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The application of big data, radiomics, machine learning, and artificial intelligence (AI) algorithms in radiology requires access to large data sets containing personal health information. Because machine learning projects often require collaboration between different sites or data transfer to a third party, precautions are required to safeguard patient privacy. Safety measures are required to prevent inadvertent access to and transfer of identifiable information. The Canadian Association of Radiologists (CAR) is the national voice of radiology committed to promoting the highest standards in patient-centered imaging, lifelong learning, and research. The CAR has created an AI Ethical and Legal standing committee with the mandate to guide the medical imaging community in terms of best practices in data management, access to health care data, de-identification, and accountability practices. Part 2 of this article will inform CAR members on the practical aspects of medical imaging de-identification, strengths and limitations of de-identification approaches, list of de-identification software and tools available, and perspectives on future directions. [ABSTRACT FROM AUTHOR]

Background: The impact of the COVID-19 pandemic on young people with eating disorders (EDs) and their families was profound, with surging rates of hospitalizations and referrals reported internationally. This paper provides an account of the additional health and social costs of ED care for young people living in Canada incurred during the COVID-19 pandemic, drawing attention to the available data to inform these estimates while noting gaps in data capacities to account for a full view of the ED system of care. Methods: Three methodologies were used to capture costs: (1) provincial administrative data holdings available at the Canadian Institute of Health Information (CIHI) were used by Deloitte Access Economics to conduct analyses on costs related to hospitalizations, emergency room visits, outpatient visits with physicians and loss of well-being from being on a waitlist. These were examined across three fiscal years (April 1 to March 31, 2019–2022) to compare costs from one year before to two years after the onset of the pandemic, (2) data collected on support-based community ED organizations and, (3) costs identified by young people, caregivers and health care professionals. Results: Estimates of additional health care costs and social costs arising from ED care waitlists were estimated to have increased by 21% across the two years after the onset of the pandemic and is likely to represent an underestimate of costs. Costs related to some standard ED care services (e.g. day treatment programs) and support-based community ED organizations that saw a 118% increase in services during this time, are some examples of costs not captured in the current cost estimate. Conclusions: This paper provides a first account of the additional health and social ED care costs associated with the pandemic, which indicate at minimum, a 21% increase. The results invite discussion for more investments in ED services for young people in Canada, as it is unclear if needs are expected to remain elevated. We suggest a call for a national surveillance strategy to improve data holdings to aid in managing services and informing policy. A robust strategy could open the door for much-needed, data-informed, system transformation efforts that can improve ED care for youth, families and clinicians. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has significantly impacted families across Canada; however, rural low-income mothers and their families have experienced significant challenges due to historical and current social, economic, cultural, and health inequities. These inequities complicated mothers' ability to navigate the pandemic. This paper is based on a study that used a grounded theory framework to explore the implications of the COVID-19 pandemic on rural, low-income mothers in Nova Scotia, Canada, while supporting their families' wellbeing during the pandemic. Through 29 interviews with rural low-income mothers, and three focus groups with community organizations serving these mothers, this study found that mothers and their families were deeply impacted by the first and second waves of the COVID-19 pandemic. Factors such as inadequate internet and internet access, limited and unaffordable transportation options, food insecurity, social isolation, and mental health challenges emerged from these interviews. Three focus groups with service providers to low-income rural mothers also informed the final results. The inequities faced by rural mothers created additional barriers to accessing services and resources to support their families' wellbeing during the pandemic. The results of the study connect to the importance of addressing inequities through a holistic social determinants of heath model. As a result, the findings of this study have implications on the actions of service providers, policymakers, and researchers, as little has been written about this demographic in relation to social determinants of health and in the context of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic disproportionately affected those who face historical and ongoing marginalization. In centering pandemic experience of recent immigrant women in the accommodation and food services sector in Canada, we examine how their precarious work translated to experiences of work precarity and wellbeing. This paper illuminates how pre-existing and ongoing marginalization are reproduced during a health crisis for those at the intersection of gender, race, migration, and labour inequities. Using semi-structured interviews and systematic analysis using the Work Precarity Framework, we found that the pandemic exacerbated pre-existing socio-economic marginalization and resulted in unique experiences of work precarity. The latter was experienced as precarity of work (unpredictable work hours and job or employment insecurity), precarity from work (inadequate incomes), and precarity at work (physical, psychological, and relational unsafety). Work precarity stood out as a social determinant of health in relation to its outcome of degraded mental health and wellbeing. Recognizing the role of policies in producing, reproducing, and distributing precarity, we recommend policy directions to reduce social inequities in pandemic recovery. [ABSTRACT FROM AUTHOR]

Purpose: This research examines the implementation of the Icelandic Prevention Model (IPM) in Canada to identify opportunities revealed by the COVID-19 pandemic to re-design our social eco-system to promote wellbeing. This paper has two objectives: 1) to provide a conceptual review of research that applies the bioecological model to youth substance use prevention with a focus on the concepts of time and physical space use and 2) to describe a case study that examines the implementation of the IPM in Canada within the context of the COVID-19 pandemic. Method: Study data were collected through semistructured qualitative interviews with key stakeholders involved in implementing the IPM. Results: Findings are organized within three over-arching themes derived from a thematic analysis: 1) Issues that influence time and space use patterns and youth substance use, 2) Family and community cohesion and influences on developmental context and time use and 3) Opportunities presented by the pandemic that can promote youth wellbeing. Conclusion: We apply the findings to research on the IPM as well as the pandemic to examine opportunities that may support primary prevention and overall youth wellbeing. We use the concepts of time and space as a foundation to discuss implications for policy and practice going forward. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic led to major service disruptions in the healthcare sector, especially regarding sexual and reproductive health services. However, the impact of the pandemic on Canadian adolescents is relatively unknown. This study aimed to investigate the impacts of the COVID-19 pandemic and associated public health measures on the sexual and reproductive health (SRH) of adolescents in Alberta, Canada. Methods: A qualitative study using an interpretive description (ID) approach and community-based participatory research principles was conducted to capture the subjective experience and perceptions of adolescents and service providers. With the collaboration of the Adolescent Advisory Group and community partners, 18 adolescents and 15 service providers were recruited for the study through purposive sampling. Findings from the qualitative interviews were analyzed using thematic analysis. Results: Three major themes emerged from the analysis: (1) COVID-19 SRH experience, (2) barriers to SRH, and (3) adolescent SRH strategies. Our findings highlight numerous barriers and challenges that prevented adolescents from accessing SRH education, products, and services. Conclusion: The COVID-19 pandemic had a profound impact on the SRH and the well-being of adolescents. Our study reflects the need for diverse SRH strategies to maintain continued access to SRH resources during disruptive events, such as the pandemic. Plain language summary: Access to sexual and reproductive health (SRH) services is a basic human right. All individuals require access to appropriate SRH services to maintain their optimal sexual and reproductive health. Adolescents require special guidance, support, and youth-friendly services in matters of SRH as they enter puberty and explore their sexual identity. However, during the COVID-19 pandemic, many health and SRH services were suspended. Access to SRH products and services became difficult due to public health restrictions, which has possible negative consequences for adolescents' SRH. The experiences of adolescents during the COVID-19 pandemic regarding their SRH are not reported in Alberta, Canada. Therefore, we explored the impacts of these public health restrictions on adolescents' SRH. We performed qualitative interviews with adolescents and SRH service providers to know their perspectives on how the pandemic influenced the SRH of adolescents. This paper provides insights into the barriers faced by adolescents while accessing SRH services during the pandemic, as well as their perceptions of digital strategies, such as mobile applications, and other recommendations for supporting SRH education and services. Based on the study findings, an adolescent-friendly mobile application will be developed to provide a virtual platform connecting adolescents to SRH educational resources, services, and support. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic caused disruptions across healthcare systems globally exposing the precarious state of patient engagement across all levels of healthcare. While evidence is emerging to describe how engagement was affected across various settings, insights about how some organizations at the policy and practice level of healthcare were able to sustain or adapt patient engagement activities is lacking. Objective: This paper addresses the following research question: "How were healthcare, government, and patient partner organizations able to sustain or adapt patient engagement activities during the COVID-19 pandemic?" Methods: A qualitative descriptive study was conducted to understand how patient engagement activities were maintained or adapted in a variety of healthcare, government, and patient partner organizations in Canada throughout the pandemic. This analysis was part of a larger qualitative, multiple case study where one-to-one interviews were conducted with organizational leaders, managers and patient partners. Results: The following themes were identified as key aspects of maintaining or adapting patient engagement activities: 1) having an embedded organizational culture of patient engagement; 2) adapting patient engagement activities to focus on COVID-19 response efforts; 3) having patient partners who exercised leadership and advocacy to support patient care and experiences during the pandemic; and 4) leveraging virtual technology as a communication tool to engage patient partners. Conclusion: This paper highlights important insights that may be useful to other health care organizations on how to sustain or adapt patient engagement activities during a healthcare crisis. Having patient engagement embedded within an organization's culture supported by, but not limited to, infrastructure, resources, investments in dedicated staff and patient partner leadership, and communication strategies and tools enabled continued patient engagement activities during the pandemic. [ABSTRACT FROM AUTHOR]

Background: Virtual care quickly became of crucial importance to health systems around the world during the COVID-19 pandemic. Despite the potential of virtual care to enhance access for some communities, the scale and pace at which services were virtualized did not leave many organizations with sufficient time and resources to ensure optimal and equitable delivery of care for everyone. The objective of this paper is to outline the experiences of health care organizations rapidly implementing virtual care during the first wave of the COVID-19 pandemic and examine whether and how health equity was considered. Methods: We used an exploratory, multiple case study approach involving four health and social service organizations providing virtual care services to structurally marginalized communities in the province of Ontario, Canada. We conducted semi-structured qualitative interviews with providers, managers, and patients to understand the challenges experienced by organizations and the strategies put in place to support health equity during the rapid virtualization of care. Thirty-eight interviews were thematically analyzed using rapid analytic techniques. Results: Organizations experienced challenges related to infrastructure availability, digital health literacy, culturally appropriate approaches, capacity for health equity, and virtual care suitability. Strategies to support health equity included the provision of blended models of care, creation of volunteer and staff support teams, participation in community engagement and outreach, and securement of infrastructure for clients. We put our findings into the context of an existing framework conceptualizing access to health care and expand on what this means for equitable access to virtual care for structurally marginalized communities. Conclusion: This paper highlights the need to pay greater attention to the role of health equity in virtual care delivery and situate that conversation around existing inequitable structures in the health care system that are perpetuated when delivering care virtually. An equitable and sustainable approach to virtual care delivery will require applying an intersectionality lens on the strategies and solutions needed to address existing inequities in the system. [ABSTRACT FROM AUTHOR]

This paper will identify existing models of professional regulatory reform that could ensure a single licensing process that results in multi-jurisdictional licensure. The paper will also distinguish models or ad hoc arrangements that fail to achieve such a result. This is a timely topic in Canada because its professional regulatory framework is being examined for modernization. The Canadian professional regulatory framework for health care providers is a legacy of the Constitution of 1867. It can be characterized as a Federation of 13 different jurisdictional systems with each province or territory having exclusive jurisdiction over regulation of its health professionals. This results in differing entry to practice requirements, standards of practice, classes or categories of registration and transfer criteria for eligibility from other provinces. The United States nursing state board regulators, the Australian Commonwealth, and their state governments have moved from their original regulatory frameworks to modern ones. Their models are more supportive of mobility, cross-border virtual care, education, and health provider professional development and well-being. Aside from recent discussions in the 4 Canadian Atlantic provinces, there has been little will, effort, or advancement to modernize the regulatory framework in Canada to support multi-jurisdictional licensure. This paper aims to briefly describe 6 existing models that support multijurisdictional licensure. In the fall of 2022, the 4 Atlantic Premiers (akin to state Governors in the US) asked each of their medical regulatory authority (akin to State Medical Boards) to develop a licensing system such that physicians could practice in all 4 Atlantic provinces without the need to acquire multiple licenses. Two models will be discussed that meet this recently stated objective of the Atlantic Premiers while the others do not. [ABSTRACT FROM AUTHOR]

In this paper, I draw on my research and experience as a disability ethics educator and advocate in order to demonstrate that both Canada􀂶s COVID-19 response and its expansion of eligibility for MAID are symptoms of the medical and systemic ableism that afflicts Canadian society. I conclude with a consideration of the enduring danger that eugenic ableism disguised as autonomy poses for people with disabilities in a Canada where COVID-19 may be waning, but where the contagion of ableism turned lethal through MAID continues to spread. [ABSTRACT FROM AUTHOR]

This paper examines the resilience of Canadian cities to the 2020 economic crisis that followed the 2019 coronavirus pandemic. It specifically investigates the resistance and recoverability (i.e., very short‐term recovery) dimensions of resilience. It reveals that Canadian cities exhibited heterogeneous resiliency to the crisis, resulting in economic restructuring. Further, the paper decomposed resilience into an industrial mix effect and local‐specific effect using a shift‐share analysis, to move away from the industrial‐structure dominated focus in the resilience literature by examining the influence of local‐specific effects. The analysis found that local‐specific effects played a dominant role in determining the resiliency of cities, while their industrial mix had a marginal influence. Moreover, the determinants of resilience are complex having different effects and functions depending on the dimension of resilience under examination. Also, the determinants of resilience may change depending on the type of shock cities experience. A key policy implication is that localities' capabilities largely determine their resilience. [ABSTRACT FROM AUTHOR]

Flooding, including inland and coastal flooding, is one of the most devastating and costly natural hazards in Canada, Mexico, and the United States. Recent research conducted by an international team has focused on understanding the true and comprehensive economic costs of floods, with an eye toward addressing their impacts, allocating adequate resources for monitoring and preparedness, and building resilient communities. Flood-costing methods vary greatly among federal and subnational jurisdictions across the three North American countries. Because the rigor and consistency of existing datasets across the three countries vary significantly, it is also difficult to determine the economic impacts of cross-border events. This paper aims to critically analyze the research methods used to conduct this trinational project and develop recommendations for enhancing impacts of such work in the future. We discuss three major research barriers: gaps in knowledge and research capacity, differences in data collation and analysis methods across the three countries, and linguistic barriers in working across disciplines and economic sectors. We also explore how the COVID-19 pandemic significantly added to these three barriers. We propose creation of new institutional mechanisms that can play a major role in developing comprehensive, consistent, and cohesive data gathering approaches in Canada, Mexico, and the United States. [ABSTRACT FROM AUTHOR]

Objective: Previous research has evaluated the sources of post-secondary student stress, but has failed to explore whether stressors fluctuate over time. The purpose of this research was to use the Post-Secondary Student Stressors Index to examine whether stressors changed significantly and meaningfully over the course of an academic year. Due to the timing of data collection, results also provide context around students' experiences of stress during the COVID-19 pandemic. Method: Cross-sectional data was collected at 3 time points via online surveys over the course of the 2020–2021 academic year from >10,000 students. Participants attended 15 post-secondary institutions across Canada, representing 9 provinces and 1 territory. Validated instruments were used to assess levels of stress, distress and the severity of student-specific stressors. Kruskal–Wallis ranked tests and multiple pairwise comparison analyses were conducted to assess whether the mean severity of stressors changed over time. Standard effect sizes were calculated using Cohen's d. Results: Mean levels of stress and psychological distress were high at the start of the study and remained high across time points. A similarly high level of stress was observed on average for student-specific stressors. While significant differences in mean severity were observed over time for some stressors, standardized effect sizes were negligible, suggesting little meaningful change and consistent levels of chronic stress over the course of the academic year. Conclusions: This is the first paper to examine trends in student-specific stress using a nationwide sample of Canadian post-secondary students during the first year of the COVID-19 pandemic. Patterns observed in student-specific stressors reflected changes likely to be indicative of the pandemic, including the most severe stress associated with academics, finances and concerns for the future. Implications for future research are discussed, in particular, the importance of examining stressors related to COVID-19 and their impact on student mental health. [ABSTRACT FROM AUTHOR]

Introduction: The COVID‐19 pandemic has had an impact on all aspects of the health system. Little is known about how the activities and experiences of patient, family and caregiver partners, as a large group across a variety of settings within the health system, changed due to the substantial health system shifts catalysed by the pandemic. This paper reports on the results of a survey that included questions about this topic. Methods: Canadian patient, family and caregiver partners were invited to participate in an online anonymous survey in the Fall of 2020. A virtual snowballing approach to recruitment was used. Survey invitations were shared on social media and emailed to health system and governmental organizations with the request that they share the survey with patient partners. This paper focuses on responses to two questions related to patient partner experiences during the COVID‐19 pandemic. Results: The COVID‐19 questions were completed by 533 respondents. Over three quarters of respondents (77.9%, n = 415) indicated their patient engagement activities had been impacted by COVID‐19. The majority (62.5%, n = 230) experienced at least a temporary or partial reduction in their patient engagement activities. Some respondents did see increases in their patient engagement activities (11.4%, n = 42). Many respondents provided insights into their experience with virtual platforms for engagement (n = 194), most expressed negative or mixed experiences with this shift. Conclusions: This study provides a snapshot of Canadian patient, family and caregiver partners' perspectives on the impact of COVID‐19 on their engagement activities. Understanding how engagement unfolded during a crisis is critical for our future planning if patient engagement is to be fully integrated into the health system. Identifying how patient partners were engaged and not engaged during this time period, as well as the benefits and challenges of virtual engagement opportunities, offers instructive lessons for sustaining patient engagement, including the supports needed to engage with a more diverse set of patient, family and caregiver partners. Patient Contribution: Patient partners were important members of the Canadian Patient Partner Study research team. They were engaged from the outset, participating in all stages of the research project. Additional patient partners were engaged to develop and pilot test the survey, and all survey respondents were patient, family or caregiver partners. The manuscript is coauthored by two patient partners. [ABSTRACT FROM AUTHOR]

Introduction: East Toronto Health Partners (ETHP) is a network of organizations that serve residents of East Toronto, Ontario, Canada. ETHP is a newly formed integrated model of care in which hospital, primary care, community providers and patients/ families work together to improve population health. We describe and evaluate the evolution of this emerging integrated care system as it responded to a global health crisis. Description: This paper begins by describing ETHP’s pandemic response mapping out over two years of data. To evaluate the response, semi-structured interviews were conducted with 30 decision makers, clinicians, staff, and volunteers who were part of the response. The interviews were thematically analyzed, and emergent themes mapped onto the nine pillars of integrated care. Discussion: The ETHP pandemic response evolved rapidly. Early siloed responses gave way to collaborative efforts and equity emerged as a central priority. New alliances formed, resources were shared, leaders emerged, and community members stepped forward to contribute. Interviewees identified positives as well as many opportunities for improvement post-pandemic. Conclusion: The pandemic was a catalyst for change in East Toronto that accelerated existing initiatives to achieve integrated care. The East Toronto experience may serve as a useful guide for other emerging integrated care systems. [ABSTRACT FROM AUTHOR]

Simple Summary: This paper looks at changes in weight, physical activity, and food/dietary intake during the first year of the COVID-19 pandemic in undergraduate students enrolled in a Canadian university. The investigation used an online survey format to collect data at the end of the two lockdown periods over one year. Participants were recruited from universities across Canada. The results show a modest weight gain accompanied by a decrease in physical activity and an unhealthy change in diet. Specifically, students reported that their engagement in specific physical activities and overall activity levels decreased during the lockdowns. The number of calories also decreased over time, while the foods consumed decreased in nutritional value. Thus, the modest weight gain observed may have resulted from the decrease in physical activity and diet quality. In conclusion, Canadian food and physical activity recommendations were not met during the lockdowns caused by the pandemic, which highlights the physical and nutritional implications of confinement. This study examined changes in body mass and body mass index (BMI), physical activity, and dietary intake in Canadian university students during the first year of the COVID-19 pandemic. Two self-reported recall surveys were conducted: after the first lockdown in September 2020 (T1) and following the second lockdown in March 2021 (T2). Eligible participants were full-time undergraduate students attending a Canadian university and residing in Canada during the first year of the pandemic. At T1, 510 students (99 male, 411 female) completed the survey, and of those, 135 (32 males, 103 females) completed the survey at T2 (73% attrition). At both T1 and T2, most participants were 18–24 years of age (93% and 90%, respectively), Caucasian (73% and 78%, respectively), and resided in the province of Ontario (79% and 80%, respectively). Body mass increased from T1 to T2 (+0.91 ± 3.89 kg t(132) = −2.7, p = 0.008). BMI also increased from T1 to T2 (+0.30 ± 1.33 kg/m2 [t(130) = −2.5, p = 0.012), with a greater number of participants within the overweight range (19.8% versus 24.4%, respectively). At T1, 38% of the participants reported a decrease in physical activity, while the number of students reporting a decrease in activity increased to 56% at T2. Dietary energy intake decreased from 1678 ± 958 kcal/day at T1 to 1565 ± 842 kcal/day at T2 [c2(1) = 7.2, p = 0.007]. Diet quality also decreased, with participants not meeting the recommended daily allowance for essential macro and micronutrients. A decrease was observed in daily servings of fruits (−27%, p < 0.001), vegetables (−72%, p < 0.001), and grains (−68%, p < 0.001). In conclusion, despite a small decrease in dietary energy intake, a modest weight gain occurred during the first year of the COVID-19 pandemic in this cohort of Canadian university students, which was potentially related to decreased physical activity and diet quality. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has been pervasive in its impact on all aspects of Canadian society. Along with its pervasiveness, the disease provided unprecedented complexity to the Canadian healthcare infrastructure, eliciting varying responses from the afflicted healthcare systems in Canada. However, insights into the various parameters and complexities endured by Canadian rural physicians and rural healthcare institutions during the pandemic have been scarce. Objective: This paper explores the conditions and complexity of living and working of Rural Family Physicians (RFPs) in rural healthcare in Canada during the pandemic. Methods: Community-based participatory research was utilized as a collaborative and partnership approach, equitably engaged community members in all aspects of research, ranging from designing the research question to analyzing data. Participants of this study include RFPs with at least one year of experience working in rural Canada. Data were collected through telephone interviews and analyzed according to the six-phase guide for the data's inductive thematic analysis. Data collection halted upon saturation. Results: Five significant compiled categories reflect the lived experiences of Rural Family Physicians. 1- virtual care as a challenge or forward progress; 2- canceling in-person visits and interrupting the routine; 3- shortage of health care providers and supporting staff; 4-ongoing coping process with the pandemic guidelines; 5-COVID-19 combat fatigue. Discussion: The inception of COVID-19 has significantly impacted rural physicians across several interconnected issues. This study illuminates the lesser-known effects of the COVID-19 pandemic, which heavily impacts rural healthcare. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic created major problems throughout the world. This led many governments to delay reassessments on the premise that the available market data would be insufficient and/or too volatile to allow an accurate mass appraisal of the properties within their jurisdictions. This paper examines that hypothesis by referring to the real estate markets for retail and industrial properties in Canada's largest cities. From this analysis, it concludes that market activity and data, in most cases, provide the assessor with enough information to proceed with reassessments. For circumstances where there may not be sufficient information, the paper provides innovative suggested interim solutions, relying upon publicly available information that enable assessors to develop assessed values that take into consideration the impact of the pandemic. Lastly, the paper will briefly comment on the need to recognize that the pandemic did not have a uniform impact on the value of different types of property, and assessors need to be mindful of that reality when performing their next reassessment. [ABSTRACT FROM AUTHOR]

When the COVID-19 pandemic hit, many countries reacted by relaxing environmental rules and Canada was no exception. Environmental regulators across Canada changed rules in unprecedented efforts to balance public health, economic wellbeing and protection of the environment. This briefing paper takes stock of and discusses these actions. When the COVID-19 pandemic hit, many countries reacted by relaxing environmental rules and Canada was no exception. Environmental regulators across Canada changed rules in unprecedented efforts to balance public health, economic wellbeing and protection of the environment. This briefing paper takes stock of and discusses these actions. Only 41 of the 61 government notices included a specific COVID-related rationale for the rule changes and the explanations lacked detail. Reasons included accommodating regulated entities' need to observe public health requirements (88), financial relief for industry (38), responding to government capacity constraints (14) and accommodating public observance of health restrictions (3). More than a third of the changes were indefinite, with no set end date. In these cases especially it is critical that government agencies be held accountable for reinstating lost protections in a timely manner. Overall, environmental regulators across Canada responded in similar ways to the pandemic. Some agencies, however, took extraordinary actions. Alberta, for example, was the only jurisdiction to completely suspend reporting requirements and did so across multiple sectors. In Ontario, the provincial government indefinitely suspended parts of the province's Environmental Bill of Rights, allowing other regulations to be approved with reduced oversight and public consultation. Newfoundland and Labrador was alone in permanently amending environmental assessment timelines. British Columbia, on the other hand, was the sole jurisdiction to change a rule to address constraints faced by the public, suspending public appeal filing deadlines to support public participation in project decisions. As the virus is brought under control, government should move swiftly to restore suspended environmental protections. Agencies must now be held to account for ensuring, at minimum, a timely return to the status quo. Where regulators are practicing enforcement discretion, fair and transparent enforcement decision-making is critical. Further, agencies have the opportunity to learn and adapt as a result of this experience, leading to smarter, more resilient environmental regulation in Canada. An important question warranting further inquiry, especially, is whether regulator actions were justifiable, ex post. What were the environmental, social and economic costs and benefits of these rule changes? The comprehensive database of rule changes presented in this paper could aid such future research. [ABSTRACT FROM AUTHOR]

International retirement migration involves the seasonal relocation of older adults to destinations abroad. For Canadians, this is typically done to escape winter at home in favour of warmer weather elsewhere. In this paper, we explore how Canadian newspapers chronicled the changes associated with managing the COVID‐19 pandemic in Canada, including border measures and calls to avoid non‐essential travel, and how they impacted international retirement migrants and their movements. We specifically present the findings of a framing analysis conducted of 187 newspaper articles published in 2020, identified through the Canadian Newsstream Database. The framing analysis identified three ways in which Canadian international retirement migrants were discussed in relation to the pandemic and the changed spatio‐temporal realities that affected their transnational movements. First, they are a group who altered their consumer practices, which had economic impacts at home and in their usual seasonal destinations. Second, they are a group who faced considerable uncertainty with regard to travel and movement, among other things, as the pandemic unfolded in 2020. Finally, Canadian international retirement migrants sought stability in a number of ways, both in terms of their social networks and living arrangements at home and abroad. Key Messages: The lives and seasonal movements of Canadian international retirement migrants were greatly impacted by the COVID‐19 pandemic and measures put in place to manage the spread of the virus.Newspaper coverage of Canadian international retirement migrants from 2020 framed them as altering consumer practices, facing uncertainties, and seeking stability in response.These responses form an interesting dualism because the COVID‐19 pandemic introduced both challenges and opportunities for Canadian international retirement migrants in 2020. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has significant impact on long-term care (LTC) residents and staff. The purpose of this paper is to report the data gathered during a COVID-19 outbreak in a Canadian LTC home regarding staff experiences, challenges, and needs, to offer lessons learned and implications. Methods: A total of 30 staff from multiple disciplines participated in the study, including nurses, care workers, recreational staff, and a unit clerk. Focus groups (n = 20) and one-on-one interviews (n = 10) were conducted as part of a larger participatory action research (PAR) study in a Canadian LTC home. All data collection was conducted virtually via Zoom, and thematic analysis was performed to identify themes. Results: Four main themes were identified: We are Proud, We Felt Anxious, We Grew Closer to Residents and Staff Members, and The Vaccines Help. Conclusions: This research details the resilience that characterizes staff in LTC, while highlighting the emotional toll of the pandemic, particularly during an outbreak. LTC staff in this study found innovative ways to connect and support residents and this resulted in stronger connections and relationships. Leadership and organizational support are pivotal for supporting team resilience to manage crisis and adapt positively in times of COVID-19 pandemic, especially during the period of outbreak. [ABSTRACT FROM AUTHOR]

Background: Public health services and systems research is under-developed in Canada and this is particularly the case with respect to research on local public health unit operational functioning and capacity. The purpose of this paper is to report on a study that will collect retrospective information on the local public health response to COVID-19 throughout Canada between 2020 and 2021. Methods/Design: The goal of the study is to develop and implement a study framework that will collect retrospective information on the local public health system response to the COVID-19 pandemic in Canada. This study will involve administering a mixed-method survey to Medical Health Officers/Medical Officers of Health in every local and regional public health unit across the country, followed by a process of coding and grouping these responses in a consistent and comparable way. Coded responses will be assessed for patterns of divergent or convergent roles and approaches of local public health across the country with respect to interventions in their response to COVID-19. The Framework Method of thematic analysis will be applied to assess the qualitative answers to the open-ended questions that speak to public health policy features. Discussion: The strengths of the study protocol include the engagement of Medical Health Officers/Medical Officers of Health as research partners and a robust integrated knowledge translation approach to further public health services and systems research in Canada. [ABSTRACT FROM AUTHOR]

The COVID-19 global pandemic has disrupted economies around the world, and rural Canada is no exception. In this paper, we explore the economic development impacts of the pandemic on rural communities across Canada. We seek to provide a deeper and more comprehensive understanding of how rural communities have responded to this crisis and the extent to which they are able to build long-term rural resilience through their responses and plans for recovery. To do so, we draw upon novel data derived from a survey of rural economic development practitioners from across Canada. Our findings are structured around three main themes: economic development and business impacts, economic development responses, and resources needed for recovery. The study highlights the geographic unevenness of impacts, responses, and resource needs to address the challenges introduced by the COVID-19 pandemic. Overall, our research underscores the importance of capacity and context as rural economic development practitioners and other rural leaders have responded to these challenges. Finally, this research provides important insights into the tools and strategies that could build long-term rural resilience. [ABSTRACT FROM AUTHOR]

Rural communities are often portrayed in the research literature and popular media as being disadvantaged and 'vulnerable'. This paper examines the extent to which rural health regions in Canada are more vulnerable than other health regions in terms of contracting COVID-19 and developing serious illness from this virus that leads to death. Data include published numbers of cases of and deaths from COVID-19 in each health region across Canada. Other data from Statistics Canada's Canadian Community Health Survey (CCHS) documents the higher rates of 'vulnerability' in rural health regions, according to (a) their socio-demographic conditions (income, education, age), and (b) the rates of 'underlying health conditions' which would make individuals more susceptible to serious illness from COVID-19. Despite these vulnerabilities, which are consistent with other research on rural areas in Canada, COVID-19 rates are found to be higher in metropolitan areas--although there is some variation in this pattern by province. In no provinces is the rate of death per case of COVID-19 highest in rural areas. Overall, in Canada, deaths per case from COVID-19 are higher in metropolitan than in rural health regions, challenging the notion of rural areas being only and always disadvantaged. [ABSTRACT FROM AUTHOR]

Since December 2019, there has been a global explosion of research on COVID-19. In Canada, the six National Collaborating Centres (NCCs) for Public Health form one of the central pillars supporting evidence-informed decision making by gathering, synthesizing and translating emerging findings. Funded by the Public Health Agency of Canada and located across Canada, the six NCCs promote and support the use of scientific research and other knowledges to strengthen public health practice, programs and policies. This paper offers an overview of the NCCs as an example of public health knowledge mobilization in Canada and showcases the NCCs' contribution to the COVID-19 response while reflecting on the numerous challenges encountered. [ABSTRACT FROM AUTHOR]

This paper documents the services and changes that library staff at a group of 15 Canadian university research libraries highlighted on their main pandemic pages and social media accounts during the early days of the coronavirus (COVID-19) pandemic. Findings suggest that libraries in the samples adopted the following services and changes: closing the physical libraries; suspending all physical collection services and in-person events; continuing to provide virtual reference services; promoting access and usage of electronic collections; suspending late fees and renewing checked-out items with a new due date; and advising users to wait before returning borrowed items. Notably, all libraries in this study were operating as full-scale digital libraries. This study will provide lessons learned to other libraries around the world to help in reviewing their own operational policies for coping with the current COVID-19 pandemic and for future global public health crises. [ABSTRACT FROM AUTHOR]

The impacts of automation and emerging technologies on federal, provincial, and local economies have direct implications for labour markets across the country and require a policy response. Taking into account the impacts of the global COVID-19 pandemic on economies and workforces across the country, this paper reviews the policy choices available to various levels of Canadian governments and businesses in response to the challenges posed by automation. It concludes that reskilling workers, closing economic gaps between rural and urban areas, and preparing for widespread automation are just some of the ways that policymakers, business leaders, and local employers can prepare for, and address, the effects of emerging technologies. [ABSTRACT FROM AUTHOR]

Purpose: The novel coronavirus disease (COVID-19) pandemic has swept the globe, with a domino effect on medical education and training. In this study, we surveyed Canadian radiology residents to understand the impact of the pandemic on their residency training, strategies utilized by the residency programs in mitigating those impacts, and factors important to residents in the selection of educational resources on COVID-19. Methods: A 10-item questionnaire was distributed to 460 resident members of the Canadian Association of Radiologists. The survey was open for 2 weeks, with a reminder sent at half-way mark. Results: We received 96 responses (response rate: 20.9%). The 4 highest affected domains of training were daytime case volumes (92.4%), daytime schedules (87.4%), internal and external assessments (86.5%), and vacation/travel (83.3%). Virtual teaching rounds (91.7%), change in schedules to allow staying home (78.1%), and virtual/phone readouts (72.9%) were the most utilized strategies by the Canadian radiology residency programs. Overall stress of exposure to the disease was moderate to low (86.5%). A minority of the residents were redeployed (6.2%), although most (68.8%) were on standby for redeployment. Residents preferred published society guidelines (92.3%), review papers (79.3%), video lectures (79.3%), and web tools (76.9%) for learning about COVID-19 imaging manifestations. Conclusion: The COVID-19 pandemic has had a significant impact on various domains of the Canadian radiology residency programs, which has been mitigated by several strategies employed by the training programs. [ABSTRACT FROM AUTHOR]

The coronavirus pandemic (COVID-19) has altered the undergraduate learning experience for many students across Canada. Medical education is no exception; clinical programs, in-person lectures, and mandatory hands-on activities have been suspended to adhere to social distancing guidelines. As remote teaching becomes the forefront of education, medical curricula have been forced to adapt accordingly in order to fulfill the core competencies of medical training and to provide quality education to medical students. With that in mind, the COVID-19 crisis offers a unique opportunity to evaluate the current "continuity plans" in medical education as they stand. This paper provides the perspective of medical students on how medical education is changing for both pre-clerkship and clerkship students, using their experience at McGill University as an example for the Canadian medical education system. Additionally, we discuss the accommodations put forth by the undergraduate medical education (UGME) office, and reflect on the limitations and sustainable solutions in supporting quality medical education. [ABSTRACT FROM AUTHOR]

The coronavirus pandemic (COVID-19) has altered the undergraduate learning experience for many students across Canada. Medical education is no exception; clinical programs, in-person lectures, and mandatory hands-on activities have been suspended to adhere to social distancing guidelines. As remote teaching becomes the forefront of education, medical curricula have been forced to adapt accordingly in order to fulfill the core competencies of medical training and to provide quality education to medical students. With that in mind, the COVID-19 crisis offers a unique opportunity to evaluate the current "continuity plans" in medical education as they stand. This paper provides the perspective of medical students on how medical education is changing for both pre-clerkship and clerkship students, using their experience at McGill University as an example for the Canadian medical education system. Additionally, we discuss the accommodations put forth by the undergraduate medical education (UGME) office, and reflect on the limitations and sustainable solutions in supporting quality medical education. [ABSTRACT FROM AUTHOR]

COVID-19 has imposed numerous challenges onto Canadians including income insecurity, reduced access to healthcare, and last-minute workplace adaptations. Although these obstacles have altered the lives of thousands, many people in the disability community have been struggling with these challenges for years. This paper outlines how Canada's response to the COVID-19 pandemic uncovers the pervasive ableist attitudes that are present at both the government and societal levels. [ABSTRACT FROM AUTHOR]

The opioid overdose crisis in Canada has dramatically worsened during the current COVID-19 pandemic. People who use opioids are dying at unprecedented rates, and a rapid expansion of available treatments for opioid use disorder (OUD) is needed. Injectable opioid agonist therapy (iOAT) is an evidence-based treatment for OUD with a superior retention rate. However, iOAT is currently only available in seven specialized clinics across British Columbia, and many people who may benefit from iOAT cannot access it. In this commentary paper, we discuss evidence behind iOAT, outline barriers preventing greater access, and make suggestions around how to improve access to iOAT. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is producing significant economic and social cost globally. As a cure or a treatment is yet unavailable, social distancing is considered the key way to prevent it. Mobility restrictions and confinement measures implemented across the world are considered to help reduce air pollution. However, empirical examination of the link between public mobility changes and air pollution during the COVID-19 period remains unavailable. This paper examines the short and long run impacts of mobility changes on carbon monoxide (CO) emissions by employing three dynamic estimators on a panel of 35 countries covering daily data from 15 February to April 17, 2020 - a period when most countries went into strict lockdowns. Findings show a consistent evidence at the all-countries level and across regions that long-run indoor mobility increases reduce CO emissions, while outdoor mobility increases across places such as transit stations, workplaces, grocery & pharmacies, retail & recreation, and parks drive up emissions. Among the regions studied, Europe excluding the EU and the UK (−8.4%), followed by East Asia and the Pacific (−4.3%), sees a larger emissions reduction from increased indoor mobility. While short-run effects are limited in general, emissions in US-Canada respond to indoor and outdoor mobility changes in both the short (1.1%) and long run (−1.4%). Findings overall indicate that reducing unnecessary outdoor mobility could help in maintaining air quality in the post-pandemic world. [Display omitted] • Longer term lockdowns and mobility restrictions slow down CO emissions globally. • Europe experiences the largest declines in air pollution due to mobility restrictions in the long run. • Emissions decline due to mobility restrictions in the US and Canada in both short and long run. • Curbing people movement through more work-from-home could save the environment. [ABSTRACT FROM AUTHOR]