Search

Artificial Intelligence (AI) carries the potential for unprecedented disruption in radiology, with possible positive and negative consequences. The integration of AI in radiology holds the potential to revolutionize healthcare practices by advancing diagnosis, quantification, and management of multiple medical conditions. Nevertheless, the ever‑growing availability of AI tools in radiology highlights an increasing need to critically evaluate claims for its utility and to differentiate safe product offerings from potentially harmful, or fundamentally unhelpful ones. This multi‑society paper, presenting the views of Radiology Societies in the USA, Canada, Europe, Australia, and New Zealand, defines the potential practical problems and ethical issues surrounding the incorporation of AI into radiological practice. In addition to delineating the main points of concern that developers, regulators, and purchasers of AI tools should consider prior to their introduction into clinical practice, this statement also suggests methods to monitor their stability and safety in clinical use, and their suitability for possible autonomous function. This statement is intended to serve as a useful summary of the practical issues which should be considered by all parties involved in the development of radiology AI resources, and their implementation as clinical tools. [ABSTRACT FROM AUTHOR]

Aim A discussion on how informatics knowledge and competencies can enable nursing to instantiate transition to integrated models of care. Background Costs of traditional models of care are no longer sustainable consequent to the spiralling incidence and costs of chronic illness. The international community looks towards technology-enabled solutions to support a shift towards integrated patient-centred models of care. Design Discussion paper. Data sources A search of the literature was performed dating from 2000-2015 and a purposeful data sample based on relevance to building the discussion was included. Discussion The holistic perspective of nursing knowledge can support and advance integrated healthcare models. Informatics skills are key for the profession to play a leadership role in design, implementation and operation of next generation health care. However, evidence suggests that nursing engagement with informatics strategic development for healthcare provision is currently variable. Implications for nursing A statistically significant need exists to progress health care towards integrated models of care. Strategic and tactical plans that are robustly pragmatic with nursing insights and expertise are an essential component to achieve effective healthcare provision. To avoid exclusion in the discourse dominated by management and technology experts, nursing leaders must develop and actively promote the advancement of nursing informatics skills. For knowledge in nursing practice to flourish in contemporary health care, nurse leaders will need to incorporate informatics for optimal translation and interpretation. Conclusion Defined nursing leadership roles informed by informatics are essential to generate concrete solutions sustaining nursing practice in integrated care models. [ABSTRACT FROM AUTHOR]

The article presents abstracts of geographical research papers. In the research paper "A Geographical Study of Nova Scotia," researcher R.H. Whitebeek discusses the geographic conditions of Nova Scotia. Lying nearer Europe and possessing many excellent harbors and peopled by immigrants from the best European stocks, the province of Nova Scotia in Canada has now, after 300 years, fewer people than the city of Boston, Massachusetts. Its total manufacturing output is less than that of single companies in New England, and the province has shared but slightly in Canada's economic growth.

Background: International and migrant students face specific challenges which may impact their mental health, well-being and academic outcomes, and these may be gendered experiences. The purpose of this scoping review was to map the literature on the challenges, coping responses and supportive interventions for international and migrant students in academic nursing programs in major host countries, with a gender lens. Methods: We searched 10 databases to identify literature reporting on the challenges, coping responses and/or supportive interventions for international and migrant nursing students in college or university programs in Canada, the United-States, Australia, New Zealand or a European country. We included peer-reviewed research (any design), discussion papers and literature reviews. English, French and Spanish publications were considered and no time restrictions were applied. Drawing from existing frameworks, we critically assessed each paper and extracted information with a gender lens. Results: One hundred fourteen publications were included. Overall the literature mostly focused on international students, and among migrants, migration history/status and length of time in country were not considered with regards to challenges, coping or interventions. Females and males, respectively, were included in 69 and 59% of studies with student participants, while those students who identify as other genders/sexual orientations were not named or identified in any of the research. Several papers suggest that foreign-born nursing students face challenges associated with different cultural roles, norms and expectations for men and women. Other challenges included perceived discrimination due to wearing a hijab and being a 'foreign-born male nurse', and in general nursing being viewed as a feminine, low-status profession. Only two strategies, accessing support from family and other student mothers, used by women to cope with challenges, were identified. Supportive interventions considering gender were limited; these included matching students with support services' personnel by sex, involving male family members in admission and orientation processes, and using patient simulation as a method to prepare students for care-provision of patients of the opposite-sex. Conclusion: Future work in nursing higher education, especially regarding supportive interventions, needs to address the intersections of gender, gender identity/sexual orientation and foreign-born status, and also consider the complexity of migrant students' contexts. [ABSTRACT FROM AUTHOR]

Neoliberal theories—whether the new public management, principal-agent theory, or performance management—have provided the rationale for sweeping reforms in the governance and operation of higher education. This paper expands our understanding of neoliberal theory and practice by examining a leading neoliberal reform: performance-based funding (PBF) for higher education in the USA, Europe, Canada, Australia, and elsewhere. Our analysis of PBF examines not only its impacts but also its origins and implementation. Neoliberal theory has been used not only prospectively to design and argue for certain public policies but also retrospectively to analyse the origins and implementation of neoliberal policy. Hence, this paper examines this retrospective neoliberal analysis in order to determine how well neoliberal theory helps us understand the origins and implementation of neoliberal policy: in this case, the socio-political forces that gave rise to PBF; and the political and organizational features of the processes by which PBF was implemented. [ABSTRACT FROM AUTHOR]

Online platforms can support health and educational professionals in their daily work; however, it is challenging to keep online platforms sustainable. This paper aims to indicate the most important factors of platform sustainability from the perspective of professionals involved in online platforms. Further, it aims to understand how these factors operate. A mixed methods study was carried out among professionals from Europe, Australia, the USA and Canada. In the first phase, the importance of 54 factors from the literature was assessed with a questionnaire among 17 professionals. The relative importance of the factors and the consensus regarding this importance were calculated using median scores and interquartile deviations. In total, 19 factors were selected representing general characteristics, characteristics related to the platform, communication, visitor and context. In the second phase, insight was gained regarding the experiences with those factors through 12 individual Skype interviews. The most frequently mentioned important factors of platform sustainability were (i) having sufficient time, resources and expertise, (ii) user friendliness and (iii) creating a sense of belonging. Platforms should use a planned approach to address a combination of factors directly from platform development. Gaining long-term resources is challenging and should be considered from the start of a project by building partnerships. To promote user friendliness, platforms should be simple, have a clear set-up and provide high-quality tools. Finally, establishing a sense of belonging could be supported by branding and face-to-face networking activities. For all aspects, involving visitors and stakeholders is essential. [ABSTRACT FROM AUTHOR]

The internationalization of universities and the aging of the global population are two current issues that converge and challenge undergraduate gerontology curriculum development in Canada. One response to this challenge is to envision an intercultural gerontology curriculum. What might this curriculum encompass? How might it be taught? An exploratory study was undertaken to address these two questions. This paper presents findings from this study based primarily on interviews with university-based stakeholders from Canada, the United States, and Europe. Thematic analysis of the interviews resulted in five themes: multiple perspectives on cultural diversity; the dynamic nature of cultural diversity and aging; flow of an intercultural curriculum; institutional culture and intercultural curricula; and principles and practice for intercultural gerontology. Framed by principles of gerontology theory and educational approaches, this paper focuses on the principles and practice suggested by study participants. Scaffolding learning, active learning strategies, experiential learning opportunities, teacher modelling, and internet-based learning are discussed as key to intercultural learning. An appendix includes a list of resources that may be useful to developing an intercultural gerontology curriculum. [ABSTRACT FROM AUTHOR]

Issues: Drug consumptions rooms (DCR) and supervised injecting facilities (SIF) are expanding internationally. Previous reviews have not systematically addressed evaluation methodologies.Approach: Results from systematic searches of scientific databases in English until June 2017 were coded for paper type, country and year of publication. For evaluation papers, study outcome, methodology/study design and main indicators of DCR/SIF 'exposure' were recorded.Key Findings: Two hundred and nineteen eligible peer-reviewed papers were published since 1999: the majority from Canada (n = 117 papers), Europe (n = 36) and Australia (n = 32). Fifty-six papers reported evaluation outcomes. Ecological study designs (n = 10) were used to assess the impact on overdose, public nuisance and crime; modelling techniques (n = 6) estimated impact on blood-borne diseases, overdose deaths and costs. Papers using individual-level data included four prospective cohorts (n = 28), cross-sectional surveys (n = 7) and service records (n = 5). Individual-level data were used to assess safer injecting practice, uptake into health and social services and all the other above outcomes except for impact on crime and costs. Four different indicators of DCR/SIF attendance were used to measure service 'exposure'.Implications: Research around DCRs/SIFs has used ecological, modelling, cross-sectional and cohort study designs. Further research could involve systematic inclusion of a control group of people who are eligible but do not access SIFs, validation of self-reported proportion of injections at SIFs or a stepped-wedge or a cluster trial comparing localities.Conclusions: Methodologies appropriate for DCR/SIF evaluation have been established and can be readily replicated from the existing literature. Research on operational aspects, implementation and transferability is also warranted. [ABSTRACT FROM AUTHOR]

Background: Since the early 90s, patient navigation programs were introduced in the United States to address inequitable access to cancer care. Programs have since expanded internationally and in scope. The goals of patient navigation programs are to: a) link patients and families to primary care services, specialist care, and community-based health and social services (CBHSS); b) provide more holistic patient-centred care; and, c) identify and resolve patient barriers to care. This paper fills a gap in knowledge to reveal what is known about motivators and factors influencing implementation and maintenance of patient navigation programs in primary care that link patients to CBHSS. It also reports on outcomes from these studies to help identify gaps in research that can inform future studies.Methods: This scoping literature review involved: i) electronic database searches; ii) a web site search; iii) a search of reference lists from literature reviews; and, iv) author follow up. It included papers from Canada, the United States, the United Kingdom, Australia, New Zealand, and/or Western Europe published between January 1990 and June 2013 if they discussed navigators or navigation programs in primary care settings that linked patients to CBHSS.Results: Of 34 papers, most originated in the United States (n = 29) while the remainder were from the United Kingdom, Canada and Australia. Motivators for initiating navigation programs were to: a) improve delivery of health and social care services; b) support and manage specific health needs or specific population needs, and; c) improve quality of life and wellbeing of patients. Eleven factors were found to influence implementation and maintenance of these patient navigation programs. These factors closely aligned with the Diffusion of Innovation in Service Organizations model, thus providing a theoretical foundation to support them. Various positive outcomes were reported for patients, providers and navigators, as well as the health and social care system, although they need to be considered with caution since the majority of studies were descriptive.Conclusions: This study contributes new knowledge that can inform the initiation and maintenance of primary care patient navigation programs that link patients with CBHSS. It also provides directions for future research. [ABSTRACT FROM AUTHOR]

This paper presents perspectives and controversies surrounding the use of milestones to assess competency in outcomes-based medical education. Global perspectives (Canada, Europe, and the United States) and developments supporting their rationales are discussed. In Canada, there is a significant movement away from conceptualizing competency based on time, and a move toward demonstration of specific competencies. The success of this movement may require complex (rather than reductionist) milestones that reflect students' progression through complexity and context and a method to narrate their journey. European countries (United Kingdom, France, and Germany) have stressed the complexity associated with time and milestones for medical students to truly achieve competence. To meet the changing demands of medicine, they view time as actually providing students with knowledge and exposure to achieve various milestones. In the United States, milestones are based on sampling throughout professional development to initiate lifelong learning. However, the use of milestones may not imply overall competence (reductionism). Milestones must be developed alongside outcomes-based curriculum with use of faculty and competency committees. The perspectives outlined in this paper underscore emerging challenges for implementing outcomes-based medical education and call for new conceptualizations of competence. [ABSTRACT FROM AUTHOR]

Background: The recognition of medical professionalism as a complex social construct makes context, geographical location and culture important considerations in any discussion of professional behaviour. Medical students, medical educators and practitioners are now much more on the move globally, exposing them to cultural and social attitudes, values and beliefs that may differ from their own traditional perceptions of professionalism. Aims and Methods: This paper uses the model of the intercultural development continuum and the concept of 'cultural fit' to discuss what might transpire when a student, teacher or doctor is faced with a new cultural environment. Using our own experiences as medical educators working abroad and supported by evidence in the literature, we have developed four anecdotal scenarios to highlight some of the challenges that different cultural contexts bring to our current (Western) understanding of professionalism. Results and Conclusions: The scenarios highlight some of the potentially different regional and/or cultural perspectives and nuances of professional behaviours, attitudes or values that many of us either take for granted or find difficult, depending on our training and socio-cultural upbringing. With this paper, we hope to start a long overdue conversation about global professionalism amongst medical educators, identify potential areas for research and highlight a need for medical schools to embrace a 'global' approach to how professionalism is embedded in their curricula. [ABSTRACT FROM AUTHOR]

Background: There is significant interest in comparing countries on many different indicators of social problems and policies. Cross-national comparisons of drug prevalence and policies are often hampered by differences in the approach used to reach respondents and the methods used to obtain information in national surveys. The paper explores how much these differences could affect cross-country comparisons.Methods: This study reports prevalence of drug use according to the most recent national household survey and then adjusts estimates as if all national surveys used the same methodology. The analysis focuses on European countries for which the European Monitoring Centre for Drugs and Drug Addiction reports data, the United States, Canada, and Australia. Adjustment factors are based on US data.Findings: Adjusting for modality differences appears likely to modestly affect the rankings of countries by prevalence, but to an extent that could be important for comparisons. For example, general population surveys suggest that the US had some of the highest cannabis and cocaine prevalence rates circa 2012, but this is partially driven by the use of a modality known to produce higher prevalence estimates. This analysis shows that country rankings are partly an artifact of the mode of interview used in national general population surveys.Conclusions: Our preliminary efforts suggest that cross-national prevalence comparisons, policy analyses and, other projects such as estimating the global burden of disease could be improved by adjusting estimates from drug use surveys for differences in modality. Research is needed to create more authoritative adjustment factors. [ABSTRACT FROM AUTHOR]

Drawing on a review of policy papers and cultural statistics from Canada and Europe, among others, this paper confirms a widespread belief in creative economy policies as panacea for revitalizing economies, while noting a general failure to acknowledge the role and the needs of creative workers. Existing policy instruments are mostly uncoordinated but can be divided into four categories entitled ‘education and training’, ‘awards and contests’, ‘business support’ and ‘social security policies’, with the greatest emphasis on the first three. Escaping the precarity trap – precarity meaning existence without security – typical of much cultural work requires a rehabilitated notion of ‘flexicurity’ that includes exceptionalist, sub-sectoral, sectoral and generalist strategies to support cultural workers. The authors argue for a more holistic policy framework that uses a rights-based perspective and emphasizes social security measures. This approach, which we term ‘creative ecology’, is based on the intersection of social, labour and cultural policy. This paper thereby begins the response to calls to academics, practitioners and policy analysts to provide a route map out of the demoralized terrain of neo-liberalism with respect to cultural work. [ABSTRACT FROM PUBLISHER]

International student mobility amongst and between countries has become increasingly common and forms a central feature of the global higher education system. This paper examines the key learning experiences relating to the student mobility component of the Canadian-European Initiative for Health Promotion Advanced Learning (CEIHPAL) project. CEIHPAL was a unique and innovative project that fostered advanced intercontinental education and learning in health promotion from 2005–2008. With co-funding from the European Commission and the Canadian Government, the project facilitated institutional, student and faculty cooperation, by developing a high level of international communication. In particular, this paper focuses on the student mobility component and experiences of the CEIHPAL programme, a central part of the project activities. Feedback from both Canadian and European students themselves is used to document their participation in the programme, including the benefits derived from taking part as well as the problems and difficulties they encountered. [ABSTRACT FROM PUBLISHER]

mcinnes e., seers k. & tutton l. (2011) Older people's views in relation to risk of falling and need for intervention: a meta-ethnography. Journal of Advanced Nursing 67(12), 2525-2536. Abstract Aim. This paper is a report of a meta-ethnography of qualitative studies of older peoples' views on risk of falling and need for intervention. Background. Falls and falls-related injuries in older people are worldwide problems. A conceptual understanding of older people's views about falls risk and need for intervention is useful for understanding factors likely to impact on acceptance of risk and recommended interventions. Data Sources. Seven electronic databases were searched 1999-2009. Reference lists of included articles were screened for eligible papers. Review Methods. Assessment of quality was carried out. Themes and concepts were extracted using a meta-ethnographic approach to compare similarities and differences across the retrieved studies. A line of argument was developed to produce an explanatory framework of the extracted themes and concepts. Results. Eleven relevant qualitative research articles of reasonable quality were identified. Six key concepts were identified: beyond personal control; rationalizing; salience; life-change and identity; taking control and self-management. A line of argument synthesis describes how older people approach self-appraisal of falls risk and intervention need, and how they cope and adapt to falls risk and intervention need. Conclusion. In response to having an elevated risk status and perceived associations with frailty and impact on an independent life-style, some prefer to adapt to this reality by taking control and implementing self-management strategies. Healthcare professionals should take into account beliefs about risk and negotiate choices for intervention, recognizing that some individuals prefer to drive the decision-making process to preserve identity as a competent and independent person. [ABSTRACT FROM AUTHOR]

It is a core element in Richard Florida's popular theory on growth to be able to attract the creative class to a geographical area. But Florida is not very specific on which kind of amenities are important for attracting and keeping the creative class. The purpose of this paper is to analyse which kind of cultural activities the creative class is actually using. Which kind of cultural activities does the creative class use more intensively than other groups in society? This paper presents new empirical results on preferences for leisure and culture. Richard Florida's theory can be, and has been, criticised - especially on the issue of causality. The analyses presented in this paper show that being part of the creative class has an independent and significant role in explaining preferences for leisure and culture. [ABSTRACT FROM AUTHOR]

Despite a large literature that addresses the gendered structure of forestry occupations in Europe and the USA, relatively little attention has been paid to these issues in Canada. In this paper, it is argued that policy makers and academics have used outdated statistics about forestry employment to shape policies and programs of government and industry. Use of these data has been to the general disadvantage of women working in the forest industry and in forestry communities. This paper draws mainly on three studies, spanning the mid-1990s to the mid-2000s. Each study relied on secondary sources such as Census data, government and industry documents, as well as primary sources such as interviews or questionnaires. On Vancouver Island, British Columbia, analysis of land reallocation policies and transition strategies for displaced workers in the 1990s did not consider women as forestry workers or consider how job losses and opportunities for retraining might vary between men and women. Consequently, gender-neutral transition strategies were more accessible for men than for women. A study of female forestry workers in Saskatchewan revealed there was very little knowledge about employment conditions for women in forestry. Women reported that they missed out on training and advancement opportunities because they lacked networks, childcare support or other benefits that might encourage them to improve their circumstances. Finally, a survey of forest sector advisory committees across the country revealed a very low rate of participation by women, even though those who did participate had some significantly different viewpoints about forestry than their male counterparts. In combination, these efforts suggest that improvements in the understanding of forestry employment would benefit forestry workers, both male and female, and ensure that all workers made lasting contributions to the industry. [ABSTRACT FROM AUTHOR]

Background: Stanford's Chronic Disease Self-Management Program (CDSMP) stands out as having a large evidence-base and being broadly disseminated across various countries. To date, neither evidence nor practice exists of its systematic adaptation into a German-speaking context. The objective of this paper is to describe the systematic German adaptation and implementation process of the CDSMP (2010-2014), report the language-specific adaptation of Franco-Canadian CDSMP for the French-speaking part of Switzerland and report findings from the initial evaluation process.Methods: Multiple research methods were integrated to explore the perspective of workshop attendees, combining a longitudinal quantitative survey with self-report questionnaires, qualitative focus groups, and interviews. The evaluation process was conducted in for both the German and French adapted versions to gain insights into participants' experiences in the program and to evaluate its impact. Perceived self-efficacy was measured using the German version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6G).Results: Two hundred seventy eight people attending 35 workshops in Switzerland and Austria participated in the study. The study participants were receptive to the program content, peer-led approach and found principal methods useful, yet the structured approach did not address all their needs or expectations. Both short and long-term impact on self-efficacy were observed following the workshop participation (albeit with a minor decrease at 6-months). Participants reported positive impacts on aspects of coping and self-care, but limited effects on healthcare service utilization.Conclusions: Our findings suggest that the process for cross-border adaptation was effective, and that the CDSMP can successfully be implemented in diverse healthcare and community settings. The adapted CDSMP can be considered an asset for supporting self-management in both German-and French-speaking central European countries. It could have meaningful, wide-ranging implications for chronic illness care and primary prevention and potentially tertiary prevention of chronic disease. Further investigations are needed to tailor the program for better access to vulnerable and disadvantaged groups who might benefit the most, in terms of facilitating their health literacy in chronic illness. [ABSTRACT FROM AUTHOR]

This paper briefly surveys the history of natural gas use and describes the main features of current gas consumption. The share of gas in total energy consumption, and the sectoral distribution of its use in major consuming regions are discussed. The main changes in the pattern of gas consumption since 1980 are reviewed and explained. I analyze the likely implications of (a) the emergence of the combined cycle gas power generation; (b) the rising environmental premium of gas; and (c) the transformation of the West European gas market structure. The paper concludes that natural gas will substantially increase its share of global energy consumption in the next 15-20 years. [ABSTRACT FROM AUTHOR]

This paper analyzes cattle killing by First Nations in Southern Alberta in the 1890s m light of different theoretical approaches to the issue of First Nations crime. This paper suggests that this form of criminal behaviour was not a result of cultural differences or cultural misunderstandings between First Nations and Europeans. Rather, this type of First Nations criminality was rooted in material circumstances characterized by extreme hunger, and was reflective of a process of resistance to state policies. The crime of cattle killing was, in part, a political act that was part of Treaty Seven First Nations efforts to oppose and change the Department of Indian Affairs rations policy. [ABSTRACT FROM AUTHOR]

Objectives: This paper provides a quantitative review that estimates exposure rates by type of violence, setting, source, and world region. Design: A quantitative review of the nursing violence literature was summarized. Data sources: A literature search was conducted using the CINAHL, Medline and PsycInfo data bases. Studies included had to report empirical results using a nursing sample, and include data on bullying, sexual harassment, and/or violence exposure rates. A total of 136 articles provided data on 151,347 nurses from 160 samples. Procedure: Articles were identified through a database search and by consulting reference lists of review articles that were located. Relevant data were coded by the three authors. Categories depended on the availability of at least five studies. Exposure rates were coded as percentages of nurses in the sample who reported a given type of violence. Five types of violence were physical, nonphysical, bullying, sexual harassment, and combined (type of violence was not indicated). Setting, timeframe, country, and source of violence were coded. Results: Overall violence exposure rates were 36.4% for physical violence, 66.9% for nonphysical violence, 39.7% for bullying, and 25% for sexual harassment, with 32.7% of nurses reporting having been physically injured in an assault. Rates of exposure varied by world region (Anglo, Asia, Europe and Middle East), with the highest rates for physical violence and sexual harassment in the Anglo region, and the highest rates of nonphysical violence and bullying in the Middle East. Regions also varied in the source of violence, with patients accounting for most of it in Anglo and European regions, whereas patents' families/friends were the most common source in the Middle East. Conclusions: About a third of nurses worldwide indicated exposure to physical violence and bullying, about a third reported injury, about a quarter experienced sexual harassment, and about two-thirds indicated nonphysical violence. Physical violence was most prevalent in emergency departments, geriatric, and psychiatric facilities. Physical violence and sexual harassment were most prevalent in Anglo countries, and nonphysical violence and bullying were most prevalent in the Middle East. Patients accounted for most physical violence in the Anglo region and Europe, and patient family and friends accounted for the most in the Middle East. [ABSTRACT FROM AUTHOR]

This paper evaluates the performance of national higher education systems in 48 countries as measured with 20 variables grouped under the four headings of Resources, Environment, Connectivity and Output. Rankings within each module are then combined into an overall ranking that is topped by the United States followed by Sweden, Canada, Finland and Denmark. Relationships between different attributes are explored. Countries ranked highest on output tend to be ranked highly on resources. Research output is correlated with government funding, especially expenditure on research and development (R&D). The impact of the policy and regulatory environment is also examined. The weakest national systems are those with low government funding but high government control. [ABSTRACT FROM PUBLISHER]

The ‘burqa’ bans that have recently been put into effect in several Euro-Atlantic countries are a testament to how public space has been rendered into a terrain of increasing securitization and legal control. The new laws are complex in that they are entangled with entrenched historical attitudes, present-day geopolitics, political expediency, and the politics of race, immigration and national identity. However, they provoke a questioning of what it means when states legislate vision and visuality and of why the visual rather than another domain has become the privileged stage to both communicate the alleged conflict between the ‘West’ and ‘Islam’ and enact the former's disciplining of the latter. In this paper, I examine the trope of the burqa from the perspective of the cultural history of vision, arguing that situating the garment as a visual text in contesting regimes of art and representation, shaped by their respective pre-modern religious narratives, will provide a critical, yet unacknowledged, perspective on facial veiling which, moreover, offers up the possibility of learning to read the sign across cultures. [ABSTRACT FROM AUTHOR]

Propagation effects such as rain or clouds attenuation cause deeper fades in the Ka-band than at lower frequencies. In this collaborative paper, the main results of four long-term Ka-band propagation campaigns are presented. The experiments are carried out in Ottawa, Canada; Aveiro, Portugal; Madrid, Spain; and Toulouse, France. Attenuation statistics are derived from satellite beacon data collected over 6 years at Aveiro, 5 years at Ottawa and Madrid and 2 years at Toulouse. Multi-year measurements allow the production of more stable statistics reflecting the long-term behavior of propagation phenomena and to investigate its year-to-year variability. The beacon signal data was monitored and collected on a continuous basis over the whole measurement period. After a brief introduction of the experiments, rain rate and excess attenuation results are discussed, first for a common measurement period and later for the whole database available. Seasonal attenuation statistics for Ottawa and Aveiro are compared. Finally, fade duration and fade slope statistics derived at three locations are presented and discussed. [ABSTRACT FROM AUTHOR]

As the baby boomer generation ages, the need for laws to enhance quality of life for the elderly and meet the increasing demand for family caregivers will continue to grow. This paper reviews the national family leave laws of nine major OECD countries (Canada, Denmark, France, Germany, Italy, Japan, Netherlands, Spain, and the United Kingdom) and provides a state-by-state analysis within the U.S. We find that the U.S. has the least generous family leave laws among the nine OECD countries. With the exception of two states (California and New Jersey), the U.S. federal Family Medical Leave Act of 1993 provides no right to paid family leave for eldercare. We survey the current evidence from the literature on how paid leave can impact family caregivers' employment and health outcomes, gender equality, and economic arguments for and against such laws. We argue that a generous and flexible family leave law, financed through social insurance, would not only be equitable, but also financially sustainable. [ABSTRACT FROM AUTHOR]

In this paper we analyze the opening hours of 50 randomly selected university libraries (UL) in Austria, Germany, Canada and the USA. The aim of this analysis is to identify possible influences on the extent of the opening hours. Potential influencing factors that we consider are library size and country (state) or linguistic area in which a library is located. The results of the analysis show that larger UL and UL that are located in the United States tend to be opened longer. [ABSTRACT FROM AUTHOR]

Evaluation of transgenic plants by ethics committees in Europe and Canada: what degrees of freedom? This paper examines from an ethical point of view the way some ethics committees in Europe and Canada evaluate transgenic plants. After analysing their reports and interviews with members sitting on these committees, we show the very relative independence of their evaluation from the scientists' position and political and industrial interests. We present here what an ethical evaluation of transgenic plants should be. Our study indicates that the more these committees develop an ethical reflection, the more they keep their distance from the social acceptability of genetically modified plants and the more they manage to avoid that scientific rationality replaces ethical argumentation - that is to say, the more they manage to incorporate scientific data in an ethical reflection. Some of these committees are even captive of a techno-scientific strategy which values research susceptible of making economic benefits, but prevents them from making an ethical evaluation. We show that making an independent ethical evaluation demands not to focus on the sole question of risks. All changes in the world associated with the development and marketing of transgenic plants should be examined. Ethical reflection also needs to be linked to an epistemological reflection in order to reinforce it. [ABSTRACT FROM AUTHOR]

One question often raised when ozone professionals gather is “How much ozone capacity is installed?” Although the use of ozone for industrial purposes is growing, the largest use for ozone resides in the use of treatment of municipal drinking and wastewater. It is very difficult to summarize ozone capacity for industrial applications as much data are kept confidential. A number of reports have been published over the years on installed ozone capacity. Ozone capacity estimation is a moving target as plants are built and others removed from service for a number of reasons. This paper summarizes, using data available, ozone capacity for drinking water and wastewater. Focus is on the United States, Canada, Europe and Japan. IOA members and member companies are encouraged to submit additional data to enable this summary to be as accurate and relevant as possible. [ABSTRACT FROM PUBLISHER]

A revised framework for the regulation of in vitro diagnostic devices (IVDs) came into force in Australia on July 1, 2010 that aims to 'ensure that public and personal health are adequately protected', but which instead may lead to adverse outcomes in clinical diagnosis and management. The regulatory process aims to regulate all IVDs, including those used by clinical diagnostic laboratories, which are already subject to scrutiny as part of the current laboratory accreditation process. The IVD regulatory process initiated in Australia is similar to that used in Canada, but different to that currently operating in the USA and Europe. However, it is feasible that other countries will in time adopt a similar regulatory framework, given that many countries are involved in the development process. In this opinion paper, the regulatory process for IVDs across several geographies are outlined, as are some benefits and weaknesses of the new regulatory process now applied to Australia, as potentially planned for other regions of the world. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Schanzer et al. (2010) A composite epidemic curve for seasonal influenza in Canada with an international comparison. Influenza and Other Respiratory Viruses 4(5), 295–306. Background Empirical data on laboratory-confirmed seasonal influenza is limited by very low and possibly non-systematic case ascertainment as well as geographical variation. Objective To provide a visual representation of an influenza epidemic at the community and regional level using empirical data and to describe the epidemic characteristics. Methods Weekly influenza A confirmations were obtained from the Canadian FluWatch program and American FluView program for the 1997/1998–2006/2007 seasons; 1- year data were also available for Europe (FluNet, WHO). For seasons where at least 80% of the influenza A strains were antigenically similar, a composite epidemic curve was created by centring the local epidemics relative to their epidemic midpoint. Results The range in timing of the regional peaks varied from 5 to 13 weeks. Once the epidemic curves were centred relative to their peak, the composite epidemic curves were similar for Canada, the United States and Europe, and the epidemic growth rates were similar for most subgroups (city size; regions; H1N1 versus H3N2 seasons). During the exponential growth period, the number of cases increased by a factor of 1·5–2·0 per week, averaging 1·8. Exponential growth was evident approximately 10 weeks before the peak. Evidence of sustained transmission occurred from mid-September to early June. Discussion The shape of the composite curve created in this study clearly demonstrates a consistency in the epidemic pattern across geographically disparate locales. Laboratory confirmation will likely play an increasing role in the development of better methods for early detection and summary measures of influenza activity. [ABSTRACT FROM AUTHOR]

This paper describes the enhancement of cultural competence through trans-Atlantic rural community experiences of European and Canadian nursing students using critical incident technique (CIT) as the students' reflective writing method. The data generated from 48 students' recordings about 134 critical incidents over a 2-year project were analysed by qualitative content analysis. Five main learning categories were identified as: cross-cultural ethical issues; cultural and social differences; health-care inequalities; population health concerns; and personal and professional awareness. Four emergent cultural perspectives for the health sector that became apparent from the reflections were: health promotion realm; sensitivity to social and cultural aspects of people's lives; channels between the health sector and society; cultural language and stories of local people. CIT was successfully used to foster European and Canadian undergraduate students' cultural reflections resulting in considerations and suggestions for future endeavours to enhance cultural competence in nursing education. [ABSTRACT FROM AUTHOR]

Abstract: This paper focuses on risk premiums paid by central governments in Europe and sub-national governments in Germany, Spain, and Canada, using data for bond yield spreads for the period 1991–2005. We find that risk premiums by central governments respond positively to debt and deficits; German states enjoyed a favourable position in financial markets before EMU but not thereafter; Spanish and Canadian provinces risk premiums over the whole period; German and Spanish sub-central governments pay liquidity-related interest rate premiums; Canadian and German provinces/states that benefit from fiscal equalization lower spreads. This is evidence of market discipline at work and of credibility of the EU no-bailout clause. [Copyright &y& Elsevier]

Background: Studies on differences between immigrant and non-immigrant groups in health care utilization vary with respect to the extent and direction of differences in use. Therefore, our study aimed to provide a systematic overview of the existing research on differences in primary care utilization between immigrant groups and the majority population. Methods: For this review PubMed, PsycInfo, Cinahl, Sociofile, Web of Science and Current Contents were consulted. Study selection and quality assessment was performed using a predefined protocol by 2 reviewers independently of each other. Only original, quantitative, peer-reviewed papers were taken into account. To account for this hierarchical structure, logistic multilevel analyses were performed to examine the extent to which differences are found across countries and immigrant groups. Differences in primary care use were related to study characteristics, strength of the primary care system and methodological quality. Results: A total of 37 studies from 7 countries met all inclusion criteria. Remarkably, studies performed within the US more often reported a significant lower use among immigrant groups as compared to the majority population than the other countries. As studies scored higher on methodological quality, the likelihood of reporting significant differences increased. Adjustment for health status and use of culture-/language-adjusted procedures during the data collection were negatively related to reporting significant differences in the studies. Conclusion: Our review underlined the need for careful design in studies of differences in health care use between immigrant groups and the majority population. The results from studies concerning differences between immigrant and the majority population in primary health care use performed within the US might be interpreted as a reflection of a weaker primary care system in the US compared to Europe and Canada. [ABSTRACT FROM AUTHOR]

This paper documents efforts in Canada, France, Finland, Germany, Hispanoamerica, Israel, Japan, The Netherlands, and Taiwan to disseminate the Model of Human Occupation (MOHO). We aim to characterize the challenges involved, the strategies used, and the impact of these efforts in diverse cultural and social conditions. [ABSTRACT FROM AUTHOR]

Europe lags far behind Australia, New Zealand, Canada and the USA in terms of implementing regulatory procedures for the import and release of invertebrate biological control agents (IBCAs). A number of standards, documents and guidelines have been produced over recent years in an attempt to harmonize regulation of IBCA introduction into Europe. Despite these efforts, the number of member countries implementing any form of IBCA regulation remains low, with many industries, biological practitioners and regulators fearing that a regulatory system would render the process of approval for IBCA introduction into a country costly and time consuming. Europe’s priority is therefore to formulate a regulatory system that will be readily approved of and adopted by all member countries. In this paper we review the current regulatory processes operating in Australia, New Zealand, Canada and the USA. There is potential for Europe to benefit from the years of experience that these countries have in IBCA regulation. We therefore propose recommendations based on features of the regulatory processes in each of the four countries that work well and that could be adopted to generate a workable Europe-wide regulatory system. [ABSTRACT FROM AUTHOR]

Since McCallum's (1995) finding of surprisingly high border effects on trade between the US and Canada, there have been a number of studies on other parts of the world, and improvements made to the gravity model to measure this effect accurately. This paper suggests some other modifications to the model, and applies it to a region of the world that presents a distinctly interesting case. Changes in border effects of formerly socialist countries in Central and East Europe, and countries in the former Soviet Union are analyzed during 1976-2002 at country and sectoral levels, and also with respect to blocs of countries. A discussion on cross-country variations in border effects follows the computations. [ABSTRACT FROM AUTHOR]

Objective: To systematically review and critically appraise the economic evaluations of one to one interventions to reduce sexually transmitted infections (STIs) and teenage conceptions. Design: Systematic review. Data Sources: Search of four electronic bibliographic databases from 1990 to January 2006. Search keywords included teenage, pregnancy, adolescent, unplanned, unwanted, cost benefit, cost utility, economic evaluation, cost effectiveness and all terms for STIs, including specific diseases. Review Methods: We included studies that evaluated a broad range of one to one interventions to reduce STIs. Outcomes included major outcomes averted, life years and quality adjusted life years (QALY). All studies were assessed against quality criteria. Results: Of 3,190 identified papers, 55 were included. The majority of studies found one to one interventions to be either cost saving or cost effective, although one highlighted the need to target the population to receive post-exposure prophylaxis to reduce transmission of HIV. Most studies used a static approach that ignores the potential re-infection of treated patients. Conclusion: One to one interventions have been shown to be cost saving or cost effective but there are some limitations in applying this evidence to the UK policy context. More UK research using dynamic modelling approaches and QALYs would provide improved evidence, enabling more robust policy recommendations to be made about which one to one interventions are cost effective in reducing STIs in the UK setting. The results of this review can be used by policy makers, health economists and researchers considering further research in this area. [ABSTRACT FROM AUTHOR]

Purpose - The aim of this paper is to provide a brief overview of the evolution of a new e-research paradigm and to outline key projects and developments in Europe, North America, Canada and Australia. The article also provides a detailed summary of the Dataset Acquisition, Accessibility and Annotation e-Research Technology (DART) project. Design/methodology/approach - A review of relevant government reports, documents and general literature was conducted. Findings - Projects currently being conducted in Europe, the USA, Canada and Australia are part of an international movement that aims to use modern ICTs to enhance e-research. The DART project is a significant part of this movement as it has adopted a "whole process" approach to e-research, and provides a platform for the examination of the technical, legal and policy issues that arise in the new e-research environment. Originality/value - Provides an overview of current projects that concern the development of e-research, with a particular focus on Australian research and the DART project. [ABSTRACT FROM AUTHOR]

This paper offers a brief review of the need for cost–benefit analysis (CBA) and the available policy instruments for air pollution. To prioritize different possible actions, one needs to know which source of pollution causes how much damage. This requires an impact pathway analysis, that is, an analysis of the chain emission → dispersion → dose-response function → monetary valuation. The methodology for this is described and illustrated with the results of the ExternE (External Costs of Energy) project series of the European Commission. Two examples of an application to CBA are shown: one where a proposed reduction of emission limits is justified, and one where it is not. It is advisable to subject any proposed regulation to a CBA, including an analysis of the uncertainties. Even if the uncertainties are large and a policy decision may have to take other considerations into account, a well-documented CBA clarifies the issues and provides a basis for rational discussion. One of the main sources of uncertainty lies in the monetary valuation of premature mortality, the dominant contribution to the damage cost of air pollution. As an alternative, an innovative policy tool is described, the Life Quality Index (LQI), a compound indicator comprising societal wealth and life expectancy. It is applied to the Canada-wide standards for particulate matter and ozone. Regardless of monetary valuation, a 50% reduction of PM10 concentrations in Europe and North America has been shown to yield a population-average life expectancy increase on the order of 4 to 5 mo. [ABSTRACT FROM AUTHOR]

This paper evaluates the relationships between atmospheric circulation, climate and streamflow in the northern North Atlantic region over the last century and especially the last 50 years. Improved understanding of climatic influences on streamflow is vital given the great importance of fluvial processes to natural systems and water resources, especially in the light of recent and predicted climate change. The main focus lies with climatic and hydrologic implications of the major circulation patterns in the northern North Atlantic, namely the North Atlantic Oscillation (NAO) and Arctic Oscillation (AO). The studies reviewed here reveal key relationships between circulation, climate and streamflow across the northern North Atlantic, allowing the construction of a simple conceptual model for this system. Generally positive NAO/AO-streamflow relationships are found in northwest Europe and northeast USA, with both positive and negative NAO/AO-streamflow linkages apparent for parts of eastern Canada. To help promote a better understanding of the system, several research gaps are identified and critically examined, including: the spatial scope and coverage of investigations; data quality and homogeneity; appropriateness of analytical techniques; and the need for greater knowledge and technique sharing between hydrology and climatology, particularly regarding the rigorous characterization of atmospheric circulation patterns. Among these, the development of seasonally varying, or mobile, NAO indices, to capture variations in subseasonal, seasonal and annual movements in the centres of action, and the need to develop analyses of more hydrologically meaningful climate variables beyond conventional time averaged statistics, are deemed particularly important. [ABSTRACT FROM AUTHOR]

The article offers information on medicine utilization research in Europe. One cross-sectional study focused on patterns of anti-psychotic drug use among nursing home residents in Switzerland between 1999 and 2002 and compared those with data from Canada. Another paper discussed the association of socio-demographic factors within and across European countries with non-compliance with medical drugs.

The telecommunication industry has experienced significant growth and consolidation in the last decade. The desire of large, multinational customers to obtain fully-integrated, end-to-end global telecommunications services from a single source pushed telecom firms to offer multiservice broadband and seamless worldwide telecommunications networks. However, a major barrier to achieving this goal is the significant capital required to construct and deploy a global network. To overcome these constraints, telecom companies typically adopt approaches like--mergers and acquisitions (M&A), joint ventures, legal partnerships and strategic alliances. As the marketplace continues to grow globally, convergence among major enforcement authorities on fundamental competition principles, such as the role of efficiencies, will be critical. The treatment of efficiencies is however controversial and poses many questions. This research paper explores some of the efficiencies-based motivations and rationales for Telecom M&A. It reviews the procedures and regulatory authorities responsible for telecom merger review in the U.S., Europe and Canada. It also examines the treatment of efficiencies in the context of merger review in three jurisdictions and finally it discusses some of the outstanding policy issues related to treatment of efficiencies.

The formation of regional alliances among sub-national governments has become a common feature of Europe in the past decade and a half. However, examples of such alliances spanning the Triad, Europe, North America and Japan, are far less common. In a brief outward-oriented phase in the late 1980s, the Four Motors for Europe expanded abroad and Ontario signed a formal agreement with them, establishing a number of exchanges, as well as a series of more targeted research projects with two of the Motors. The relationship between Ontario and the Four Motors was somewhat unique in terms of its transcontinental reach. This paper analyses the factors which led to the establishment of the alliance and assesses some of the benefits achieved and problems encountered in developing it. It concludes that transatlantic alliances must surmount additional barriers of space and cultural differences to survive and require a strong degree of policy and institutional continuity to ensure they have sufficient time to mature and develop. [ABSTRACT FROM AUTHOR]

This paper presents the results of the first comprehensive international survey to catalogue health technology assessment (HTA) activities. By 1995, there were formal HTA programs in 24 countries, established mostly in the late 1980s and early 1990s. European countries generally have one or two federal or provincial HTA programs each. Canada has an extensive network of federal and regional organizations coordinated by a central body, and the US has 53 HTA organizations, the vast majority of which are in the private sector. While the commitment of the US government to HTA has been erratic, the private sector has been witness to an expansion of HTA activities by insurance companies, hospitals, medical/device manufacturers, consulting firms, and health professional societies. In contrast to other developed countries, the current state of technology assessment in the US is decentralized, fragmented, and duplicative. We conclude by discussing the importance of a US HTA agency at the national level. [ABSTRACT FROM AUTHOR]

Background: A systematic attempt to summarize the literature that examines working conditions and occupational health among immigrant in Europe and Canada.Methods: We established inclusion criteria, searched systematically for articles included in the Medline, Embase and Social Sciences Citation Index databases in the period 2000-2016 and checked the reference lists of all included papers.Results: Eighty-two studies were included in this review; 90% were cross-sectional and 80% were based on self-report. Work injuries were consistently found to be more prevalent among immigrants in studies from different countries and in studies with different designs. The prevalence of perceived discrimination or bullying was found to be consistently higher among immigrant workers than among natives. In general, however, we found that the evidence that immigrant workers are more likely to be exposed to physical or chemical hazards and poor psychosocial working conditions is very limited. A few Scandinavian studies support the idea that occupational factors may partly contribute to the higher risk of sick leave or disability pension observed among immigrants. However, the evidence for working conditions as a potential mediator of the associations between immigrant status and poor general health and mental distress was very limited.Conclusion: Some indicators suggest that immigrant workers in Europe and Canada experience poorer working conditions and occupational health than do native workers. However, the ability to draw conclusions is limited by the large gaps in the available data, heterogeneity of immigrant working populations, and the lack of prospectively designed cohort studies. [ABSTRACT FROM AUTHOR]

The trade liberalization associated with NAFTA has affected the pattern of state exports by altering the origin as well as the destination of merchandise exports. We find that NAFTA has increased US merchandise exports to Mexico and Canada by just over 15%, and has increased total US merchandise exports by nearly 8%. We also find that although many states have seen large increases in exports to both Mexico and Canada, others have seen large decreases. NAFTA has also affected states’ exports to non-NAFTA regions of the world, tending to decrease exports to Europe and Latin America and increase exports to Asia. States in the northeast regions of the United States have seen the smallest increases in exports in the wake of NAFTA. [ABSTRACT FROM AUTHOR]