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Methadone has several unique characteristics that make it an attractive option for pain relief in serious illness, but the safety of methadone has been called into question after reports of a disproportionate increase in opioid-induced deaths in recent years. The American Pain Society, College on Problems of Drug Dependence, and the Heart Rhythm Society collaborated to issue guidelines on best practices to maximize methadone safety and efficacy, but guidelines for the end-of-life scenario have not yet been developed. A panel of 15 interprofessional hospice and palliative care experts from the U.S. and Canada convened in February 2015 to evaluate the American Pain Society methadone recommendations for applicability in the hospice and palliative care setting. The goal was to develop guidelines for safe and effective management of methadone therapy in hospice and palliative care. This article represents the consensus opinion of the hospice and palliative care experts for methadone use at end of life, including guidance on appropriate candidates for methadone, detail in dosing, titration, and monitoring of patients' response to methadone therapy. [ABSTRACT FROM AUTHOR]

Abstract Researchers seeking to identify public policies to reduce automobile use have frequently compared characteristics such as population density and freeway provision across metropolitan regions to identify differences, their causes, and their implications for automobile reliance. One frequent comparison has been between metropolitan regions in Canada and the United States given their similar contexts but differing modal shares. However, past studies have produced inconsistent findings with respect to how Canadian and American metropolitan regions can be distinguished with respect to population densities and freeways. In response to methodological concerns with past research, this paper measures population densities and freeways in the 57 North American metropolitan regions with at least one million residents. Two spatial scales (metropolitan region and central core) are used to measure overall density, population-weighted average census tract density, and density of the top 5% of the population. These same spatial scales are also used to measure the absolute and per capita quantities of freeway lanes. The paper provides methodological explanations using Los Angeles and Vancouver as examples. While Canada's metropolitan regions are commonly portrayed as denser and less auto-oriented than their US counterparts, the six largest of Canada's metropolitan regions do not have population higher densities and fewer freeways than all of the 51 largest US metropolitan regions. Indeed, this generalization holds only when individual results are combined to produce national averages, as there are numerous US metropolitan regions that have density and freeways in the same range as Canada's metropolitan regions. The paper discusses some of the differences and recommends approaches for future comparative research into the causes of variation in transport and land use. [ABSTRACT FROM AUTHOR]

A student's accuracy on drug calculation tests may be influenced by maths anxiety, which can impede one's ability to understand and complete mathematic problems. It is important for healthcare students to overcome this barrier when calculating drug dosages in order to avoid administering the incorrect dose to a patient when in the clinical setting. The aim of this study was to examine the effects of maths anxiety on healthcare students' ability to accurately calculate drug dosages by performing a scoping review of the existing literature. This review utilised a six-stage methodology using the following databases; CINAHL, Embase, Medline, Scopus, PsycINFO, Google Scholar, Trip database ( http://www.tripdatabase.com/ ) and Grey Literature report ( http://www.greylit.org/ ). After an initial title/abstract review of relevant papers, and then full text review of the remaining papers, six articles were selected for inclusion in this study. Of the six articles included, there were three experimental studies, two quantitative studies and one mixed method study. All studies addressed nursing students and the presence of maths anxiety. No relevant studies from other disciplines were identified in the existing literature. Three studies took place in the U.S, the remainder in Canada, Australia and United Kingdom. Upon analysis of these studies, four factors including maths anxiety were identified as having an influence on a student's drug dosage calculation abilities. Ultimately, the results from this review suggest more research is required in nursing and other relevant healthcare disciplines regarding the effects of maths anxiety on drug dosage calculations. This additional knowledge will be important to further inform development of strategies to decrease the potentially serious effects of errors in drug dosage calculation to patient safety. [ABSTRACT FROM AUTHOR]

This paper presents a review of social distancing measures deployed by transit agencies in the United States and Canada during the COVID-19 pandemic and discusses how specific operators across the two countries have implemented changes. Challenges and impacts on their operations are also provided. Social distancing is one of the community mitigation measures traditionally implemented during influenza pandemics and the novel coronavirus pandemic. Research has shown that social distancing is effective in containing the spread of disease. This is applicable to the current situation with the novel coronavirus, given the lack of effective vaccines and treatments in the United States and Canada in the first eight months of the pandemic. Moreover, social distancing is particularly useful in settings where community transmission is substantial. Directives for social distancing were issued in several states and public transit operators were charged with how to provide for physical distance of six feet between passengers on their property including physical infrastructure such as station buildings and rolling infrastructure (rolling stock) including trains, subway cars and buses. Operational changes were also required due to physical distancing, e.g. adding train cars to provide for opportunities to physically distance on the train. Examples of some measures discussed in this research includes taping off every other seat on buses, increasing the total length of trains by adding cars, separating bus drivers from passengers with plastic sheeting, rear door boarding, etc. This research also analyzes long-term impacts for transit operators and challenges to encourage passengers to return to public transit after lockdown requirements ordered by government officials are lifted. A section on the policies that are being explored by government to continue to sustain public transportation is also included. • We review the interventions deployed by public transit operators to comply with social distancing measures. • We explore operational changes recommended to facilitate physical distancing. • We analyze the impacts for transit operators and challenges for passengers to return to public transit post pandemic. • We discuss the challenges for transit to return to pre-pandemic conditions and some solutions explored. [ABSTRACT FROM AUTHOR]

The majority of research participants in the social sciences are recruited from populations that are Western , educated , industrialized , rich , and democratic. This has the potential to threaten the external validity and limit the generalizability of research findings. It also highlights the need to provide a historical accounting of participant characteristics and reporting practices across coherent disciplines of research. This paper reports the participant characteristics from studies published in 12 leading journals in the sport and exercise psychology literature. In total, 15,650 peer-reviewed articles were published across these outlets from 1930 to 2021, involving 4,487,437 human participants. A descriptive overview of participant characteristics and reporting practices suggests that empirical understanding of human experiences and outcomes in sport and exercise settings is built from an incomplete and unrepresentative sample of participants. Findings illuminate potential knowledge gaps that may have resulted from the lack of diverse samples and offer potential paths forward for contemporary sport and exercise psychology scholars who wish to address these gaps. • 15,650 articles with 4,487,437 human participants have been published across 12 sport and exercise psychology journals from 1930 to 2021. • 75.6% of participants from these studies have been drawn from the United States, Canada, the United Kingdom, and Australia. • Across this literature, many important participant characteristics have gone uncollected and/or unreported. [ABSTRACT FROM AUTHOR]

This paper presents the development effort that created a robust representation of the combined capacity expansion of the U.S. and Canadian electric sectors within the NREL ReEDS model. The abbreviated scenario analysis effort was designed to understand drivers behind various Canadian–U.S. power sector futures out to 2036. We model the impact of natural gas prices, increased Canadian hydropower deployment, and increased renewable energy (RE) penetrations. The sample results analyzed in this paper show the highly dynamic nature of the modeling tool as it performs a simultaneous optimization of the two countries’ generation portfolios. The interactions between the two countries go beyond energy generation and also include firm capacity contracts and renewable energy certificates (RECs). The reference scenario results show a significant increase in wind generation in both the United States and Canada with a gradual retirement of coal and nuclear energy. The evolution of net energy and firm capacity exchange was very dynamic through the span of the analysis period and drives significant investment in transmission capacity across the border, almost doubling the existing capacity of transmission lines. The exchange of energy was driven by regional stories. ISO-NE and NYISO import energy throughout the analysis period. However, in the Western Interconnection we observed increasing imports to Canada from the United States, whereas the exchanges with MISO switched directions. [ABSTRACT FROM AUTHOR]

Summary Background Presentations to emergency departments (EDs) and patient acuity continue to increase. Whilst strategies to deliver safe patient care in the ED are evolving, emergency nurses need to be well educated through specialist qualifications to enable delivery of advanced patient care. This paper presents a comparative analysis of available international practice and competency standards for nurses graduating from emergency nursing courses in Australia, Canada, New Zealand, the United Kingdom, and the United States. Methods CINAHL, Scopus, Ovid MEDLINE, and Embase were searched for papers, published in English, using the terms: ‘emergency’, ‘accident and emergency’, ‘nursing’, ‘competency’, ‘practice standards’, ‘scope of practice’, ‘regulation’, and ‘specialist standards’. Secondary sources from relevant reference lists and professional websites were also searched. Results The standards from the five countries were common across five domains: clinical expertise, communication, teamwork, resources and environment, and legal. None of the standards were specific to the emergency nursing graduate, and there was variability in the level of expertise required for which the standards apply. Conclusions The available practice standards demonstrated some commonality. Consideration of the utility of a universal framework for informing the development of emergency nursing practice standards and emergency nursing curriculum for nurses wishing to specialise is needed. [ABSTRACT FROM AUTHOR]

• ASR expansion was suppressed and transferred to free or low stress directions. • Stress reduces the degradation of the modulus of elasticity. • ASR did not affect the peak shear strength of the low aspect ratio shear walls. • The Disturbed Stress Field Model provides a viable platform for implementing ASR constitutive models. Concrete nuclear structures have been identified as suffering from alkali aggregate reaction (AAR) in both Canada and the United States. Although much research effort has been directed toward understanding its effect on reinforced concrete structures, unresolved issues still remain. Among them are the effect of multiaxial stress states, commonly developed in nuclear structures, on the response of AAR-affected concrete; also of concern is the possible invalidity of conventional methods of analysis for structural assessment due to the induced anisotropy in the mechanical properties of concrete. The Canadian Nuclear Safety Commission initiated and funded an extensive study aimed to reveal the implications of concrete deterioration due to AAR on structural integrity, which included material and structural testing and modeling. This paper presents an overview of the entire research program and discusses the key results. [ABSTRACT FROM AUTHOR]

• Sheltered natural carbonation can be similar between different climates. • Huge impact of curing on natural carbonation for very early age (i.e. 1 day) • Impact of curing is negligible for advanced curing age, regardless of cement type. • Strong impact of precipitation on natural carbonation. • The higher the number of rainy days, the lower the carbonation speed. This paper describes a unique international inter-laboratory study on the carbonation resistance of concrete prepared with different supplementary cementing materials. Concrete specimens – from 45 different concrete mixtures – prepared centrally in Lafarge Centre de Recherche (France) were shipped in a sealed condition to 4 other academia research laboratories (located in USA, Canada, India and China). The specimens were exposed to the ambient environments and atmospheric CO2 concentrations in the five locations, including Lafarge Centre de Recherche in France, in both sheltered and unsheltered condition for a period of 5 years. Measurements of carbonation depth were performed at periodic intervals, and the data was analyzed to assess the influence of climatic conditions on the resistance to carbonation. The results indicate that the general trend of carbonation is not much different irrespective of the macroclimate. Further, the number of rainy days seems to have a more significant influence on the progress of carbonation than the total rainfall in the region. [ABSTRACT FROM AUTHOR]

Abstract Global warming is already affecting the oceans through changes in water temperature, acidification, oxygen content and sea level rise, amongst many others. These changes are having multiple effects on marine species worldwide, with subsequent impacts on marine fisheries, peoples' livelihoods and food security. This work presents a review of the recent literature on the current and projected impacts of climate change on Canada's Pacific marine ecosystem. We find that there is an increasing number of studies in British Columbia focusing on changes in ocean conditions and marine species responses under climate change, including an emerging literature on the socio-economic impacts of these changes considered to be a knowledge gap. According to the literature, it is well established that ocean temperatures are increasing over the long-term, especially, in southern areas of British Columbia. Warming trends are increasing in the spring and are strongest in summer. However, there are important uncertainties regarding other climate drivers, such as oxygen concentration and acidification, stemming mainly from the insufficiency of data. Pacific salmon, elasmobranchs, invertebrates and rockfishes are amongst the most vulnerable species groups to climate change in British Columbia. Also, shifts in stock distribution and fish abundance under climate change may have a significant impact on fish supply affecting the livelihoods and food security of some British Columbians. The magnitude of these impacts is likely to vary according to a latitudinal gradient, with southern coastal areas being more affected than northern and central areas; challenging multiple areas of governance, such as equity and fishing access amongst First Nations; and institutional arrangements for transboundary stocks between the U.S. and Canada. Highlights • Climate change is impacting marine species worldwide, affecting marine fisheries, peoples' livelihoods and food security. • There is an emerging literature on the socio-economic impacts of climate change at the local level. • This paper presents a review of the literature published on these impacts in British Columbia's marine species and fisheries. • Socio-economic impacts will vary according to a latitudinal gradient with unequal distribution of losses in marine catches. • We identify some of the risks that fisheries, communities and the economy are facing in the region due to climate change. [ABSTRACT FROM AUTHOR]

• The Finnish Baby Box provides parents of newborns with a wide range of infant clothing and other basics. • The cardboard box in which the infant can sleep was emphasized by the media and commercial companies outside Finland. • The box preventing SIDS was advanced by private companies and the media. • This was less the case in Wales and Scotland, a result of their being governed by authorities with a "left" orientation. For over 80 years the Finnish state has provided expectant mothers with a cardboard box containing an extensive collection of clothing, bathing products for the baby, nappies, bedding and a small mattress. Numerous jurisdictions have implemented it in some form. We investigated through a critical case study methodology whether its translation into the liberal welfare states of Canada, UK, and USA experienced message distortion (the box as a means of preventing SIDS), commercialization, watering down of content; and separation from the complex of Finnish welfare state policies that support families with children. We find that only Scotland and Wales recognized the decommodification and equity roles played by the baby box. This study identified numerous barriers to building progressive public policy in Canada, UK, and USA: the structures and processes of the liberal welfare state, commercial interests that skew public policymaking and media logic that limits news reporting to the concrete and simple, eschewing complex analysis. [ABSTRACT FROM AUTHOR]

Background: The United States and Canada have observed sharp increases in substance use disorder among women of child-bearing or child-rearing age. Substance use disorder can have deleterious effects on children, families, and communities. Many evidence-based treatments exist, but engaging mothers in treatment is difficult. No recent review is available to help systems and providers understand the facilitators of and barriers to treatment for mothers.Objective: To systematically identify facilitators and barriers to substance use and mental health treatment for mothers with substance use disorder who are pregnant or parenting young children in the United States and Canada.Methods: We systematically searched the literature using five online databases and performed a gray literature search. We included studies published in the past two decades focused on parent or provider perspectives.Results: Our search identified 23 high-quality papers. The majority of papers qualitatively examined the perspectives of treatment-seeking pregnant women and mothers diverse in race/ethnicity, region, and treatment settings. Our synthesis of findings revealed the compelling and complex centrality of motherhood, which served as both a facilitator and barrier. Motherhood often interacted with relational (e.g., perceiving stigma vs. support from providers, family, friends, partners) and structural (e.g., time commitments, childcare) factors to both hinder and help engagement in treatment.Conclusions: Our findings can help policy-makers and practitioners make tangible improvements to the financing and delivery of substance use treatment for mothers. Our review points to specific areas for future research, including an examination of the relationships between various structural factors and treatment outcomes. [ABSTRACT FROM AUTHOR]

Research indicates that there is considerable variability in teachers' approaches to assessment resulting in different learning cultures for students. The primary purpose of the study is to examine the relationship between teachers' approaches to assessment across a set of dimensions (including their conceptions of assessment purposes, processes, fairness, and measurement theory) and career stage. The results of this paper illustrate nuanced impacts of career stage on teachers' approaches to multiple dimensions of assessment and enable the generation of assessment profiles that provide empirical support for differences in teachers’ approaches to assessment both within and between career stages. [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]

Much work has been undertaken to publicize the plight of female rape survivors, but until recent years the rape and sexual assault of adult males received little research or public attention. The aim of this paper is to selectively review the literature on male survivors of sexual violence highlighting, where relevant, timely implications for policy and practice. First, changes in UK legislation relating to male rape are discussed, with cross-national comparisons made against United States, Australian and Canadian statute to overview developing definitions and legal good practice. Second, prevalence issues relating to the under-reporting and long-term consequences of male sexual victimization are outlined. Third, the current dearth of UK service provision for male rape survivors is reported. Finally, literature on how male rape myth acceptance, victim blaming and homophobia relate to the secondary victimization of male survivors is considered. Suggestions for continued research in this developing area of work are made. [ABSTRACT FROM AUTHOR]

Urban centres in the US, Britain and Canada have responded to identified visible 'social problems' such addiction, mental health and homelessness by providing some supportive housing for the urban poor and marginalized. While some critics have questioned what supportive housing specifically entails in terms of the built environment, what remains under explored, though a growing area of concern, is the relationship between surveillance and supportive housing for urban residents identified as having addiction and mental health problems - a gap addressed in this paper. Drawing upon qualitative ethnographic observational data we examine some of the measures of control and coercion that are encroaching into social housing primarily established for poor and marginalized people with addiction and mental health problems in the urban centre of Vancouver, Canada. We witnessed three modes of regulation and control, that vary widely, among the residencies observed: physical surveillance technologies; site-specific modes of coercion; police presence and staff surveillance, which all together impact the everyday lives of residents living in low-income and supportive housing. We argue that supportive housing has the potential to provide its intended commitment - safe and secure affordable housing. However, owing to an (over)emphasis on 'security', the supportive housing we observed were also sites of social control. [ABSTRACT FROM AUTHOR]

The planet is rapidly urbanizing, the need for actionable evidence to guide the design of cities that help (not hinder) our health has never felt more urgent. One essential component of healthy city design is improving neighborhood conditions in previously disinvested areas. To ensure equitable city design, policy makers, city planners, health practitioners, and researchers are interested in understanding the complex relationship between urban change, gentrification, and population health. Yet, the causal link between gentrification and health outcomes remain unclear. Without clear and consistent gentrification measures, researchers struggle to identify populations who are exposed to gentrification, and to compare health outcomes between exposed and unexposed populations. To move the science forward, this paper summarizes the challenges related to gentrification measurement in the United States and Canada when aspiring to conduct studies to analyze causal relationships between gentrification and health. The paper concludes with a series of recommendations for studies aimed at examining both causes and consequences of gentrification and health. [ABSTRACT FROM AUTHOR]

To identify the patient classification systems used to classify nursing intensity in the assessment of nursing staffing resources currently used in home health care, with a special emphasis on validity, reliability and staff allocation. Scoping review of internationally published and grey literature, based on a methodological framework by Arksey and O'Malley. Searches of the electronic databases Cinahl, Medline, Embase and SweMed, the websites Google and Google Scholar and hand searches of reference lists occurred. Eligibility criteria included (A) a focus on patient classification systems measuring nursing intensity and workload in home health care and (B) published in English between January 2007 and March 2019. In level one testing two team members screened titles and abstracts, in level two testing two team members determined which papers should undergo a full text review. Data were extracted using structured extraction by one team member and verified by two other members. Thirteen peer-reviewed articles and grey literature documents were identified, from Canada, Ireland, the UK, the USA, Scotland, Turkey and the Netherlands. Four patient classification systems had been tested for both validity and reliability. Validity was tested through face validity, predictive validity, concurrent validity or content validity index. Reliability was tested through stability, internal consistency, observer agreement or inter rater reliability. One patient classification system had been tested only for reliability, through interrater reliability and observer agreement. Two patient classification systems had been evaluated through summative evaluation; one qualitatively through focus group interviews and one through semi-structured interviews. Only one patient classification system had been validity and reliability tested and evaluated. Overall, the patient classification systems in the included papers (13) were considered to have benefits and to be appropriate for the measurement of patients' needs, workload and allocation of staff, although specific information was not always given. Little has been published on validity or reliability tested patient classification systems linked to staffing allocation in home health care in the past decade. Limited research was seen where a patient classification system was considered to be fully operational in home health care. [ABSTRACT FROM AUTHOR]

The CanMars Mars Sample Return Analogue Deployment (MSRAD) was a closely simulated, end-to-end Mars Sample Return (MSR) mission scenario, with instrumentation, goals, and constraints modeled on the upcoming NASA Mars 2020 rover mission; this paper reports on the post-mission validation of the exercise. The exercise utilized the CSA Mars Exploration Science Rover (MESR) rover, deployed to Utah, USA, at a Mars-analogue field site. The principal features of the field site located near Green River, Utah are Late Jurassic inverted, fluvial paleochannels, analogous to features on Mars in sites being considered for the ESA ExoMars rover mission and present within the chosen landing site for the Mars 2020 rover mission. The in-simulation ("in-sim") mission operations team worked remotely from The University of Western Ontario, Canada. A suite of MESR-integrated and hand-held spectrometers was selected to mimic those of the Mars 2020 payload, and a Utah-based, on-site team was tasked with field operations to carry out the data collection and sampling as commanded by the in-sim team. As a validation of the in-sim mission science findings, the field team performed an independent geological assessment. This paper documents the field team's on-site geological assessment and subsequent laboratory and analytical results, then offers a comparison of mission (in-sim) and post-mission (laboratory) science results. The laboratory-based findings were largely consistent with the in-sim rover-derived data and geological interpretations, though some notable exceptions highlight the inherent difficulties in remote science. In some cases, available data was insufficient for lithologic identification given the absence of other important contextual information (e.g., textural information). This study suggests that the in-sim instruments were largely adequate for the Science Team to characterize samples; however, rover-based field work is necessarily hampered by mobility and time constraints with an obvious effect on efficiency but also precision, and to some extent, accuracy of the findings. The data show a dearth of preserved total organic carbon (TOC) – used as a proxy for ancient biosignature preservation potential – in the fluvial-lacustrine system of this field site, suggesting serious consideration with respect to the capabilities and opportunities for addressing the Mars exploration goals. We therefore suggest a thorough characterization of terrestrial sites analogous to those of Mars rover landing sites, and in-depth field studies like CanMars as important, pre-mission strategic exercises. • We present a field geological assessment of the CanMars analogue mission field site. • Characterization of terrestrial, analogous Mars landing sites is crucial for mission success. • In-depth field studies allow an understanding of how to address habitability potential. [ABSTRACT FROM AUTHOR]

Prior research suggests that racial inequalities in health vary in magnitude across societies. This paper uses the largest nationally representative samples available to compare racial inequalities in health in the United States and Canada. Data were obtained from ten waves of the National Health Interview Survey (n = 162,271,885) and the Canadian Community Health Survey (n = 19,906,131) from 2000 to 2010. We estimated crude and adjusted odds ratios, and risk differences across racial groups for a range of health outcomes in each country. Patterns of racial health inequalities differed across the United States and Canada. After adjusting for covariates, black-white and Hispanic-white inequalities were relatively larger in the United States, while aboriginal-white inequalities were larger in Canada. In both countries, socioeconomic factors did not explain inequalities across racial groups to the same extent. In conclusion, while racial inequalities in health exist in both the United States and Canada, the magnitudes of these inequalities as well as the racial groups affected by them, differ considerably across the two countries. This suggests that the relationship between race and health varies as a function of the societal context in which it operates. [ABSTRACT FROM AUTHOR]

Background and Aims: There is little information on consumption patterns across the diverse range of cannabis product types. This paper examines trends in consumption patterns in Canada and the United States (US) between 2018-2020.Design: Repeat cross-sectional surveys were conducted as part of the International Cannabis Policy Study online survey in 2018 (n=27,024), 2019 (n=45,426), and 2020 (n=45,180).Setting: Respondents were recruited from commercial panels in Canada and US states that had and had not legalized non-medical cannabis (US 'legal' and 'illegal' states, respectively).Participants: Respondents were male and female participants aged 16-65 years.Measurements: Data on frequency and consumption amounts were collected for nine types of cannabis products, including dried flower and processed products (e.g., oils and concentrates). Consumers were also asked about mixing cannabis with tobacco. Socio-demographic information was collected.Findings: Dried flower was the most commonly used product, although use in the past 12 months declined between 2018 and 2020 in Canada (81% to 73%), US legal (78% to 72%) and illegal states (81% to 76%; p<0.05 for all). Prevalence of past 12-month use increased for virtually all other product forms, although prevalence of daily use remained stable across years. In 2020, edibles and vape oils were the most commonly used products after flower. Use of non-flower products was highest in US legal states, although similar trends were observed in all jurisdictions. Males were more likely to report using processed products, and vape oils were the most commonly processed product among 16-20-year-olds. Daily use of cannabis flower increased in US legal and illegal states, and average joint size increased across all jurisdictions over time.Conclusions: Dried flower remains the dominant product in Canada and the US; however, use of processed cannabis products has increased, with the largest increases observed in legal cannabis markets. [ABSTRACT FROM AUTHOR]

Objective To assess the efficacy of interventions and environmental factors on increasing fluid intake or reducing dehydration risk in older people living in long-term care facilities. Design Systematic review of intervention and observational studies. Data Sources Thirteen electronic databases were searched from inception until September 2013 in all languages. References of included papers and reviews were checked. Eligibility Criteria Intervention and observational studies investigating modifiable factors to increase fluid intake and/or reduce dehydration risk in older people (≥65 years) living in long-term care facilities who could drink orally. Review Methods Two reviewers independently screened, selected, abstracted data, and assessed risk of bias from included studies; narrative synthesis was performed. Results A total of 4328 titles and abstracts were identified, 325 full-text articles were obtained and 23 were included in the review. Nineteen intervention and 4 observational studies from 7 countries investigated factors at the resident, institutional, or policy level. Overall, the studies were at high risk of bias due to selection and attrition bias and lack of valid outcome measures of fluid intake and dehydration assessment. Reported findings from 6 of the 9 intervention studies investigating the effect of multicomponent strategies on fluid intake or dehydration described a positive effect. Components included greater choice and availability of beverages, increased staff awareness, and increased staff assistance with drinking and toileting. Implementation of the US Resident Assessment Instrument reduced dehydration prevalence from 3% to 1%, P = .01. Two smaller studies reported positive effects: one on fluid intake in 9 men with Alzheimer disease using high-contrast red cups, the other involved supplementing 13 mildly dehydrated residents with oral hydration solution over 5 days to reduce dehydration. Modifications to the dining environment, advice to residents, presentation of beverages, and mode of delivery (straw vs beaker; prethickened drinks vs those thickened at the bedside) were inconclusive. Two large observational studies with good internal validity investigated effects of ownership; in Canada, for-profit ownership was associated with increased hospital admissions for dehydration; no difference was seen in dehydration prevalence between US for-profit and not-for-profit homes, although chain facilities were associated with lower odds of dehydration. This US study did not suggest any effect of staffing levels on dehydration prevalence. Conclusions A wide range of interventions and exposures were identified, but the efficacy of many strategies remains unproven due to the high risk of bias present in many studies. Reducing dehydration prevalence in long-term care facilities is likely to require multiple strategies involving policymakers, management, and care staff, but these require further investigation using more robust study methodologies. The review protocol was registered with the International Prospective Register of Systematic Reviews ( http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42012003100 ). [ABSTRACT FROM AUTHOR]

In this paper, environmental sustainability performance assessment of 27 U.S. and Canada metropoles is addressed. A four-step hierarchical fuzzy multi-criteria decision-making approach is developed. In the first step, the proposed methodology is established by determining the sustainability performance indicators (a total of 16 sustainability indicators are considered), collecting the data and contacting experts from academia, U.S. government agencies and within the industry. In the second step, experts are contacted and the entire list is finalized; sustainability performance evaluation forms are delivered; and then expert judgment results are obtained and quantified, respectively. In the third step, the proposed Multi-criteria Intuitionistic Fuzzy Decision Making model is developed and sustainability performance scores are quantified by using the collected data, multi-criteria decision making model and sustainability indicator weights obtained from expert judgment phase. In the final step, the sustainability scores and rankings of the 27 metropoles, results analysis and discussions, and statistical highlights about the research findings are provided. Results indicated that the average sustainability performance score is found to be 0.524 over scale between 0 and 1. The metropole with the greatest sustainability performance score is found to be New York with 0.703 and the poorest performing city is identified as Cleveland with 0.394. The results of the statistical analysis indicate that the greatest significant correlations are obtained with carbon dioxide (CO 2 ) emissions per person (−0.749 – significant negative correlation with sustainability performance score) and share of workers traveling by public transport (+0.753 – significant positive correlation with sustainability performance score). Therefore, the CO 2 emissions and public transport are found to have the most significant impact on the sustainability scores. [ABSTRACT FROM AUTHOR]

Abstract: Given the increasing number of interactions between police and people with mental illnesses (PMI), there has been widespread interest in the development of education for police about how best to interact with PMI. This paper reflects the review of current practice in a variety of jurisdictions across Canada as well as in the United States (U.S.), the United Kingdom (U.K.) and Australia; it proposes a comprehensive model of learning based on the literature that addresses not only the content in the narrow sense but also the importance of broader contextual knowledge and understanding in developing effective education and training. Embedded in the principles articulated in the Mental Health Strategy for Canada, the TEMPO (Training and Education about Mental illness for Police Organizations) model is a multilevel learning strategy for Canadian police personnel. Learning objectives and key principles are articulated in order to ensure the model is applicable to a wide range of police agencies and individual jurisdictional needs. In addition to providing a firm basis of factual knowledge for police personnel, the resultant model embraces a human rights/anti-stigma philosophy, provides for a range of education appropriate to diverse police audiences, emphasizes a systems approach to police/mental health liaison activities and addresses issues related to the delivery and implementation of police education and training. [Copyright &y& Elsevier]

[Display omitted] • Respondents adapted their delivery of the Lidcombe Program during the pandemic. • Perceived advantages outweigh disadvantages to using telepractice. • Respondents easily adapted the components of the Lidcombe Program to telepractice. • Most speech-language pathologists would use telepractice in the future. Telepractice has been shown to be a viable modality for the delivery of stuttering treatment. Since the advent of COVID-19, speech-language pathologists must adapt in-clinic treatments for online presentation. This research aimed to gather information from speech-language pathologists on their experiences of telepractice to deliver the Lidcombe Program to treat stuttering in young children. This paper presents the findings of an online survey that polled the clinical experiences of 106 speech-language pathologists who were delivering the Lidcombe Program via telepractice during COVID-19. The majority of respondents were experienced clinicians from the United States and Canada who had attended a Lidcombe Program workshop. Prior to COVID-19, 80 % had provided some clinical services online (up to 10 % of the time), and at the start of COVID-19 public lockdown orders, 77 % viewed telepractice as both a necessity and an opportunity. Three months after the public lockdown orders, the large majority, 94 %, said that they would continue to use both telepractice and in-clinic treatment in the future. Technology issues, concerns about establishing the clinical relationship, and identification of mild stuttering featured as challenges of telepractice service delivery, while benefits included time efficiency, flexibility of scheduling, and improved clinical processes. Respondents reported that the Lidcombe Program was easily translatable to telepractice and the majority intend to continue telepractice in the future. [ABSTRACT FROM AUTHOR]

Background: The emergence of legal cannabis industries poses a new public health challenge. Health information labels are part of the public health strategy for tobacco and alcohol, but there is limited research on cannabis-related messaging. This study explored perceptions of cannabis health information labels among people who used cannabis in the last 12 months residing in the U.S. and Canada.Methods: The Global Drug Survey (GDS) is a large anonymous cross-sectional web-survey. In GDS2019, respondents were presented with six labels with cannabis-related health information (dependence; driving stoned; harms of smoking; harms to developing brain; lack of motivation; effects on memory), and asked if information was new, believed, would it change behavior, and about acceptability of having health labels on legal products. This paper includes 1,275 respondents from Canada and 2,224 from U.S. states where cannabis was legal at the time of the survey, and 5,230 from other U.S. states.Results: Few respondents said that the information was new (6.6-24.6%). Most said the information was believable (63.5-72.0%) other than for the dependence message (28.1% new, 56.8% believed), which was perceived to be the least likely to change behavior (10.2%). Driving stoned was the message perceived to be the most likely to change behavior (58.5%). Respondents living in Canada were less likely to say information was new and rated most messages more believable than those in the U.S. Respondents from legal U.S. states were less likely to say information was new compared to other states. Respondents who used cannabis daily rated acceptability of labels lower (27.8%) than those using 1-48 days (40.6%).Conclusions: Novel, believable information may be more effective at changing behavior. Regular consumers may be less susceptible to messages. Information focusing on safer use strategies and benefits of reducing use may be more acceptable and should be assessed in future research. [ABSTRACT FROM AUTHOR]

• Data availability and cost can be prohibitive barriers for energy modeling. • We use a statistical method to predict power plant parameters using available data. • We apply two learning methods: linear regression and k-nearest-neighbors. • These approaches are applied in the context of U.S. and Canadian power plant data. • Results show reasonable predictions of heatrates and, to a lesser extent, costs. Energy systems models are used to perform energy and environmental policy analysis, inform company strategy, and understand implications of technological change. Although open-source models can promote transparency and reproducibility, data availability and cost can be prohibitive barriers for researchers and other stakeholders. This paper presents a novel application of a statistical approach to predict unknown power plant parameters in Canada using available data from the United States, which can be applied in other settings where critical model inputs are missing. We apply two statistical learning methods, linear regression and k -nearest-neighbors, and compare their performance on unseen portions of the United States data before applying the learned functions to unknown Canadian data. Results indicate that reasonable predictions of heatrates and, to a lesser extent, operation and maintenance costs are possible even with limited data about age, capacity, and power plant types. The nearest-neighbor approach generally outperforms linear regressions for the datasets and applications to power plant parameters investigated here. [ABSTRACT FROM AUTHOR]

• Despite consensus on importance of relationships in RCC, theorisation is limited. • Relational practice most prominently identified as threshold in transatlantic study. • All 5 characteristics of threshold concepts were reflected across interview data. • There was an emphasis on the troublesome nature of relationship boundaries. • The relational nature of teaching and learning relational practice was identified. Despite growing international consensus around the complex and demanding nature of residential child care for children and young people, consensus is lacking around how to develop a workforce equal to the task. Similarly, there is near unanimity about the essential nature of relationships, particularly the relationship between practitioner and child, for good residential care. At the same time, theorization on how those relationships are enacted and how to support practitioners' related development of practice is underdeveloped or even absent in some contexts. This second of a two-part paper discusses stage two of a two-stage, transatlantic study aimed at identifying and exploring threshold concepts in residential child care. Threshold concepts are central concepts in a given discipline which are transformative but troublesome for many. They are important to their given discipline because they shape thinking and practice, but they are often difficult to master. In stage one, relational practice was the most prominently discussed potential threshold concept in focus groups comprised of educators and practitioners who had studied, practiced and/or taught in the UK, Canada and/or the US. In stage two, in-depth individual interviews were carried out with practitioners around their threshold experiences of relational practice. Analysis found all five characteristics of threshold concepts reflected in the data, with a particular emphasis on the troublesome nature of relationship boundaries. A further theme around the relational nature of teaching and learning relational practice was identified, raising important parallels between the relational experiences practitioners have as part of their training, and their relational practice in the field. Implications are discussed, including the misfit between the demarcation of professional boundaries as applied by cognate fields and the actual requirements of ameliorative relationships in residential child care. [ABSTRACT FROM AUTHOR]

• Threshold concepts are core concepts in a given field that are transformative. • They are important because they shape thinking and practice. • A transatlantic study was carried out to identify them in residential child care. • Relational Practice and Use of Self were prominently identified. • They have explanatory power in guiding workforce development. Despite growing international consensus around the complex and demanding nature of residential child care for children and young people, consensus is lacking around how to develop a workforce equal to the task. Threshold concept theory casts a light on related issues of training and education, and offers direction in addressing them. Threshold concepts are central concepts in a given discipline which are transformative but troublesome for many. They are important to their given discipline because they shape thinking and practice, but they are often difficult to master. This first of a two-part paper discusses the first of a two-stage, transatlantic study aimed at identifying and exploring threshold concepts in residential child care. Using focus groups and individual interviews with participants who had studied, practiced and/or taught in the UK, Canada or the US, it explored the views and experiences of educators who have contributed to knowledge production in the field, as well as front-line practitioners who have completed a dedicated course in child and youth care, residential child care or therapeutic child care. Findings included unanimous agreement about the relevance of threshold concept theory to their experiences, and strong support for its utility in considering how curricula should be taught. There was a greater degree of commonality than divergence between educator and practitioner views about what might be threshold, with relational practice the most prominently discussed. A theme around the self of the learner was identified in discussions of threshold concept theory more generally, particularly across the educator focus groups. Implications for pedagogical practice are discussed, including the concept of praxis which provides a useful counterpoint for conceptualising the relationship between threshold concept theory and the use of self in practice, especially in fields where the self is a primary instrument of the work. [ABSTRACT FROM AUTHOR]