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ABSTRACT This study aimed to evaluate the forage yield, morphology, and nutritional value of three winter cereal wheat (Triticum aestivum cv. BRS Umbu), white oats (Avena sativa cv. URS Guará), and black oats (Avena strigosa cv. Embrapa 139), harvested in two successive cuts, at the vegetative and full vegetative stages, applied or not with fungicide pyraclostrobin. Pyraclostrobin was sprayed two times during the vegetative stage, the first application at the phenological stage V5, and the second, 12 days after the first cut of each forage species. In general, the application of pyraclostrobin resulted in an increase in the participation of leaves in the plant structure, from 72.2% to 86.9% in the second cut; and crude protein increased, and lignin decreased (from 22.75% and 9.89% to 25.60% and 6.30%, respectively) in the first cut and (from 20.82% and 11.73% to 22.28% and 9.20%, respectively) in the second cut. Black and white oats had a higher cumulative biomass production, 3,698 kg ha-1, and 3,277kg ha-1, respectively, and white oats had the lowest content of acid detergent fiber (27.90%) at the second cut.

The convective structure and heat transfer characteristics of evaporating films undergoing cyclical superheating were examined experimentally. Films were evaporated into their own vapor with no non-condensable gases present. Superheat was controlled by modulating the system pressure, with nominal superheat results of approximately 2 Kelvin. Initial film thicknesses were between 3 and 5 mm. A double-pass schlieren system imaged the convective structures, and an ultrasound thickness measurement technique was used to yield dynamic heat flux measurements at the film surface. Time scales based on transient heat transfer phenomena from impulsively superheated films were adopted, and used to characterize the different durations of “on” (pressure dropped) and “off” (pressure restored to baseline). “Convective” and “conductive'' time scales of 11 s, and 1 s respectively were used to classify evaporating films as convective-convective (Case I), convective-conductive (Case II), and conductive-conductive (Case III). For all cases, cyclical modulation of the superheat is seen to have a strong impact on the heat transfer trends. Once convection is established, convective activity can persist even after evaporation is stopped. For Case II, superheat modulation results in complex multi-wavelength behavior, even as late as the point corresponding to quasi-steady transition. For Case III, stopping the evaporation has a negligible effect on the convective structure. An 8% gain in total heat rejection compared to a baseline quasi-steady evaporating film was achieved in Case II experiments.

Background: The species Megalurothrips usitatus is a thrips insect that has been recorded in Asia, Oceania, Australia and recently in America, attacking legume crops. Objective: to report Megalurothrips usitatus as species associated with flowers of common bean plants in Costa Rica. Methodology: the thrips from three growing bean locations were sampled and characterized through light microscopy in Costa Rica. Furthermore, a phylogenetic analysis of the COI gene compared with the databases of the National Center for Biotechnology Information (NCBI) was performed. Results: The species was recorded in three bean growing areas (Sardinal of Guanacaste, Estación Experimental Agrícola Fabio Baudrit Moreno in Alajuela and La Managua in Quepos). Implications: the new report of the insect in flowers of Phaseolus vulgaris implies future monitoring actions and respective integrated management; ignoring thrips populations could cause losses in the bean's regional production. Conclusion: the bean flower thrips is reported for the first time in Costa Rica.

Background: Chronic kidney disease (CKD) is increasing in patients older than 65 years and is related to morbidity, frailty, and dependence. Peritoneal dialysis (PD) has classically been associated with young patients with an active life. Hypothesis: PD should be offered to patients over 65 years. We search for any unfavorable results that may advice not to recommend PD therapy for this group. Objective: To describe PD treatment and outcomes in patients > 65 years, to compare their results with patients < 65 years and to identify areas with room for improvement in a real-life study. Study: Prospective, observational, and multicenter study performed in incident PD patients, from January 2003 until January 2018. Results: We included 2,435 PD patients, 31.9% were older than 65 years; there was a difference of 25 years between both groups. Median follow up was 2.1 years. Older than 65 years group had more comorbidity: Diabetes (29.5% vs 17.2%; p < 0.001), previous CV events 34.5% vs 14.0%; p < 0.001), Charlson index (3.8 vs 3.0; p < 0.001).We did not find differences in efficacy and PD adequacy objectives fulfillment, anaemia management or blood pressure during follow-up. Peritonitis rate was higher in older 65 years group (0.65 vs 0.45 episodes/patient/year; p < 0.001), but there was not differences in germs, admission rate and follow up. Mortality was higher in older 65 years group (28.4% vs 9.4%) as expected. PD permanence probability was similar (2.1 years). The main cause of PD withdrawal was transplant in group < 65 years (48.3%) and transfer to HD in group > 65 years. The main reason was caregiver or patient fatigue (20.2%), and not technique failure (7.3%).Multivariate Cox regression analysis showed a relation (HR [95%CI]) between mortality and age > 65 years 2.4 [1.9-3.0]; DM 1.6 [1.3-2.1]; CV events 2.1 [1.7-2.7]. Multivariate Cox regression analysis identify a relation between technique failure and age > 65 years 1.5 [1.3-1.9]; DM 1.6 [1.3-1.9] and previous transplant 1.5 [1.2-2.0]. Conclusion: Patients older than 65 years fulfilled PD adequacy criteria during the follow up. We believe PD is a valid option for patients older 65 years. It is necessary to try to prevent infections and patient/caregiver fatigue, to avoid HD transfer for reasons not related to technique failure. Resumen: Escenario: La prevalencia de enfermedad renal crónica (ERC) aumenta en población mayor de 65 años y asocia morbilidad, dependencia y fragilidad. La diálisis peritoneal (DP) se ha considerado una técnica de paciente joven y vida active. Hipótesis: La DP puede ser adecuada en pacientes de edad avanzada. Buscamos resultados desfavorables que contravengan esta hipótesis. Objetivo: Describir el tratamiento con DP en mayores de 65 años, evaluar su evolución clínica comparada con los menores de 65 e identificar áreas de mejora asistencial. Estudio: Prospectivo, observacional y multicéntrico en incidentes en DP, seguimiento hasta evento o fin del estudio (ene-2003 a ene-2018). Resultados: Se incluyen 2.435 pacientes; el 31,9% (777) eran mayores de 65 años. El tiempo medio de seguimiento fue de 2,1 años para ambos grupos. El grupo de edad avanzada era 25 años mayor, con más comorbilidad: diabetes (29,5% vs. 17,2%; p < 0,001), evento CV previo (34,5% vs. 14,0%; p < 0,001) e índice de Charlson sin edad (3,8 vs. 3,0; p < 0,001). No encontramos diferencias en cumplimiento de objetivos intermedios de eficacia de DP, control de anemia o hipertensión durante el seguimiento. La tasa de peritonitis fue mayor en la cohorte mayor de 65 años (0,65 vs. 0,45 episodios/paciente-año; p < 0,001), aunque la distribución gérmenes, tasa de ingreso y evolución final fue similar en ambos grupos. Lógicamente, registramos mayor mortalidad en el grupo mayor de 65 años (28,4% vs. 9,4%), aunque el tiempo de permanencia en DP fue similar (2,1 años). La principal causa de salida fue el trasplante renal en jóvenes (48,3%), mientras que en los pacientes de mayor edad fue el paso a hemodiálisis, principalmente por cansancio de cuidador/autocuidado (20,2%) y no por fallo de la técnica (7,3%). El análisis multivariante por regresión de Cox identifica los factores de riesgo para mortalidad con los siguientes HR [IC 95%]: Edad > 65: 2,4 [1,9-3,0]; DM: 1,6 [1,3–2,1]; CV: 2,1 [1,7–2,7]. Y para el evento fallo de la técnica y paso a HD: Edad > 65: 1,5 [1,3–1,9]; DM: 1,6 [1,3–1,9]; trasplante renal previo: 1,5 [1,2-2,0]. Conclusión: Los pacientes mayores de 65 años cumplen los objetivos de calidad intermedios y se mantienen en DP el tiempo suficiente como para seguir ofertando esta técnica. Es necesario mejorar la prevención de infecciones y del agotamiento del paciente/cuidador con medidas de soporte para evitar la transferencia a HD por causas ajenas a las complicaciones de la técnica.

Resumen: Escenario: La prevalencia de enfermedad renal crónica (ERC) aumenta en población mayor de 65 años y asocia morbilidad, dependencia y fragilidad. La diálisis peritoneal (DP) se ha considerado una técnica de paciente joven y vida activa. Hipótesis: La DP puede ser adecuada en pacientes de edad avanzada. Buscamos resultados desfavorables que contravengan esta hipótesis. Objetivo: Describir el tratamiento con DP en mayores de 65 años, evaluar su evolución clínica comparada con los menores de 65 e identificar áreas de mejora asistencial. Estudio: Prospectivo, observacional y multicéntrico en incidentes en DP, seguimiento hasta evento o fin del estudio (ene-2003 a ene-2018). Resultados: Se incluyen 2.435 pacientes; el 31,9% (777) eran mayores de 65 años. El tiempo medio de seguimiento fue de 2,1 años para ambos grupos. El grupo de edad avanzada era 25 años mayor, con más comorbilidad: diabetes (29,5% vs. 17,2%; p 65: 2,4 [1,9-3,0]; DM: 1,6 [1,3-2,1]; CV: 2,1 [1,7-2,7]. Y para el evento fallo de la técnica y paso a HD: Edad > 65: 1,5 [1,3-1,9]; DM: 1,6 [1,3-1,9]; trasplante renal previo: 1,5 [1,2-2,0]. Conclusión: Los pacientes mayores de 65 años cumplen los objetivos de calidad intermedios y se mantienen en DP el tiempo suficiente como para seguir ofertando esta técnica. Es necesario mejorar la prevención de infecciones y del agotamiento del paciente/cuidador con medidas de soporte para evitar la transferencia a HD por causas ajenas a las complicaciones de la técnica. Abstract: Background: Chronic kidney disease (CKD) is increasing in patients older than 65 years and is related to morbidity, frailty, and dependence. Peritoneal dialysis (PD) has classically been associated with young patients with an active life. Hypothesis: PD should be offered to patients over 65 years. We search for any unfavorable results that may advice not to recommend PD therapy for this group. Objective: To describe PD treatment and outcomes in patients > 65 years, to compare their results with patients 65 years. The main reason was caregiver or patient fatigue (20.2%), and not technique failure (7.3%).Multivariate Cox regression analysis showed a relation (HR [95%CI]) between mortality and age > 65 years 2.4 [1.9-3.0]; DM 1.6 [1.3-2.1]; CV events 2.1 [1.7-2.7]. Multivariate Cox regression analysis identify a relation between technique failure and age > 65 years 1.5 [1.3-1.9]; DM 1.6 [1.3-1.9] and previous transplant 1.5 [1.2-2.0]. Conclusion: Patients older than 65 years fulfilled PD adequacy criteria during the follow up. We believe PD is a valid option for patients older 65 years. It is necessary to try to prevent infections and patient/caregiver fatigue, to avoid HD transfer for reasons not related to technique failure.

Resumen: Introducción: Las placas en banda de tensión (PBT) son utilizadas con frecuencia en cirugías de crecimiento guiado (CG). Recientemente, ha ganado popularidad el concepto de retirar solo el tornillo metafisario para detener el efecto de modulación del crecimiento, en lugar de retirar completamente el implante. Si bien esta estrategia tendría ciertas ventajas potenciales, se desconocen los riesgos asociados. El objetivo de este trabajo es reportar la experiencia de tres instituciones con esta estrategia. Métodos: Se recopiló una base de datos con la información demográfica de todos los pacientes tratados mediante CG entre enero de 2014 y enero de 2019 en tres centros. Se identificaron los casos en los que se realizó solo el retiro del tornillo metafisario. Se revisaron los registros para analizar las indicaciones, datos demográficos, características del procedimiento, complicaciones y necesidad de procedimientos adicionales de estos casos. Resultados: Se evaluaron 28 retiros parciales, realizados en 10 pacientes (todos masculinos). La cirugía inicial fue indicada en seis casos por deformidad angular y en cuatro casos por discrepancia de longitud. La edad promedio al momento de la cirugía fue de 9,5 ± 2,9 años (rango de cuatro a 13 años). Se llevaron a cabo tres procedimientos en el fémur distal y tres en tibia proximal, dos en tibia distal y 20 en ambos segmentos. El seguimiento promedio fue de 23,3 ± 11 meses (rango de 12 a 52 meses). El 25% (7/28 PBT) requirieron re-colocación del tornillo metafisario por recurrencia del diagnóstico inicial. Dos pacientes presentaron complicaciones por el procedimiento: irritación partes blandas (n = 1) y deformidad angular (n = 1). Ambos pacientes requirieron de una cirugía no programada. Discusión: El retiro aislado del tornillo metafisario en cirugía de crecimiento guiado podría favorecer la presentación de complicaciones. Los beneficios de esta estrategia deben considerarse frente a los posibles efectos no deseados generados por la aplicación de la misma. Diseño del estudio: Estudio terapéutico (Nivel de evidencia IV). Abstract: Background: Tension band plates (TPBs) are frequently used in guided growth (CG) surgeries. Recently, the concept of removing the metaphyseal screw only to stop the growth modulating effect rather than completely removing the implant, has gained popularity. Although this strategy would have certain potential advantages, the associated risks are unknown. The aim of this study is to report the experience of three institutions with this strategy. Methods: A database was compiled with the demographic information of patients treated by guided growth using TBPs between January 2014 and January 2019 at three institutions. The cases where only the metaphyseal screw was removed were identified. The records were reviewed to analyze the indications, demographic data, characteristics of the procedure, complications and need for additional procedures. Results: We reviewed 28 partial hardware removals, performed in 10 patients (all male). Initial surgery was indicated for angular deformity (N = 6), and leg-length discrepancy (N = 4). The average age at the time of surgery was 9.5 ± 2.9 years (range 4 to 13 years). Three procedures were performed on the distal femur, 3 on the proximal tibia, 2 on the distal tibia, and 20 combined. The average follow-up was 23.3 ± 11 months (range 12 to 52 months). We observed recurrence of deformities in 7 of 28 (22%) limbs that required re-insertion of the metaphyseal screw. Two patients presented complications from the procedure: soft tissue irritation (N = 1) and angular deformity (N = 1). Both patients required unplanned surgery. Discussion: Partial hardware removal in guided growth surgery could favor the presentation of complications. The benefits of this strategy must be considered against the possible undesired effects generated by its application. Study design: Therapeutic study (Level IV).

ABSTRACT The present study aimed to evaluate the agronomic productive and qualitative traits of forage of black oats grown in different stands of plants. The experimental design was a 2 x 2 factorial randomized complete block design consisting of four treatments, two plant stands (175 and 350 plants m2) associated with two successive cutting periods (vegetative and full vegetative) and four replications. The stand of plants did not influence the production of dry biomass; with 175 plants m2, we obtained a compensatory effect by the greater number of tillers m2-1 and/or tiller plant-1. The population stand influenced the chemical parameters, where 175 plants m2 resulted in forage with higher contents of hemicellulose and total digestible nutrients and a lower content of neutral detergent fiber. In the comparison between cuts, the first cut compared to the second presented higher values of crude protein (26.53%). It is recommended that the black oat be cultivated with a population stand of 175 plants m2 for generating an increase in the number of tillers m2-1 and tillers plant-1, in addition to improving the in situ dry matter digestibility of the whole plant, without causing reduction of production of dry biomass per unit area.

In this paper, we present a numerical analysis of a novel comb filter in a double-pass Mach–Zehnder interferometer and a Sagnac interferometer (DP-MZI–SI) configuration and verify it by partial experimental demonstration. The proposed filter comprises an in-line fibre polarisation controller (PC), positioned in one arm of the Mach–Zehnder interferometer, and a polarisation-maintaining fibre (PMF) with a three-component fibre-coil PC in the Sagnac loop. The transmission of the DP-MZI–SI filter was determined using the Jones matrix of each component. This filter allows control of the free spectral range (Δλ) via two alternative modes of operation: by changing the length of the PMF or by increasing the arm length of the filter. In addition, the contrast of the interference fringes and their position can be controlled by adjusting the PCs. The possibility to generate stable patterns with narrow fringe separation was also demonstrated. Simulation results for the DP-MZI–SI filter were validated through experimental measurements. The experimental and numerical results agreed closely in terms of both Δλ and fringe visibility. The proposed DP-MZI–SI filter has characteristics suitable for application to tunable multi-wavelength and switchable fibre laser development, as well as to optical sensors, communication systems, and microwave generation.

Lying behaviour is important for the welfare of the cow. Therefore, reliable electronic devices may improve the management of the cows, and the devices can be used as a tool in research. However, accelerometer-based devices measure acceleration, and an algorithm is therefore necessary for the calculation of lying behaviour. Thus, validation of such devices is imperative prior to use. The objective of this study was to validate the use of the AfiTagII device for measurements of the lying time and frequency of lying bouts of Danish Holstein (DH) and Danish Jersey (DJ) cows in a loose-house system on two different bedding materials. The validation included correlations and linear regression analyses of data collected by the AfiTagII compared with data collected both by direct observations and recordings from a previously validated device (IceQube). In total, 40 cows were observed directly with primiparous and multiparous DJ and DH cows, equally represented. Furthermore, 21 cows were monitored with both AfiTagII and IceQube devices, and data from both devices were collected simultaneously. The devices were attached to the hind leg of the cow. The estimates of the lying time from the AfiTagII device was highly correlated with the recordings from direct observations (r=0.98), and there was a linear relation between these with an intercept equal to 0 and a slope close to 1. The estimates of the lying time from the AfiTagII device was also highly correlated with the IceQube recordings (r=0.94). However, the intercept deviated from 0. The frequency of lying bouts recorded by the AfiTAgII compared to direct observations showed a positive predictive value of 0.96 for lactating cows on the slatted floor and of 0.85 for the dry cows on the deep bedding. The correlations between frequency of lying bouts recorded with the two devices were high (r=0.94), but the intercept deviated from 0. In conclusion, the AfiTagII has a high accuracy for the measurements of lying behaviour in both DH and DJ cows kept on different bedding materials.

Aims: Diet is a major risk factor for type 2 diabetes mellitus. As cofactors necessary for enzyme function of all metabolic pathways, vitamins and minerals have the potential to improve glucose metabolism. We investigated the effects of a nutrient intervention program on glycemic status. Methods: We used a form of natural experiment to compare Pure North program participants (nâ¯=â¯1018) that received vitamin D alone (Vital 1) or vitamin D in combination with other nutrients (Vital 2) during two different time periods. Changes in 25-hydroxyvitamin D [25(OH)D], high-sensitivity C reactive protein (hs-CRP), glycated hemoglobin (HbA1c) and glycemic status were characterized over one and two years. Results: Serum 25(OH)D concentrations increased significantly in both Vital 1 (to 111â¯â¯Â±â¯â¯49â¯nmol/L) and Vital 2 (to 119â¯â¯Â±â¯â¯52â¯nmol/L) over one year. HbA1c and hs-CRP were significantly reduced over time in Vital 2. Higher 25(OH)D levels after one year were associated with larger decreases in HbA1c and hs-CRP in Vital 2. At one year, 8% of Vital 2 and 16% of Vital 1 participants progressed from normoglycemia to prediabetes/diabetes, whereas 44% of Vital 2 and 8% of Vital prediabetes/diabetes subjects regressed to normoglycemia. Conclusions: Vitamin D combined with other nutrients was associated with a reduced risk of progression to diabetes and with an increased rate of reversion to normoglycemia in high risk participants. The results suggest that nutrient supplementation regimes may provide a safe, economical and effective means for lowering diabetes risk. Further examination of this potential via randomized controlled trials is warranted. Keywords: Prediabetes, Type 2 diabetes mellitus, Vitamin D, Nutritional supplements, Multivitamin, Normoglycemia

Colleges and universities in Alberta feel the booms and busts of the oil-driven economy, too. When oil prices are high, and oil exploration and new project construction are booming, post-secondary institutions will often find themselves unable to keep up with the demand for the education and skills-training programs that employers are clamouring for, with fewer spots available for students than there are students eager to fill them. When oil prices drop, and exploration and construction dry up, the schools face the opposite problem: They have too much capacity in the kinds of programs for skills that traditionally serve those sectors directly connected to oil, or closely linked to them, where there is suddenly a glut of available labour. Making matters particularly complicated is that when oil prices fall, there is never any certainty of when they will rebound. If the lower oil prices are short lived like after 2009, colleges and universities have needed only to be patient and ride out shortterm disruptions, without the need to restructure their program offerings. However, that was not the case after 1985, where oil prices stagnated for an extended period of time. Now, some observers project that the decline in oil prices that began in 2014, with prices yet to fully recover, could last even longer, perhaps with oil becoming the “new coal” and remaining in glut indefinitely. Not knowing whether oil prices will rebound sooner, later, or never puts Alberta’s post-secondary institutions in a tricky situation. Their programs providing skilled workers to the province’s oil-based economy are longstanding and well-respected and the prospect of shrinking them or dismantling them, and shifting a school’s focus to different programming priorities, should not be taken lightly as it could be very expensive to reverse if oil prices do indeed end up rebounding. But if they do not, they will nevertheless face pressure to do so, anyway, due to the considerable resources being tied up by programs that are not in high demand. If post-secondary administrators and governors cannot know when oil prices will rebound, if ever, they are even less able to predict what sectors Alberta’s future economy will shift toward as it diversifies away from its energy export reliance. Whatever decision is made, to stay the course or shift to exploit expected opportunities, university and college leaders are taking risk where the consequences will be borne across the institutions’ students and faculty and the Alberta taxpayer. In that light there is a larger, existential question that must be addressed when considering Alberta post-secondary education institutions and how they respond to the slumping energy sector. What is the mission of PSE institutions in the Alberta economy? Are they instruments of economic adjustment, providing education and skills training that allow Albertans to be mobile across jobs, employers, industries and regions? Or, are they instruments for fostering economic diversification, where research, education and skills training are oriented toward meeting the needs of a targeted or emerging economic opportunity?

Abstract We discuss the generation of small neutrino masses from d = 7 1-loop diagrams. We first systematically analyze all possible d = 7 1-loop topologies. There is a total of 48 topologies, but only 8 of these can lead to “genuine” d = 7 neutrino masses. Here, we define genuine models to be models in which neither d = 5 nor d = 7 tree-level masses nor ad = 51-loop mass appear, such that the d = 71-loop is the leading order contribution to the neutrino masses. All genuine models can then be organized w.r.t. their particle content. We find there is only one diagram with no representation larger than triplet, while there are 22 diagrams with quadruplets. We briefly discuss three minimal example models of this kind.

Teen violence in dating and peer relationships has huge costs to society in numerous areas including health care, social services, the workforce and the justice system. Physical, psychological, and sexual abuse have long-lasting ramifications for the perpetrators as well as the victims, and for the families involved on both sides of that equation. An effective violence prevention program that is part of a school’s curriculum is beneficial not only for teaching teenagers what is appropriate behaviour in a relationship, but also for helping them break the cycle of violence which may have begun at home with their own maltreatment as children. The Fourth R program is an efficacious violence prevention program that was developed in Ontario and has been implemented in schools throughout Canada and the U.S. Covering relationship dynamics common to dating violence as well as substance abuse, peer violence and unsafe sex, the program can be adapted to different cultures and to same-sex relationships. The program, which gets its name from the traditional 3Rs — reading, ’riting and ’rithmetic — offers schools the opportunity to provide effective programming for teens to reduce the likelihood of them using relationship for violence as they move into adulthood. The federal government has estimated that the societal costs of relationship violence amount to more than $7 billion. These costs can continue to be incurred through the legal and health-care systems as the ripple effects of violence play out over the years, even after a relationship has ended. Other types of violence are also costly to society and not just in terms of dollars, but in young lives diverted into criminal activity. Up to 15 per cent of youth who become involved with the justice system grow into serious adult offenders who develop lengthy criminal careers. Yet, research shows that if prevention programs such as the Fourth R can deter just one 14-year-old high-risk juvenile from a life of crime, up to $5 million can be saved in costs to society. Research involving 1,700 Grade 9 students in 20 schools showed that those who did not take the Fourth R programming had a rate of relationship violence 2.5 times greater than those who did, and that the program had the greatest impact on boys, who are the most frequent perpetrators. There was also a significant reduction in violence towards peers, especially for youth who were at risk to be violent because they had experienced previous child abuse. Students likewise became more aware of violence and its impacts on others, and they gained a greater command of coping strategies. The program’s start-up costs vary depending on the school’s geographical location. This paper shows that the program’s costs per student are small compared to the savings to society in terms of violence avoidance. In a large Ontario school board, costs were down to $5 per student. In the Northwest Territories, smaller class sizes and bigger geographic distances make implementing the program more expensive, but still only $15-33 per student. The authors calculated savings based on costs avoided related to dating and peer violence at $2,101 per student. Violence prevention is an ethical imperative and it must start with teenagers. In an era of fiscal restraint and demand for more financial accountability, the Fourth R has proven to be a pro-active success in terms of saving both public money and young lives from the deleterious effects of violence.

In this paper, we carry out a numerical study on nonlinear and chaotic effects produced by the propagation of hyperbolic secant optical pulse in standard fibre. We use the fourth-order Runge–Kutta in the interaction picture (RK4IP) method to analyse the pulse interaction in the fibre medium, this method was employed due to its potential to reduce the numerical error while simultaneously allow increasing the step size. During the study, the input peak power was varied up hundreds of kW trough 1 km of standard single-mode fibre (SMF-28); as a consequence, it was possible to observe the generation of nonlinear and chaotic effects on the final spectrum. These numerical results show the spectral and temporal evolution of energy in a 3D rendering, here, it was possible to demonstrated break frequencies and fragmentation of packets of energy by changing the pump power. Finally, we show that this analysis can be used in subsequent studies employing complex dynamic pulses (noise-like pulses, NLPs). Keywords: Fibre optics, Nonlinear fibre optics, Optical solitons, Generalized nonlinear Schrödinger equation

Canadians are not saving for the inevitable costs of drugs and long-term care which they will have to pay for out of pocket in their old age, and these costs could potentially be financially devastating for them. Later in life, when out-of-pocket health-care costs mount, those who previously enjoyed the security of a workplace insurance plan to cover such expenses will face a grim financial reality. Many aspects of care for older Canadians aren’t covered by this country’s single-payer health-care system. Besides prescription drugs, these include management of chronic conditions by ancillary health professionals, home care, long-term care, and dental and vision care. Statistics show that in 2012, Canadians’ private spending on health care totaled $60 billion, with private health insurance covering $24.5 billion of that amount. Coverage of health-care costs that don’t fall under Medicare’s purview is at present rather piecemeal. The non-refundable federal Medical Expense Tax Credit covers expenses only after the three-per-cent minimum, or first $2,171, of out-of-pocket costs have been paid by the individual. The Disability Tax Credit is available to those with a certified chronic disability, and these individuals are eligible for further support via the Registered Disability Savings Plan. A Caregiver Tax Credit is also available. The federal government has a golden opportunity to provide an incentive for Canadians to set aside money to pay not only for the often catastrophic medical and drug costs that can come with aging, but also to save so they can afford long-term care, or purchase private health insurance. Too many Canadians, unfortunately, believe that the federal government picks up the tab for long-term care. In fact, provincial subsidies are provided on a means-testing basis, thus leaving many better-off Canadians in the lurch when they can no longer live alone and must make the transition to long-term care. Providing more generous tax treatment of current and future out-of-pocket health costs, including insurance premiums, is an obvious way for the federal government to support Canadians to meet their health care needs and improve their well-being. Two existing vehicles can play an essential part of this plan. The government can change the currently non-refundable Medical Expenses Tax Credit and the refundable Medical Expenses Supplement so that out-ofpocket health-care costs are eligible from the first dollar. This would place no added burden on government if the exemption of employer-provided health benefits from employees’ taxable income were removed. Making an altered METC available to Canadians who pay their out-of-pocket costs from a registered health savings vehicle, which could be created within an RRSP to avoid extra administrative burdens, would provide them with an incentive to save. They could then either self-insure for future out-of-pocket health costs, or purchase private health insurance. A grant component could be added for lower-income families to make such savings incentives more widely diffuse. Treating health benefits as taxable income subject to the modified Medical Expenses Tax Credit would address efficiency and equity issues with the existing tax treatments of health-care costs while extending tax assistance for out-of-pocket costs to more of the population. When the onus for decision making about payments and insurance purchases is placed on consumers, cost containment in health care and quality improvement incentives naturally follow.

This analysis of Pure North S’Energy Foundation’s preventive health services shows that the acute health care cost savings of being pro-active, rather than reactive, and averting chronic disease, are significant, immediate and worth pursuing further. Chronic disease, such as cardiovascular maladies, diabetes, cancer and other long-term illnesses, represents the leading cause of disability and death in Canada. An estimated 25 per cent of expenditures in the public health system go towards treating these frequently avoidable diseases. This health-care cost curve, which sees more money expended on fighting the increase of chronic disease, can be bent, so to speak, through prevention services that offer long-term benefits to people’s health. Preventing disease is not just good for individuals, but for the health system in general, as prevention frees up acute care beds for more timely access by those who need them. The concern for health care decision makers struggling to find dollars to meet current health care needs is that investment in prevention is risky compared spending on medical treatment. It is often expressed that the health cost savings of prevention are too far off in the future and there is a lack of convincing evidence that preventive services and interventions will achieve the health gains expected. Pure North offers participants in its eight-year-old program access to a variety of healthcare practitioners, including doctors, naturopaths, nurses, nurse practitioners and dentists. Participants receive lifestyle counselling and dietary supplements aimed at combating vitamin D insufficiency, obesity, insulin resistance and other problems that can lead to chronic disease. Our study found that participants who stay with the program for two years demonstrate significant reductions in their number of visits to emergency rooms and hospitals. Indeed, after just one year in the program, the number of hospital visits was down 27 per cent and the number of visits for ambulatory care reduced by 14 per cent over a control group matched for age, sex and postal code, who did not participate in the Pure North program. In the second year after joining the program, hospital admissions dropped by 32 per cent for participants aged 55 and over. If these effects could be achieved in the population of Albertans aged 55 to 75, the hospital bed nights freed up per year would be equivalent to adding the acute care bed capacity of the Foothills Medical Centre in Calgary. These figures translate into significant cost differences. The average cost of hospitals, ambulatory care and visits to general practitioners in the year prior to joining Pure North’s program came to $1,320 per individual. Cost reductions in annual health-care utilization among participants ranged from $294 (22 per cent) per person who joined the program to $600 (45 per cent) per person who stayed in the program for at least a year. Two years into the program, a participant could expect to avoid $276 in hospitalization and emergency room costs. The Pure North program is a cost-effective model for preventive health services, resulting in better health and labour productivity for individuals, and considerable savings in public money for the health-care system. Every dollar spent on a participant who stays with the program for at least a year represents a $2.36 benefit in the avoidance of hospitalization and ambulatory care, as well as gains in personal health and productivity. The public health-care system must shift its focus to preventive care if it wants to realize cost savings, efficiency and improved health for Albertans, rather than waiting to treat people until after they become ill with chronic diseases. Pure North offers an important model to help the public system understand how to make that transition to a prevention-oriented mindset.

Early Childhood Caries (ECC) is a serious disease that is about much more than cavities on baby teeth. In Canada, it is a growing public health problem with adverse long-term effects on children's physical, emotional and intellectual well-being. The failure to invest in preventive care has resulted in reactive, rather than proactive, measures against this disease. These measures are expensive and a needless drain on costs in the public health-care system. Children with severe ECC end up in hospital; in fact, in Canada, this disease is the most common reason children undergo day surgery. From 2010 to 2012, one in 100 children under age five required day surgery for ECC, with approximately 19,000 of these surgeries performed each year on children under age six. Canadian hospital costs for ECC day surgery in children aged one to five ranged from $1,271 to $1,963 per child, totalling $21.2 million between 2010 and 2012. Children from low-income families, along with aboriginal, immigrant and refugee children are disproportionately affected by dental disease, with between 50 per cent and 90 per cent of suffering from some form of ECC. This compares to an average of 57 per cent of children affected in the general population. A recent Alberta study indicates that when municipalities cease fluoridating their water supplies, children suffer increased levels of tooth decay. This has reignited the discussion around whether municipalities should add fluoride to the drinking water, or reinstate it in places where the water used to be fluoridated. While fluoridation can be an effective prevention strategy, this study also shows that fluoride alone is not enough. To reduce the costs and developmental consequences associated with severe ECC and improve well-being, oral health policies focused on disease prevention and health promotion are still necessary. This briefing paper provides background on the etiology, risk factors and prevalence of ECC in Canada to provide scope for the magnitude of this preventable disease in children. To address the avoidable socioeconomic costs, three areas require policy development. First is the need for increased public education and access to ECC prevention services for at-risk populations. Parents need to know they should reduce their children’s intake of sweet drinks, and avoid filling bottles with sugar water, juice or soft drinks, especially at night. They should also clean an infant’s gums with a soft toothbrush or cloth and water starting at birth. When the baby’s first tooth erupts, parents should commence daily brushing with toothpaste and book a first dental visit. Second is the need to empower health-care professionals to integrate ECC prevention in their early visits with parents of young children. Such visits are more common in family medicine, and these primary care providers can play a critical role in educating parents and promoting children’s oral health. Curriculum and continuing education for these health professions should be enhanced to emphasize ECC’s long-term health effects. Third, government should invest in preventive oral health services for children rather than relying on emergency dental care. Children should have access to early preventive dental services to instill in them habits for lifetime oral health. Provinces without universal public funding for children’s preventive dental health should remove the access barriers that children without dental insurance face.

With rising health care costs, often health research is viewed as a major cost driver, calling to question the role and value of provincial funding of health research. Most agree that the quality of healthcare provided is directly linked to our ability to conduct quality research; however currently there is little empirical evidence supporting the link between engagement in health research and healthcare performance. In Canada this has resulted in funding for health research that varies over time and between provinces. While medical knowledge is a public good, we hypothesize there are local benefits from health research, such as the attraction of a specialized human capital workforce, which fosters a culture of innovation in clinical practice. To address this question, we look at whether health outcomes are impacted by changes in provincial research funding in Alberta compared to other provinces. Provincial funding for medical research, which varies greatly over time and among provinces, is used as a proxy for medical treatment inputs. Trend rates of reduction in mortality from potentially avoidable causes (MPAC) (comprised of mortality from preventable causes (MPC) and mortality from treatable causes (MTC)), are used as a proxy health outcome measure sensitive to the contributions of technological progress in medical treatment. Our analysis suggests that investment in health research has payback in health outcomes, with greater improvements in the province where the research occurs. The trend declines seen in age standardized MPAC rates in different Canadian provinces may be impacted by shifts in provincial research funding investment, suggesting that knowledge is not transferred without cost between provinces. Up until the mid-1980s, Alberta had the most rapid rate of decline in MPAC compared to the other provinces. This is striking given the large and unique investment in medical research funding in Alberta in the early 1980s through AHFMR, the only provincial health research funding agency at the time. However in recent years, Alberta’s rate of decrease in MPAC has occurred at a rate slower than the other provinces (British Columbia, Ontario or Quebec) with provincial medical research funding. This is striking at a population level, where Alberta’s failure to achieve a reduction in age standardized rates of MTC comparable to British Columbia, Ontario or Quebec after 1985 represents 240 unnecessary deaths in 2011 and 48,250 Potential Life Years Lost worth around $4.8 billion. The findings from our study suggest that some of the divergence in the rates of reduction in MPAC between provinces may be due to beneficial changes in institutional structure and human capital, resulting in differences across provinces in the capacity to adopt new effective healthcare innovations. While health indicators such as MPAC are the result of complex interactions between the patient, treatment and the healthcare system, as well as socioeconomic and demographic factors, this analysis suggests that a different capacity for health research within the provinces impacts health outcomes. The findings from this analysis are limited by the lack of data related to research funding and the health research workforces within provinces. This analysis has important implications for health research policy and funding allocations, suggesting that decision makers should consider the long-term impact provincial funding for health research has on health outcomes. This study also highlights the lack of longitudinal public data available for provincial health research funding. This information is critical to inform future health research policy.

As part of our analysis in the paper published in January 2015, “Bending the Medicare Cost Curve in 12 Months or Less: How Preventative Health Care Can Yield Significant Near-Term Savings for Acute Care in Alberta,”1 we had carried out analyses of sub-groups of interest, such as workers at Canadian Natural Resources Ltd. (CNRL) and seniors (participants aged 55-plus) that, for reasons of length, we did not include in the published paper. The details for the data, the models estimated, the statistics calculated and the sample inclusion and exclusion restrictions are described in the full paper that was peer reviewed. This addendum discusses the results of the analysis of the sample of seniors (participants aged 55 and up at the time of joining Pure North, n=5,516, made up of 2,758 Pure North participants and 2,758 age- and sex-matched controls). The models estimated are described on pages 9 and 10 of the published paper. Persisting participants are Pure North joiners who have a 25OHD (vitamin D blood serum) measure at the time of joining and one year later. We interpret participants with two 25OHD one year apart as persisting in the Pure North program but we do not infer the degree of adherence to the program. The In-Clinic Seniors Program (ICP) sub-sample of Pure North senior participants had over 90 per cent persistence in the program for at least one year. For this sub-sample, relative to the frequency of hospital and emergency department visits of the ICP seniors program participants and matched controls in the year prior to joining the program, the program reduces hospital visits for seniors in the program by 22 per cent, emergency department visits by 34 per cent and avoids 22 per cent of annual health-care costs. For the 68 per cent of the full sample of Pure North participants aged 55 and over who we can confirm persisted in the program for at least one year, relative to the frequency of hospital and emergency department visits of the program participants and matched controls in the year prior to joining the program, the program reduces hospital visits for seniors persisting in the program by 39 per cent and emergency department visits by 24 per cent. These reductions in health care system contacts result in public health-care expenditures avoided of 35 per cent per year. These magnitudes are comparable to what we calculated for the overall and Vital 2.2 samples in the full 2015 report. Not accounted for in those direct health-care costs avoided is the relief that preventative care can provide to the medical treatment system. Scaled to the population level, the reductions observed in the Pure North seniors sample would represent at least six per cent fewer visits to Alberta emergency departments per year and reduce the need for hospital beds by at least six per cent in the Alberta hospital system. In terms of freed-up hospital beds, this is equivalent to adding another Foothills Medical Centre to the Alberta health-care system.

Over the course of more than 30 years, a series of Canadian government commissions and health policy researchers have repeatedly identified the importance of “bending the cost curve” to sustain publicly funded health care, and the potential to do so through upstream investment in health promotion and disease prevention. So far, however, the level of public investment in prevention represents only a slight portion of total public health care expenditure, largely consisting of traditional public health initiatives such as vaccinations, disease screening and information campaigns. This study of the Pure North S’Energy Foundation’s preventative health care program — wherein health care usage by program participants was measured against age- and sex-matched control samples — finds that the sort of preventative health care services offered by Pure North can lead to genuine and significant near-term cost savings for Canada’s single-payer health care system. Participants in the first year of the program required 25 per cent fewer hospital visits and 17 per cent fewer emergency room visits compared to the control group. Among those who persisted in the program for a year or longer, the effects were even more significant: 45 per cent fewer hospital visits in the year after joining, and 28 per cent fewer visits to emergency departments, compared to the control group. This represents real cost savings for a public health service: From $388 per person who joined the program to $677 per person who persisted beyond the first year. As a proportion of annual health spending for these participants on hospitals, emergency departments and general practitioners, this represents a cost reduction ranging from 22 to 39 per cent. If the Alberta government were able to implement this kind of program provincewide (at an estimated cost of $500 per participant), and were to realize similar results in terms of reduced strain on acute care services, it is possible that the province could free-up the equivalent of 1,632 hospital beds every year. That is roughly the same as building two entirely new hospitals each on the scale of Calgary’s Foothills Medical Centre. This demonstrates that “bending the cost curve” for public health care spending is not merely something that is realizable in the long term, but rather in the immediate future, as quickly as within a year after this kind of program could be implemented province-wide. And yet, the near-term savings in acute care services represent only the first wave of benefits. The prevalence of chronic diseases and conditions, including diabetes, heart disease, cancer and mental illness, have been rising and are projected to keep doing so over the coming decade. The Pure North program aims to prevent and address these health conditions and chronic diseases through a combination of screening and testing, lifestyle modification, nutrition education, the identification of nutritional deficiencies, and dietary supplements. The long-term benefits of a Pure North-style program implemented province-wide in Alberta are likely to be that much greater as the prevalence of diabetes, heart disease, cancer and mental illness is tempered through the use of widespread preventative care. Then there are the broader “indirect benefits” of a generally healthier population: higher labour productivity, higher incomes and greater well-being. These returns to the Alberta government, and taxpayer, have the potential to be as large, if not larger, than the direct benefits of significantly reduced acute care costs.

When a child is diagnosed with autism spectrum disorder, the significance of the impact that diagnosis can have on his or her family’s life is incalculable, except in one respect: cost. If that child is severely impacted and requires constant and lifelong supports, then the value of caregiver time required to support that individual is approximately $5.5 million higher than that for someone without autism. An autism diagnosis of a high-needs child at age two represents the equivalent of telling the family that they must make an immediate lump-sum investment on that day of $1.6 million, invested at a five-per-cent return, to pay for the lifetime costs of care and support their loved one will require. And that amount does not even account for added professional services, such as speech therapists, psychologists, and occupational therapists, or additional out-of-pocket expenses that may be required, such as special equipment or diets. Autism is the most common neurological condition diagnosed in children and it is now estimated that one in 88 children will be diagnosed with autism spectrum disorders. Yet, across Canada, there are significant gaps in the publicly provided support system, leaving the cost burden to be picked up by families. In the case of those individuals requiring constant support, 24 hours a day, every day, the cost of hiring caregivers alone would require an annual income of $200,000 — before a family even begins to pay for shelter, clothing, groceries and other basic necessities. Already families with severe high-needs children are more likely to experience lower income than they might otherwise, due to the extra care commitment their loved one requires. Only a very few families will have the means to afford to pay for total care. So, in most cases, the responsibility for care falls largely, if not entirely, on the family, or in a worst-case scenario, the autistic individual is left with inadequate care. Autism is an expensive condition and governments may underestimate the full cost of community-based supports needed for the vast range of unique needs of those living with autism. A scan of provincial programs finds a patchwork of unequal and incomplete supports for individuals living with autism spectrum disorders. Gaps are particularly evident once individuals leave the public school system, where they are at least provided with some form of day support. Sufficient adult day supports, evening and night supports, quality group homes, the availability of properly trained caregivers and respite services, recreational activities, post-secondary opportunities and employment supports all suffer varying levels of inadequacy across the country. As autism becomes increasingly prevalent, continuing to rely largely on family supports where community services are fragmented or unavailable is not a sustainable approach. Canadian policy-makers will need to consider the costs of a growing and aging population of individuals living with autism who need a range of supports so that adequate quality of care and a decent quality of life are enjoyed by many who remain some of this country’s most vulnerable citizens.

Over the course of more than 30 years, a series of Canadian government commissions and health policy researchers have repeatedly identified the importance of “bending the cost curve” to sustain publicly funded health care, and the potential to do so through upstream investment in health promotion and disease prevention. So far, however, the level of public investment in prevention represents only a slight portion of total public health care expenditure, largely consisting of traditional public health initiatives such as vaccinations, disease screening and information campaigns. This study of the Pure North S’Energy Foundation’s preventative health care program — wherein health care usage by program participants was measured against age- and sex-matched control samples — finds that the sort of preventative health care services offered by Pure North can lead to genuine and significant near-term cost savings for Canada’s single-payer health care system. Participants in the first year of the program required 25 per cent fewer hospital visits and 17 per cent fewer emergency room visits compared to the control group. Among those who persisted in the program for a year or longer, the effects were even more significant: 45 per cent fewer hospital visits in the year after joining, and 28 per cent fewer visits to emergency departments, compared to the control group. This represents real cost savings for a public health service: From $388 per person who joined the program to $677 per person who persisted beyond the first year. As a proportion of annual health spending for these participants on hospitals, emergency departments and general practitioners, this represents a cost reduction ranging from 22 to 39 per cent. If the Alberta government were able to implement this kind of program provincewide (at an estimated cost of $500 per participant), and were to realize similar results in terms of reduced strain on acute care services, it is possible that the province could free-up the equivalent of 1,632 hospital beds every year. That is roughly the same as building two entirely new hospitals each on the scale of Calgary’s Foothills Medical Centre. This demonstrates that “bending the cost curve” for public health care spending is not merely something that is realizable in the long term, but rather in the immediate future, as quickly as within a year after this kind of program could be implemented province-wide. And yet, the near-term savings in acute care services represent only the first wave of benefits. The prevalence of chronic diseases and conditions, including diabetes, heart disease, cancer and mental illness, have been rising and are projected to keep doing so over the coming decade. The Pure North program aims to prevent and address these health conditions and chronic diseases through a combination of screening and testing, lifestyle modification, nutrition education, the identification of nutritional deficiencies, and dietary supplements. The long-term benefits of a Pure North-style program implemented province-wide in Alberta are likely to be that much greater as the prevalence of diabetes, heart disease, cancer and mental illness is tempered through the use of widespread preventative care. Then there are the broader “indirect benefits” of a generally healthier population: higher labour productivity, higher incomes and greater well-being. These returns to the Alberta government, and taxpayer, have the potential to be as large, if not larger, than the direct benefits of significantly reduced acute care costs.

Claims have been made that families with children living with autism spectrum disorders (ASD) have been migrating to Alberta because of higher funding available for ASD supports compared to other provinces. The legitimacy of these claims, along with many others about the adequacy or inadequacy of funding for supporting persons living with ASD, has not been evaluated because we simply don’t know how many people in Alberta are living with ASD. Typically in Canada, ASD prevalence is reported in national figures, based on international estimates. Canadian prevalence estimates for ASD are needed. With no national surveillance system in place, national estimates are difficult to determine. In addition, such broad measurements are problematic as they may not adequately inform the service delivery needs for specific jurisdictions. A new study shows that 1,711, or 1 in 94, school age children in the Calgary region have an ASD diagnosis. As this number matches what is often reported for the national prevalence of ASD, it suggests that Alberta’s relatively higher ASD funding is not inducing in-migration of families seeking better support. The data also show that the prevalence is higher in elementary-grade children, with a diagnosis in one of every 86 children. In the senior grades, there are significantly fewer students with ASD diagnoses, specifically within the Calgary Board of Education. There is no evident reason for diagnoses to seemingly dematerialize in the older grades. These students could be dropping out or choosing home-schooling in greater numbers. Possibly there has been an increase in prevalence. These prevalence estimates help to inform the demand for special-needs services within the local school system. In addition, there is growing concern that upon graduation there is a “support cliff” resulting from a less systematized, less generous support system available for adults with neurodevelopmental disability. Families that need support for ASD face enough challenges; it is critical for policy-makers to be aware of the extent of the situation in their own jurisdiction so as to develop the right kinds of supports for these families.

Introducción: El glaucoma crónico simple de ángulo abierto es causa frecuente de ceguera debido a la falta de signos, que solo se hacen evidentes cuando se encuentra en fases avanzadas. Objetivo: Determinar si hay cambios en la presión intraocular de pacientes con hipertensión arterial sistémica. Metodologia: Se realizó un estudio observacional, prospectivo, transversal, analítico, en los pacientes con hipertensión arterial sistémica que asistieron a la consulta de Cardiología. Se midió la presión intraocular con el tonómetro de Perkins y el tamaño de la excavación papilar por oftalmoscopia directa. Se estimó la correlación entre presión arterial y presión intraocular. Resultados: Se identificó una correlación estadísticamente significativa entre la presión arterial diastólica en el brazo derecho con la presión intraocular de ambos ojos. La presión diastólica del brazo izquierdo se correlacionó con la presión intraocular del ojo derecho. La presión intraocular no mostró correlación con la edad de los pacientes. Conclusiones: En este estudio se encontró correlación entre presión intraocular y la presión arterial diastólica, pero no se encontró correlación entre la sistólica. Es recomendable vigilar la presión intraocular en pacientes hipertensos, especialmente en aquellos con hipertensión diastólica persistente y con antecedentes familiares de glaucoma.

When a child is diagnosed with autism spectrum disorder, the significance of the impact that diagnosis can have on his or her family’s life is incalculable, except in one respect: cost. If that child is severely impacted and requires constant and lifelong supports, then the value of caregiver time required to support that individual is approximately $5.5 million higher than that for someone without autism. An autism diagnosis of a high-needs child at age two represents the equivalent of telling the family that they must make an immediate lump-sum investment on that day of $1.6 million, invested at a five-per-cent return, to pay for the lifetime costs of care and support their loved one will require. And that amount does not even account for added professional services, such as speech therapists, psychologists, and occupational therapists, or additional out-of-pocket expenses that may be required, such as special equipment or diets. Autism is the most common neurological condition diagnosed in children and it is now estimated that one in 88 children will be diagnosed with autism spectrum disorders. Yet, across Canada, there are significant gaps in the publicly provided support system, leaving the cost burden to be picked up by families. In the case of those individuals requiring constant support, 24 hours a day, every day, the cost of hiring caregivers alone would require an annual income of $200,000 — before a family even begins to pay for shelter, clothing, groceries and other basic necessities. Already families with severe high-needs children are more likely to experience lower income than they might otherwise, due to the extra care commitment their loved one requires. Only a very few families will have the means to afford to pay for total care. So, in most cases, the responsibility for care falls largely, if not entirely, on the family, or in a worst-case scenario, the autistic individual is left with inadequate care. Autism is an expensive condition and governments may underestimate the full cost of community-based supports needed for the vast range of unique needs of those living with autism. A scan of provincial programs finds a patchwork of unequal and incomplete supports for individuals living with autism spectrum disorders. Gaps are particularly evident once individuals leave the public school system, where they are at least provided with some form of day support. Sufficient adult day supports, evening and night supports, quality group homes, the availability of properly trained caregivers and respite services, recreational activities, post-secondary opportunities and employment supports all suffer varying levels of inadequacy across the country. As autism becomes increasingly prevalent, continuing to rely largely on family supports where community services are fragmented or unavailable is not a sustainable approach. Canadian policy-makers will need to consider the costs of a growing and aging population of individuals living with autism who need a range of supports so that adequate quality of care and a decent quality of life are enjoyed by many who remain some of this country’s most vulnerable citizens.

The federal Conservative government recently began phasing in a plan to raise the age of eligibility for Old Age Security from 65 to 67. But a more sensible move for improving the effectiveness of Canada’s social safety-net system may be to actually lower the age below 65 and rely strictly on an income test instead, regardless of age. The government could go a lot further toward the reduction of poverty in Canada by building on the success of its income supports for seniors, and making them available to poor Canadians of all ages. Canada can boast of having one of the lowest rates for poverty among seniors in the world, largely due to its guaranteed income programs for those 65 years and older. When low-income Canadians turn 65 years old and leave behind low-paying, often unstable jobs, their poverty levels drop substantially. What a guaranteed income provides, that their vulnerable job situation did not, is a form of protection against budget shocks — a sudden volatility in income or expenses without the access to savings or credit to smooth things out until stability returns. A guaranteed income provides a kind of “disaster insurance” that can protect someone in a crisis situation from going without necessities such as food or even shelter. Statistics show that the rate of Canadians experiencing “food insecurity” — that is, lack of access to food because of financial constraints — is half that among Canadians aged 65 to 69 years than it is among those aged 60 to 64. Self-reported rates of physical and mental health improve markedly as well after lowincome Canadians move from low-wage, insecure employment to a guaranteed income at the age of 65. That dramatic shift in physical and mental health indicates that expanding guaranteed income programs to younger Canadians is more than a simple cost calculation: there are potential savings to be found as poorer Canadians, given a guaranteed income, become healthier and therefore reduce the burden on the public health-care system. Canadian governments already spend billions of dollars on the downstream effects of poverty, but scant emphasis is put on programs targeting poverty’s roots. There is no evidence, where smaller-scale experiments have been tried, to show that a guaranteed income program creates a serious problem with negative incentives and discourages people from working who otherwise might. But because this is a common worry with working-age guaranteed income eligibility, phasing in the program gradually, by lowering eligibility a few years at a time, will allow ongoing investigation and analysis of the effects, before the program is rolled out on a large scale. The tremendous impact that guaranteed incomes have had on reducing poverty and improving health among seniors is something for which Canadians can be rightly proud. So much so that it is incumbent upon us to investigate whether Canada could use the same policy tools to drastically reduce poverty and improve health among Canadians of all ages.

There is a widespread impression among Canadians that their health-care system is universal, comprehensive and equitable. Given this impression, Canadians may be surprised to discover that, for instance, while annual physicals and receiving advice on dealing with cold symptoms are covered by the public plan, the costs of rehabilitation from a brain injury or stroke are not fully covered. While universal, the public plan is not comprehensive nor, arguably, is it equitable. The Canada Health Act (CHA) uses the term “medically necessary” to define medical procedures and treatments to be paid for by the publicly-funded medicare system. In Canada’s health-care system, the term has come to refer almost exclusively to those services provided by a physician, or provided within a hospital setting, by a physician or other staff. Services that a reasonable person might consider “necessary,” but are provided outside those settings, are typically not covered. In many ways the federally-legislated Canada Health Act has been culturally enshrined as a consecrated icon of national identity. But the legislation fails to clearly identify the line between necessary and unnecessary medical services. This has put provincial governments — who are responsible for medical-funding decisions — in the difficult position of having to make this decision, and they have resorted to drawing that line in sometimes surprising places. The line drawn between “necessary” and “unnecessary” medical treatments has been determined by the financial self-interest of medical stakeholders, by hospitals rationing global budgets, and by financially-constrained provincial governments. The result is a relatively narrow definition of medical necessity that undermines the equality goals the CHA is often claimed to uphold. Health care is arguably the most important public-expenditure program in Canada. It is important for Canadians to understand clearly what services and levels of care this program provides so that they can prepare for, and possibly insure against, outcomes that are not covered. We do not argue it is easy to make this demarcation between what is and what is not covered by medicare. We do argue, however, that it is necessary to establish this line and to draw attention to its position.

While Canada has socialized most of the costs of treating illness, Canada has maintained a reliance on individuals interacting through private markets to invest in upstream health promotion and disease prevention. The failure of the market to provide the efficient level of upstream investment in health is leading to large and avoidable increases in the need for downstream medical treatment. The way to reduce the future deadweight loss of illness and disease is for provincial governments to address the upstream market failures through an expansion of the scope of public payment for health care to include upstream services for health promotion and disease prevention. Perhaps somewhat counterintuitively, spending public health-care dollars across a broader range of health and wellness services can result in spending less in total, because of the efficiency gains that will come from better health in the population. That is certainly what the evidence from a unique Albertan pilot project leads us to conclude. The Pure North S’Energy Foundation is a philanthropic initiative that pays for and provides preventative health-care services for Albertans drawn from groups that are vulnerable to poor health. This includes homeless people, people suffering from addiction, people with low incomes, people in isolated areas and susceptible seniors. The health improvements observed in those participating in the Pure North program have been significant. Effective health-promotion and disease-prevention services obviously benefit patients. But there are also substantial benefits to society as well. The annual health-care bill for a Canadian in poor health is estimated to be more than $10,000 higher than for someone in good health, meaning that keeping people in good health can be an important means for controlling public health-care budgets, and can free up scarce acutecare hospital resources. If the Pure North program were scaled-up province-wide to cover the nearly quartermillion Albertans in poor health, the resulting health improvement seen in Pure North participants could translate into a nearly 25-per-cent reduction in hospital days used by Alberta patients every year and a net savings of $500 million on hospital and physician costs. That does not even include the economic benefits of keeping workers in better health and productive, while spending fewer days ill or hospitalized. To date, Canada’s approach to health care has largely left it to patients to choose whether to seek healthpromotion and disease-prevention services on their own, suggesting an implicit deference to an individual’s rights and responsibilities. But for many low-income, isolated, addicted or aboriginal Canadians, there often is no choice: These services, when delivered privately, are often too expensive or may be otherwise inaccessible. The initial spirit behind Canadian medicare was to correct a health-market failure, so that no patient would face barriers to accessing necessary treatments. That same philosophy also recommends extending universal coverage for health-promotion and disease-prevention to vulnerable Canadians who today face similar barriers to access. If the Alberta government wants to show both foresight and fairness, the benefits from this kind of program, economically and societally, are simply too attractive to disregard.

The predictions in the media and from think tanks sound altogether alarming: Saskatchewan, with its booming economy, could be facing a worker shortage so severe that it could drastically hobble the province’s ultimate economic potential. While the world craves only more of Saskatchewan’s abundant natural resources, the province won’t possibly be able to keep up, due to a scarcity of workers that could be as significant as one-fifth of the labour supply by 2020. The Saskatchewan government has rushed to analyze the predicament, issuing reports that urgently seek solutions. But it hasn’t really developed any solutions. In fact, it hasn’t done much about the supposedly looming crisis at all. And that, actually, might just be all it can — and should — do. In truth, Saskatchewan can’t be sure it will be facing a serious shortage, or any shortage, at all. And any attempt by the provincial government to substantially intervene in the labour market could cause more problems for employers and the economy, than it addresses. Saskatchewan’s labour market has already shown a remarkable ability to adjust, on its own, to the commodities boom, and what employers today call a shortage, could well just be everyone getting used to a much tighter, but still very functional, labour market. The province’s lack of action did mean it missed a once-in-a-lifetime opportunity to redirect a huge cohort of Gen-Y students into training for trades that are in high demand (that cohort is already in its mid-20s and finished, or finishing, its career training). That was a mistake. But one big thing the Saskatchewan government can still do to help employers — and workers — is to stop making the strains on labour worse by launching imminent public infrastructure projects that compete with the private sector for labour. Instead, the province should plan those for when the boom slows down and workers need the jobs. It should also abandon any ideas of ramping up the import of temporary foreign workers to fill short-term job vacancies: those workers have a way of dampening wage signals that would draw more permanent, and therefore desirable, workers to the province. What few things the province could be actively doing, it should do anyway. It should help retrain workers with skills in low-demand for jobs in higher demand. It should recruit migrants from other provinces and overseas to settle in Saskatchewan. It should carefully review its post-secondary education system to minimize drop-out rates from apprenticeship programs and to ensure it is training people to match the economy’s demands. And it should be finding ways to mobilize large portions of the population that could be working, yet aren’t, including underemployed males and Aboriginals, but also the elderly and disabled. If there is, indeed, a shortage somewhere in Saskatchewan’s future, having those people working can only help. But even if there is never a shortage, having large pools of potential labour sitting idle is something that will truly limit Saskatchewan’s economic potential.

En el presente artículo se propone un sistema de visión artificial para la detección del fruto de café apto para producción. Para lograr esta detección se desarrollaron dos algoritmos, uno encargado de clasificar los frutos de café en maduros o no maduros, y otro que detecta la presencia de la plaga de la broca. Para el primero se extrajeron características de color y se usó un clasificador bayesiano. Por otra parte, el algoritmo de detección de brocas busca zonas negras en la imagen, esto debido a que la evidencia dejada por esta plaga son orificios en la superficie del fruto. Además, se diseñó un sistema mecánico para el transporte de los frutos de café durante el proceso, y un mecanismo de extracción para separar los frutos, una vez estos sean clasificados por el algoritmo. Los resultados obtenidos mostraron una efectividad del 87%.

Funding for Canadian public health care has long relied on a “pay-as-you-go” funding model: for the most part, government pays for health costs each year from taxes collected in that fiscal year with effectively nothing put aside for projected rising health-care costs in the future. But the future of Canadian public health care is going to get more expensive as the relatively large cohort of baby boomers reaches retirement age. As they exit the work force, and enter the ages at which Canadians use the health-care system more, a smaller population of younger workers is going to be left paying the growing health-care costs of older Canadians. If Canadians intend to preserve a publicly funded medicare system that offers a similar level of service in the future as it does today, under the pay-as-you-go model, eventually peak taxes for Canadians born after 1988 will end up twice as high as the peak taxes that the oldest baby boomers paid. The “payas-you-go” model has become like a Ponzi scheme, where those who got in early enough make out nicely, while those who arrive late stand to suffer a serious financial blow. This should concern both Canadians who value a comprehensive public health system as well as Canadians who value competitive tax rates: There is no reason to be certain that future taxpayers will blithely accept having their taxes substantially increased to finance health care for another, older generation that did not pay for a significant portion of its own health care. If the burden proves too high for the taxpaying public to accept, that could well jeopardize Canada’s health-care system as we know it. If Canadians intend to preserve their iconic public health system, and are unprepared to unjustly overburden future generations with the tax bill left by their parents and grandparents, provincial governments must make strong and rapid efforts to reform the health system. They must find more cost-efficient ways of managing medicine, including new approaches to eldercare, chronic disease prevention and better health promotion. If policymakers respond in time with a workable strategy and adequate effort, the substantial financial health-care liability currently faced by future generations may not be eliminated entirely, but it can still be reduced dramatically.

Homelessness in Alberta is overwhelmingly concentrated in Calgary and Edmonton, with almost two-thirds of total provincial shelter usage in the former. Calgary also experiences much greater fluctuations in shelter use. Three interconnected economic factors — the supply of rental accommodations, the state of the labour market and the inward flow of jobseekers — go a long way toward explaining both Calgary’s unusually large share of Alberta’s homeless as well as the swings in shelter use. Calgary has proportionately less than half as many rental units as Edmonton and this gap is widening. Simultaneously, Calgary, more than any other Canadian city, attracts a significant share of migrants during times of economic growth increasing demand for affordable housing and then shelter space when the availability of housing approaches zero. The recent fall in shelter use in Calgary (and so Alberta) may therefore prove temporary should a recovering economy attract more arrivals and so drive up shelter use again. The provincial government’s recent efforts to increase the stock of affordable housing are appropriate but greater progress could be made if it devised ways to enlist the energy and efficiency of the private sector to expand Calgary’s rental market.

Surprisingly little attention has been paid to how we pay for health care affects how much we spend on health care. In this paper, I discuss how noncontributory finance and effective subsidization of public health care spending with federal cost sharing crowded out demand for private insurance as voters opted for high levels of public health spending. From this perspective, the Romanow Report’s call for increases in federal cash transfers to provinces for health care spending would result in an increase in provincial health spending and a diminution of the demand for private health insurance. It is not clear, however, that federal subsidization of health spending is either sustainable or socially desirable. Indeed, as Canada’s population ages, the current financing of health care represents enormous unfunded liabilities for the provinces. To sustain current levels and growth rates of health spending without tying current revenues to that objective means asking the next generation of working Canadians to pay far more for their health care than do working Canadians today. Although the effect of population aging on health care expenditures is projected to be modest, it could trigger a serious political crisis for Canadian medicare as taxes rise.

Should Canadian governments prohibit private insurance for services parallel to those provided in the publicly insured health care system? We believe that the values engaged by this issue have not been made clear and explicit in health policy discussion and debate. With reference to the recent Chaoulli case at the Supreme Court of Canada, we articulate what we take to be the main values in tension and conflict, and distinguish three main value-based positions on the policy issue. By doing so we hope to contribute to a more informed, explicit and open public policy discussion.

The boom and bust in energy prices experienced recently has its parallels in the boom and bust of energy prices in the 1970s and 1980s. The earlier boom period saw the Government of Alberta struggle with restraining spending and so became heavily dependent on high energy prices. When in 1986 energy prices crashed the government suff ered a string of large defi cits that was followed by draconian cuts to spending. From 2000 to 2008 the government enjoyed another boom in energy prices and again found it diffi cult to restrain spending. The recent crash in energy prices threatens the government with repea ng the earlier experience of defi cits followed by drama c spending cuts. As it prepares its 2009 budget the government has an opportunity to learn from the past and to quickly and decisively put its budget on a path toward a much smaller reliance on energy-related revenues.

En el ámbito de los estudios de pre factibilidad y factibilidad de una central eólica, se aplica la Transformada Wavelet Discreta al análisis de los registros de viento de un emplazamiento con el fi n de descomponer la serie en su espectro de frecuencias. La serie descompuesta para varias Wavelet madre y fi ltrada se emplea para estimar la energía que produciría la central a través del análisis de la función de densidad de probabilidad de Weibull del emplazamiento. Para validar el modelo se analizan los resultados de la estimación de la energía empleando la serie original de vientos, aquella obtenida con la serie descompuesta a través de Wavelet y la energía real medida en una central existente, tomada como caso de estudio.