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Spirituality is an important aspect of treatment and recovery for substance use disorders (SUDs), but ambiguities in measurement can make it difficult to incorporate as part of routine care. We evaluated the psychometric properties of an adapted short-form version of the Spirituality Scale (the Spirituality Scale–Short-Form; SS-SF) for use in SUD treatment settings. Participants were adult patients (N = 1,388; Mage = 41.23 years, SDage = 11.55; 68% male; 86% White) who entered a large, clinically mixed inpatient SUD treatment program. Factor analysis supported the two-dimensional structure, with factors representing Self-Discovery and Transcendent Connection. Tests of measurement invariance demonstrated that the scale was invariant across age and gender subgroups. The SS-SF exhibited convergent and concurrent validity via associations with participation in spiritual activities, hopefulness, life satisfaction, 12-step participation, and depressive symptoms. Finally, scores on the SS-SF were significantly higher at discharge compared to admission, demonstrating short-term sensitivity to change. These findings support use of the SS-SF as a concise, psychometrically sound measure of spirituality in the context of substance use treatment. [ABSTRACT FROM AUTHOR]

Objective. Although physical activity declined with social distancing measures and stay-at-home orders during the COVID-19 pandemic, youth who engaged in more physical activity experienced fewer mental health problems. If and how physical activity maintained its protective role throughout the ongoing pandemic remains unclear. This study models associations between three types of physical activity (indoor, outdoor, with parents), affect regulation, and anxious and depressive symptoms in two independent adolescent samples (T1: Summer 2020; T2: Winter 2020/21). Methods and Measures. Six hundred sixty-two Canadian adolescents (T1: Mage = 15.69, SD = 1.36; 52% girls; 5% trans+) and 675 Canadian adolescents (T2: Mage = 15.80, SD = 1.46; 50% girls; 6% trans+) participated in an online survey. Data included frequency of physical activity indoors, outdoors, and with parents, affect regulation difficulties, and measures of anxious and depressive symptoms. Results. Multiple-group path analysis showed indoor physical activity had an indirect effect on anxiety and depressive symptoms through affect dysregulation, but only at T1. Physical activity with parents was protective for adolescent anxiety and depressive symptoms at both T1 and T2 and had an indirect effect through affect dysregulation and suppression. Conclusion. Findings contribute to our understanding of how physical activity protects adolescent mental health, and point to strengthening family supports and recreation opportunities. [ABSTRACT FROM AUTHOR]

Background and aims: Identifying effective opioid treatment options during pregnancy is a high priority due to the growing prevalence of opioid use disorder across North America. We assessed the temporal impact of three population‐level interventions on the use of opioid agonist treatment (OAT) during pregnancy in Ontario, Canada. Design: This was a population‐based time‐series analysis to identify trends in the monthly prevalence of pregnant people dispensed methadone and buprenorphine. The impact of adding buprenorphine/naloxone to the public drug formulary, the release of pregnancy‐specific guidance and the start of the COVID‐19 pandemic were assessed. Setting and participants: The study was conducted in Ontario, Canada between 1 July 2013 and 31 March 2022, comprising people who delivered a live or stillbirth in any Ontario hospital during the study period. Measurements We identified any prescription for methadone or buprenorphine dispensed between the estimated conception date and delivery date and calculated the monthly prevalence of OAT‐exposed pregnancies among all pregnant people in Ontario. Findings Overall, rates of OAT during pregnancy have declined since mid‐2018. Methadone‐exposed pregnancies decreased from 0.46% of all pregnancies in Ontario in 2015 to a low of 0.16% in 2022. In the primary analysis, none of the interventions had a statistically significant impact on overall OAT rates; however, in the stratified analyses, there was a small increase in buprenorphine after the formulary change [0.006%, 95% confidence interval (CI) = 0.0032−0.0081, P < 0.0001] and a decrease in buprenorphine after the release of the 2017 guidelines (−0.005%, 95% CI = −0.0080 to −0.0020, P = 0.001) and the start of the COVID‐19 pandemic (−0.003%, 95% CI = −0.0054 to −0.0006, P = 0.015). Conclusion: Despite changes in guidance and funding, opioid agonist treatment during pregnancy has been declining in Ontario, Canada since 2018. [ABSTRACT FROM AUTHOR]

The international context of Indigenous mental health and wellbeing has been shaped by a number of key works recognizing Indigenous rights. Despite international recognitions, the mental health and wellness of Indigenous Peoples continues to be negatively affected by policies that ignore Indigenous rights, that frame colonization as historical rather than ongoing, or that minimize the impact of assimilation. Research institutions have a responsibility to conduct ethical research; yet institutional guidelines, principles, and policies often serve Indigenous Peoples poorly by enveloping them into Western knowledge production. To counter epistemological domination, Indigenous Peoples assert their research sovereignty, which for the purposes of this paper we define as autonomous control over research conducted on Indigenous territory or involving Indigenous Peoples. Indigenous sovereignty might also be applied to research impacting the landscape and the web of animal and spiritual lives evoked in a phrase such as “all my relations.” This narrative review of material developed in the Canadian context examines the alignment with similar work in the international context to offer suggestions and a practice-based implementation tool to support Indigenous sovereignty in research related to wellness, mental health, and substance use. The compilation of key guidelines and principles in this article is only a start; addressing deeper issues requires a research paradigm shift. [ABSTRACT FROM AUTHOR]

Concerns about methamphetamine/crystal methamphetamine (MA) have featured prominently in the Canadian media and on addiction treatment agency agendas. We examined MA admissions at addiction treatment agencies to determine if a service gap existed. In 2006, all addiction treatment agencies (n = 124) in Ontario, Canada were invited to complete an on-line survey. The provincial database provided admissions data for 2006-2008. Amongst participants (n = 100), 53% reported an increase in clients with MA problems between 2004 and 2005. Nine percent considered MA to be a significant problem and 60% indicated that MA was a minor problem or not a problem in 2005. Forty-seven percent of participants said that MA problems were more common among males and 60% of MA clients were aged 16-24. Most (89%) agencies integrated MA clients into regular programs and 73% had not considered developing specialized MA programs. MA admissions peaked at 2.4% of admissions in 2005 and dropped to a lower, stable percent (2006-2008). Media and public alarm about a MA "epidemic" is not consistent with admissions data or agency experience. Consideration of objective evidence before demands for additional resources is necessary.

Adolescent methamphetamine use is a prominent concern for Canadian media and government. Few empirical studies, however, have established the scope of adolescent methamphetamine use or associated outpatient substance abuse treatment utilization. The current study aimed to answer the following questions: (1) What was the overall proportion of primary methamphetamine-related cases seen at youth outpatient substance abuse treatment centres in British Columbia in 2005-2006?; (2) What kind of treatment programming did these treatment centres offer primary methamphetamine users?; and (3) How prepared were these treatment programs to provide services to primary methamphetamine users? We developed a comprehensive list of all sites offering outpatient substance-abuse treatment programs for youth in British Columbia. We asked the Executive Director (or designate) of each facility about the program's annual caseload, proportion of primary methamphetamine-related cases, treatment approach, and preparedness to provide effective treatment for methamphetamine users. Responses were received from 68 of the 80 centres on our final master list. Approximately 11% (780/6,840) of all cases at the sites were due primarily to methamphetamine use. The proportion of primary methamphetamine-related cases varied widely across sites in B.C., with contacted centres reporting between 0-65% of their caseload in 2005-2006 as primarily methamphetamine-related. Almost all facilities integrated primary-methamphetamine users into treatment-as-usual, and few centres (12%) felt inadequately prepared to offer treatment for methamphetamine users. The current study found a substantial proportion of all cases seen at youth outpatient substance abuse treatment centres in British Columbia in 2005-2006 were primarily due to methamphetamine misuse. While most treatment sites integrated youth methamphetamine users into regular treatment programming and few treatment directors indicated that their programs were inadequately prepared to offer treatment services to methamphetamine-using clients, more evidence is needed to ascertain the most effective treatment strategies for methamphetamine users.

Undergraduate nursing students at McMaster University are mentored by program alumni. Feedback from surveys and group discussions revealed benefits beyond career and personal development, resulting from having experienced the same educational program. Alumni appreciated the opportunity to reconnect with their alma mater. (SK)

Describes a peer support approach to evaluating outcomes within supported employment programs for people with developmental disabilities. Presents a case study of one Canadian county agency's experience with peer support evaluation and draws several lessons from the implementation experience of several agencies. (SLD)

Background: Technology holds great potential for promoting health equity for rural populations, who have more chronic illnesses than their urban counterparts but less access to services. Yet, more participatory research approaches are needed to gather community‐driven health technology solutions. The purpose was to collaboratively identify and prioritize action strategies for using technology to promote rural health equity through community stakeholder engagement. Methods: Concept mapping, a quantitative statistical technique, embedded within a qualitative approach, was used to identify and integrate technological solutions towards rural health equity from community stakeholders in three steps: (1) idea generation; (2) sorting and rating feasibility/importance and (3) group interpretation. Purposeful recruitment strategies were used to recruit key stakeholders and organizational representatives from targeted rural communities. Results: Overall, 34 rural community stakeholders from western Canada (76% female, mean age = 55.4 years) participated in the concept mapping process. In Step 1, 84 ideas were generated that were reduced to a pool of 30. Multidimensional scaling and cluster analysis resulted in a six‐cluster map representing how technological solutions can contribute toward rural health equity. The clusters of ideas included technological solutions and applications, but also ideas to make health care more accessible regardless of location, training and support in the use of technology, ensuring digital tools are simplified for ease of use, technologies to support collaboration among healthcare professionals and ideas for overcoming challenges to data sharing across health systems/networks. Each cluster included ideas that were rated as equally important and feasible. Key themes included organizational and individual‐level solutions and connecting patients to newly developed technologies. Conclusions: Overall, the grouping of solutions revealed that technological applications require not only access but also support and collaboration. Concept mapping is a tool that can engage rural community stakeholders in the identification of technological solutions for promoting rural health equity. Patient or Public Contribution: Rural community stakeholders were involved in the generation and interpretation of technological solutions towards rural health equity in a three‐step process: (1) individual brainstorming of ideas, (2) sorting and rating all ideas generated and (3) collective interpretation and group consensus on final results. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, educators around the globe seek to understand how to support students whose academic performance is impacted by mental health challenges. This article presents a co-operative inquiry undertaken by colleagues in Canada and Australia, responding to the question; what insights can the existing Carleton University framework of reflective questions offer to educators responding to student mental health challenges in social work education during the COVID-19 pandemic? The risks and complexities of attending to student mental health needs are illustrated by a pandemic-informed case study that extends the framework into this unique context and illustrates the importance of respecting learning requirements, combating discrimination, protecting students' rights, and honouring the professional and legislative mandates of social work within all responses aimed at supporting student mental health resilience during COVID-19. This article acknowledges the limitations of previous practices guiding work with students with mental health needs during any period of crisis or disaster and demonstrates that the Carleton University framework assists in developing improved processes and policy grounded in social work's commitment to social justice and critical reflection. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization World Mental Health International College Student (WMH-ICS) initiative aims to screen for mental health and substance use problems among postsecondary students on a global scale as well as to develop and evaluate evidence-based preventive and ameliorative interventions for this population. This protocol paper presents the Canadian version of the WMH-ICS survey, detailing the adapted survey instrument, the unique weekly cross-sectional administration, the multitiered recruitment strategy, and the associated risk mitigation protocols. Objective: This paper aims to provide a methodological resource for researchers conducting cross-national comparisons of WMH-ICS data, as well as to serve as a useful guide for those interested in replicating the outlined cross-sectional methodology to better understand how mental health and substance use vary over time among university students. Methods: The online survey is based on the WMH-ICS survey instrument, modified to the Canadian context by the addition of questions pertaining to Canadian-based guidelines and the translation of the survey to Canadian French. The survey is administered through the Qualtrics survey platform and is sent to an independent stratified random sample of 350 students per site weekly, followed by two reminder emails. Upon survey closure every week, a random subsample of 70 nonresponders are followed up with via phone or through a personal email in an effort to decrease nonresponder bias. The survey is accompanied by an extensive risk mitigation protocol that stratifies respondents by the level of need and provides tailored service recommendations, including a facilitated expedited appointment to student counseling services for those at increased risk of suicide. The anticipated sample size is approximately 5500 students per site per year. Results: In February 2020, the Canadian survey was deployed at the University of British Columbia. This was followed by deployment at Simon Fraser University (November 2020), McMaster University (January 2021), and the University of Toronto (January 2022). Data collection at all 4 sites is ongoing. As of May 6, 2022, 29,503 responses have been collected. Conclusions: Based on international collaboration, the Canadian version of the WMH-ICS survey incorporates a novel methodological approach centered on the weekly administration of a comprehensive cross-sectional survey to independent stratified random samples of university students. After 27 months of consecutive survey administration, we have developed and refined a survey protocol that has proven effective in engaging students at four Canadian institutions, allowing us to track how mental health and substance use vary over time using an internationally developed university student survey based on the criteria from the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). [ABSTRACT FROM AUTHOR]

Background: End-of-life doulas are emerging as a potentially important new form of community-based caregiving in the global North, yet we know little about this form of care. The aim of our study was to solicit the perspective of key stakeholders and early innovators in community-based end-of-life care about the development and practices of end-of-life doulas. Methods: We conducted 22 semi-structured interviews with participants in four countries where end-of-life doulas are most active: Australia, Canada, the United States, and the United Kingdom. Findings: This article focuses on participants' description of the end-of-life doula role and attendant practices, and our findings provide the first detailed taxonomy of the end-of-life doula role and specific services on the basis of the perspective of subject experts in four countries. We situate our findings within literature on the professionalization of caregiving, with particular attention to nomenclature, role flexibility and boundary blurring, and explicit versus tacit knowledge. We also discuss the importance of jurisdictional considerations as the end-of-life doula movement develops. Discussion: We speculate that the end-of-life doula role is potentially experiencing common developmental antecedents similar to other now-professionalized forms of caregiving. Our findings contribute substantial new information to the small body of empirical research about the end-of-life doula role and practices, provide critical firsthand insight as the movement develops, and are the first research to explore end-of-life doulas from a comparative international perspective. [ABSTRACT FROM AUTHOR]

Background/Objective: This study investigated the validity of the Actiheart device for estimating free-living physical activity energy expenditure (PAEE) in adolescents. Subjects/Methods: Total energy expenditure (TEE) was measured in eighteen Canadian adolescents, aged 15-18 years, by DLW. Physical activity energy expenditure was calculated as 0.9 X TEE minus resting energy expenditure, assuming 10% for the thermic effect of feeding. Participants wore the chest mounted Actiheart device which records simultaneously minute-by-minute acceleration (ACC) and heart rate (HR). Using both children and adult branched equation modeling, derived from laboratory-based activity, PAEE was estimated from the ACC and HR data. Linear regression analyses examined the association between PAEE derived from the Actiheart and DLW method where DLW PAEE served as the dependent variable. Measurement of agreement between the two methods was analyzed using the Bland-Altman procedure. Results: A nonsignificant association was found between the children derived Actiheart and DLW PAEE values (R = .23, R2 = .05, p = .36); whereas a significant association was found between the adult derived Actiheart and DLW PAEE values (R = .53, R2 = .29, p < .05). Both the children and adult equation models lead to overestimations of PAEE by the Actiheart compared with the DLW method, by a mean difference of 31.42 kcal·kg- 1·d-1 (95% limits of agreement: -45.70 to -17.15 kcal·kg-1·d-1 and 9.80 kcal·kg-1·d-1 (95% limits of agreement: -21.22-1.72 kcal·kg-1·d-1), respectively. Conclusion: There is relatively poor measurement of agreement between the Actiheart and DLW for assessing free-living PAEE in adolescents. Future work should develop group based branched equation models specifically for adolescents to improve the utility of the device in this population. [ABSTRACT FROM AUTHOR]

Background: People with multiple sclerosis (MS) are at increased risk for cognitive impairment, mental health concerns, and psychosocial issues, which can negatively affect disease outcomes and quality of life. Current MS care guidelines recommend integrated interdisciplinary services to address these concerns; however, issues can be overlooked during routine care. To date, there is inadequate research on how often these issues are identified and addressed during routine MS care. Methods: One hundred medical records were randomly selected and reviewed (55 relapsing-remitting MS, 17 secondary progressive MS, 8 primary progressive MS, and 20 other or subtype not indicated). All visits to, and contacts with (ie, telephone, e-mail), an MS clinic over 1 year were included in the analysis to determine the proportion of patients presenting with cognitive, mental health, and psychosocial concerns and the proportion of patients offered associated services. Results: Of the 25 patients with at least one identified concern, treatment recommendations occurred for 13 (52%). Rates of identification of cognitive, mental health, and psychosocial concerns in standard clinical practice were significantly lower than the identified prevalence in epidemiologic studies. Demographic factors had no bearing on who was offered treatment. Patients with concerns access MS clinic services more often than those without. Conclusions: Discrepancies between reported and expected frequencies may be due to overreliance on patient self-disclosure and concerns by the health care team that inadequate resources are available to address issues. An interdisciplinary team model may help address these issues. [ABSTRACT FROM AUTHOR]

Objective: This paper reports on substance use, mental health problems, and mental health service utilisation in an early adolescent school-based sample.Method: Participants were 1,360 grade 7 and 8 students from 4 regions of Ontario, Canada. Students completed an in-class survey on mental health and substance use. The sampling strategy and survey items on demographics, substance use, service utilisation, and distress were adapted from the Ontario Student Drug Use and Health Survey. Internalising and externalising mental health problems were assessed using the Global Assessment of Individual Needs - Short Screener. Distress was defined as fair or poor self-rated mental health.Results: Rates of internalising and/or externalising problems above the threshold exceeded 30%; yet, fewer than half had received mental health services in the past 12 mo. Substance use was associated with increased odds of internalising and externalising problems above the threshold and distress. Youth using cannabis had 10-times the odds of exceeding the threshold for internalising or externalising problems. The use of substances other than alcohol or cannabis was associated with increased odds of fair or poor self-rated mental health among grade 8 students. Of the youth who confirmed at least a substance use problem, most also reported mental health problems; this association was stronger among girls than boys.Conclusions: Early adolescent substance use was associated with concurrent self-reported mental health problems in a non-clinical sample. The low levels of service utilisation reported highlight the need for improved access to early identification and intervention to prevent the development of concurrent disorders. [ABSTRACT FROM AUTHOR]

Background: We aimed to determine the frequency and predictors of exercise limitation after pulmonary embolism (PE) and to assess its association with health-related quality of life (HRQoL) and dyspnea.Methods: One hundred patients with acute PE were recruited at five Canadian hospitals from 2010 to 2013. Cardiopulmonary exercise testing (CPET) was performed at 1 and 12 months. Quality of life (QoL), dyspnea, 6-min walk distance (6MWD), residual clot burden (perfusion scan, CT pulmonary angiography), cardiac function (echocardiography), and pulmonary function tests (PFTs) were measured during follow-up. The prespecified primary outcome was percent predicted peak oxygen uptake (Vo2 peak) < 80% at 1-year CPET.Results: At 1 year, 40 of 86 patients (46.5%) had percent predicted Vo2 peak < 80% on CPET, which was associated with significantly worse generic health-related QoL (HRQoL), PE-specific HRQoL and dyspnea scores, and significantly reduced 6MWD at 1 year. Predictors of the primary outcome included male sex (relative risk [RR], 3.2; 95% CI, 1.3-8.1), age (RR, 0.98; 95% CI, 0.96-0.99 per 1-year age increase), BMI (RR 1.1; 95% CI, 1.01-1.2 per 1 kg/m2 BMI increase), and smoking history (RR, 1.8; 95% CI, 1.1-2.9), as well as percent predicted Vo2 peak < 80% on CPET at 1 month (RR, 3.8; 95% CI,1.9-7.2), and 6MWD at 1 month (RR, 0.82; 95% CI, 0.7-0.9 per 30-m increased walking distance). Baseline or residual clot burden was not associated with the primary outcome. Mean PFT and echocardiographic results (pulmonary artery pressure, right and left ventricular systolic function) at 1 year were similarly within normal limits in both patients with exercise limitations and those without such limitations.Conclusions: Almost half of patients with PE have exercise limitation at 1 year that adversely influences HRQoL, dyspnea, and walking distance. CPET or 6MWD testing at 1 month may help to identify patients with a higher risk of exercise limitation at 1 year after PE. Based on our results, we believe that the deconditioning that occurs after acute PE could underlie this exercise limitation, but we cannot exclude the fact that this may have been present before PE.Trial Registry: ClinicalTrials.gov; No.: NCT01174628; URL: www.clinicaltrials.gov. [ABSTRACT FROM AUTHOR]

Purpose: To understand risk-related practices of older adults returning home posthospitalization. Research Design: Qualitative methods informed by critical discourse theory, designed to uncover linkages between broader social practices and peoples' talk and stories, were used. Methods: Eight older adults, screened as high-risk from an inpatient cardiology unit, and six partners were interviewed face-to-face within three weeks of discharge. A discourse analysis of participants' accounts of risk was conducted: the cultural and social understandings or conceptual frameworks used to understand risk were identified. Results: Ableism, a discourse in our society that privileges abledness, was found to permeate the data. Participants underscored that being abled was normal and being disabled was abnormal. Ableism, as a discourse or conceptual framework, compelled participants to appear and act abled, or to perform "compulsory abledness." That, in turn, produced their responses to risk: a pressure to preserve ableist identities created internal and external tensions related to objects and situations of risk and forced participants to use strategies to diminish and minimize risk. Participants created a new response--a position of "liminality" or in-between--where their accounts portrayed them as neither abled nor disabled. This discourse of liminality allowed them to reconcile tensions associated with risk. Implications: Critical discourse analysis sheds new light on older adults' risk practices. This approach challenges accepted ways of acting and thinking about what constitutes risk and produces possibilities for alternate ways of representing the same reality. [ABSTRACT FROM AUTHOR]

Purpose: There is limited published data on anti‐MOG disease in Canada. The purpose of this study was to increase the understanding of the ophthalmic and neurological manifestations of anti‐MOG disease in adults living in a Canadian setting through a retrospective/prospective chart review. Methods: Data from standard of care ophthalmic and neurological assessments was collected for patients who were diagnosed with Anti‐MOG disease at a quaternary care teaching hospital. Results: Nineteen patients diagnosed with Anti‐MOG disease were identified. Of these, 70% were female and 30% were male, with ages ranging from 18 to 82 years old. On ocular examination the majority of eyes had normal visual acuity (87%). Three eyes were hand motion or no light perception. On fundus examination, 84% of participants presented with optic disc abnormalities with the most common findings being disc atrophy and temporal pallor. In patients affected with Anti‐MOG with decreased visual acuity, pattern Visual Evoked Potentials were significantly reduced in amplitude. Other than the initial optic neuritis, half of participants experienced no additional neurological effects, while the others experienced variable residual symptoms such as scintillating scotomas, recurrent mild paresthesia of both legs, seizures, urinary urgency, oscillopsia and neuropathic pain. Of the 15 participants with recent MRI results, 67% showed persistent hyperintense T2 abnormalities while 22% showed resolution of prior T2 abnormalities. Conclusions: The initial results of this study match existing literature for anti‐MOG disease. Optic nerve atrophy and temporal pallor are commonly found ocular signs in patients with anti‐MOG. Interestingly, patients were found to have persistent decreased VEP amplitudes with normal inner and outer retinal function. Overall, the ophthalmic and neurological findings were variable between participants. Study recruitment is ongoing. [ABSTRACT FROM AUTHOR]

This article outlines the development of an integrated information system for specialized alcohol and drug treatment agencies in Ontario, Canada. The system is being developed following a strategic planning process involving provincial funding ministries and coalitions of service providers. An overview of the system's development is provided and the implementation of one subcomponent, a client-tracking system, is described. Some challenges to the implementation of this component are identified. [ABSTRACT FROM AUTHOR]

Alcohol binge drinking puts a person at a higher risk for hazards of poor judgment, such as violence, vandalism, sexual assault, and unprotected sexual encounters. Thorough assessment and judicious management of patients who have consumed too much alcohol serve as a basis for competent nursing care. [ABSTRACT FROM AUTHOR]

This study examined the day-to-day relationships between temporal perspective and well-being. Temporal perspective has predominantly been measured with single-occasion measurement designs, which ignore the potential for within-person variations that may be important in accounting for fluctuations in well-being. A 14-day daily diary design was employed to examine the dimensions of temporal perspective (temporal focus, temporal attitude, and temporal distance) and their dynamic relationships with daily well-being. The results from multilevel analyses indicated that: (a) there is evidence of within-person variability in daily temporal perspective, and (b) this within-person variability in temporal perspective fluctuated systematically with fluctuations in daily well-being. Each temporal perspective dimension was useful in predicting daily well-being. Temporal perspective dimensions interacted with each other such that the daily relationships with well-being depended on both the temporal region (past, present, or future) and the nature of the thoughts (pleasant vs. unpleasant; near vs. far). [ABSTRACT FROM AUTHOR]

Individuals who are alcohol dependent pose significant challenges for nurses when they are admitted to hospital for treatment. Clinical problems presented by these individuals are examined and the critical aspects of their care are highlighted. [ABSTRACT FROM AUTHOR]

The author comments on the issues of art and technology in the Patent Act in Canada. The author argues that the Amazon.com decision is warranting scrutiny of testing patentability. The author stresses that the decision is precedential because the analysis is endorsing a strict and literal construction of the Canadian Patent Act. The author argues that the decision in instructive for those who maintain that a strong patent regime is a component to stimulate innovation.

In this article, the author discusses the decision of the Federal Court of Canada concerning the patent lawsuit involving Amazon.com Inc. She expresses sanguinity about the court's reasoning and welcomes the judgment for accommodating inventors who work in the intangible industrial arts. She also tackles the central issues of art and technology in the Canadian Patent Act.

It is well known that only a relatively small proportion of people in the community who experience substance use problems seek assistance from the specialized sector of services that have been commissioned to provide treatment and support for these problems. Going back to seminal reports from the early 1990s there has been a call for a systems approach to "broaden the base of treatment" in order to achieve wider coverage and yield positive outcomes at a population level. In some jurisdictions conceptual models referred to as "tiered models" have been advanced to support planning, system design and performance monitoring. This paper traces the evolution of such tiered models for substance use services and describes a recent model advanced in Ontario Canada for design of an integrated system of mental health, substance use and problem gambling services and supports. The paper concludes by highlighting key features and principles of the tiered approach that are critical for its actual operationalization. Some challenges operationalizing such a comprehensive system design framework are also noted. [ABSTRACT FROM AUTHOR]

The article discusses the concept of technological neutrality in relation to the factors that are used in the copyright valuation process for collective rights under Canadian law as of 2016, and it mentions the Supreme Court of Canada's determination in the case Canadian Broadcasting Corp. v. SODRAC 2003 Inc. that the Canadian Copyright Act should not be interpreted or applied to favor or discriminate against technology. Tariff-related litigation is also examined.

Contact zones between recently diverged taxa offer unique opportunities to test whether the forms are reproductively isolated and therefore distinct species. The Pacific-slope flycatcher Empidonax difficilis and Cordilleran flycatcher Empidonax occidentalis are closely related taxa that were officially separated into two species in 1989, a treatment that has been controversial due to reports of phenotypically intermediate birds across the southern interior of British Columbia and Alberta. We present the first analysis of molecular variation across this region, in order to determine whether there is genetic introgression between the taxa. Allopatric populations of Pacific-slope and Cordilleran flycatchers belong to distinct mitochondrial clades, and all of the individuals sampled in interior southwestern Canada have the Pacific-slope haplotype. In contrast, variation in nuclear DNA (AFLPs) indicates hybridization between Pacific-slope and Cordilleran flycatchers in this region. We suggest that the discordance between the mitochondrial and nuclear markers most likely results from stochastic loss of Cordilleran mitochondrial haplotype lineages facilitated by asymmetries in mating due to earlier arrival and greater abundance of Pacific-slope flycatchers in the contact zone. The discovery of hybridization between Pacific-slope and Cordilleran flycatchers in southwestern Canada may call into question the decision to split them into two species. On the other hand, allopatric populations are genetically distinct in both mitochondrial and nuclear DNA, and the hybridization might not affect populations outside of the contact zone. This study highlights the importance of employing multiple genetic markers in studies of contact zones between closely related species. [ABSTRACT FROM AUTHOR]

Objective: Population health surveys around the world have studied the epidemiology of comorbid substance use disorders (SUDs) and other mental disorders as part of larger efforts to assess needs and direct integrated planning and delivery of services. This study presents the first national assessment in Canada of the prevalence of co-occurring SUDs and other mental disorders, with attention to differences by substance problem severity, sex, age, and region.Methods: This work is a secondary analysis of data from the 2002 Canadian Community Health Survey: Mental Health and Well-Being. The sample was obtained using a multistage stratified cluster design (n = 36,984, response rate = 77%).Results: The 12-month population prevalence of co-occurring disorders was 1.7%. The 12-month prevalence of other mental disorders was higher among those with illicit drug, relative to alcohol, problems and among those with dependence, compared with those with less severe problems. Sex and age differences mirrored population differences in pure disorders. Salient regional differences included the higher rate of co-occurring disorders in British Columbia and the lower rates in Quebec.Conclusions: Cross-study comparisons are hampered by methodological differences; however, these Canadian rates are at the lower end of the range reported internationally. This might have resulted from the exclusion of several disorders known to be highly comorbid with SUDs. Nonetheless, prevalence is high in certain subgroups, and efforts under way to improve Canada's substance abuse and mental health services should continue to ensure that adequate attention is directed to the needs of people with co-occurring disorders. [ABSTRACT FROM AUTHOR]

Objective: To examine the prevalence and profile of people with co-occurring mental and substance use disorders in relation to numerous demographic, diagnostic, and needs-related variables across a comprehensive system of mental health services using a standard methodology.Method: Data were collected on cases (n = 9839) sampled from specialty tertiary inpatient, specialty outpatient, and community-based mental health programs. Status with respect to co-occurring disorders was based on recorded diagnosis of substance use disorder and the substance abuse measure within the Colorado Client Assessment Record. The demographic and needs profile was compared across groups with or without co-occurring disorders within each level of care.Results: Overall, the prevalence of co-occurring disorders was 18.5%, and highest among clients receiving specialty tertiary inpatient care (28%), and within selected subpopulations such as younger adults (55%) and those with personality disorders (34%). There were few differences between groups based on co-occurring disorders in the specialty inpatient programs. For outpatient and community settings, the clients with co-occurring disorders were distinguished by a more impaired and complex needs profile and more likely to be young, single, male, and of low education. Across all levels of care, having a co-occurring disorder was strongly associated with antisocial and challenging behaviour, legal involvement, and risk of suicide or self-harm.Conclusion: The prevalence estimate of co-occurring disorders is likely representative of a multilevel system of care that serves a large, mixed urban and rural population. Results highlight the need to focus on specific subpopulations and sectors in pursuit of more integrated treatment and support for their mental health and addictions problems. [ABSTRACT FROM AUTHOR]

Abstract: To assess geographic distributions of elements in the Arctic we compared essential and non-essential elements in the livers of polar bears (Ursus maritimus) collected from five regions within Canada in 2002, in Alaska between 1994 and 1999 and from the northwest and east coasts of Greenland between 1988 and 2000. As, Hg, Pb and Se varied with age, and Co and Zn with gender, which limited spatial comparisons across all populations to Cd, which was highest in Greenland bears. Collectively, geographic relationships appeared similar to past studies with little change in concentration over time in Canada and Greenland for most elements; Hg and Se were higher in some Canadian populations in 2002 as compared to 1982 and 1984. Concentrations of most elements in the polar bears did not exceed toxicity thresholds, although Cd and Hg exceeded levels correlated with the formation of hepatic lesions in laboratory animals. [Copyright &y& Elsevier]

The article presents a report that represents the culmination of the National Telehealth Outcome Indicators Project (NTOIP) in Canada. The NTOIP looks at outcome indicators in four categories, namely quality, access, acceptability and cost. The article describes the four phases of the study, strategy and approach, systematic review of the literature, national experts workshop and refinement and consensus.

The article outlines the strategy and approach for the National Telehealth Outcome Indicators Project (NTOIP) process in Canada. The project used the Clinical Accountability, Service Planning and Evaluation (CASPE) model. Meanwhile, the structure used in the NTOIP was adapted from the National Committee on Clinical Laboratory Standards (NCCLS) consensus process.

The article presents a review of literature on aspects of quality with respect to telehealth, for the National Telehealth Outcome Indicators Project (NTOIP), Canada's national guidance on specific outcome indicators for use when evaluating telehealth applications. Aspects of quality included in the review are quality of care, quality of life, safety and efficacy.

The article presents the literature review for the outcome category acceptability of the National Telehealth Outcome Indicators Project (NTOIP), Canada's national guidance on specific outcome indicators for use when evaluating telehealth applications. Several articles stated what they were measuring in terms of satisfaction and provided sample questions. Some articles used multiple outcomes to evaluate a measure of satisfaction.

The article presents the literature review for the National Telehealth Outcome Indicators Project (NTOIP), Canada's national guidance on specific outcome indicators for use when evaluating telehealth applications. Several information provided in the articles include detailed cost analyses and telemedicine service. The article explains the five types of generally recognized economic evaluations.

The article discusses the national experts workshop of the National Telehealth Outcome Indicators Project (NTOIP), Canada's national guidance on specific outcome indicators for use when evaluating telehealth applications. The primary goal of the workshop was to identify candidate outcome indicators (COI) for further analysis and development. The article outlines the aims of the workshop such as critiquing and approving the telehealth outcomes development (TOD) framework.

A key theme of Charter-era Canadian constitutional thought has been to emphasize the difference between Canadian and American conceptions of individual rights and, correspondingly, the different roles played by the respective Supreme Courts when hearing rights-based challenges to legislation. We argue that this distinction between the Canadian and American courts is inaccurate if not mythical, and that a convergence has occurred, especially concerning the manner in which the Supreme Courts of both nations regard scope and vision of the franchise. Members of both courts now acknowledge that it is not possible to defer to the elected branches when dealing with voting rights claims because there is an inherent conflict of interest when elected officials write the rules by which they are returned to office. As a result, the Canadian Supreme Court now manifests an increasing awareness of the need to follow (or, at least, bear in mind) John Hart Ely's call for courts to police the process of representation and protect the integrity of the democratic process. This suggests that 25 years of judicial deference under the Charter is likely to be to be succeeded by an era of increased conflict between the judiciary and the legislature as the Supreme Court struggles to set forth a clear definition of the franchise and the notion of a meaningful political process. [ABSTRACT FROM AUTHOR]

Comments on the consensus guidelines of the Canadian Society of Transplantation on the eligibility for kidney transplantation. Increase in the incidence and prevalence of end-stage renal disease in Canada from 1981 to 1999; Example of the variation in transplantation rates across Canada; Risk factors of end-stage renal disease.

We report on the extent of cannabis treatment-seeking within an addiction treatment system in Canada. Data represent all new admissions in fiscal year 2000 to substance abuse treatment agencies in the province of Ontario (n = 47,995). Analyses examine the prevalence of cannabis problems by demographic and treatment characteristics and provide contrasts with other client subgroups (alcohol, cocaine, and opiates). Clients reporting cannabis as their primary problem substance (13%) were more likely to be male, single, under age 20 and in high school. Legal system involvement and school- or family-based pressure to enter treatment were commonly reported, but less so by older cannabis clients. The distinctiveness of these clients within the larger treatment system raises questions of the relevance to cannabis clients of interventions designed for other substance-abusing populations. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Purpose: To examine the types of presenting problems and symptoms among individuals seeking treatment for cannabis-related problems in a large treatment centre in Ontario. Methods: Data from assessment interviews conducted with clients who identified cannabis as their primary drug problem (n=426) were analyzed using descriptive statistics. Results: The majority of people seeking treatments were male (80%) and single (77%). Cannabis treatment seekers varied in their socio-demographic characteristics, drug consumption, pressure to seek treatment, and adverse consequences of cannabis use. They experienced a broad range of substance-related problems, however, the majority were classified as below the action stage in terms of readiness to change their drug consumption. Daily users were older, more likely to be employed, to be cannabis dependent, to suffer from an anxiety disorder, and to use multiple substances. Discussion: Cannabis treatment seekers are a heterogeneous group. A better understanding of the relationship between client characteristics and different interventions may improve outcomes. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims To examine public opinion and experiences of family physician involvement in alcohol use issues and to identify patient characteristics associated with these opinions and experiences. Design A secondary analysis of population survey data from the 1993 Ontario Alcohol and Other Drug Opinion Survey (OADOS), a random household telephone survey of adults in Ontario, Canada. Opinion and experiences regarding alcohol use were examined by drinking status. Participants All survey respondents (n = 941; 65% response rate). Population expansion weights were applied to ensure the sample's representativeness of the adult population of Ontario. Measurements Measures assessed the prevalence of opinions and experiences of family physicians: (1) asking patients about their drinking; (2) advising regular drinkers to cut down/quit; and (3) helping patients with alcohol problems. Self-reported past-year alcohol consumption and related problems were used to construct a categorical variable describing current drinking status. Findings Public opinion supported routine inquiries into patients’ drinking habits and advising regular drinkers to cut down. However, the experience of being asked by a physician about drinking, being advised to cut down or being helped with alcohol problems was uncommon. Respondents’ drinking status was associated with experiences of being asked about drinking and being advised to cut down. Conclusions Physician training should inform physicians that public opinion supports inquiries about drinking and advisement to reduce consumption, as it does not appear that family doctors are meeting these expectations of patients. [ABSTRACT FROM AUTHOR]

Examines the effect of a preoperative intervention on preoperative and postoperative outcomes in low-risk patients awaiting elective coronary artery bypass graft surgery in Ontario. Less length of hospital day among patients who received the preoperative intervention; Better quality of life of patients in the intervention groups during the waiting period.

Presents a summary of things learned about assessment/referral (A/R) services for addicts in Ontario after a decade of program development and evaluation research. Objectives; Difficulties encountered; Expectations regarding the impact of A/R centers; Issues on the horizon for A/Rs and for treatment system research and development.