Search

Purpose: The purpose of this study is to determine if using abdominal circumference percentile (AC) to define fetal growth restriction (FGR) improves ultrasound at ≥36 weeks as a screening test for small for gestational age (SGA).Materials and Methods: All non-anomalous singletons undergoing ultrasound at a single center at ≥36 weeks during 12/2008-5/2014 were included. FGR was defined as (estimated fetal weight) estimated fetal weight (EFW) and/or abdominal circumference (AC) < 10 for gestational age (GA). The primary outcome was SGA (birthweight ≤10th percentile for GA). Data were stratified by maternal race/ethnicity and BMI. Sensitivity, specificity, false-positive rate (FPR), positive- and negative-predictive values (positive-predictive value (PPV), negative-predictive value (NPV)), and areas under the receiver-operating characteristic (ROC) curve (AUC were calculated.Results: There were 1594 ultrasounds. Median (IQR) ultrasound GA was 37.3 (36.6-38.0), days to delivery 10.6 (5.0-18.4), and delivery GA 39.29 (38.6-39.9). EFW <10 had the following characteristics: sensitivity 50.6%, FPR 2.0%, PPV 83.8%, and AUC 0.743. Using AC <10, these were 64.0, 2.9, 81.3, and 0.806, respectively. Using AC or EFW <10, these were 67.5, 3.3, 80.3, and 0.821, respectively; this criterion has the largest AUC (p < .008). This finding persisted when stratified by maternal race/ethnicity and BMI.Conclusions: AC <10 is more sensitive and has a similar PPV compared with EFW <10 for SGA. Using AC <10 or EFW <10 has the best balance of sensitivity and specificity as a screening test and has a low FPR. AC may be a reasonable alternative criterion to EFW for FGR diagnosis. [ABSTRACT FROM AUTHOR]

The source attribution of observed variability of total PM2.5 concentrations over Halifax, Nova Scotia, was investigated between 11 July and 26 August 2011 using measurements of PM2.5 mass and PM2.5 chemical composition (black carbon, organic matter, anions, cations and 33 elements). This was part of the BORTAS-B (quantifying the impact of BOReal forest fires on Tropospheric oxidants using Aircraft and Satellites) experiment, which investigated the atmospheric chemistry and transport of seasonal boreal wildfire emissions over eastern Canada in 2011. The US EPA Positive Matrix Factorization (PMF) receptor model was used to determine the average mass (percentage) source contribution over the 45 days, which was estimated to be as follows: long-range transport (LRT) pollution: 1.75 µg m-3 (47%); LRT pollution marine mixture: 1.0 µg m-3 (27.9%); vehicles: 0.49 µg m-3 (13.2%); fugitive dust: 0.23 µg m-3 (6.3%); ship emissions: 0.13 µg m-3 (3.4%); and refinery: 0.081 µg m-3 (2.2%). The PMF model describes 87% of the observed variability in total PM2.5 mass (bias = 0.17 and RSME = 1.5 µg m-3). The factor identifications are based on chemical markers, and they are supported by air mass back trajectory analysis and local wind direction. Biomass burning plumes, found by other surface and aircraft measurements, were not significant enough to be identified in this analysis. This paper presents the results of the PMF receptor modelling, providing valuable insight into the local and upwind sources impacting surface PM2.5 in Halifax and a vital comparative data set for the other collocated ground-based observations of atmospheric composition made during BORTAS-B. [ABSTRACT FROM AUTHOR]

The source attribution of observed variability of total PM2.5 concentrations over Halifax, Nova Scotia was investigated between 11 July-26 August 2011 using measurements of PM2.5 mass and PM2.5 chemical composition (black carbon, organic matter, anions, cations and 33 elements). This was part of the BORTAS-B (quantifying the impact of BOReal forest fires on Tropospheric oxidants using aircraft and satellites) experiment, which investigated the atmospheric chemistry and transport of seasonal boreal wild fire emissions over eastern Canada in 2011. The US EPA Positive Matrix Factorization (PMF) receptor model was used to determine the average mass (percentage) source contribution over the 45 days, which was estimated to be: Long-Range Transport (LRT) Pollution 1.75 µg m-3 (47 %), LRT Pollution Marine Mixture 1.0 µg m-3 (27.9 %), Vehicles 0.49 µg m-3 (13.2 %), Fugitive Dust 0.23 µg m-3 6.3 %), Ship Emissions 0.13 µg m-3 (3.4 %) and Refinery 0.081 µg m-3 (2.2 %). The PMF model describes 87% of the observed variability in total PM2.5 mass (bias=0.17 and RSME=1.5 µg m-3). The factor identifications are based on chemical markers, and they are supported by air mass back trajectory analysis and local wind direction. Biomass burning plumes, found by other surface and aircraft measurements, were not significant enough to be identified in this analysis. This paper presents the results of the PMF receptor modelling, providing valuable insight into the local and upwind sources impacting surface PM2.5 in Halifax during the BORTAS-B mission. [ABSTRACT FROM AUTHOR]

Overall, the greatest threats to Canadian and global biodiversity are associated with conversions of natural ecosystems to anthropogenic ones, and over-exploitation of biological resources. This circumstance does not, however, trivialize the importance of atmospheric influences. Although scientific understanding of the risks is incomplete, itis nevertheless clear that anthropogenic changes in atmospheric stressors are potentially damaging to biodiversity and other ecological values over medium- and longer-term scales. It is important that greater investments be made in support of longer-term monitoring and research designed to understand the effects of atmospheric and other environmental stressors on the biodiversity and structure and function of Canadian ecosystems. [ABSTRACT FROM AUTHOR]

Although the COVID-19 pandemic has caused the need for the largest mass vaccination campaign ever undertaken to date, African, Caribbean, and Black (ACB) populations have shown both a disproportionately high degree of negative impacts from the pandemic and the lowest willingness to become vaccinated. This scoping review aims to investigate low vaccine uptake in ACB populations relative to public health in high-income countries. A search was conducted in MEDLINE(R) ALL (OvidSP), Embase (OvidSP), CINAHL (EBSCOHost), APA PsycInfo (OvidSP), the Cochrane Central Register of Controlled Trials (OvidSP), the Cochrane Database of Systematic Reviews (OvidSP), the Allied and Complimentary Medicine Database (Ovid SP), and the Web of Science following the Joanna Briggs Institute (JBI) framework for scoping reviews, supplemented by PRISMA-ScR. Theoretical underpinnings of the intersectionality approach were also used to help interpret the complexities of health inequities in the ACB population. The eligibility criteria were based on the population, concept, context (PCC) framework, and publications from 2020-19 July 2022 which discussed vaccine uptake amongst ACB people in high-income countries were included. Analysis was carried out through thematic mapping and produced four main themes: (1) racism and inequities, (2) sentiments and behaviors, (3) knowledge and communication, and (4) engagement and influence. This study has contributed to the identification and definition of the issue of low vaccine uptake in ACB populations and has illustrated the complexity of the problems, as vaccine access is hampered by knowledge, psychological, socioeconomic, and organizational barriers at the individual, organizational, and systemic levels, leading to structural inequities that have manifested as low vaccine uptake., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

The objective of this study was to evaluate the implementation and outcomes of a quality improvement intervention for older adults discharged from hospital to home, that used a patient-centred discharge education tool called the Patient-Centered Discharge Plan (PCAP). We conducted a pre-post evaluation of PCAP implementation among patients 65 years and older and discharged home from an acute medical or geriatric admission at two general hospitals. Two patient cohorts, PRE and POST, were analysed using administrative data ( n = 3,309) and post-discharge structured interviews in a subset of patients ( n = 326). Outcomes were 90-day readmissions and return emergency department (ED) visits, and transition experiences (10-item scale). The PCAP was provided to 20 per cent of 1,683 patients. Transition experience scores increased from PRE to POST at both hospitals (adjusted beta 1.3; 95% CI: 0.8, 1.7), and return ED visits declined in one of the two hospitals (adjusted decline 1.3%; 95% CI: -3.7, 6.2). In conclusion, dedicated resources are needed to support future PCAP implementation.