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Summary: Healthcare administrative (claims) data are commonly utilized to estimate drug effects. We identified considerable heterogeneity in fracture outcome definitions in a scoping review of 57 studies that estimated osteoporosis drug effects on fracture risk. Better understanding of the impact of different fracture definitions on study results is needed. Purpose: Healthcare administrative (claims) data are frequently used to estimate the real-world effects of drugs. Fracture incidence is a common outcome of osteoporosis drug studies. We aimed to describe how fractures are defined in studies that use claims data. Methods: We searched MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO), and gray literature for studies published in English between 2000 and 2020 that estimated fracture effectiveness (hip, humerus, radius/ulna, vertebra) or safety (atypical fracture of the femur, AFF) of osteoporosis drugs using claims data in Canada and the USA. Literature searches, screening and data abstraction were completed independently by two reviewers. Results: We identified 57 eligible studies (52 effectiveness, 3 safety, 2 both). Hip fracture was the most common fracture site studied (93%), followed by humerus (66%), radius/ulna (59%), vertebra (61%), and AFF (9%). Half (n = 29) of the studies did not indicate specific data sources, codes, or cite a validation paper. Of the papers with sufficient detail, heterogeneity in fracture definitions was common. The most common definition within each fracture site was used by less than half of the studies that examined effectiveness (12 definitions in 29 hip fracture papers, 8 definitions in 17 humerus papers, 8 definitions in 13 radius/ulna papers, 9 definitions in 15 vertebra papers), and 3 definitions among 4 AFF papers. Conclusion: There is ambiguity and heterogeneity in fracture outcome definitions in studies that leverage claims data. Better transparency in outcome reporting is needed. Future exploration of how fracture definitions impact study results is warranted. [ABSTRACT FROM AUTHOR]

Introduction: This study presents a global research scenario in the broad domain of osteoarthritis (OA) research, using quantitative and qualitative publication and citation indicators. Methods: The study is based on 45,368 global publications, sourced from the Scopus bibliographical database, covering three decades (1994–2023). We studied the performance of the top 12 developed and top 12 developing countries. The key countries, organizations and authors at national and international levels were identified. The broad subject areas and key journals contributing to global OA research were delineated, besides identifying the broad characteristics of highly cited papers in the field. Results: The United States and China were the most productive countries, while the Netherlands and Canada made the largest citation impact. Harvard Medical School and the University of Sydney made the most contribution, while Boston University and Pfizer Inc., USA registered the highest citation impact. Hunter DJ and Guermazi A were the most productive authors, while Lohmander LS, and Hochberg MC registered the highest citation impact. Osteoarthritis and Cartilage (n = 4879) and Annals of the Rheumatic Diseases (n = 786) published the maximum papers, while Arthritis and Rheumatism and Nature Reviews Rheumatology registered the largest citation impact. The highly cited papers with 100 or more citations constituted 6.25% of the total publications. Conclusions: There has been a systematic growth of publications on OA. The research on OA was mainly done in developed countries, with the maximum publications coming from the United States of America, China and Canada. The most impactful publications on OA were from the Netherlands, Canada and the United States of America. [ABSTRACT FROM AUTHOR]

In both Canada and the United States, immigrants often experience different residential outcomes than non-immigrants. Previous research often attributes these differences to differential treatment in either the labour market or the housing market. We adopt a unique approach in this paper, comparing the behavior of racial groups in Canada and the United States, two countries with large non-white immigrant populations, and distinct housing and labour markets. We examine the role that factors such as immigration status, ethnic group, and housing costs play in differentiating the housing careers of White, South Asian, Black, Latin American, Filipino, and Chinese immigrants from their White native-born counterparts. We find that immigrants often converge upon the native-born in both countries, and that the differences between countries are not nearly as stark as the differences between groups. [ABSTRACT FROM AUTHOR]

We are honored to present this collection of abstracts from the Research and Thesis Poster Session of the 57th American Dance Therapy Association (ADTA) Conference in Montreal, Canada held from October 27–30, 2022. This paper features eleven abstracts that showcase the latest research in dance therapy from various perspectives and approaches. These abstracts were selected and curated by Research and Practice committee members, Karolina Bryl, Cecilia Fontanesi, and Chevon Stewart, who were responsible for organizing the Research and Thesis Poster Session. The Research and Thesis Poster Session is a vital component of the ADTA Conference, providing a platform for researchers and practitioners to share their work, exchange ideas, and connect with colleagues. The abstracts presented in this paper offer insights into a broad range of topics, including the use of dance therapy in clinical and community settings, the integration of technology in dance therapy, and the examination of cultural and social factors that impact the practice of dance therapy. We hope this collection of abstracts will inspire and inform future research in dance therapy, and we extend our appreciation to all the presenters for their contributions. [ABSTRACT FROM AUTHOR]

Almost 80 million people globally are forcibly displaced. A small number reach wealthy western countries and seek asylum. Over half are children. Wealthy reception countries have increasingly adopted restrictive reception practices including immigration detention. There is an expanding literature on the mental health impacts of immigration detention for adults, but less about children. This scoping review identified 22 studies of children detained by 6 countries (Australia, Canada, Hong Kong, Netherlands, the UK and the US) through searches of Medline, PsychINFO, Emcare, CINAHL and Scopus data bases for the period January 1992–May 2019. The results are presented thematically. There is quantitative data about the mental health of children and parents who are detained and qualitative evidence includes the words and drawings of detained children. The papers are predominantly small cross-sectional studies using mixed methodologies with convenience samples. Despite weaknesses in individual studies the review provides a rich and consistent picture of the experience and impact of immigration detention on children's wellbeing, parental mental health and parenting. Displaced children are exposed to peri-migration trauma and loss compounded by further adversity while held detained. There are high rates of distress, mental disorder, physical health and developmental problems in children aged from infancy to adolescence which persist after resettlement. Restrictive detention is a particularly adverse reception experience and children and parents should not be detained or separated for immigration purposes. The findings have implications for policy and practice. Clinicians and researchers have a role in advocacy for reception polices that support the wellbeing of accompanied and unaccompanied children who seek asylum. [ABSTRACT FROM AUTHOR]

The proper interpretation of offers and acceptances has, despite their undisputable role in the formation of contracts, received relatively little theoretical and comparative analysis in recent years. The notorious legal question of when a contract is considered to have been formed is a fundamental concept in all legal systems, yet its nature remains poorly understood and controversial. Moreover, recent doctrinal and jurisprudential developments in English, French, US, German, and Canadian law of contracts call for further systematic assessment of this fascinating topic. This paper seeks to provide a systematic comparative evaluation of the disparate doctrines governing offer and acceptance and the consequential formation of contracts in English, US, German, French, and Canadian law of contracts. While employing well-defined normative criteria of justice and wealth-maximization, it identifies the aspects of suboptimal reliance, rent-seeking, cost-avoidance, and opportunistic revocations and provides a set of economically inspired arguments for justification of the mailbox rule. The paper is an attempt to determine how much new light the comparative analysis of law can shed on the puzzling issues of offer and acceptance so as to help clarify them. [ABSTRACT FROM AUTHOR]

This paper provides a narrative review of the existing literature on differences in demographic and biological features of breast cancer at time of diagnosis between Black and White women in Canada, the United Kingdom and the United States. Electronic database searches for published peer-reviewed articles on this topic were conducted, and 78 articles were included in the final narrative review. Differences between Black and White women were compared for eight categories including age, tumour stage, size, grade, lymph node involvement, and hormone status. Black women were significantly more likely to present with less favourable tumour features at the time of diagnosis than White women. Significant differences were reported in age at diagnosis, tumour stage, size, grade and hormone status, particularly triple negative breast cancer. Limitations on the generalizability of the review findings are discussed, as well as the implications of these findings on future research, especially within the Canadian context. [ABSTRACT FROM AUTHOR]

Canadian lockdown response to the COVID-19 pandemic has included province-wide school shutdowns and frequent individual school closures to contain outbreaks. A number of scientists and political figures have shared their concerns about the medium- and long-term effects of school closures/shutdowns on student academic achievement, learning loss, and learning gaps. Unfortunately, there are no pan-Canadian studies to date to help define the scope of the problem. In this commentary, we report the results of a number of longitudinal research studies conducted in the Netherlands, Belgium, England, and the United States. Using these studies as a basis for comparison, we extrapolated a "Canadian" hypothesis on the unintended academic consequences of school closures, keeping in mind the unique nature of each province. We continue with recommendations on the types of research required to validate this hypothesis, and conclude with implications on public health and education should learning loss and gaps prove true., (© 2021. The Canadian Public Health Association.)

Epidemiological evidence suggests that regular physical activity (PA) positively impacts individuals' mental health (MH). The PA-MH relationship may be critical among immigrants owing to psycho-social-cultural influences. This scoping review of 61 studies employed a holistic bio-psycho-socio-cultural framework to thoroughly investigate the complex relationship between PA (across life domains) and immigrants' MH in Western countries. A systematic search of five electronic databases (Medline, PubMed, Embase, PsycINFO and Anthropology Plus) was conducted to locate relevant articles. No limitations were applied to study design, age, gender, home country, MH condition or PA type. A bio-psycho-socio-cultural-informed conceptual model guided the analysis of the multi-domain PA-MH relationship. Immigrant PA-MH studies were conducted and reported most commonly in the USA (38%), Australia (18%), and Canada (11%). Overall, PA was positively related to MH. Each domain-specific PA appeared to be associated with unique MH-promoting pathways/mechanisms. Leisure-related PA may support MH by enhancing self-agency and minimizing risky behaviors, whilst travel- and domestic-related PA may promote self-accomplishment and physical engagement. Ethnic sports appeared to enhance resilience. Occupational-related PA was associated with either positive or negative MH, depending on the type of occupation. A bio-psycho-socio-cultural-informed model is required to gain an encompassing and integrated understanding of immigrants' health. The first iteration of such a model is presented here, along with an illustration of how the model may be used to deepen analysis and understanding of the multi-domain PA-MH relationship among immigrants and inform public health planners and practitioners. [ABSTRACT FROM AUTHOR]

Millions of people cross political borders yearly without having the proper documents. This has led to increased detention and deportation practices in destination countries for reasons related to security and sovereignty. The objective of the current study was to analyze and visualize research publications on the detention and deportation of migrants to identify current research hotspots, research gaps, and potential future research in the field. Relevant research articles were obtained from the Scopus database for the study period from 1900 to December 31, 2022. The analysis included presentations of key contributors to the field and visualization of topics, themes, and international collaboration. In total, 906 articles were found. The earliest was in 1982. The majority of articles were published in journals within the subject areas of social sciences and humanities. The number of publications showed a steep rise from 2011 to 2022. The Journal of Ethnic and Migration Studies was the most prolific, but publications in the Citizenship Studies journal received the highest number of citations per article. Researchers from the United States contributed the most. Mexico ranked fifth in the number of publications. Oxford University was the most prolific institution, followed by three universities in Australia. The majority of articles were single-authored, indicative of limited author-author collaboration. Research hotspots in the field were "human rights" and "mental health". The detention and deportation of Mexican and other Latino migrants in the United States constituted a distinct research theme in the field. International research collaboration was limited by geographical proximity (e.g., the United States and Mexico) or common language (e.g., the United Kingdom and Australia). Future research topics should focus on alternatives to detention, family separation, and healthcare services for detained migrants. Research activity on detention and deportation is required from all world regions, including the source countries of migrants. Future research should promote alternatives to traditional detentions. The contribution of countries in Africa, the Middle East, and South-Eastern Asian regions needs to be encouraged. Future research on the detention and deportation of non-Latino migrants is highly required. [ABSTRACT FROM AUTHOR]

Young mothers with child welfare involvement often participate in programs to prevent future child maltreatment. However, most programs are not designed for young mothers and overlook unique challenges related to development, psychosocial stressors, relationships, and stigma. This scoping review synthesized existing literature and mapped what is known about programs designed for young mothers with child welfare involvement in Canada and the United States. The scoping review protocol was designed using Arksey and O'Malley's methodological framework. An extensive search was conducted from university databases and grey literature. The inclusion criteria were (1) the program was designed for parents under 25 years old, (2) the program serves mothers with child welfare involvement, (3) the studies are published in English, and (4) the programs were delivered in Canada or the United States. The search results included 1925 articles and 14 were screened using the inclusion criteria. Article publication dates ranged from 1981 to 2017, with most studies being conducted in the United States. Three themes identified in this review were (1) service delivery approaches, (2) program outcomes, and (3) collaboration with child welfare services. The findings suggest that few programs designed for young mothers exist in Canada and the United States. A variety of program evaluation methods and program delivery approaches were found. Program characteristics that may benefit young mothers with child welfare involvement include incorporating peer support initiatives, the explicit intention to build a therapeutic alliance between the service provider and the mother, and prolonged service delivery. [ABSTRACT FROM AUTHOR]

Across different faith traditions, Sabbath day observance shares a close relationship with theological conceptions of rest. Sabbath-keeping, with its promise of rest, may be a valuable spiritual practice in the context of teaching as prior research has consistently documented the adverse effects of teacher burnout. Yet no research has examined Sabbath-keeping and its connections to teaching practices and teacher burnout. We aim to fill this gap with a quantitative study of Sabbath-keeping and burnout among 1,300 teachers in Christian schools throughout the USA, Canada, Indonesia, and Paraguay. We report their conceptions of Sabbath and how those conceptions inform their teaching practice. We find an inverse and statistically significant relationship between Sabbath-keeping and burnout that is robust across several model specifications, suggesting that Sabbath-keeping may be helpful in reducing burnout among educators. [ABSTRACT FROM AUTHOR]

Interbasin water transfers (IBTs) can have a significant impact on the environment, water availability, and economies within the basins importing and exporting water, as well as basins downstream of these water transfers. The lack of comprehensive data identifying and describing IBTs inhibits understanding of the role IBTs play in supplying water for society, as well as their collective hydrologic impact. We develop three connected datasets inventorying IBTs in the United States and Canada, including their features, geospatial details, and water transfer volumes. We surveyed the academic and gray literature, as well as local, state, and federal water agencies, to collect, process, and verify IBTs in Canada and the United States. Our comprehensive IBT datasets represent all known transfers of untreated water that cross subregion (US) or subdrainage area (CA) boundaries, characterizing a total of 641 IBT projects. The infrastructure-level data made available by these data products can be used to close water budgets, connect water supplies to water use, and better represent human impacts within hydrologic and ecosystem models. [ABSTRACT FROM AUTHOR]

Purpose: The burden of health and safety related issues emanating from the modern workplace is overwhelming. Although the prevailing statistics found in the literature show that victims of workplace fatalities and injuries are higher in developing countries and transition economies, there is a very limited understanding of the causal factors that may correspond to the continuous increase in the occupational exposure of employees to various fatalities and injuries. The purpose of this study was to review the literature on occupational safety of workers with the objective of highlighting the major causal factors of workplace injuries and fatalities from a multi-regional perspective, particularly on job-contexts with highest safety and health related hazards. Methodology: A systematic review of the literature was conducted on 73 empirical studies in the regions of Europe, Africa, the Middle East, Asia, Australia, and the Americas (the US & Canada). Findings: The results showed that the highest number of injuries and fatalities were mostly found in the construction industry. It further emerged that most of the studies were centered in developing countries within Africa and Asia. Other results and recommendations were discussed for each region. Value: The findings from this study have the potential to expose the regional dynamics in relation to safety in the workplace. This study also addresses the main areas of concern for stakeholders to promote organizational development and safety culture. [ABSTRACT FROM AUTHOR]

Summary: Background. Previous research focused on the clinical evidence supporting new cancer drugs' initial US Food and Drug Administration (FDA) approval. However, targeted drugs are increasingly approved for supplementary indications of unknown evidence and benefit. Objectives. To examine the clinical trial evidence supporting new targeted cancer drugs' initial and supplementary indication approval in the US, EU, Canada, and Australia. Data and Methods. 25 cancer drugs across 100 indications were identified with FDA approval between 2009–2019. Data on regulatory approval and clinical trials were extracted from the FDA, European Medicines Agency (EMA), Health Canada (HC), Australian Therapeutic Goods Administration (TGA), and clinicaltrials.gov. Regional variations were compared with χ2-tests. Multivariate logistic regressions compared characteristics of initial and supplementary indication approvals, reporting adjusted odds ratios (AOR) with 95% confidence intervals (CI). Results. Out of 100 considered cancer indications, the FDA approved 96, the EMA 92, HC 86, and the TGA 83 (83%, p < 0.05). The FDA more frequently granted priority review, conditional approval, and orphan designations than other agencies. Initial approvals were more likely to receive conditional / accelerated approval (AOR: 2.69, 95%CI [1.07–6.77], p < 0.05), an orphan designation (AOR: 3.32, 95%CI [1.38–8.00], p < 0.01), be under priority review (AOR: 2.60, 95%CI [1.17–5.78], p < 0.05), and be monotherapies (AOR: 5.91, 95%CI [1.14–30.65], p < 0.05) than supplementary indications. Initial indications' pivotal trials tended to be shorter (AOR per month: 0.96, 95%CI [0.93–0.99], p < 0.05), of lower phase design (AOR per clinical phase: 0.28, 95%CI [0.09–0.85], p < 0.05), and enroll more patients (AOR per 100 patients: 1.19, 95%CI [1.01–1.39], p < 0.05). Conclusions. Targeted cancer drugs are increasingly approved for multiple indications of varying clinical benefit. Drugs are first approved as monotherapies in rare diseases with a high unmet need. Whilst expedited regulatory review incentivizes this prioritization, indication-specific safety, efficacy, and pricing policies are necessary to reflect each indication's differential clinical and economic value. [ABSTRACT FROM AUTHOR]

Cultural background influences how migrants and ethnic minority populations view and assess health. Poor oral health literacy (OHL) may be a hindrance in achieving good oral health. This systematic review summarizes the current quantitative evidence regarding OHL of migrants and ethnic minority populations. The PubMed database was searched for original quantitative studies that explore OHL as a holistic multidimensional construct or at least one of its subdimensions in migrants and ethnic minority populations. 34 publications were selected. Only 2 studies specifically addressed OHL in migrant populations. Generally, participants without migration background had higher OHL than migrant and ethnic minority populations. The latter showed lower dental service utilization, negative oral health beliefs, negative oral health behavior, and low levels of oral health knowledge. Due to its potential influence on OHL, oral health promoting behavior, attitudes, capabilities, and beliefs as well as the cultural and ethnic background of persons should be considered in medical education and oral health prevention programs. [ABSTRACT FROM AUTHOR]

Child maltreatment (CM) is a global public health problem. Evidence-based home visiting programs, such as SafeCare®, reduce CM risk, and enhance parent-child relationships and other protective factors. As the result of the COVID-19 pandemic and resulting restrictions, SafeCare Providers transitioned from home to virtual delivery for the SafeCare curriculum. The purpose of this study is to 1) examine active SafeCare Providers' opinions on the feasibility and effectiveness of SafeCare via remote delivery, and 2) better understand workforce concerns for human service professionals within the context of COVID-19 mitigation efforts. Data are from a cross-sectional survey of SafeCare Providers (N = 303) in the United States, Canada, and Australia. The majority of Providers reported they were actively delivering SafeCare virtually and were comfortable with the delivery format. Providers indicated that the majority of SafeCare families are making progress on target skills, and that engagement is high among many families. Some service delivery challenges were reported, ranging from family data plan limitations to difficulty with delivery of specific components of the SafeCare curriculum related to modeling and assessment. The impact of COVID-19 on Providers' daily routines, stress level, and work-life balance has been significant. Remote, virtual delivery of CM prevention programming offers the opportunity to continue serving vulnerable families in the midst of a pandemic. Barriers related to family technology and data access must be addressed to ensure reach and the effective delivery of prevention programming during the pandemic and beyond. [ABSTRACT FROM AUTHOR]

Purpose: The Risk of Pediatric and Adolescent Cancer Associated with Medical Imaging (RIC) Study is quantifying the association between cumulative radiation exposure from fetal and/or childhood medical imaging and subsequent cancer risk. This manuscript describes the study cohorts and research methods. Methods: The RIC Study is a longitudinal study of children in two retrospective cohorts from 6 U.S. healthcare systems and from Ontario, Canada over the period 1995–2017. The fetal-exposure cohort includes children whose mothers were enrolled in the healthcare system during their entire pregnancy and followed to age 20. The childhood-exposure cohort includes children born into the system and followed while continuously enrolled. Imaging utilization was determined using administrative data. Computed tomography (CT) parameters were collected to estimate individualized patient organ dosimetry. Organ dose libraries for average exposures were constructed for radiography, fluoroscopy, and angiography, while diagnostic radiopharmaceutical biokinetic models were applied to estimate organ doses received in nuclear medicine procedures. Cancers were ascertained from local and state/provincial cancer registry linkages. Results: The fetal-exposure cohort includes 3,474,000 children among whom 6,606 cancers (2394 leukemias) were diagnosed over 37,659,582 person-years; 0.5% had in utero exposure to CT, 4.0% radiography, 0.5% fluoroscopy, 0.04% angiography, 0.2% nuclear medicine. The childhood-exposure cohort includes 3,724,632 children in whom 6,358 cancers (2,372 leukemias) were diagnosed over 36,190,027 person-years; 5.9% were exposed to CT, 61.1% radiography, 6.0% fluoroscopy, 0.4% angiography, 1.5% nuclear medicine. Conclusion: The RIC Study is poised to be the largest study addressing risk of childhood and adolescent cancer associated with ionizing radiation from medical imaging, estimated with individualized patient organ dosimetry. [ABSTRACT FROM AUTHOR]

Purpose: To determine institutional practice requirements for personal protective equipment (PPE) in cross-sectional interventional radiology (CSIR) procedures among a variety of radiology practices in the USA and Canada. Methods: Members of the Society of Abdominal Radiology (SAR) CSIR Emerging Technology Commission (ETC) were sent an eight-question survey about what PPE they were required to use during common CSIR procedures: paracentesis, thoracentesis, thyroid fine needle aspiration (FNA), superficial lymph node biopsy, deep lymph node biopsy, solid organ biopsy, and ablation. Types of PPE evaluated were sterile gloves, surgical masks, gowns, surgical hats, eye shields, foot covers, and scrubs. Results: 26/38 surveys were completed by respondents at 20/22 (91%) institutions. The most common PPE was sterile gloves, required by 20/20 (100%) institutions for every procedure. The second most common PPE was masks, required by 14/20 (70%) institutions for superficial and deep procedures and 12/12 (100%) institutions for ablation. Scrubs, sterile gowns, eye shields, and surgical hats were required at nearly all institutions for ablation, whereas approximately half of institutions required their use for deep lymph node and solid organ biopsy. Compared with other types of PPE, required mask and eye shield use showed the greatest increase during the SARS-CoV-2 pandemic. Conclusion: PPE use during common cross-sectional procedures is widely variable. Given the environmental and financial impact and lack of consensus practice, further studies examining the appropriate level of PPE are needed. [ABSTRACT FROM AUTHOR]

Anesthesia Information Management Systems are specialized forms of electronic medical records used by anesthesiologists to automatically and reliably collect, store, and present perioperative patient data. There are no recent academic publications that outline the names and features of AIMS in the current American and Canadian marketplace. An environmental scan was performed to first identify existing AIMS in this marketplace, and then describe and compare these AIMS. We found 13 commercially available AIMS but were able to describe in detail the features and functionalities of only 10 of these systems, as three vendors did not participate in the study. While all AIMS have certain key features, other features and functionalities are only offered by some of the AIMS. Features less commonly offered included patient portals for pre-operative questionnaires, clinical decision support systems, and voice-to-text capability for documentation. The findings of this study can inform AIMS procurement efforts by enabling anesthesia departments to compare features across AIMS and find an AIMS whose features best fit their needs and priorities. Future studies are needed to describe the features and functionalities of these AIMS at a more granular level, and also assess the usability and costs of these systems. [ABSTRACT FROM AUTHOR]