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This paper examines the use of vignettes as a research method in a comparative exploration of the provision for children with special educational needs across eleven countries. The investigation selected in-country researchers, who responded to questions with respect to children described in 14 vignettes. The questions related to school placement options; assessment processes; support arrangements; service provision; curriculum responses and those involved in placement decisions. The vignette findings were able to highlight differences in placement decisions between the countries; the general lack of pupil voice in decision making and the ubiquitous influence of medical categories within educational settings. The utility of using vignettes in this type of research is discussed in relation to reflecting the complex reality of educational practice in different countries.

Background: Epilepsy management during pregnancy is crucial for both the mother and fetus. The use of antiseizure medications (ASMs) during pregnancy requires careful consideration due to their potential effects on maternal and fetal health. Methods: This study analyzed trends in ASMs use among pregnant people in four Canadian provinces over 20 years (Manitoba, Saskatchewan, Alberta, and Quebec). Descriptive statistics were utilized to examine the characteristics of the population, with the frequency and patterns of ASM use estimated throughout each trimester. Linear regression models were developed to analyze yearly patterns of ASM utilization for the overall study population, as well as for people with and without epilepsy. Results: Among 1,317,141 pregnant individuals across four provinces, 0.7% had epilepsy. Of the total pregnancies, 1.7% (n = 22,783) were exposed to ASMs, comprising 4,392 from pregnant people with epilepsy (PPWE) and 18,391 from those without epilepsy (PPWOE). Results demonstrated varying trends in ASM usage between provinces, with an overall increase in usage among people without epilepsy in Manitoba, Saskatchewan, and Alberta. ASM use among PPWOE surged significantly in Manitoba (24.2–149.1 per 10,000 pregnant people), Saskatchewan (29.4–107.0 per 10,000), and Alberta (65.7–241.7 per 10,000) (p < 0.05). In Alberta, PPWE's ASM exposure also rose, from 23.6 in 2008 to 43.0 per 10,000 pregnant people in 2021, while Quebec witnessed a decrease from 59.2 in 1998 to 45.5 per 10,000 pregnancies in 2015. Analysis of ASM use by trimester illustrated a substantial decline among PPWOE from 365 days pre-pregnancy to the third trimester in all provinces. ASM utilization by drug class showcased significant shifts, with second-generation ASMs experiencing a notable rise. Carbamazepine, once prominent, declined, making way for lamotrigine. Regional variations underscore diverse preferences, such as clonazepam's sustained popularity in Manitoba and Quebec. Conclusion: The study identified increasing trends in ASM use, particularly the increased use of second-generation ASMs, and differences in prescription patterns for pregnant individuals with and without epilepsy. These findings reveal changing ASM use patterns, including increased second-generation ASM use and regional disparities, providing valuable insights into real-world prescription practices. [ABSTRACT FROM AUTHOR]

Following stroke, individuals who live in a low-income or are at risk of living in a low-income situation face challenges with timely access to social services and community resources. Understanding the usual care practices of stroke teams, specifically, how they support this access to services and resources, is an important first step in promoting the implementation of practice change. A qualitative multiple-case study of acute care, inpatient, and outpatient rehabilitation stroke teams in an urban area of Canada. Semi-structured interviews and questionnaires about the workplace context were conducted with 19 professionals (social workers, occupational therapists, physiotherapists, speech-language pathologists) at four sites. In their usual practice, stroke teams prioritized immediate care needs. The stroke team professionals did not address income or resources unless it directly affected discharge. Usual care was influenced by factors such as time constraints, lack of knowledge about services and resources, and social service system limitations. To better support post-stroke access to social services and resource for low-income individuals, a multidisciplinary approach, with actions beginning earlier on and extending throughout the continuum of care, is recommended, in addition to system-level advocacy. Access to social services and community resources for people with stroke and living in a low-income situation is not consistently addressed in acute care or rehabilitation settings. Supporting access to social services and community resources is influenced by the professionals' availability of time and resources, as well as knowledge about services and resources and the limitations of the social service system. Using a multidisciplinary approach, extending over the continuum of care from acute care to rehabilitation program may be a way forward to better support people with stroke and low income to access services and resources. [ABSTRACT FROM AUTHOR]

Individuals with mild cognitive impairment are at risk of cognitive and physical decline. Virtual reality (VR) exercise may provide beneficial physical and cognitive exercise. The objectives of this study were to assess the feasibility and safety of home-based VR exercise and to provide pilot data for physical and cognitive efficacy. Eleven individuals with mild cognitive impairment (seven males/four females, average 78 years old, and average 3 years since diagnosis) performed a 30-min home-based VR exercise program 5 days a week for 6 weeks. The VR platform was successfully installed in participants' homes, and all participants were able to learn the VR program and progress. Participants completed 99% of the prescribed exercise. There were no major adverse events. Most participants enjoyed the VR program and reported physical benefits; fewer reported cognitive benefits. No physical or cognitive outcome measures showed change after 6 weeks. Home-based VR exercise is safe and feasible in individuals with mild cognitive impairment. [ABSTRACT FROM AUTHOR]

This project aimed to create a descriptive map of international research which explores the notion of the continuum of educational provision for children with special educational needs. It also aimed to determine and examine the nature of how the continuum of provision is conceptualised, operationalised and enacted in a sample of selected countries. Commissioned by the National Council for Special Education, it also identified implications for the development of provision within the Irish context. The research involved a systematic identification and thematic review of theory, identifying and examining literature associated with the conceptualisation of the continuum; it examined the policy and provision across 55 administrations as publically reported, primarily to international agencies; it carried out more detailed examination of policy and practice in 10 countries using a survey and vignette study; and it involved a series of interviews with a range of individuals in a range of settings in four countries with differing approaches to supporting children with special educational needs. This paper outlines the overall findings of the research. It focuses in particular upon the need to change how we think about provision associated with continua, recognising the lack of international coherence in approaches to support for pupils with special educational needs. It identifies in particular the opportunities presented by a reconceptualisation of the class and the management of class resources, and the role key personnel can play in creating links between diverse services.

Internationally, the “rough sex defence” appears to be on the rise. Used to suggest that women enjoy violence as part of “sex play,” it invites judges and jurors to find either consent to acts causing bodily harm or an honest but mistaken belief in consent. Our review of the Canadian case law from 1988–2021 examines how courts approach this defence. We found that the defence is gendered, with only men as perpetrators and overwhelmingly women on the receiving end. We explore themes from the cases including the role of pornography, the trivialization of bodily harm, the mischaracterization of strangulation, and how consent to some sexual activity undermines women’s credibility. We conclude that consent should be barred as a defence to causing bodily harm unless that harm was unforeseeable when inflicted. [ABSTRACT FROM AUTHOR]

Over the last decade, the use of medically assisted reproduction (MAR) has steadily increased but controversy remains with regards to its risks. We aimed to quantify the risk of being born small for gestational age (SGA) and very SGA (VSGA) associated with MARs overall and by type, namely ovarian stimulators (OS) and assisted reproductive technology (ART). We conducted a cohort study within the Quebec Pregnancy Cohort. Pregnancies coinciding with Quebec's MAR reimbursement PROGRAM period (2010-2014) with a singleton liveborn were considered. MAR was first defined dichotomously, using spontaneous conception as the reference, and categorized into three subgroups: OS alone (categorized as clomiphene and non-clomiphene OS), ART, OS/ART combined. SGA was defined as being born with a birth weight below the 10th percentile based on sex and gestational age (GA), estimated using populational curves in Canada, while VSGA was defined as being born with a birth weight below the 3rd percentile. We then estimated odds ratios (OR) for the association between MAR and SGA as well as VSGA using generalized estimated equation (GEE) models, adjusted for potential confounders (aOR). Two independent models were conducted considering MAR exposure overall, and MAR subgroup categories, using spontaneous conceptions as the reference. The impact of prematurity status (less than 37 weeks gestation) as an effect modifier in these associations was assessed by evaluating them among term and preterm pregnancies separately. A total of 57,631 pregnancies met inclusion criteria and were considered. During the study period, 2,062 women were exposed to MARs: 420 to OS alone, 557 to ART, and 1,085 to OS/ART combined. While no association was observed between MAR and SGA nor VSGA in the study population, MAR was associated with an increased risk for SGA (aOR 1.69, 95% CI 1.08-2.66; 25 exposed cases) among preterm pregnancies; no increased risk of SGA was observed in term pregnancies. MARs are known to increase the risk of preterm birth and our results further confirm that they also increase the risk of SGA among preterm pregnancies. [ABSTRACT FROM AUTHOR]

This paper explores Canadian family law cases involving claims of parental alienation and of family violence from 2014–2018, reporting the data on these claims, their resolution, and their impacts upon custody and access. A close reading of those cases where both alienation and intimate partner violence claims are made reveals troubling patterns in how intimate partner violence is discounted in this context. We suggest that the rise of shared parenting as a dominant norm assists in understanding why alienation has achieved such unquestioned status, and call for greater focus on safety and women's and children's voices. [ABSTRACT FROM AUTHOR]

This article explores the recent expansion of Medical Assistance in Dying (MAiD) in Canada and its negative implications for women with disabilities. In 2021, the government extended MAiD to people with disabilities who are not dying, which the authors contend is a modern form of eugenics. Structured as a conversation and deploying a systemic, equality-based feminist analysis, the article tracks the shifts in scope and justification for MAiD through judicial and legislative developments, the overwhelming opposition by organizations representing people with disabilities, and the failure of feminist organizations to support their disabled sisters. The authors articulate a feminist response to the expansion of MAiD to address this troubling silence. After Isabel Grant sets out the foundations of Track 2 MAiD, Janine Benedet develops a critique of the concepts of autonomy, choice, and privacy as used by MAiD expansionists to justify these premature deaths. Elizabeth Sheehy explores some of the structural issues that affect the impetus for MAiD: women's poverty, the medical profession, the gendered nature of caregiving, and men's violence. Isabel Grant demonstrates the particular dangers for women of the extension of MAiD on the basis of mental illness, as evidenced by data from other countries. Catherine Frazee describes what a truly intersectional feminist approach to MAiD demands of more privileged feminists and concludes the conversation with a call for feminist solidarity. [ABSTRACT FROM AUTHOR]

Perinatal psychological stress has been associated with unfavorable maternal and neonatal outcomes. We aimed to assess the impact of perinatal stress on infant development at 1 year of age. We recruited pregnant women calling North American Teratogen Information Services or attending outpatient clinics at CHU Sainte Justine (Montreal) between 2008 and 2010 and their spouses. To be part of our study, women had to be (1) >18 years of age, (2) <15 weeks of gestational age at recruitment, (3) living within 250-km radius of Montreal, and (4) taking antidepressants or non-teratogenic drugs. Stress was assessed using the telephone-administered four-item perceived stress scale during pregnancy in mothers and at 2 months postpartum in both parents. Child development at 1 year of age was evaluated with the Bayley III scales. Socio-demographic and potential confounders were collected through telephone interviews. Multivariable linear regression models were built to assess the association between perinatal parental stress and child development. Overall, 71 couples and their infants were included. When adjusted for potential confounders, maternal prenatal stress was positively associated with motor development (adjusted β = 1.85, CI 95 % (0.01, 3.70)). Postpartum maternal and paternal stresses were negatively associated with motor and socio-emotional development, respectively (adjusted β = −1.54, CI 95 % (−3.07, −0.01) and adjusted β = −1.67, CI 95 % (−3.25, −0.10), respectively). Maternal and paternal postnatal stress seems to be harmful for the motor and socio-emotional development in 1-year-old children. No association was demonstrated between parental stress and cognitive, language, and adaptive behavioral development. However, prenatal maternal stress appears to improve motor skills. [ABSTRACT FROM AUTHOR]

Background: Sitting ability and function are commonly impaired after stroke. Balance training has been shown to be helpful, but abundant repetitions are required for optimal recovery and patients must be motivated to perform rehabilitation exercises repeatedly to maximize treatment intensity. Virtual reality training (VRT), which allows patients to interact with a virtual environment using computer software and hardware, is enjoyable and may encourage greater repetition of therapeutic exercises. However, the potential for VRT to promote sitting balance has not yet been explored. The objective of this study is to determine if supplemental VRT-based sitting balance exercises improve sitting balance ability and function in stroke rehabilitation inpatients. Methods/design: This is a single-site, single-blind, parallel-group randomized control trial. Seventy six stroke rehabilitation inpatients who cannot stand independently for greater than one minute but can sit for at least 20 minutes (including at least one minute without support) are being recruited from a tertiary-care dedicated stroke rehabilitation unit. Participants are randomly allocated to experimental or control groups. Both participate in 10-12 sessions of 30-45 minutes of VRT performed in sitting administered by a single physiotherapist, in addition to their traditional therapy. The experimental group plays five games which challenge sitting balance while the control group plays five games which minimize trunk lean. Outcome measures of sitting balance ability (Function in Sitting Test, Ottawa Sitting Scale, quantitative measures of postural sway) and function (Reaching Performance Scale, Wolf Motor Function Test, quantitative measures of the limits of stability) are administered prior to, immediately following, and one month following the intervention by a second physiotherapist blind to the participant's group allocation. Discussion: The treatment of sitting balance post-stroke with VRT has not yet been explored. Results from the current study will provide important evidence for the use of low-cost, accessible VRT as an adjunct intervention to increase sitting balance in lower-functioning patients receiving inpatient rehabilitation. The motivating and enjoyable attributes of VRT may increase exercise dosage, leading to improved function and optimal results from rehabilitation. Trial Registration: https://clinicaltrials.gov/; Identifier: NCT02285933. Registered 06 November 2014. Funded by the Heart & Stroke Foundation of Canada and a generous donation from Tony & Elizabeth Graham. [ABSTRACT FROM AUTHOR]

Background Traditionally, the Arctic diet has been derived entirely from locally harvested animal and plant species; however, in recent decades, imported foods purchased from grocery stores have become widely available. The present study aimed to examine Inuvialuit, traditional or nontraditional dietary patterns; nutrient density of the diet; dietary adequacy; and main food sources of energy and selected nutrient intakes. Methods This cross-sectional study used a culturally appropriate quantitative food frequency questionnaire to assess diet. Traditional and nontraditional eaters were classified as those consuming more or less than 300 g of traditional food daily. Nutrient densities per 4184 kJ (1000 kcal) were determined. Dietary adequacy was determined by comparing participants' nutrient intakes with the Dietary Reference Intakes. Results The diet of nontraditional eaters contained, on average, a lower density of protein, niacin, vitamin B12, iron, selenium, zinc, omega-3 fatty acids ( P ≤ 0.0001), vitamin B6, potassium, thiamin, pantothenic acid ( P ≤ 0.001), riboflavin and magnesium ( P ≤ 0.05). Inadequate nutrient intake was more common among nontraditional eaters for calcium, folate, vitamin C, zinc, thiamin, pantothenic acid, vitamin K, magnesium, potassium and sodium. Non-nutrient-dense foods (i.e. high fat and high sugar foods) contributed to energy intake in both groups, more so among nontraditional eaters (45% versus 33%). Traditional foods accounted for 3.3% and 20.7% of total energy intake among nontraditional and traditional eaters, respectively. Conclusions Diet quality and dietary adequacy were better among Inuvialuit who consumed more traditional foods. The promotion of traditional foods should be incorporated in dietary interventions for this population. [ABSTRACT FROM AUTHOR]

Background Little is understood about the economic factors that have influenced the nutrition transition from traditional to store-bought foods that are typically high in fat and sugar amongst people living in the Canadian Arctic. This study aims to determine the pattern of household food expenditure in the Canadian Arctic. Method Local food prices were collected over 12 months in six communities in Nunavut and the Northwest Territories. Dietary intake data were collected from 441 adults using a validated quantitative food frequency questionnaire. Money spent on six food groups was calculated along with the cost of energy and selected nutrients per person. Results Participants spent approximately 10% of total food expenditure on each of the food groups of fruit/vegetables, grains and potatoes, and dairy, 17% on traditional meats (e.g. caribou, goose, char, and seal liver), and 20% on non-traditional meats (e.g. beef, pork, chicken, fish, and processed meats). Non-nutrient-dense foods (NNDF) accounted for 34% of food expenditure. Younger participants (<30 years) spent more on NNDF and less on traditional meats compared with the older age groups. Participants with higher levels of formal education spent more on fruit and vegetables and less on traditional meats, when compared with participants with lower levels of formal education. Conclusions Participants spent most household income on NNDF, a possible consequence of generation discrepancy between younger and older participants. The tendency toward NNDF, particularly among youth, should be addressed with an assessment of predictive factors and the development of targeted approaches to population-based interventions. [ABSTRACT FROM AUTHOR]

Background Healthy Foods North ( HFN) is a community-based intervention designed to promote a healthy diet and lifestyle of Inuit and Inuvialuit populations in Arctic Canada. The objective of the present study was to determine the effects of HFN on the nutrient intake of women of childbearing age. Methods Six communities in Nunavut ( n = 3) and the Northwest Territories ( n = 3) were selected for programme implementation; four received a 12-month intervention and two served as controls. Quantitative food frequency questionnaires were used to assess dietary intake at baseline and 1 year post-intervention. Among women participants aged 19-44 years ( n = 136), 79 were exposed to the intervention and 57 were not. Mean daily energy and nutrient intake and density were determined. Dietary adequacy was assessed by comparing the women's daily nutrient intakes with dietary reference intakes ( DRI). Results Main outcomes were the pre- to post-intervention changes between intervention and control groups for energy and selected nutrient intakes, nutrient density and dietary adequacy. Among the participants, the intervention had a beneficial effect on vitamin A and D intake. The percentage of individuals with nutrient intakes below the DRI increased from pre- to post-intervention for vitamin A and D in the control group but only for vitamin A in the intervention group. The programme did not have a significant impact on calorie, sugar, or fat consumption. Conclusions The HFN programme is effective in mitigating some of the negative impacts of the nutrition transition on dietary adequacy among Inuit and Inuvialuit women of childbearing age. [ABSTRACT FROM AUTHOR]

The article presents a study that determined dietary intake of Inuvialuit adults in Northwest Territories (NWT) in Arctic Canada, using a culturally specific validated quantitative food frequency questionnaire (QFFQ). Topics discussed include the nutritional and lifestyle transition among the Inuvialuits, and the finding on mean daily energy, saturated fat and sodium intakes. Also mentioned are the inadequacies in food consumption among the Inuvialuits and the need for nutritional intervention.

Background Inuit in Nunavut, Canada, are currently undergoing a nutritional transition that may contribute to an increased prevalence of chronic disease. Information is lacking about the extent to which contemporary Inuit diets are meeting current dietary recommendations. Methods A culturally appropriate quantitative food frequency questionnaire ( QFFQ) developed and validated for Inuit in Nunavut, Canada, was used to assess food and nutrient intake in a cross-sectional sample of adults. Results Participants included 175 women and 36 men with mean (SD) ages of 42.4 (13.2) and 42.1 (15.0) years, respectively. The response rate for those who completed the study was 79% with 208 QFFQs included for analysis. Reported mean daily energy intakes were: men 15 171 kJ (3626 kcal); women 11 593 kJ (2771 kcal). Dietary inadequacy was expressed as the percentage of participants reporting intakes below the sex- and age-specific estimated average requirements ( EARs). For nutrients without EARs, adequate intakes were used. Energy and sodium intakes exceeded the recommendations. Less than 10% of participants met recommendations for dietary fibre intake. Vitamin E intakes were below EARs for ≥97% of participants, whereas >20% reported inadequate vitamin A, folate and magnesium intakes. Among women, >50% reported inadequate calcium and vitamin D intakes. Non-nutrient-dense foods contributed 30% of energy, 73% of sugars and 22% of fat. Traditional foods contributed 56% of protein and 49% of iron. Conclusions The present study demonstrates a relatively high prevalence of inadequate nutrient intakes among Inuit. The results may be used to monitor the nutrition transition among Inuit, evaluate nutritional interventions, and inform public health policy decision-making. [ABSTRACT FROM AUTHOR]

Background: Arctic populations are at an increased risk of vitamin D inadequacy due to geographic latitude and a nutrition transition. This study aimed to assess the adequacy of dietary vitamin D and calcium among women of child-bearing age in Arctic Canada. Methods: This study collected data from 203 randomly selected women of child-bearing age (19-44 years) in Nunavut and the Northwest Territories of Arctic Canada. Cross-sectional surveys using a validated quantitative food frequency questionnaire were analysed to determine the dietary adequacy of vitamin D and calcium and summarize the top foods contributing to vitamin D and calcium intake among traditional food eaters (TFE) and non-traditional food eaters (NTFE). Results: The response rate was between 69-93% depending on the community sampled. Mean BMIs for both TFE and NTFE were above the normal range. Traditional food eaters had a significantly higher median vitamin D intake compared with non-traditional eaters (TFE = 5.13±5.34 µg/day; NTFE = 3.5±3.22 µg/day, p = 0·004). The majority of women (87%) were below the Estimated Average Requirements (EAR) for vitamin D. Despite adequate median daily calcium intake in both TFE (1299±798 mg/day) and NTFE (992±704 mg/day; p = 0.0005), 27% of the study population fell below the EAR for calcium. Dairy products contributed the most to intake of vitamin D (TFE = 30.7%; NTFE = 39.1%) and calcium (TFE = 25.5%; NTFE = 34.5%). Conclusions: Inadequate dietary vitamin D intake is evident among Inuit and Inuvialuit women of child-bearing age in Arctic Canada. Promotion of nutrient-rich sources of traditional foods, supplementation protocols and/or expanded food fortification should be considered to address this nutrition concern. [ABSTRACT FROM AUTHOR]

Limited data exist regarding nutrient intakes and overall dietary quality in Canadian Arctic populations. This cross-sectional study determined the frequency of consumption of traditional meats (e.g. caribou, polar bear, seal, char and whale) and non-traditional store-bought foods including non-traditional meats (e.g. beef, pork and chicken), grains, dairy, fruits, vegetables and non-nutrient dense foods (NNDFs) (e.g. butter, chocolate, chips, candy and pop) by Inuvialuit adults (175 women, mean age 44 ± 14 years; 55 men, mean age 41 ± 13 years) in three remote communities in the Northwest Territories. Using a validated quantitative food frequency questionnaire, frequency of consumption over a 30-day period was determined for 141 commonly reported foods. Mean consumption of traditional meats (1.6 times/day), fruits (1 time/day) and vegetables (0.6 times/day) was less frequent than that of NNDFs (5.0 times/day). Nutritional intervention strategies are needed to promote more frequent consumption of nutrient-rich foods and less frequent consumption of NNDFs in these Arctic communities. [ABSTRACT FROM AUTHOR]

The article presents information on the defence of battered women, charged for homicide in New Zealand, Australia and Canada. The current legal requirements, relevant defences in different jurisdictions are considered. The legal developments and general trends used for resolving cases related to homicide by battered women are discussed. The need of improvement in the legal response and statutory reform is also discussed.

Background: IMAGe provides information on risks and benefits of medication use during pregnancy and lactation Objective: The aim of this study was to determine the impact of Health Canada warnings on the number of calls received at IMAGe. Methods: We analyzed calls received between January 2003 and March 2008. The impact of the following warning/withdrawal were studied: paroxe tine and risk of cardiac malformations (09/29/2005), selective serotonin reuptake inhibitors (SSRIs) and risk of persistent pulmonary hypertension of the newborn (PPHN) (03/10/2006), and impact of rofecoxib market withdrawal (09/30/ 2004). Interrupted auto-regressive integrated moving average (ARIMA) analyses were used to test the impact of each warning on the number of calls received to IMAGe. Results: 61 505 calls were analyzed. The paroxetine warning had a temporary impact increasing the overall number of calls to IMAGe, and an abrupt permanent effect on the number of calls related to antidepressant exposures. The PPHN warning had no impact but we observed a significant increase in the number of calls following rofecoxib market withdrawal. Conclusion: Health Canada needs to consider the increase in the demand of information to IMAGe following warnings on the risk of medication use during pregnancy. [ABSTRACT FROM AUTHOR]

Background: Inuvialuit in the Canadian Arctic have been experiencing a nutrition transition resulting in a decrease in nutrient-dense food consumption, which may, in part, explain this population’s increasing chronic disease rates. Because the available literature is limited, the present study aimed to document the extent of this transition by examining current dietary patterns and socioeconomic factors affecting food group consumption. Methods: This cross-sectional study was conducted in three Inuvialuit communities in the Northwest Territories between 2007 and 2008. A validated food frequency questionnaire determined intake frequency of fruit and vegetables (FV), traditional foods (TF) and non-nutrient-dense foods (NNDF). Socioeconomic status (SES) was assessed by questions on education, ownership of items in working condition used to create a Material Style of Life (MSL) scale and residents in household employed/on income support. Daily intake frequencies were compared by gender and age group using Wilcoxon rank sum test. SES association with food group intake was determined using logistic regression. Results: The response rate was 65–85%. One hundred and seventy-five participants were female and 55 were male, aged 19–84 years [mean (SD) 44 (14)]. Mean frequencies of FV and TF consumption were 1.6 (1.5) and 1.6 (1.7) times per day, respectively. NNDF were reported 9.2 (3.0) times per day. The highest MSL score (>12) was significantly associated with higher fruit (≥0.7 times per day) and higher TF intake (≥1.1 times per day) compared with the lowest score (≤7). An intermediate MSL score (8–12) was related to higher vegetable consumption (≥0.4 times per day). Conclusions: NNDF were consumed approximately seven times more frequently than TF in the present study, indicating that the dietary transition is well underway amongst Inuvialuit. Participants with higher SES were more likely to consume nutrient-dense foods, suggesting possible cost barriers. [ABSTRACT FROM AUTHOR]

Background: Traditional foods are rich sources of essential nutrients, but Inuvialuit in the Northwest Territories (NWT), Canada, have been undergoing a nutrition transition, characterised by an increased consumption of non-nutrient-dense foods. The present study aimed to characterise energy, nutrient and food intakes amongst adult Inuvialuit. Methods: The study collected up to three 24-h dietary recalls on nonconsecutive days for each participant in spring/summer of 2008 in one remote community in the NWT. Recall data were analysed for energy and nutrient intake, dietary adequacy, most commonly reported foods, and food contributors to energy and nutrients. Results: Participants included 14 men and 50 women (response rate 79%). Median daily energy intake was 9.4 (interquartile range = 5.7) MJ for men and 8.3 (3.6) MJ for women. The majority of adult Inuvialuit did not meet the recommendation for vitamins A [median intake = 344.7 (246.3) μg-RAE in men, 248.9 (213.8) μg-RAE in women], B6 [0.9 (0.8) mg in men, 1.0 (0.5) mg in women] and E [2.4 (2.1) mg in men, 1.8 (1.0) mg in women], dietary fibre [7.7 (5.7) g in men, 8.7 (4.4) g in women], calcium [779.6 (842.0) mg in men, 610.4 (431.5) mg in women] and total folate [222.6 (57.7) μg in men, 264.6 (127.5) μg in women]. Vitamin D intake was below the recommendation for most women [median intake = 100.0 (119.2) IU]. Traditional foods contributed substantially to protein and iron intake. Juices were the main contributors to energy, carbohydrate and calcium. Conclusions: The present study revealed an inadequate consumption of essential nutrients in an Inuvialuit population. If these nutrient deficiencies continue, this population will face an increased burden of chronic diseases and malnutrition. [ABSTRACT FROM AUTHOR]

Background: Food intake amongst Canadian Inuit is currently in transition with a concurrent increase in diet-related chronic disease. There is a lack of current data on nutrient intake and dietary adequacy in this population. The present study aimed to assess dietary intake and adequacy amongst Inuit adults in a community in Nunavut, Canada. Methods: Random sampling of 130 households in a remote Inuit community in the Kitikmeot region of Nunavut, Canada, was used for this cross-sectional study. Up to three 24-h dietary recalls were collected on nonconsecutive days, capturing weekday and weekend consumption. Data were analysed to estimate energy and nutrient intake, to determine dietary adequacy, and to summarise the most commonly reported foods and the top food contributors to selected nutrients. Results: The response rate was 69%, with 75 Inuit adults participating (mean (standard deviation (SD)) age 44 (SD = 17) years). Mean (SD) daily energy intake was 9.3 (4.4) MJ and 8.7 (3.5) MJ for men and women, respectively. Intakes of dietary fibre, calcium, total folate and vitamins A, D and E were below the Dietary Reference Intakes (Estimated Average Requirements where available) for 60–100% of all men and women. Traditional foods contributed substantially to protein and iron intake, whilst shop-bought foods were primary contributors to total fat, carbohydrate and sugar intake. Conclusions: The present study reports an in-depth assessment of total dietary quality amongst Inuit adults in Nunavut, Canada. The results obtained indicate inadequate intakes of several essential nutrients, as well as a reliance on a nontraditional diet. A nutrition intervention is needed to prevent a continued rise in diet-related chronic disease incidence. [ABSTRACT FROM AUTHOR]

Background: Increasing consumption of non-nutrient-dense foods (NNDF), decreasing consumption of traditional foods (TF) and low consumption of fruit and vegetables (FV) may contribute to increasing chronic disease rates amongst Inuit. The present study aimed to assess the daily frequency and socioeconomic and demographic factors influencing consumption of TF, FV and NNDF amongst Inuit adults in Nunavut, Canada. Methods: Using a cross-sectional study design and random household sampling in three communities in Nunavut, a food frequency questionnaire developed for the population was used to assess frequency of NNDF, TF and FV consumption amongst Inuit adults. Socioeconomic status (SES) was assessed by education level, ownership of items in working condition, and whether or not people in the household were employed or on income support. Mean frequencies of daily consumption were compared across gender and age groups, and associations with socioeconomic indicators were analysed using logistic regression. Results: Two hundred and eleven participants (36 men, 175 women; mean (standard deviation) ages 42.1 (15.0) and 42.2 (13.2) years, respectively; response rate 69–93%) completed the study. Mean frequencies of consumption for NNDF, TF and FV were 6.3, 1.9 and 1.6 times per day, respectively. On average, participants ≤50 years consumed NNDF ( P = 0.003) and FV ( P = 0.01) more frequently and TF ( P = 0.01) less frequently than participants >50 years. Education was positively associated with FV consumption and negatively associated with TF consumption. Households on income support were more likely to consume TF and NNDF. Conclusions: These results support the hypothesis that the nutrition transition taking place amongst Inuit in Nunavut results in elevated consumption of NNDF compared with TF and FV. [ABSTRACT FROM AUTHOR]

In an observational cohort of patients treated with biphosphonates (BP), we observed that poor adherence to these drugs causes important expenditures in terms of avoidable fractures. Of particular interest are the amounts of money wasted by patients who did not take their BPs long enough to obtain a clinical benefit. A large proportion of patients initiated with oral weekly BP therapy stop their treatment within the first year. The objective of this study was to estimate the impact of the poor adherence to BPs in terms of drug wasted and avoidable fractures. The study was done on primary and secondary prevention cohorts from the Régie de l’assurance maladie du Québec (Québec). The concept of the “point of visual divergence” was used to determine the amount of wasted drug. The risk of fracture was estimated using Cox regression models. The hazard ratios of compliant patients (+80%) versus non compliant patients were used to estimate the number of fractures saved. The cost of wasted drugs was $25.87 per patient initiated in the primary prevention cohort and $30.52 in the secondary prevention cohort. If all patients had been compliant, 110 fractures would have been avoided in the primary prevention cohort and 19 fractures in the secondary prevention cohort. The cost of these avoidable fractures per patient initiated on BP therapy was $62.95 in primary prevention cohort and $330.84 in secondary prevention cohort. This study confirms that poor adherence to oral BPs leads to a significant waste of money and avoidable fractures. [ABSTRACT FROM AUTHOR]

Background: Generic substitution may not always save health care costs for antiepileptic drugs (AED).Objective: (1) To examine the economic impacts of generic substitution of lamotrigine in Canada; and (2) to convert observed Canadian costs to a United States (US) setting.Methods: Health claims from Québec's health plan (RAMQ) between 08/2002 and 07/2006 were analyzed. Patients with ≥ 1 epilepsy claim and treated with branded lamotrigine (Lamictal) before generic entry were selected. Health care costs ($/person-year) were compared during periods of branded and generic use of lamotrigine. Two cost-conversion methods were employed; one using purchasing power parities, US/Canada service use ratios, and exchange rate, and another employing Canadian health care utilization and US unit costs.Results: 671 patients were observed during 1650.9 and 291.2 person-years of branded and generic use of lamotrigine, respectively. The generic-use period was associated with an increase in overall costs (2006 constant Canadian dollars) relative to brand use (C$7902 vs. C$6419/person-year; cost ratio (CR) = 1.22; p = 0.05), despite the lower cost of generic lamotrigine. Non-lamotrigine costs were 33% higher in the generic period (p = 0.013). Both conversion methods yielded increases in total projected health care costs excluding lamotrigine (2006 constant US dollars) during the generic period (Method 1: cost difference: US$1758/person-year, CR = 1.33, p = 0.01); Method 2: cost difference: US$2516, CR = 1.39, p = 0.004).Limitations: Study limitations pertain to treatment differences, indicators used for conversion and possible claim inaccuracies.Conclusion: Use of generic lamotrigine in Canada was significantly associated with increased overall medical costs compared to brand use. Projected overall US health care costs would likely increase as well. [ABSTRACT FROM AUTHOR]

In this article, Elizabeth Sheehy argues that Jane Doe v. Metropolitan Toronto Police, wherein the police were held accountable in law for sex discrimination in violation of women's section 15 equality rights under the Charter and for negligence in their investigation of a serial rapist, represents a high point in feminist litigation. She details the feminist knowledge, language, and strategy as well as the individual contributions by Jane Doe herself, her lawyers, her experts, her judges, and even a police officer that together made this groundbreaking legal victory possible. She compares this case to Mooney v. Canada, a case also involving sexism in the policing of male violence against women, where Bonnie Mooney's negligence case was lost on the legal stumbling block of proof of causation. Elizabeth Sheehy suggests that although feminists became involved in this case on appeal and argued that Bonnie Mooney's section 15 rights were infringed, proof of the element of causation could have been facilitated had women's equality been at issue at the trial level. She shows how a feminist analysis of wife battering and femicide could have been used to challenge the assumptions of both police and judges that in turn shaped the ruling on causation and argues that even when lawyers fail to raise section 15 arguments, judges bear a responsibility to interpret the law consistent with the equality guarantee. [ABSTRACT FROM AUTHOR]

Judge-Lynn Ratushny's Self-Defence Review (SDR) of the cases of women convicted of homicide for killing violent male partners presents a significant opportunity for the integration of feminist activism and analysis into the legal understanding of self-defence, the legal system's complicity in male violence against women, and the violence of systemic racism. The author uses the objectives of the Canadian Association of Elizabeth Fry Societies to assess the work of the SDR, concluding that while the SDR accomplished some goals that could not have otherwise been achieved, the SDR was constrained by its political location and by the women's need for confidentiality such that many feminist aspirations were ultimately compromised. [ABSTRACT FROM AUTHOR]

Explains the impact on women as victims/witnesses and as accused persons of the Supreme Court of Canada's decision in R. v. Daviault regarding the defense of intoxication. Overview of the law of the intoxication defense and the impact of the Canadian Charter of Rights and Freedoms; Implications of the Daviault case for women as victims of violent offenders or accused of criminal offenses; Law reform options.

This paper provides an overview of Canadian feminist literature on law, starting with a brief chronology of the development of the scholarship from the time of the Report of the Royal Commission on the Status of Women (1970). The authors break the literature down into the five substantive areas most often written about: criminal law, family law, income redistribution, employment law, and legal education/legal profession. They also examine the major theoretical frameworks that feminists use: liberal (rule equality) feminism; result-equality/integrative feminism; radical feminism; and socialist feminism. In addition to providing an extensive bibliography of existing Canadian feminist legal scholarship, the authors identify significant themes and characteristics of the literature and illustrate how feminist scholarship can be differentiated from non feminist scholarship. The authors conclude that Canadian feminist scholarship on law is gaining rapidly in abundance, depth, and diversity. They also conclude that it is innovative in developing feminist theoretical perspectives that recognize the significance of law and theories of equality that acknowledge women's specificities. Feminists writing on law are urged to utilize theoretical perspectives to a greater degree in order to facilitate the development of short term and long term strategies, and to explain apparent contradictions in the ways in that the legal system affects women. [ABSTRACT FROM AUTHOR]

Examines various consumer issues with respect to biotechnological products in Canada. Background information on biotechnology; Consumer knowledge of and reaction to biotechnology; Factors influencing consumer attitudes; Examination of ways of overcoming marketplace barriers contrasting increased consumer awareness with more traditional legislative mechanisms.

The article discusses the court case R. v. Wholesale Travel Inc., wherein the Supreme Court of Canada upheld the doctrine of strict liability against a Charter challenge but struck down the statutory defence to false advertising. It describes the lower court rulings regarding the constitutionality of absolute and strict liability. Other case law is used in illustrating the ways in which the Wholesale decision emboldens corporations to invoke the Constitution of Canada.

Objective: The prevalence of smoking in Aboriginal Canadians is higher than non-Aboriginal Canadians, a behavior that also tends to alter dietary patterns. Compared with the general Canadian population, maternal smoking rates are almost twice as high. The aim of this study was to compare dietary adequacy of Inuvialuit women of childbearing age comparing smokers versus non-smokers.Research Methods& Procedures: A cross-sectional study, where participants completed a culturally specific quantitative food frequency questionnaire. Non-parametric analysis was used to compare mean nutrient intake, dietary inadequacy and differences in nutrient density among smokers and non-smokers. Multiple logistic regression analyses were performed for key nutrients inadequacy and smoking status. Data was collected from three communities in the Beaufort Delta region of the Northwest Territories, Canada from randomly selected Inuvialuit women of childbearing age (19-44 years).Results: Of 92 participants, 75% reported being smokers. There were no significant differences in age, BMI, marital status, education, number of people in household working and/or number of self employed, and physical activity between smokers and non-smokers. Non-parametric analysis showed no differences in nutrient intake between smokers and non-smokers. Logistic regression however revealed there was a positive association between smoking and inadequacies of vitamin C (OR = 2.91, 95% CI, 1.17-5.25), iron (OR = 3.16, 95% CI, 1.27-5.90), and zinc (OR = 2.78, 95% CI, 1.12-4.94). A high percentage of women (>60%), regardless of smoking status, did not meet the dietary recommendations for fiber, vitamin D, E and potassium.Conclusions: This study provides evidence of inadequate dietary intake among Inuvialuit of childbearing age regardless of smoking behavior. [ABSTRACT FROM AUTHOR]