2017. Its goal is to support the training of new professionals and researchers (> 100) who will be the next generation of science and engineering leaders and policymakers in Canada. The program has successfully developed a framework for operating almost completely virtually, well ahead of the world's transition to online learning due to the COVID-19 pandemic. Our psychology lab, The Individual and Team Performance (ITP) lab, has dedicated over a decade to researching and designing tools that enhance specific training and skill growth necessary for effective remote teamwork. In partnership with the REDEVELOP program, we support students in navigating the unique interpersonal and collaboration challenges posed by virtual team environments. We will discuss how a complex and multidisciplinary program succeeds in training graduate students to become stronger academics, practitioners, and communicators of knowledge. [Articles in this journal were presented at the University of Calgary Conference on Postsecondary Learning and Teaching.]

The series of responses in this article were gathered as part of an online mini conference held in September 2021 that sought to explore different ideas and articulations of school autonomy reform across the world (Australia, Canada, England, Ireland, the USA, Norway, Sweden and New Zealand). It centred upon an important question: what needs to happen for school autonomy to be mobilised to create more equitable public schools and systems of education? There was consensus across the group that school autonomy reform creates further inequities at school and system levels when driven by the logics of marketisation, competition, economic efficiency and public accountability. Against the backdrop of these themes, the conference generated discussion and debate where provocations and points of agreement and disagreement about issues of social justice and the mobilisation of school autonomy reform were raised. As an important output of this discussion, we asked participants to write a short response to the guiding conference question. The following are these responses which range from philosophical considerations, systems and governance perspectives, national particularities and teacher and principal perspectives.

Reflective learning has been considered an important learning experience in higher education because of its value for personal and professional self. Despite the potential benefits, there is diverse interpretation of the meaning and process of reflective learning. Theoretical frameworks and models that purport to explain what it entails abound; however, there is a dearth of research that explores conceptions from the perspective of instructors. This study examined university instructors' conceptions of reflective learning in the context of education courses. Semi-structured interviews were employed to collect data from 32 instructors who consented to participate. The interviews were transcribed, segmented, coded and compared. Our phenomenographic analysis resulted in four qualitatively different conceptions of reflective learning: critical engagement with content, improving professional practice, identity development, and developing critical consciousness. The study has implications for faculty development and research on reflective learning.

In recent decades civil services worldwide have experienced exogenous forces that are transforming their work and workplace. In turn, these changes are altering the skills set associated with civil service employment. As professional degrees oriented towards careers in civil service these changes can have important ramifications on the curriculum. Focusing on member schools of the Canadian Association of Programmes in Public Administration (CAPPA) our research explores whether and how the postgraduate public administration and public policy programmes (MPA and MPP) curriculum has adapted to changes in the natural labour market for their graduates. Our threefold findings are that: A lack of alignment exists between the MPA/MPP currently taught and the requirements of civil services; a recognition by programme heads that some degree of curriculum alignment is indeed necessary; and that engagement between schools and civils services exists, but is typically informal and conducted through intermediary bodies. Our findings further highlight the necessity for civil services to engage with MPA and MPP programmes to ensure that future civil servants possess the skills relevant at a time of significant change in the nature of work.

Achieving fluency in sightreading--particularly rhythm reading--is cited by researchers as a universally problematic component of formal music education. This study employed an experimental design to examine the efficacy of focused practice on rhythm reading with targeted feedback. College music majors (n = 28) were sent a novel, challenging piece of sheet music every day for five days, and were required to return a recording of themselves clapping or tapping the rhythm. Half of the students received only a polite acknowledgement each day. The others received personalised feedback on their errors by the end of the same day, and were required to repeat the incorrect passages in the following day's recording, along with the new material. Sightreading tests were administered pre and post. On average, students in the feedback group improved significantly more than their peers in the practice-only group. Implications for postsecondary music instruction are discussed.

Undergraduate students often have a choice about the modality in which they complete a particular course (in-person or online), and their decisions can be more complex than scholarship suggests. Most studies of modality choice have relied exclusively on closed-form, quantitative surveys; and this approach has denied students the opportunity to correct or complicate researchers' assumptions about their decision-making. We present findings from one of the largest and most comprehensive studies yet conducted on undergraduates' choice of course modality, which provided students with the opportunity to explain their choices in their own words. Our data reveal complexities of undergraduates' modality choice not mentioned previously in the literature, and open new avenues for research. They also have implications for course design during the period of COVID-19, by identifying features of in-person courses that instructors may wish to replicate in their emergency remote teaching for in-person students suddenly forced online.

Canadian schools introduced community service program in 1999 to engage youth in diverse communities of Canada. Many studies have identified the gap in understanding immigrant youths' experience on mandatory community service but has yet to study immigrant youth's experience. Therefore, this paper explores the experiences of young Nepalese Canadians aged 18-24 who participated in mandatory community involvement for graduating from high schools in Ontario, Canada. The findings are based on qualitative data gathered from ten interviews with young Nepalese Canadians who went to Canadian high schools, and are currently living in the Greater Toronto area (GTA). The study provides a nuanced understanding of visible minority immigrant youth's experiences of mandatory community service in high school. The findings suggest that participants experience the program as merely an obligatory requirement to graduate from high school rather than a platform for learning civic skills and engaging in diverse Canadian communities. In addition, this case study of Nepalese Canadian youth depicts how young Nepalese Canadians depend on informal sources, mainly peer-to-peer sharing, for engaging in community, and illustrates how they conceptualize what community involvement means to them. Finally, based on this study, we argue that amendment to this mandatory program is an urgent call for engaging visible minority immigrant youth civically and meaningfully in Canadian communities.

This article explores the degree to which student collaborations on research and writing assignments can effectively realize learning outcomes. The assignment, in this case, encouraged students to contribute discrete parts of a research project in order to develop their complementary abilities: researching, consulting, drafting, and revising. The outcomes for students included appreciation for their individual expertise, and experience combining discrete contributions into a result that surpasses the sum of its parts. In the course, we gave students preliminary guidance for establishing team objectives and roles for the duration of this assignment and asked them to evaluate their learning experience at the end. In this paper, we analyze the students' quantitative and qualitative feedback, and suggest ways to structure and supervise collaborative assignments so that students develop their expertise and complementary skills. We suggest that collaborative work such as this is essential for advanced undergraduates in the humanities, where collaborations are less common than in other disciplines. Moreover, we conclude that future humanities instructors should be open to the benefits of collaborative research and writing. This article will be of interest to instructors who wish to develop collaborative assignments that improve students' disciplinary expertise, engagement with course materials, and outreach to audiences beyond the academy.

The comprehensive examination is a customary, yet relatively unexamined, requirement in North American doctoral education. This case study explored the purpose of a comprehensive examination as perceived by faculty members and students in a Faculty of Education program, at a Western Canadian University. We found that, in addition to the traditional gatekeeping function of the examination, other purposes emerged. Contrasting views about whether the examination was designed to assess content mastery necessary for teaching or designed to assess readiness for doctoral research were found. The use of the comprehensive examination as an opportunity to learn and as a means for identity formation, including introducing students to the pressures of academic life, also contrasted with its traditional assessment function. The purposes of the comprehensive examination remained ambiguous to students, even though they had been privy to discussions concerning the design and development of the examination. Moreover, faculty members did not always agree on the purposes of the comprehensive examination. The differences in perspective and how these affect the administration of the comprehensive examination have an impact on students' experience, including examination preparation. Implications for the implementation, preparation, and assessment of the examination are discussed.

This qualitative case study examines the affordances and constraints of an intergenerational multimodal arts curriculum that was designed to expand communication and identity options for children and elder participants. The authors drew on actor-network theory to conceptualize curriculum as a network effect and refer to literature on multimodal literacy to discuss how interests, knowledge, and the modes themselves (e.g., art and singing) influenced communication and identity options in the curriculum. Focusing on singing, the findings indicate that the affordances and constraints of the curriculum were created through a network that included the participants and the materials of communication (e.g., musical instruments). Art and talking supported singing as did the emergent curricular model. The elders had mixed prior experiences and facility with singing, however, their desire to support the children engaged them in the practice. The curriculum supported symmetrical relationships between participants, and the case adds to the literatures on intergenerational programs, multimodal literacy, arts education, and curriculum.

Background: Caregivers supporting adults with fetal alcohol spectrum disorder (FASD) report concerns regarding living arrangements and services for their adult children with FASD. Best practices for living support for adults with FASD are under‐researched, and few studies have explored the experiences of caregivers whose children are adults. This study examined the perspectives of caregivers who support adults (18+) with FASD regarding: (1) current ways adults with FASD are supported with daily life activities; and (2) ideal future living arrangements and supports. Methods: This article presents findings from the perspective of caregivers who support adults with FASD, as part of a broader project involving both adults with FASD and caregivers. Semi‐structured interviews were conducted with 11 Canadian caregivers who live at home with an adult with FASD (aged 18+). Responses were examined using framework analysis, a structured approach to analyzing qualitative data. Results: Caregivers described their experiences and perspectives regarding: (1) current ways adults with FASD are supported in their daily activities; (2) strategies for successful support; (3) ideal future living arrangements and supports; and (4) concerns for the future. Notably, almost every participant raised pressing concerns regarding the future living arrangements for the person they support once they are no longer able to provide care. Conclusions: This study explores caregivers' perspectives regarding living support needed by adults with FASD, which can inform support programs and housing services. Findings demonstrate an urgent need for policy change directed toward developing available, affordable, and appropriate housing for adults with FASD. [ABSTRACT FROM AUTHOR]

Objective: To compare how different imputation methods affect the estimates and performance of a prediction model for premature mortality. Study Design and Setting: Sex-specific Weibull accelerated failure time survival models were run on four separate datasets using complete case, mode, single and multiple imputation to impute missing values. Six performance measures were compared to access predictive accuracy (Nagelkerke R2, integrated brier score), discrimination (Harrell's c-index, discrimination slope) and calibration (calibration in the large, calibration slope). Results: The highest proportion of missingness for a single variable was 10.86% for the female model and 8.24% for the male model. Comparing the performance measures for complete case, mode, single and multiple imputation: the Nagelkerke R2 values for the female model was 0.1084, 0.1116, 0.1120 and 0.111–0.1120 with the male model exhibited similar variation of 0.1050, 0.1078, 0.1078 and 0.1078–0.1081. Harrell's c-index also demonstrated small variation with values of 0.8666, 0.8719, 0.8719 and 0.8711–0.8719 for the female model and 0.8549, 0.8548, 0.8550 and 0.8550–0.8553 for the male model. Conclusion: In the scenarios examined in this study, mode imputation performed well when using a population health survey compared to single and multiple imputation when predictive performance measures is the main model goal. To generate unbiased hazard ratios, multiple imputation methods were superior. This study shows the need to consider the best imputation approach for a predictive model development given the conditions of missing data and the goals of the analysis. [ABSTRACT FROM AUTHOR]

This research explored the experiences of 8 street-involved youth (4 male, 4 female) between the ages of 20 and 27 living in north-central British Columbia. The analysis was carried out in 3 phases based on the narrative approach developed by Lieblich, Tuval-Mashiach, and Zilber (1998). The narratives represented the holistic experiences of the youth and the meanings they attached to their experiences. The 26 themes that emerged from the data were organized into 5 main categories representing the participants' experiences prior to street life, the challenges associated with being on the streets, supports, personal qualities, and moving on. Three overarching metathemes were interpreted from the youths' narratives: trauma, coping, and the essence of living. (Contains 1 table.)

Ten young women were interviewed regarding their experiences of resisting invitations to use illicit drugs. Hermeneutic phenomenology was used to gather and analyze information. One key theme was the motivations that inspired women to refuse drug offers. Young women resisted drug invitations because of their desires to be authentic, protect their futures, reflect a sense of maturity, maintain physical and mental health, and sustain healthy relationships, and because overall they enjoyed life and did not feel the need to alter their emotions and psychological experiences. Implications for prevention programs, counselling and interventions programs, and future research are discussed.

The objectives of this study were to investigate the alignment of exam questions with course learning outcomes in a first year biology majors course, to examine gaps and overlaps in assessment of content amongst the sections of the course, and to use this information to provide feedback to the teaching team to further improve the course. Our ultimate goal was to provide students with learning outcomes that would clearly indicate the content and the level at which they would be expected to learn the content for this course, regardless of the section in which they were registered. We took an evidence-based approach to course evaluation and employed the Blooming Biology Tool to compare the learning outcomes and the exam questions of the course, investigating whether the cognitive skill level of each learning outcome as written matched the level at which it was assessed. We identified misalignments and recommended revising the learning outcomes to better reflect the intended level of learning for the course. We also investigated student performance on exam questions of different cognitive levels and found that students scored statistically significantly higher (p < 0.05) on questions in which learning outcomes were tested at the stated cognitive skill level compared to at a higher level.

In the current research, we introduce the team CARE model for supporting team development during post-secondary education. Team CARE is part of a larger suite of assessments at itpmetrics.com. Team CARE is a free, online, survey-based assessment that allows team members to rate their team's health and functioning in four key categories (communicate, adapt, relate and educate), as well as provide written feedback about the team's functioning to add nuance and supplemental context to the numeric scores. Team members completing the assessment receive a report documenting their team's scores on the variables measured. We report on data from student learning teams suggesting that the variables in the team CARE model are reliable, and that they are correlated with team performance outcomes. Students' perceptions of the tool were also examined, and the findings suggest that team CARE is perceived to be valuable, useful and easy to use. Recommendations for practice are detailed, including sample assessment schedules for teams with differing life spans. Implications for future research and implementation are discussed.

Background: People who are unhoused, use substances (drugs and/or alcohol), and who have mental health conditions experience barriers to care access and are frequently confronted with discrimination and stigma in health care settings. The role of Peer Workers in addressing these gaps in a hospital-based context is not well characterized. The aim of this evaluation was to 1) outline the role of Peer Workers in the care of a marginalized populations in the emergency department; 2) characterize the impact of Peer Workers on patient care, and 3) to describe how being employed as a Peer Worker impacts the Peer. Methods: Through a concurrent mixed methods evaluation, we explore the role of Peer Workers in the care of marginalized populations in the emergency department at two urban hospitals in Toronto, Ontario Canada. We describe the demographic characteristics of patients (n = 555) and the type of supports provided to patients collected through a survey between February and June 2022. Semi-structured, in-depth interviews were completed with Peer Workers (n = 7). Interviews were thematically analyzed using a deductive approach, complemented by an inductive approach to allow new themes to emerge from the data. Results: Support provided to patients primarily consisted of friendly conversations (91.4%), discharge planning (59.6%), tactics to help the patient navigate their emotions/mental wellbeing (57.8%) and sharing their lived experience (50.1%). In over one third (38.9%) of all patient interactions, Peer Workers shared new information about the patient with the health care team (e.g., obtaining patient identification). Five major themes emerged from our interviews with Peer Workers which include: (1) Establishing empathy and building trust between the patient and their care team through self-disclosure; (2) Facilitating a person-centered approach to patient care through trauma-informed listening and accessible language; (3) Support for patient preferences on harm reduction; (4) Peer worker role facilitating self-acceptance and self-defined recovery; and (5) Importance of supports and resources to help Peer Workers navigate the emotional intensity of the emergency department. Conclusions: The findings add to the literature on Peer Worker programs and how such interventions are designed to best meet the needs of marginalized populations. [ABSTRACT FROM AUTHOR]

This article surveys state-owned enterprise director training programmes in Canada at both the national and provincial levels. In Canada director training programmes have emerged to enable good private-sector corporate governance. This trend has been embraced by governments seeking to improve corporate governance among their state-owned enterprises. The article reviews the state of director training in Canadian state-owned enterprises. Considered are the programme delivery models and contents. The article highlights the specific nature of state-owned enterprise boards and how this affects the learning needs of their directors. Accordingly, the article underscores the necessity of providing directors who are new to state-owned enterprises training specific to the public sector. The article concludes by highlighting notable practices and how these may contribute to improving outcomes in public administrations.

Common‐garden trials of forest trees provide phenotype data used to assess growth and local adaptation; this information is foundational to tree breeding programs, genecology, and gene conservation. As jurisdictions consider assisted migration strategies to match populations to suitable climates, in situ progeny and provenance trials provide experimental evidence of adaptive responses to climate change. We used drone technology, multispectral imaging, and digital aerial photogrammetry to quantify spectral traits related to stress, photosynthesis, and carotenoids, and structural traits describing crown height, size, and complexity at six climatically disparate common‐garden trials of interior spruce (Picea engelmannii × glauca) in western Canada. Through principal component analysis, we identified key components of climate related to temperature, moisture, and elevational gradients. Phenotypic clines in remotely sensed traits were analyzed as trait correlations with provenance climate transfer distances along principal components (PCs). We used traits showing clinal variation to model best linear unbiased predictions for tree height (R2 =.98–.99, root mean square error [RMSE] = 0.06–0.10 m) and diameter at breast height (DBH, R2 =.71–.97, RMSE = 2.57–3.80 mm) and generated multivariate climate transfer functions with the model predictions. Significant (p <.05) clines were present for spectral traits at all sites along all PCs. Spectral traits showed stronger clinal variation than structural traits along temperature and elevational gradients and along moisture gradients at wet, coastal sites, but not at dry, interior sites. Spectral traits may capture patterns of local adaptation to temperature and montane growing seasons which are distinct from moisture‐limited patterns in stem growth. This work demonstrates that multispectral indices improve the assessment of local adaptation and that spectral and structural traits from drone remote sensing produce reliable proxies for ground‐measured height and DBH. This phenotyping framework contributes to the analysis of common‐garden trials towards a mechanistic understanding of local adaptation to climate. [ABSTRACT FROM AUTHOR]

To prepare students for participation in a pluralistic, democratic society, history curriculum should help them develop mature ideas about why multiple accounts of the same events exist. But how can we know if we are successful? In this article, we describe work on the design, validation, and piloting of a paper-and-pencil instrument called the Historical Account Differences (HAD) survey. It is intended to add to the tool set that researchers and practitioners can use to evaluate students' developing metahistorical conceptions. Data are presented from a pilot involving sixty-five eleventh-grade students. One group completed the survey once, whereas the other completed it prior to and after a curriculum unit designed to enhance their conceptions about multiple accounts of past events. Initially, the two groups' responses were not detectably different. However, students completing the two-week curriculum unit showed an increase in mature conceptions. The limitations of this work and plans for future research are discussed.

We have designed, developed, and validated a 17-question Meiosis Concept Inventory (Meiosis CI) to diagnose student misconceptions on meiosis, which is a fundamental concept in genetics. We targeted large introductory biology and genetics courses and used published methodology for question development, which included the validation of questions by student interviews ("n" = 28), in-class testing of the questions by students ("n" = 193), and expert ("n" = 8) consensus on the correct answers. Our item analysis showed that the questions' difficulty and discrimination indices were in agreement with published recommended standards and discriminated effectively between high- and low-scoring students. We foresee other institutions using the Meiosis CI as both a diagnostic tool and an instrument to assess teaching effectiveness and student progress, and invite instructors to visit http://q4b.biology.ubc.ca for more information.

This study investigated the influence of book genre (narrative or didactic) on mothers' language use during a book sharing interaction with their 18- to 25-month-olds. Mother-child dyads were videotaped sharing both a narrative and a didactic book, adapted from two commercially available books, and matched in terms of length, quantity of text, and target content. A greater proportion of mothers' talk was complex (i.e., predictions, text-to-life comparisons) during narrative book sharing than during didactic book sharing. Mothers also used a greater variety of verb tenses and referenced more mental states during narrative book sharing. These results differ from findings from previous studies with older children where it has been concluded that didactic books offer greater opportunities for complex talk than narrative books. The results also highlight the importance of taking situational factors into account when investigating parent--child communicative interactions.

This article highlights a narrative inquiry study that considered the experience of and the effects on 8 northern helping practitioners (5 women, 3 men, ages 30-60) who have 7 to 40 years of experience in providing trauma support in isolated communities in northern BC and the Yukon. Using a three-phase narrative analysis, 10 categories provided a structure for arranging the themes generated from the eight narratives. Six metathemes were interpreted from the data: helping takes over life, humanity, respectful engagement, invested and embedded, profoundly affected, and belief. Protective factors found in elements of embeddedness and connectiveness of practitioners and their motivation for doing the work they do emerged from the study.

Long‐term (1991–2018) thaw tube measurements highlight widespread permafrost thaw and ground surface (GS) subsidence over a large portion of northwest Canada. Statistically significant positive trends in thaw penetration (TP), measured with respect to a fixed datum, were observed at 18 of 28 sites with data that span three decades at a median rate of 0.8 cm a−1. This rate implies thawing of about 22 cm of permafrost over the study period. Similarly significant trends in GS subsidence occurred at 21 of 28 sites, at a median rate of 0.4 cm a−1. In contrast with TP and GS elevation, long‐term trends in active layer thickness (ALT) were less consistent, with 10 of 28 sites having statistically significant trends indicating increasing ALT (median rate: 0.6 cm a−1), and 7 sites having trends indicating decrease in ALT (median: 0.3 cm a−1). The ALT measurements underestimated the thawing of ice‐rich permafrost due to GS subsidence. Sites with high rates of thaw had relatively warm permafrost, deep snow cover, and poor drainage. Masking of ice‐rich permafrost degradation by ALT measurements has important implications for modeling permafrost thaw and climate change reporting. Accurate simulation of ice‐rich permafrost thaw is conceivable for sites where conditions are well‐defined. However, the prediction of subsidence and TP at regional or broader scales is only possible in general terms due to variation in surface conditions and ground ice content. Trends in TP and GS subsidence more accurately characterize ice‐rich permafrost degradation than trends in ALT. Plain Language Summary: Measurements from instruments that account for changes in the ground surface (GS) elevation indicate that permafrost has thawed, and the GS has subsided in the past three decades over a large area in northwest Canada. Traditional measurements that do not account for changes in the GS elevation mask how much permafrost is thawing and are therefore less useful for tracking the effects of climate change in permafrost areas where there is a significant amount of ice in the ground. The results of this study also highlight that it may be difficult to predict permafrost degradation and GS subsidence over large areas using simulations because conditions such as vegetation, soil wetness, snow, and ground ice content may vary over short distances and strongly affect the rates of thawing. Key Points: Permafrost thaw and ground surface subsidence are widespread in northwest CanadaActive layer thickness (ALT) measurements poorly represent the magnitude of permafrost thaw in ice‐rich settingsALT is widely used in climate change reporting, but it may be a poor indicator of climate change at ice‐rich sites [ABSTRACT FROM AUTHOR]

What does it mean for a mentoring program to succeed? Most evaluations focus on participants' perceptions of success. Few studies employ an independent measure of the intended outcomes of the program, and fewer still examine both participant satisfaction and achievement. This article presents an example of how comparing data on perceived and achieved success can foster new insights into the trade-offs inherent in program design and improvement. Based on an analysis of survey and interview data from an online mentoring program in which 17 history experts supported 108 high school students in historical research, it was found that mentees' satisfaction did not correlate with their achievement of intended program outcomes. Further analysis illuminated design trade-offs between the aspects of the online mentoring program that supported perceived success and those that supported intended outcomes. The authors argue that examining such trade-offs in other mentoring programs may facilitate their improvement over time. (Contains 4 tables and 1 figure.)

Introduction: To engage effectively and efficiently in self-directed learning and knowledge-seeking practices, it is important that physicians construct well-formulated questions; yet, little is known about the quality of good questions and their relationship to self-directed learning or to change in practice behavior. Methods: Personal learning projects (PLPs) submitted to the Canadian Maintenance of Certification program were examined to include underlying characteristics, quality of therapeutic questions (population, intervention, comparator, outcome [PICO] mnemonic), and relationships between stage of change and level of evidence used to resolve questions. Results: We assessed 1989 submissions (from 559 Fellows of the Royal College of Physicians and Surgeons of Canada [RCPSC]). The majority of submissions were by males (69.2%) aged 40-59 (59.4%) with an average of 24.3 (range 6-58, SD 11.1) years since graduation. The most frequent submissions were treatment (36.6%) and diagnosis (22.3%) questions. Half of all questions described [greater than or equal to] 2 components (PICO), and only 3.7% of questions included all 4 components. Cross tabulations indicated only 1 significant trend for the use of narrative reviews and the outcome "integrating new knowledge" (P less than 0.000). Discussion: Self-directed learning skills comprise an important strategy for specialists maintaining or expanding their expertise in patient care, but an important obstacle to answering patient care questions is the ability to formulate good ones. Engagement in most major learning activities is stimulated by management of a single patient: formal accredited group learning events are of limited value in starting episodes of self-directed learning. Low levels of evidence used to address learning projects. Future research should determine how best to improve the quality of questions submitted and whether or not these changes result in increased efficiencies, more appropriate uses of evidence, and increased changes in practice behaviors. (Contains 5 tables.)

The Collaborative Mental Health Care program offers infant mental health consultations to case managers in child protection offices throughout the city of Calgary, Alberta, Canada. Through case examples, the authors demonstrate why clinicians working with maltreated infants should expand the scope of their practice to include multidisciplinary training, program development, and policy advocacy.

Dramatic increases in child welfare rates in Canada over recent years have been largely driven by an increased reporting of neglect cases (Trocme, Fallon, MacLaurin, & Neves, 2005). To a large extent, exploring the importance of neglect separate from physical maltreatment has been ignored in the child maltreatment literature. This study examined the differential effects of foster care in the child welfare system with children who presented as either experiencing physical maltreatment or neglect prior to their admission to care. Findings from this study are important to child welfare decision making about the differential needs of these two groups of children. The files of a sample of 110 children (79 neglected children and 31 physically maltreated children) were examined for differences in their adjustment while in foster care and on discharge. Some distinct differences in presentation were noted between the children experiencing the two types of maltreatment. Children experiencing neglect were younger, were more likely to have caregivers diagnosed with a substance abuse disorder, and had higher rates of exposure to spousal violence than maltreated children. Physically maltreated children displayed greater difficulty during their foster care adjustment. Once discharged from care, neglected children were more likely to be returned to the care of the agency. This study draws attention to the differential needs of children who experience neglect prior to their admission to a child welfare agency. Longer-term outcome studies are necessary to more completely understand how these two types of maltreatment influence the outcomes of children who are provided care within the child welfare system. (Contains 3 footnotes and 3 tables.)

Purpose: To demonstrate the internal reliability and discriminative validity of the Language Use Inventory for Young Children (LUI; D. K. O'Neill, 2002), a newly developed parent-report measure designed to assess pragmatic language development in 18-47-month-olds. Method: To examine internal reliability, the LUI was completed by mail by 177 parents recruited from the University of Waterloo's Centre for Child Studies database, 175 of whom completed the LUI again within 4 weeks to assess test-retest reliability. To examine discriminative validity, 49 parents of children awaiting assessment at a local speech-language clinic and 49 parents of typically developing children recruited from the Centre for Child Studies database and matched in age and sex to the clinic group completed the LUI. Results: Alpha values for the subscales of the LUI were at or above acceptable levels (0.80-0.98), and steady growth in children's pragmatic language development was demonstrated. The study of discriminant validity revealed sensitivity and specificity levels over 95%. Conclusions: The LUI's internal reliability and stability were strongly supported and its sensitivity and specificity in distinguishing between typically developing and language-delayed children exceeded even the most stringent criteria of 90% accuracy.

This article discusses the state of Canadian democracy. Although calling Canadian democracy as something to be in a crisis is still debatable, the author expresses worry over the declining turnout levels in recent elections. Canada--along with a number of other liberal democracies--has experienced a significant and consistent decline in election turnout since the 1980s. The author also points out that even when there are no simple answers to the question of what is causing this decline in election turnout, it is clear that the dropping turnout rate among young Canadians is an essential component of the explanation. (Contains 9 notes.)

This article provides an overview of Telementoring Orchestrator[TM] (TMO), a new web-based software tool designed to aid small or large organizations in supporting telementoring programs (also called online mentoring or e-mentoring programs). In this report, we review the research that inspired the design of the software, and survey the major components of the system, explaining the rationale behind our design choices. Since software designers cannot avoid making assumptions about an application's users and its uses, our goal is to explain the assumptions that TMO makes about telementoring programs and telementoring relationships, and how these relate to our own research and field experiences. We aim to help potential users understand the range of programs that TMO might help manage and study in its current form, and to help the prospective designers of similar systems understand other design choices that might be made. We conclude by setting an agenda for future work, including both feature extensions for the software itself, and new research that could be carried out with it. (Contains 1 table and 6 figures.)

Diabetes is present in approximately 10% of people living with schizophrenia and substantially contributes to early mortality, but some aspects of diabetes care among those with schizophrenia have been inadequately investigated to date. We assessed diabetes care and comorbidity management among people with and without schizophrenia. We conducted a cohort study with data obtained from primary care electronic medical records stored in the Diabetes Action Canada (DAC) National Repository from Alberta, Ontario, and Quebec, Canada. The population studied included patients with diabetes, with and without schizophrenia, who had at least 3 primary care visits in a 2 year period between July 2017 and June 2019. Outcomes included glycemia; diabetes complication screening and monitoring; antihyperglycemic and cardioprotective medication prescription; health service use. We identified 69,512 patients with diabetes; 911 (1.3%) of whom also had schizophrenia. Prevalence of high HbA1C (>8.5%) (9083/68601; 13.2% vs. 137/911; 15.0%) and high blood pressure (>130/80 mmHg) (4248/68601; 6.2% vs. 73/911; 8.0%) was similar between the two groups. Half (50.0%) of patients with schizophrenia (n = 455) had 11 or more primary care visits in the past year, compared with 27.8% of people without schizophrenia. (p < 0.0001). Patients with schizophrenia had lower odds of ever having blood pressure recorded (OR = 0.81, 95% CI 0.71–0.94) and fewer of those with chronic kidney disease (CKD) were prescribed renin-angiotensin aldosterone system inhibitors, compared to patients without schizophrenia (10.3% vs 15.8%, p = 0.0005). Patients with diabetes and schizophrenia achieved similar blood glucose and blood pressure levels to those without schizophrenia, and had more primary care visits. However, they had fewer blood pressure readings and lower prescription of recommended medications among those who also had CKD. These results are both encouraging and represent opportunities for improvement in care. [ABSTRACT FROM AUTHOR]

Postsecondary aspirations (educational and occupational) of high school seniors from five different residential settings (rural farm, rural nonfarm, village, small-town, and large city) in Durham, Ontario, are examined. Two variables account for most of the variance: parental expectations and peer group. (Author/MLW)

Three Canadian surveys of teachers and school administrators indicated clear support for limited term appointments for school consultants, vice-principals, and department heads. Those under 40 and with less than 20 years' experience strongly supported term appointments for principals, while older and more experienced respondents were opposed. (SV)

Background: An increasing number of patients with end-of-life (EOL) conditions, particularly those with advanced cancer, are presenting to the emergency department (ED). Objectives: To assess the characteristics, management and short-term outcomes of ED patients with advanced cancer compared to patients with other EOL conditions. Methodology/Design: A secondary analysis of a prospective cohort study. Setting/Participants: Volunteer emergency physicians in two Canadian EDs identified presentations for advanced cancer and other EOL conditions with the aid of a modified screening tool March–August 2018. Results: Among the 663 presentations by patients with EOL conditions, 272 (41%) presented with advanced cancer. The majority of presentations for advanced cancer (81%) or other EOL conditions (77%) were by patients with unmet palliative care (PC) needs. Patients with advanced cancer were significantly less likely to have active goals of care (GOC) documented on their charts (53% vs. 75%; p < 0.001). While no significant differences were found between the groups, the majority of presentations involved imaging, investigations, consultations, and hospitalization. Presentations for advanced cancer were more likely to receive a postdischarge referral (38% vs. 23%; p < 0.001). Referrals to PC consultations or postdischarge referrals were infrequent. Regression analysis found that patients with advanced cancer were associated with shorter length of stay (LOS). Conclusions: The majority of presentations for advanced cancer or other EOL conditions involved significant resource use. Patients with cancer experienced shorter LOS; however, had less documentation of GOC and gaps in referrals to PC services were identified. Interventions should be explored to promote early GOC discussions and PC referrals in this patient group. [ABSTRACT FROM AUTHOR]

Objective: Scheduling ambulatory clinic appointments includes a complex set of factors and diverse stakeholders. Families, administrative staff and clinicians may have varied experiences with scheduling clinic appointments. The objective of our study was to understand stakeholders' perceptions and experiences with scheduling pediatric ambulatory clinic appointments.Design: Guided methodologically by qualitative description, focus groups were conducted separately with three stakeholder groups and analyzed using qualitative content analysis.Setting: This qualitative study was completed at a children's hospital in Alberta, Canada.Participants: Parents, administrative professionals and clinicians who used the pediatric ambulatory scheduling system regularly to elicit perceptions and experiences about issues and areas where improvements could be made.Results: Across 12 focus groups, parents (n = 11), administrative professionals (n = 23) and clinicians (n = 13) discussed areas for improvement related to the pediatric ambulatory scheduling system. The perceived areas for improvement were grouped into three categories regarding levels of influence: (i) 'intrapersonal': knowledge, skills and behaviors (e.g. insufficient training of administrative professionals); (ii) 'interpersonal': communication processes (e.g. parents not receiving confirmation letters); and (iii) 'institutional': structures and processes (e.g. varying practices and processes across clinics).Conclusions: Stakeholders provided a rich description of the interrelated factors and processes that influenced the scheduling of pediatric ambulatory clinic appointments. Multilevel, experimental interventions are needed to test whether the findings described herein can enhance the structure and function of pediatric ambulatory appointment scheduling. [ABSTRACT FROM AUTHOR]

This article reviews research and presents recommendations concerning bimodal bilinguaiism for families with young deaf and hard of hearing children. Bimodal bilinguaiism means deaf children and their families have access to a national sign language in addition to other spoken/written languages. National sign languages are one or more of the sign languages that make up the linguistic ecology of a country, including but not limited to British Sign Language (BSL) in the UK and American Sign Language (ASL) in Canada. National sign languages have their own vocabulary, grammar, and social rules of use, and many sign languages are used by deaf communities around the world. Bimodal bilingualism and enhanced family communication have long-lasting benefits for deaf children's development and wellbeing. We look at how to support early bimodal bilingual communication and literacy, and the role of practitioners in guiding families. [ABSTRACT FROM AUTHOR]

Background: Presentations to the emergency department (ED) by patients with end-of-life (EOL) conditions for their acute care needs are common. Objectives: The objective of this study was to identify and describe the ED management across presentations to the ED for EOL conditions. Design: Prospective observational cohort study. Settings/Subjects: Emergency physicians in two Canadian ED's were asked to identify presentations by adult patients with EOL conditions using a modified screening tool. Measurements: Patient characteristics and ED management for each presentation were collected through chart review by trained research assistants. Descriptive analyses were conducted as appropriate and bivariate comparisons of dichotomous and continuous variables were completed using χ2 tests and using t test or Wilcoxon rank-sum test, respectively. Results: Physicians identified 663 ED presentations for EOL conditions, with advanced cancer (41%), dementia (23%), and chronic obstructive pulmonary disease (16%) being the most common EOL conditions. The majority of presentations involved consultations (77%), hospitalization (65%), and numerous investigations (97%), including blood work (97%) and imaging (92%). The majority of patients with EOL conditions had a history of ED visits (68%). Using a modified screening tool, 78% of presentations involved patients with unmet palliative care needs, but only 1% of presentations involved a palliative consultation or admission to a palliative care unit. Conclusion: Presentations to the ED for EOL conditions involve significant ED resources; however, only a handful of patients are referred to palliative services. Patients with EOL conditions are appropriate targets for palliative services and community support outside the ED. [ABSTRACT FROM AUTHOR]

Background: Stakeholders can provide valuable input to improve scheduling paediatric ambulatory clinic appointments, a complex process that requires effective planning and communication between parents, administrative staff and clinicians. The purpose of our study was to characterize recommendations from parents, administrative staff and clinicians to improve paediatric ambulatory appointment scheduling. Methods: Conducted between February 2018 and January 2019, this qualitative study was guided by qualitative description. Data collection was completed using focus groups with three stakeholder groups: parents, administrative staff and clinicians. Participants provided recommendations to optimize paediatric ambulatory appointment scheduling at the Stollery Children's Hospital in Edmonton, Alberta, Canada. Focus group data were transcribed verbatim and analysed using manifest inductive content analysis. Results: Forty‐six participants (mean age: 42.7; 87% female) participated in 12 focus groups. Parents (n = 11), administrative staff (n = 22) and clinicians (n = 13) made recommendations that were organized into two categories: appointment triaging and arranging. Triaging recommendations were related to appointment availability (e.g. providing alternatives to cancelling clinics with short notice) and waitlist management (e.g. developing clear and consistent policies regarding information flow and communication between clinics and administrative staff). Appointment arranging recommendations referred to booking (e.g. directly involving parents in the booking process), reminders (e.g. using text message reminders) and attendance (e.g. providing parents with a single point of contact who can provide the correct information about late and cancellation policies). Recommendations were similar across stakeholder groups. Conclusion: Our findings showed congruent recommendations across stakeholder groups to address challenges with scheduling ambulatory appointments, many of which have the potential to be modified. Experimental research and quality improvement initiatives are needed to determine the feasibility, acceptability and effectiveness of stakeholder recommendations to improve triaging and scheduling paediatric ambulatory appointments. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to determine the degree to which reasons for primary care visits changed during the COVID-19 pandemic. Methods: We used data from the University of Toronto Practice Based Research Network (UTOPIAN) to compare the most common reasons for primary care visits before and after the onset of the COVID-19 pandemic, focusing on the number of visits and the number of patients seen for each of the 25 most common diagnostic codes. The proportion of visits involving virtual care was assessed as a secondary outcome. Results: UTOPIAN family physicians (N = 379) conducted 702,093 visits, involving 264,942 patients between March 14 and December 31, 2019 (pre-pandemic period), and 667,612 visits, involving 218,335 patients between March 14 and December 31, 2020 (pandemic period). Anxiety was the most common reason for visit, accounting for 9.2% of the total visit volume during the pandemic compared to 6.5% the year before. Diabetes and hypertension remained among the top 5 reasons for visit during the pandemic, but there were 23.7% and 26.2% fewer visits and 19.5% and 28.8% fewer individual patients accessing care for diabetes and hypertension, respectively. Preventive care visits were substantially reduced, with 89.0% fewer periodic health exams and 16.2% fewer well-baby visits. During the pandemic, virtual care became the dominant care format (77.5% virtual visits). Visits for anxiety and depression were the most common reasons for a virtual visit (90.6% virtual visits). Conclusion: The decrease in primary care visit volumes during the COVID-19 pandemic varied based on the reason for the visit, with increases in visits for anxiety and decreases for preventive care and visits for chronic diseases. Implications of increased demands for mental health services and gaps in preventive care and chronic disease management may require focused efforts in primary care. [ABSTRACT FROM AUTHOR]

Background: Several new classes of glucose-lowering medications have been introduced in the past two decades. Some, such as sodium-glucose cotransporter 2 inhibitors (SGLT2s), have evidence of improved cardiovascular outcomes, while others, such as dipeptidyl peptidase-4 inhibitors (DPP4s), do not. It is therefore important to identify their uptake in order to find ways to support the use of more effective treatments.Aim: To analyse the uptake of these new classes among patients with type 2 diabetes.Design and Setting: This was a retrospective repeated cross-sectional analysis in primary care. Rates of medication uptake in Australia, Canada, England, and Scotland were compared.Method: Primary care Electronic Medical Data on prescriptions (Canada, UK) and dispensing data (Australia) from 2012 to 2017 were used. Individuals aged ≥40 years on at least one glucose-lowering drug class in each year of interest were included, excluding those on insulin only. Proportions of patients in each nation, for each year, on each class of medication, and on combinations of classes were determined.Results: Data from 238 619 patients were included in 2017. The proportion of patients on sulfonylureas (SUs) decreased in three out of four nations, while metformin decreased in Canada. Use of combinations of metformin and new drug classes increased in all nations, replacing combinations involving SUs. In 2017, more patients were on DPP4s (between 19.1% and 27.6%) than on SGLT2s (between 10.1% and 15.3%).Conclusion: New drugs are displacing SUs. However, despite evidence of better outcomes, the adoption of SGLT2s lagged behind DPP4s. [ABSTRACT FROM AUTHOR]

Dr. Danielle Martin is an Associate Professor at the University of Toronto and Executive Vice President and Chief Medical Executive at Women's College Hospital in Toronto, where she is also a practicing family physician. Her career epitomizes an idea that is often discussed in medical training, but rarely manifests in practice: physicians are both advocates for individual patients and stewards of public health equity at a systems level. Dr. Martin has dedicated her career to improving and strengthening Canada's universal health care system. She is a public leader in the ongoing debate about health care privatization and founded the organization Canadian Doctors for Medicare. Notably, Dr. Martin spoke about Canadian health care and advocated for single-payer health care in a widely publicized US Senate hearing led by Senator Bernie Sanders. She has also published a book titled, Better Now: Six Big Ideas to Improve Health Care for All Canadians, which breaks down complex health policy into six actionable steps in order to improve the health care system for all Canadians. She continuously advocates for public involvement in health policy through research and public outreach and is a role model for young physicians aspiring to leadership roles in health and health care policy, while simultaneously pursuing a career in clinical practice. In fact, doing both provides a unique framework for improving the individual wellbeing and health of Canadians. Dr. Martin believes that advocacy is a skill that requires practice and training; she advises young trainees that the time to start is now. [ABSTRACT FROM AUTHOR]

Technology-Facilitated Sexual Violence (TFSV) is an understudied but prevalent phenomenon with initial research investigations demonstrating significant adverse consequences. TFSV is defined by unwanted sexual behaviors communicated and transmitted through digital means, which can include online/digital harassment, coercive sex-based communications, and sexuality-based harassment. The purpose of this study was threefold: (1) to examine prevalence rates of TFSV in males and females; (2) to assess the psychological symptoms associated with TFSV, and (3) to identify factors that could mitigate any negative psychological effects following TFSV victimization. Results indicated that overall prevalence rates of TFSV self-identifying victims in Canadian undergraduate students were 84.3%. Females were at increased risk of victimization, with prevalence rates as high as 87.9% and males reporting 74.3% as per the TFSV-V. Furthermore, self-identifying victims of TFSV tended to have lower levels of self-esteem and perceived control, and higher levels of depressive symptoms compared to those without TFSV experience. Regression analysis revealed that self-esteem, social support, and perceived control moderated the relationship between TFSV victimization and depressive symptoms. Limitations of the study and suggestions for further research investigating the impact of TFSV are discussed. [ABSTRACT FROM AUTHOR]

In the early 20th century, the numbers of motor vehicles in use grew rapidly in the USA, Canada, and many European countries. By the 1930s, the number of automobile crashes and the resulting deaths and injuries was a significant problem and various safety organizations tried to address it with education and publicity programs aimed at changing driver behaviour. It is not clear when the high crash risks of young drivers were first identified, but in the early 1930s driver education courses began to be offered in US high schools (feasible because US licensing ages were 16 or younger) and soon such courses were being touted (with no evidence) as 'the most obvious way' to reduce traffic crashes. Over the years many claims were made for the effectiveness of high school driver education, however, it was not until the late 1960s that competent research studies (including randomized control trials) were undertaken. The consistent findings from these studies have been that high school driver education does not reduce crashes. Furthermore, the trained students get their licenses sooner, and because teenagers have very high crash risks, the net result of high school driver education is increased numbers of crashes. [ABSTRACT FROM AUTHOR]

The article presents a critical overview of research on the integration of moderately mentally handicapped children in Ontario schools. Findings suggest that the literature is still inconclusive or, at best, equivocal. Indeed, like their predecessors, recent studies have been based, for the most part, on descriptive or impressionistic evidence. (Author/CL)

An analysis of 10 intermediate history textbooks currently used in Ontario, Canada, showed that current texts show less prejudice toward Indians than earlier works. However, there is still ample room for improvement. (RM)