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Purpose: This study examines the competencies delineated by the Chartered Professional Accountants (CPA) in Canada and explores the gap between what universities provide, represented by the students' confidence in the knowledge acquired--and what the accounting profession in Canada requires and deems necessary. Design/methodology/approach: Using the 44 sub-competencies listed under the main seven competencies set by CPA, a pair of questionnaires were drafted. The first questionnaire asked post-secondary accounting students to rate their perceived confidence in these 44 sub-competencies and received 105 responses. The second questionnaire asked accounting professionals to rate the frequency and degree of use of each sub-competency in their workplace and received 72 responses. The responses to the two questionnaires were used to compare perceived student competencies with industry expectations. Findings: The study suggests an industry-neutral framework that employers and post-secondary institutions (PSIs) can use to determine where knowledge gaps exist between students' qualifications and professionals' requirements. The paper concludes that while there are synergies in many competencies in the accounting field in Canada, there are also areas of discord. Research limitations/implications: The study relies on one accredited PSI. Relying on one case study limits the ability to generalize the findings. Nevertheless, the in-depth nature of the study allows it to shed light on many key issues related to accounting education and the profession in Alberta, Canada. Originality/value: This paper adds to the existing literature by exploring the gap between what students learn and what the profession needs in the accounting field in Canada. Studying Canada adds to the accounting knowledge and draws attention to gaps that could exist in other countries. To the authors' knowledge, this is the first paper to focus on Canada from this perspective. The paper also proposes a curriculum development model that is based on market needs and applicable to all fields of knowledge.

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]

With an increasing volume of health information online, it becomes critical for consumers to improve their search and evaluation skills to retrieve reliable information. The Patient Information Aid (PIA) program is aimed to facilitate information seeking, potentially leading to positive outcomes of online consumer health information and the reduction of negative outcomes. This program consists of an educational website based on findings from a systematic literature review and a qualitative research. By teaching information evaluation skills at-the-point-of-search, the general objective of the PIA website is to improve users' e-health information literacy. Adopting user-centered design methods, we ran two focus groups with users having various literacy levels. We applied usability heuristics and information architecture strategies to design the PIA website, and developed "personas" and task scenarios to inform the wireframing. In this paper, we share our experience and insights on designing an educational information literacy program, which can be useful for information professionals working in all areas.

Online consumer health information (OCHI) is being used at an unprecedented rate, and this trend is expected to continue. Most people have used OCHI, and many may have seen the outcomes of this use (either positive or negative or both). Education and income, as indicators of socioeconomic status, are important contextual factors influencing OCHI outcomes. Much of the literature states that individuals with higher income and education are more likely to access OCHI and with this, experience better health outcomes. On the other hand, our research shows that when OCHI websites offer high-quality information that is accessible to those with low literacy levels, individuals with low socioeconomic status report as many benefits as those with higher income and education. In this commentary, we will describe the context of our research and present our findings. This work is relevant to information professionals (librarians) working with health professionals and the public, those teaching information literacy and health literacy, as well as researchers interested in information literacy and information use.

Addressing inadequacies in the implementation of existing evidence-based approaches into practice, such as injectable opioid agonist treatment (iOAT), is imperative for the management of opioid use disorder. With the expansion of iOAT, stakeholder perspectives are needed to inform program optimization. This study aimed to understand stakeholder and provider perspectives on iOAT care and how it can be improved to better meet service users' needs. Semi-structured interviews (n = 11), email correspondence (n = 2), a focus group (n = 4), and one regional meeting were conducted with iOAT stakeholders to receive feedback on how iOAT can better meet service users' needs. Qualitative analysis employed a thematic and interpretive description approach to identify key themes, presented as a thematic summary. Stakeholder narratives highlight the importance they attribute to client autonomy, individualized care, tensions between providers and the system (policies, governing structures, etc., that establish, facilitate and determine how iOAT is delivered in Canada) as well as power dynamics between providers and service users. IOAT providers and stakeholders surveyed in this study are committed to seeing the needs of service users met but often feel constrained by system-level regulations that influence power dynamics between providers and service users. Findings underline pragmatic suggestions to advance person-centered care as a way to make iOAT accessible and individualized. [ABSTRACT FROM AUTHOR]

River flow monitoring is a critical task for land management, agriculture, fishery, industry, and other concerns. Herein, a robust least squares triple cross-wavelet analysis is proposed to investigate possible relationships between river flow, temperature, and precipitation in the time–frequency domain. The Athabasca River basin (ARB) in Canada is selected as a case study to investigate such relationships. The historical climate and river flow datasets since 1950 for three homogeneous subregions of the ARB were analyzed using a traditional multivariate regression model and the proposed wavelet analysis. The highest Pearson correlation (0.87) was estimated between all the monthly averaged river flow, temperature, and accumulated precipitation for the subregion between Hinton and Athabasca. The highest and lowest correlations between climate and river flow were found to be during the open warm season and cold season, respectively. Particularly, the highest correlations between temperature, precipitation, and river flow were in May (0.78) for Hinton, July (0.54) for Athabasca, and September (0.44) for Fort McMurray. The new wavelet analysis revealed significant coherency between annual cycles of climate and river flow for the three subregions, with the highest of 33.7% for Fort McMurray and the lowest of 4.7% for Hinton with more coherency since 1991. The phase delay analysis showed that annual and semiannual cycles of precipitation generally led the ones in river flow by a few weeks mainly for the upper and middle ARB since 1991. The climate and river flow anomalies were also demonstrated using the baseline period 1961–90, showing a significant increase in temperature and decrease in precipitation since 1991 for all the three subregions. Unlike the multivariate regression, the proposed wavelet method can analyze any hydrometeorological time series in the time–frequency domain without any need for resampling, interpolation, or gap filling. [ABSTRACT FROM AUTHOR]

Insomnia, and Excessive Daytime Sleepiness (EDS), a surrogate marker of Obstructive Sleep Apnea (OSA), are common sleep-related conditions among painful temporomandibular disorders (TMD) patients. OSA was found to increase the risk of chronic painful TMD. This prospective cohort study aims to determine the contribution of insomnia and EDS on acute to chronic painful TMD transition as well as its persistence when chronic pain is defined by: (i) duration (> 3 months), and (ii) dysfunction (Graded Chronic Pain Scale [GCPS II-IV]). From 456 patients recruited between 2015 to 2021, through four locations in Canada, 378 completed the follow-up. A diagnosis was obtained using the Research Diagnostic Criteria or the Diagnostic Criteria for TMD. Insomnia was assessed with the Insomnia Severity Scale (ISS), and OSA was assessed using the Epworth Sleepiness Scale (ESS) which measures EDS, both at baseline. Patients completed the GCPS form at baseline and 3-month follow-up. Borderline associations were found between EDS and the transition or persistence of chronic painful TMD when chronic pain was defined by pain duration (RR adjusted_duration = 1.11, P = 0.07) and dysfunction (RRadjusted_dysfunction =1.40, P = 0.051). Furthermore, EDS was specifically associated with persistent painful TMD when chronic pain was defined by pain duration (RR = 1.13, 95%CI: 1.00-1.26, P = 0.04). Insomnia was not related to the study outcomes (RRadjusted_duration = 0.94, P = 0.27, RRadjusted_dysfunction =1.00, P = 0.99). Results indicate that EDS contrary to insomnia predicted the persistence of chronic painful TMD at a 3-month follow-up. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has led the Canadian provincial governments to take unprecedented measures, including restrictions to healthcare services and pharmacists. Limited evidence exists on changes in prescription trends in Canada during the pandemic period. Objectives: To examine the trend of prescription medications' utilization before and during COVID-19, among incident and prevalent users in the general population. We examined 18 major classes of medications. Methods: We used the administrative health databases from the province of Manitoba, Canada, to conduct a province-wide cross-sectional study. Incident and prevalent use was compared between two time periods; pre-COVID-19: July 2016-March 2020 and during COVID-19: April 2020-March 2021. Interrupted time series analysis using autoregressive models was used to quantify the change in level and slope in quarterly medication use among incident and prevalent users. Results: The quarterly study population ranged from 1,353,485 to 1,411,630 Manitobans. The most common comorbidities were asthma (26.67%), hypertension (20.64%), and diabetes (8.31%). On average, the pandemic restrictions resulted in a 45.55% and 12.17% relative decline in the aggregated utilization of all drugs among both incident and prevalent users, respectively. Subclass analysis showed a 46.83%, 23.05%, and 30.98% relative drop among incident users of antibiotics, cardiovascular drugs and opioids use, respectively. We observed a significant slope increase during COVID-19 among the quarterly cardiovascular, antidiabetics, alpha-1 blockers, and statins incident users compared to the pre-COVID-19 period. We noted a significant decrease in level among NSAIDs, opioids, and antibiotic prevalent users, however, no significant changes in slope were observed. Conclusion: Our findings show a significant impact of COVID-19 measures on prescription trends in the general population. The observed decline among several medication classes was temporary. Further research is needed to monitor prescription trends and better understand if those changes were associated with increased health services and worsened outcomes. [ABSTRACT FROM AUTHOR]

Background: Seasonal respiratory viral infections are associated with exacerbations and morbidity among patients with COPD. The real‐world clinical outcomes associated with seasonal viral infections are less well established among hospitalized patients. Research Question: To estimate the association between seasonal respiratory viral infections, 30‐day mortality, and intensive care unit (ICU) admission among hospitalized COPD patients. Study Design and Methods: We conducted an analysis of a national prospective multicenter cohort of COPD patients hospitalized with acute respiratory illness during winter seasons (2011–2015) in Canada. Nasopharyngeal swabs were performed on all patients at the onset of hospital admission for diagnosis of viral infection. Primary outcomes were 30‐day mortality and ICU admissions. Secondary outcomes included invasive/non‐invasive ventilation use. Results: Among 3931 hospitalized patients with COPD, 28.5% (1122/3931) were diagnosed with seasonal respiratory viral infection. Viral infection was associated with increased admission to ICU (OR 1.5, 95% CI 1.2–1.9) and need for mechanical ventilation (OR 1.9, 95% CI 1.4–2.5), but was not associated with mortality (OR 1.1, 95% CI 0.8–1.4). Patients with respiratory syncytial virus (RSV) were equally likely to require ICU admission (OR 1.09, 95% CI 0.67–1.78), and more likely to need non‐invasive ventilation (OR 3.1; 95% CI 1.8–5.1) compared to patients with influenza. Interpretation: Our results suggest COPD patients requiring hospitalization for respiratory symptoms should routinely receive viral testing at admission, especially for RSV and influenza, to inform prognosis, clinical management, and infection control practices during winter seasons. Patients with COPD will be an important target population for newly developed RSV therapeutics. Clinical Trial Registration: ClinicalTrials.gov ID: NCT01517191. [ABSTRACT FROM AUTHOR]

Changes in water resources within basins can significantly impact ecosystems, agriculture, and biodiversity, among others. Basins in northern Canada have a cold climate, and the recent changes in climate can have a profound impact on water resources in these basins. Therefore, it is crucial to study long term trends in water flow as well as their influential factors, such as temperature and precipitation. This study focused on analyzing long term trends in water flow across the Athabasca River Basin (ARB) and Peace River Basin (PRB). Long term trends in temperature and precipitation within these basins were also studied. Water flow data from 18 hydrometric stations provided by Water Survey of Canada were analyzed using the Mann-Kendall test and Sen's slope. In addition, hybrid climate data provided by Alberta Environment and Parks at approximately 10 km spatial resolution were analyzed for the ARB and its surrounding regions during 1950–2019. Trend analysis was performed on the water flow data on monthly, seasonal, and annual scales, and the results were cross-checked with trends in temperature and precipitation and land use and land cover data. The overall temperature across the basins has been increasing since 1950, while precipitation showed an insignificant decrease during this period. Winter water flow in the upper ARB has been slowly and steadily increasing since 1956 because of the rising temperatures and the subsequent slow melting of snowpacks/glaciers. The warm season flows in the middle and lower subregions declined up to 1981, then started to show an increasing trend. The middle and lower ARB exhibited a rapid increase in warm-season water flow since 2015. A similar trend change was also observed in the PRB. The gradual increase in water flow observed in the recent decades may continue by the mid-century, which is beneficial for agriculture, forestry, fishery, and industry. However, climate and land cover changes may alter the trend of water flow in the future; therefore, it is important to have a proper management plan for water usage in the next decades. [ABSTRACT FROM AUTHOR]

Use of online health information is positively associated with citizen knowledge, empowerment, self-care, health outcomes, and quality of life. However, little is known about how mothers with incomes below the poverty threshold and with education levels of high school or less use and interact with the Internet as a key source of lay knowledge and skills for infant care and childrearing. Our objective in this study was to understand mothers' perceptions of their experience in using online information for these purposes. To obtain a rich and nuanced understanding of their experience, we used a qualitative study approach based on 40 individual semi-structured interviews with mothers. Adopting Freidson's concept of "lay referral system" to grasp mothers' experience with online parenting information, we found that they relied on this information source extensively. Our findings showed that Internet-based information and online interactions were part of their lay referral system and modified to some extent how they interacted with their lay consultants (family and friends). Three major themes emerged in relation to how the Internet functioned as a component of the mothers' lay referral systems: (1) strategic use of the Internet for better parenting; (2) critical stance towards the Internet; and (3) strengthening of autonomy, skills, and self-confidence. Mothers with spouses and an active social network were more likely to use online information to complement information obtained from their entourage or from professionals than were mothers with a less active social network or who were more socially isolated. Highlights: Mothers with incomes below the poverty threshold and with low educational attainment made extensive use of Internet-based information for child care and parenting. Mothers applied critical judgment to use online information strategically. For some mothers, information obtained or shared on the Internet replace conversations with family members or professionals. [ABSTRACT FROM AUTHOR]

Purpose: In this study, the authors explore the boundaryless careers of faculty and adopt the intelligent career framework to examine success factors for academic careers. Design/methodology/approach: The authors conducted a field study of 36 researchers in the management information systems field from 22 institutions in the US, Australia and Canada. The authors selected the participants representing four strata of researchers: luminaries (high expertise status and high citizenship behavior), experts (high expertise status but low leadership roles), statesmen (low expertise status but high leadership) and journeymen (low expertise status and low leadership). Data regarding the participants' experience of social relationships and social resources as well as entrepreneurial motivations were collected and analyzed. Findings: Results show that faculty who "know-why", "know-how", and "know with whom" possess socially valued resources and are successful in advancing their careers. They establish high social status and exercise power within their networks to mobilize resources that promote their careers. On the other hand, faculty who fall short of these competencies impose social closure on themselves and do not strive to exploit resources available through their contacts. The study advances a number of theoretical propositions to guide future research on boundaryless intelligent careers. Social implications: Social relationships and social resources do not substitute individual competence, leadership and entrepreneurial motivations; individuals need to develop competence valued by their professional communities and exploit available opportunities and assume leadership roles in order to effectively establish instrumental relationships and mobilize social resources to achieve career advancement. Originality/value: In this study, we attempt to extend career development research through an examination of the bidirectional relationship between know-why, know-how and know-who in academia. [ABSTRACT FROM AUTHOR]

Background. Statins and exercise are recommended for managing hypercholesterolemia. However, statin types may vary in their interaction with exercise. We compared rosuvastatin versus atorvastatin combination with exercise on lipid profile and functional capacity. Methods. A retrospective cohort study using data from a 12-week cardiovascular rehabilitation program between 2014 and 2016. Statin use was determined through prescriptions, and the average exercise minutes/week were computed from exercise logs. The outcomes were changes in total cholesterol, low- and high-density lipoproteins (LDL and HDL), triglycerides, and functional capacity (6-minute walk test (6MWT)). Directed acyclic graphs were used to identify potential confounders, accounted for using multiple linear regression modeling. Results. The cohort included 282 patients from 106 atorvastatin and 176 rosuvastatin users. The average exercise minutes/week was 109.4 ± 66.1 among atorvastatin and 106.7 ± 49.1 among rosuvastatin users. Interaction models suggested that a higher number of exercise minutes/week were more favorable among atorvastatin users on total cholesterol and LDL (0.004, 95% CI: 0.001, 0.008 and 0.004, 95% CI: 0.001, 0.007, respectively) but did not reach significance for HDL and triglycerides. Rosuvastatin use was associated with greater increases in 6MWT; however, we observed no between-group differences in interaction estimates by the type of statin used. Conclusion. Rosuvastatin use could blunt the beneficial effect of exercise on LDL and total cholesterol compared to atorvastatin. No significant differences were observed in triglycerides, HDL, and functional capacity levels. Additional studies are warranted with randomized treatments and larger samples. Healthcare providers should continue prescribing statins alongside recommending exercise modalities, with a careful follow-up for rosuvastatin users. [ABSTRACT FROM AUTHOR]

Aims The aim of our study was to establish normal ranges for left atrial (LA) strain and strain rate using cardiac magnetic resonance feature tracking (CMR-FT), LA sphericity index, and to compare LA strain using CMR-FT with 2D-speckle tracking echocardiography (STE) in a healthy population. Methods and results A total of 112 volunteers (45 male, 67 female) had adequate tracking for analysis on CMR-FT (Circle Cardiovascular Imaging, Calgary, Canada). The median age was 42 years (range 19–79 years, interquartile range 30–53 years). LA reservoir, conduit, booster strain, strain rate using CMR-FT, and sphericity index were evaluated. Of the 112 volunteers, 91 patients had adequate tracking on 2D-STE using three commonly applied zero-baseline time reference methods: R-R gating, P-P gating, and volume gating (defining end-systole at the LA maximum and end-diastole at the LA minimum). The LA strain, strain rate using CMR-FT, and sphericity index were reported and comparable between both genders (P > 0.05 for all). The LA booster function including strain and strain rate increased significantly with age (P < 0.001 for all), while the LA conduit function gradually decreased. In comparison with STE, the LA reservoir strain was comparable between CMR and volume-gating methods (38.48 ± 9.31 vs. 36.77 ± 6.46; P = 0.13) but not with R-R and P-P gating methods (P < 0.001 for all). LA strain, strain rate, and sphericity index using CMR-FT had good intraobserver and interobserver reproducibility. Conclusion LA strain, strain rate using CMR-FT, and sphericity index can be quickly assessed with good intraobserver and interobserver reproducibility. [ABSTRACT FROM AUTHOR]

Purpose Tamsulosin is associated with intraoperative floppy iris syndrome (IFIS), an important risk factor for complications during cataract surgery. Significant efforts have been made to increase awareness of the risks associated with tamsulosin, and educational initiatives have fostered the uptake of technical adjustments to decrease adverse event rates among tamsulosin-exposed patients. However, the effectiveness of these efforts at the population level has not been studied. Design Population-based study to evaluate cataract surgical adverse event rates over time among patients exposed to tamsulosin and those not exposed to this drug. Participants All male patients 66 years of age and older undergoing cataract surgery in Ontario, Canada, between January 1, 2003, and December 31, 2013, were included in the study. Methods Linked healthcare databases were used to study the evolution in the risk of cataract surgical adverse events over time among tamsulosin-exposed and non–tamsulosin-exposed patients adjusting for patient-, surgeon-, and institution-level covariates. The study timeframe incorporated periods before and after the first reports of tamsulosin-associated IFIS. Main Outcome Measures Four important cataract surgical adverse events were evaluated: posterior capsule rupture, dropped lens fragments, retinal detachment, and suspected endophthalmitis. Results Among patients exposed to tamsulosin, the risk of surgical adverse events decreased over time (odds ratio, 0.95 per year; 95% confidence interval, 0.91–0.99 per year). This trend was observed across patient age strata. Among patients not recently exposed to tamsulosin, the risk of surgical adverse events also decreased over time (odds ratio, 0.96 per year; 95% confidence interval, 0.95–0.98 per year). Conclusions The risk of cataract surgical complications among both tamsulosin-exposed and non–tamsulosin-exposed patients declined between 2003 and 2013. Tamsulosin remains an important risk factor for cataract surgical adverse events, and ongoing efforts will be needed to develop and disseminate surgical approaches that mitigate the risks posed by tamsulosin. [ABSTRACT FROM AUTHOR]

What are the pedagogical encounters through which we learn about hierarchies of citizenship and the positions to which we belong in a nation? In this article, we seek to answer this question by examining the ways Muslim and non-Muslim bodies are spatially related to the settler nation-state of Canada, to reveal how outsider subjectivities are constructed and maintained. We articulate the ways spatiality and subjectivity are intertwined with how normative and non-normative citizenship is learned. This relationship is examined through the events of the Parliament Hill shooting in Ottawa in 2014, and the subsequent state funeral held in the city where the authors live. We argue that these events were explicitly pedagogical and demonstrate the ways spatial subjectivities are produced along the racial lines of the nation. We trace how spatiality and subjectivity are interwoven in conceptions of Canadian citizenship, how these relationships prioritize the maintenance of a normative white settler citizenship identity, and we highlight this process in the pedagogical nature of the War Memorial and the subjectivity it calls forth. We define what we see as pedagogies of citizenship and analyse the subsequent state funeral and procession through our own lived experiences of the funeral's spatial imperative of subjectivity. We take up how the funeral as pedagogy asserted explicit Anglo-colonial power and its necessary constructs of embodied emplacement and settler futurity. Throughout, we consider how Anglo-dominance rests on multiple oppressions. [ABSTRACT FROM PUBLISHER]

BACKGROUND: Polybrominated diphenyl ethers (PBDEs) are flame retardants found in North American household products during the past four decades. These chemicals leach out in dust as products age, exposing individuals daily through inhalation and ingestion. Animal studies suggest that PBDEs disrupt sex hormones and adversely affect development of the reproductive system. OBJECTIVES: In the present study, we examined whether there is a link between maternal hair PBDE concentrations and the risk of cryptorchidism (undescended testes) in male infants; testis descent is known to be dependent on androgens. METHODS: Full-term male infants were recruited through clinics in Montreal, Toronto, and London, Canada. Boys with cryptorchidism at 3-18 months of age (n=137) were identified by pediatric urologists and surgeons; similar-aged controls (n=158) had no genitourinary abnormalities as assessed by pediatricians. Eight BDE congeners (BDE-28, -47, -99, -100, -153, -154, -183, -209) were measured by GC-MS (gas chromatography-mass spectrometry) in maternal hair samples collected at the time of recruitment. RESULTS: The ∑PBDE geometric mean for maternal hair was 45.35 pg/mg for controls and 50.27 pg/mg for cases; the concentrations of three BDEs (BDE-99, -100, and -154) were significantly higher in cases than controls in unadjusted models. In adjusted models, every 10-fold increase in the concentration of maternal hair BDE-99 [OR=2.53 (95% CI: 1.29, 4.95)] or BDE-100 [OR=2.45 (95% CI: 1.31, 4.56)] was associated with more than a doubling in the risk of cryptorchidism. BDE-154 [OR=1.88 (95% CI: 1.08, 3.28)] was also significant. CONCLUSIONS: Our results suggest that maternal exposure to BDE-99, -100, and -154 may be associated with abnormal migration of testes in the male fetus. This may be due to the anti-androgenic properties of the PBDEs. [ABSTRACT FROM AUTHOR]

Copyright of Paediatrics & Child Health (1205-7088) is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Stratification is one of the fundamental physical processes that may have a significant impact on water quality in stormwater wet ponds. However, the role of thermal and chemical stratifications in governing water quality processes is not fully understood. This is in part due to the lack of detailed field measurements of sufficient governing parameters over time periods that span a wide range of environmental conditions. To fill this gap, a comprehensive 2-year field program was undertaken in two stormwater wet ponds in Calgary, Alberta, Canada, during the ice-free season from May to November in 2018 and 2019. At different locations in each pond, thermal and chemical stratifications were observed, thermocline depth and strength were determined, and continuous water velocity profiles were measured. In addition, the effect of local weather conditions on stratification, thermocline, and hydrodynamics was investigated. The results showed that the ponds had vertical water temperature differences >1 °C for 99% of the time, May to August. In addition, salt-laden inflows from road deicing salts led to strong chemical stratification up to five times stronger in the sediment forebays than in the main cells in spring. Wind-induced surface currents were insignificant, scaling at 0.3% of the wind speed with negligible impact on vertical mixing in the ponds. Our results demonstrate that the ponds' strong and prolonged stratification decreased pollutant retention capacity and caused the water at depth to become anoxic, degrading the quality of the water discharged downstream. Hence, additional consideration of stratification is required when designing new stormwater ponds. • Stratification in ponds extended for up to 96% of the time, May–September. • Stratification caused anoxic conditions for up to 88% of the study period. • Strong densimetric stratification created dead zones. • Wind-induced surface currents scaled at 0.3% of the wind speed. • The impact of wind on vertical mixing in the 3 m deep ponds was negligible. [ABSTRACT FROM AUTHOR]

BACKGROUND: Surgeons' satisfaction levels may affect patient care and the stability of the surgical workforce. METHODS: A detailed Internet-based satisfaction survey was administered to paediatric surgeons in Canada in 2005 and 2012. Satisfaction was rated 1 (most) to 5 (least), in five areas: quality of life, financial compensation, work environment, academics and patient care. RESULTS: Responses were received from 21 surgeons in 2005 and 61 in 2012, representing 43% and 98% of practicing paediatric surgeons in Canada, respectively. Satisfaction levels were generally moderate to high in most areas during both years. In academics, surgeons were more satisfied in 2012 with the amount of teaching they provided (1.8 versus 2.2; P=0.02), and clinical research they performed (2.5 versus 3.0; P=0.04). In patient care, there was higher satisfaction with the ability to provide elective services without impediment (2.5 versus 3.0; P=0.02). Over the seven-year period, surgeons increasingly preferred the Canadian health care system over that of the United States (1.7 versus 2.2; P=0.02). In the 2012 survey, no differences in levels of satisfaction were found between male and female surgeons. CONCLUSIONS: During the recent seven-year period, satisfaction levels of paediatric surgeons in Canada have been stable with regard to quality of life, compensation and work environment, and improving in areas of academics and patient care. Male and female surgeons are equally satisfied. The Canadian health care system is preferred over that of the United States. [ABSTRACT FROM AUTHOR]

Abstract: Background: Multiple treatment options currently exist for the correction of pectus carinatum (PC). We performed a survey of Canadian pediatric surgeons to define current practices. Methods: All active members of Canadian Association of Paediatric Surgeons were surveyed online during winter 2011 through the Canadian Association of Paediatric Surgeons Web site. The survey assessed multiple facets of PC evaluation and treatment, with particular emphasis on the practice of bracing. Results: Forty-five active members (85%) responded, of whom 32 (71%) currently treat PC. Fifty-three percent of practices are low volume (<5 patients annually). In terms of preferred or most used treatment modality, 69% of surgeons used bracing, 25% performed Ravitch repairs, 3% performed open minimal cartilage resections, and 3% performed reverse Nuss procedures. Of 23 surgeons (72%) who used bracing, 83% used it for most or the patients. Fifty-seven percent judged their bracing results as good or excellent, and 74% felt that most or all patients braced were satisfied; 80% and 88% agreed or strongly agreed that bracing was generally preferable to surgical repair and that bracing should be first line treatment, respectively. Conclusions: Bracing is the preferred treatment for PC by most Canadian pediatric surgeons, despite lack of prospective outcome data. This presents an opportunity for a multicenter prospective study. [Copyright &y& Elsevier]

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Immigrants to Canada must pass a set of pedagogical gate-keeping exercises that compel settler socio-spatial relations to allow them to come into the fort of the nation-state as neoliberal multicultural subjects. Bringing together Sunera Thobani's concept of exalting the white subject and Sherene Razack's theorizations on Muslim eviction from Western politics, I argue that those racialized as Muslim are positioned as perpetual immigrants, compelled to exalt whiteness or be evicted. Caught between an unresolved tension of settler spatial relations to nation and Indigenous spatial relations to Land, I examine what decolonial subject positions are available for "Muslims" using the Canadian citizenship study guide and oath as focal points. I foreground an Indigenous analytic and my Arab lived experience to do a contrapuntal reading of the social construction of Canada in the study guide and trace how the relationships to nation espoused in the manual are incommensurable with the relationships to Land fundamental to Indigenous worldviews. Throughout the paper, I draw on the experience of Masuma Khan, who was censured by her university and the public when she advocated that Canada 150 be remembered as Indigenous genocide rather than a celebration of nationhood, to unpack how racialization colonizes and colonization racializes. [ABSTRACT FROM AUTHOR]

Background: Diabetic retinopathy (DR) is one of the leading causes of vision loss and blindness in Canada. Eye examinations play an important role in early detection. However, DR screening by optometrists is not always universally covered by public or private health insurance plans. This study assessed whether expanding public health coverage to include diabetic eye examinations for retinopathy by optometrists is cost-effective from the perspective of the health care system.Methods: We conducted a cost-utility analysis of extended coverage for diabetic eye examinations in Prince Edward Island to include examinations by optometrists, not currently publicly covered. We used a Markov chain to simulate disease burden based on eye examination rates and DR progression over a 30-year time horizon. Results were presented as an incremental cost per quality-adjusted life year (QALY) gained. A series of one-way and probabilistic sensitivity analyses were performed.Results: Extending public health coverage to eye examinations by optometrists was associated with higher costs ($9,908,543.32) and improved QALYs (156,862.44), over 30 years, resulting in an incremental cost-effectiveness ratio of $1668.43/QALY gained. Sensitivity analysis showed that the most influential determinants of the results were the cost of optometric screening and selected utility scores. At the commonly used threshold of $50,000/QALY, the probability that the new policy was cost-effective was 99.99%.Conclusions: Extending public health coverage to eye examinations by optometrists is cost-effective based on a commonly used threshold of $50,000/QALY. Findings from this study can inform the decision to expand public-insured optometric services for patients with diabetes. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate trends in glaucoma surgery subspecialization. Design: Population-based analysis of incisional glaucoma surgery and laser trabeculoplasty practice patterns among all ophthalmologists in Ontario, Canada, from 1995 through 2010. Participants: All ophthalmologists in Ontario, Canada, providing universal health care for the provincial population of approximately 12 million. Methods: The province of Ontario provides government-funded universal health care insurance to all citizens through the Ontario Health Insurance Plan (OHIP). Anonymized physician services data were obtained from the OHIP database, which has excellent accuracy for procedure performance. Main Outcome Measures: Proportion of ophthalmologists providing incisional glaucoma surgery and laser trabeculoplasty and the distribution of these surgical and laser procedures among ophthalmologists. Results: Between 1995 and 2010, the median number of ophthalmologists in Ontario was 427 (35.1 per 1 million population), ranging from 417 to 453 (32.9–40.3 per 1 million population). The percentage of ophthalmologists providing incisional glaucoma surgery dropped from 35% in 1995 to 19% in 2010, a 47% decline. Over the same period, the mean number of incisional glaucoma surgeries performed per surgeon doubled, and the percentage of incisional glaucoma operations provided by high-volume surgeons rose from 23% to 59%. The percentage of ophthalmologists performing laser trabeculoplasty was relatively stable (48% in 1995 to 50% in 2010). Conclusions: Over the past 16 years, the proportion of ophthalmologists providing incisional glaucoma surgery has declined significantly. At the same time, the proportion of incisional glaucoma surgery provided by high-volume glaucoma surgeons has more than doubled. These trends will have important implications for stakeholders from policy makers and hospitals to academic departments and residency education programs. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. [Copyright &y& Elsevier]

Educational partnerships between academic health sciences centers in high- and low-resource settings are often formed as attempts to address health care disparities. In this Perspective, the authors describe the Toronto Addis Ababa Academic Collaboration (TAAAC), an educational partnership between the University of Toronto and Addis Ababa University. The TAAAC model was designed to help address an urgent need for increased university faculty to teach in the massive expansion of universities in Ethiopia. As TAAAC has developed and expanded, faculty at both institutions have recognized that the need to understand contextual factors and to have clarity about funding, ownership, expertise, and control are essential elements of these types of collaborative initiatives. In describing the TAAAC model, the authors aim to contribute to wider conversations and deeper theoretical understandings about these issues.