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COVID‐19 has had deep impacts on a wide range of vulnerable communities in Canada. Migrant agricultural workers in the southwestern region of Ontario were particularly impacted. Fearing the threat of the 'racialized foreign other', the Canadian state produced myriad securitization responses with heightened surveillance. This paper will examine both state and non‐state forms of securitization and the response from both workers and activists such as the advocacy group Justicia for Migrant Workers (J4MW). While there has been ample discussion of how vulnerable migrant agricultural workers were affected during the pandemic, there has been less attention paid to how state policies have heightened and targeted specific groups such as migrant agricultural workers through modes of securitization. Central to this was to ensure that labour needs would be met to ensure the viability of Canada's multi‐billion agricultural industry. This paper shows how securitization and control were vital to ensure no disruptions to production levels and Canada's role as a leading agricultural export producer. [ABSTRACT FROM AUTHOR]

Canada's immigration policy is regarded globally as a best practice model for selecting highly skilled migrants. Yet, upon arrival many immigrants face challenges integrating into employment. Where immigrants settle is one factor that has been shown to impact on employment integration. In Canada, regionalization policies have resulted in more immigrants settling in small to mid‐sized cities. It is important to understand how these local systems are organized to promote immigrant integration into employment. Using a systems approach, this paper presents a case study of immigrant employment in a mid‐sized city in Ontario, Canada. Through a document review and stakeholder interviews, a systems map was developed, and local perspectives were analyzed. Results demonstrate that in a mid‐sized city, few organizations play a large role in immigrant employment. The connections between these core organizations and the local labour market are complex. Any potential challenges to the system that interfere with these connections can cause a delay for newcomers seeking employment. As cities begin to experience growth driven by immigration, there is a need to ensure local services are not only available but also working effectively within the larger employment system. Key messages: An important focus of Canada's immigration policy has been to improve employment integration locally.Using a systems approach allows mid‐sized cities to identify local services and how they are connected to promote employment integration of newcomers.Greater connectivity between services can streamline the employment process for immigrants settling in mid‐sized cities. [ABSTRACT FROM AUTHOR]

In this paper, we use intersectionality-based policy analysis (IBPA) to examine how COVID-19 income support policies enacted in Ontario, Canada, affected people living with poverty. We find that the privileging of formal labor market attachment in eligibility requirements systemically excluded constituencies most likely to be living with poverty. More broadly, these exclusions represent a retrenchment of neoliberal logics in social policy, and the rejection of universal social welfare programs. In conclusion, we suggest that the experiences of people living with poverty during the COVID-19 pandemic further highlight the need for comprehensive social welfare programs, including a universal basic income. [ABSTRACT FROM AUTHOR]

The migration literature focusing on understanding interactions between immigrants' integration and transnationalism is replete with mixed findings. However, contemporary consensus among migration scholars suggests that immigrants' integration and transnational connections can occur simultaneously. Focusing on transnational dating—which is understudied—this exploratory study draws on an online qualitative survey with five Ghanaian male immigrants in southwestern Ontario, Canada, to explore how immigrants' attachment to the host society, homeland, and "elsewhere" shape transnational dating behaviour. Transnational dating is conceptualized in this paper as dating partners that live part or most of their life or time detached from each other, yet hold together and create a sense of shared welfare and harmony, namely "datehood" that surpasses national borders. Using the integration‐transnationalism matrix as the theoretical framework, this paper demonstrates that the roles of integration and transnationalism should not be seen as separate influences on participants' transnational dating behaviour given participants' strong attachment to the host society, sending country, and "elsewhere." Importantly, our finding indicates that the motivation for transnational dating is related to transnational connections rather than not feeling integrated into Canadian society. Overall, the finding contributes to discourses on dating, transnational dating, transnationalism, and the conceptual framework of the integration‐transnationalism matrix. Key Messages: The migration literature focusing on understanding interactions between immigrants' integration and transnationalism is replete with mixed findings.This exploratory study has taken a critical step in stimulating a research agenda on transnational dating within the integration‐transnationalism matrix.Our finding indicates that the motivation for transnational dating is related to transnational connections rather than not feeling integrated into Canadian society. [ABSTRACT FROM AUTHOR]

Introduction: Bladder cancer (BC) is the fifth most prevalent cancer in Canada, with 9000 Canadians diagnosed each year. While smoking is the most important risk factor, environmental and occupational carcinogens have been found to significantly contribute to BC rates. As Canada is highly reliant on natural resource industries, this study seeks to identify geographical and industry-related trends of BC rates in Ontario. Methods: The 1991 and 2001 Canadian Census Health and Environment Cohort (CanCHEC; Statistics Canada) was used, along with individual years of census data. Maps identifying hot and cold spots for BC within Ontario were generated, and the former were assessed for industry patterns between location and BC rates. Cox proportional hazards models were run for each age cohort to predict the likelihood of developing BC by industry of work. Results: Significant geographical and industrial trends in BC rates were identified. For 1991-2001, hot spots included the Cochrane, Manitoulin, Parry Sound, and Sudbury (90% confidence interval [CI]), and Nipissing and Temiskaming (95% CI) regions. Toronto and York were cold spots. Concurrently, metal (p=0.039), paper and publishing (p=0.0062), and wood and furniture (p<0.0001) industries had increased rates of BC. Notably, these industries had high employment density in our hot spot areas and low density in our cold spots. Conclusions: Significant geographical and industrial BC trends were found in Northern Ontario regions reliant on heavy employment in natural resource-based industries, such as forestry, agriculture, and wood/paper. These findings may inform future screening guidelines and aid in identifying individuals at risk of BC development. [ABSTRACT FROM AUTHOR]

This paper examines how policymakers interpret and deploy cultural economy approaches within municipal economic development strategies and cultural plans. Focusing on the 33 largest municipalities in Ontario, Canada, we conduct a keyword analysis of 63 municipal planning documents, supplemented with key informant interviews with economic development and cultural planning staff. Our analysis reveals that the use of cultural economy approaches in economic development and cultural plans varies depending upon city size, municipal governance structure and municipal organizational structure. However, despite the widespread use of cultural economy ideas in planning documents, we conclude that its uptake in municipal policymaking fails to reflect its professional and scholarly popularity. [ABSTRACT FROM AUTHOR]

• Developing a new optimization model for designing a tire closed-loop supply chain. • Presenting a Spherical fuzzy logic method to calculate the importance of suppliers. • Discussing the application of the model in Greater Toronto Area, Canada. • Solving the multi-objective model using the augmented ε -constraint method. • Performing extensive sensitivity analyses and analyzing the results. For tire manufacturers to remain profitable while fulfilling environmental and social obligations such as producer responsibility, the opportunity lies in designing a tire Closed-Loop Supply Chain (CLSC) which combines forward and reverse supply chains. In this paper, a new multi-objective mixed-integer linear programming model is proposed to configure and optimize a multi-echelon, multi-product, multi-period tire CLSC network based on multiple recovery options and markets. For one of the objectives of the model, the weighting factors (importance) of suppliers are determined according to a unique framework of qualitative criteria. In this respect, a novel decision-making method based on Spherical fuzzy logic is developed. Finally, the solution approach is devised based on the formulation of the augmented ε -constraint method for finding efficient solutions. The application of the model is illustrated focusing on the region of Greater Toronto Area in Ontario, Canada. The optimal quantities for the flows of products, and number and locations of open facilities of the network are computed. The results show that the selected suppliers and allocated orders from them are impacted by considering multiple objectives. [ABSTRACT FROM AUTHOR]

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

In December 2020, Canada released its national strengthened climate change plan with focus on cutting energy waste, cutting pollution, and build clean industrial advantage. Two weeks later, the national hydrogen strategy was announced urging all involved stakeholders to delve into the deployment of large-scale clean energy technologies. Ontario, Canada's largest economy and leading manufacturing province, it releases its provincial hydrogen strategy and roadmap later this year. represents a viable solution for reducing CO2 emissions from large industry pollutants by integrating our innovative copper chlorine (Cu-Cl) thermochemical water splitting cycle with the energy intensive and polluting industry of cement manufacturing. The paper highlights the nexus between the production process of two valuable commodities, namely cement and Hydrogen, and the role their integration introduces for increased energy efficiency and reduction of greenhouse gas emissions. In addition, as most of the thermal energy demand in cement manufacturing is utilized during the kiln processes, the paper proposes several energy mix scenarios involving the use of hydrogen to partially meet the kiln's heat demand. The results from these scenarios show the possibility of achieving over 15% to 19.6% reduction in CO2 emissions compared to coal-based kiln production, along with reduced recurring cost for operating the kiln. On-site large-scale hydrogen production, mixed with natural gas, was found to be financially viable and environmentally advantageous alternative to power the kilns. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic highlighted the importance of immigrant health workers in OECD nations, and intensified debates about the current and future supply and distribution of such workers, particularly nurses. This review paper considers internationally educated nurses in the case of Ontario, Canada, and the policy responses developed during the pandemic to address the increased utilization of immigrant health workers. To further consider the evolving place of migrant workers within health, the broader issue of the future of health care work is examined to imagine what a sustainable and resilient health workforce agenda that integrates internationally educated nurses might look like. [ABSTRACT FROM AUTHOR]

Introduction: Bladder cancer (BC) is the fifth most prevalent cancer in Canada, with 9000 Canadians diagnosed each year.1 While smoking is the most important risk factor, environmental and occupational carcinogens have been found to significantly contribute to BC rates.2 As Canada is highly reliant on natural resource industries, this study seeks to identify geographical and industry-related trends of BC rates in Ontario. Methods: The 1991 and 2001 Canadian Census Health and Environment Cohort (CanCHEC; Statistics Canada) was used, along with individual years of Census data. Maps identifying hot and cold spots for BC within Ontario were generated, and the former were assessed for industry patterns between location and BC rates. Cox proportional hazards models were run for each age cohort to predict the likelihood of developing BC by industry of work. Results: Significant geographical and industrial trends in BC rates were identified. For 1991-2001; hot spots included the Cochrane, Manitoulin, Parry Sound, and Sudbury (90% confidence interval [CI]), and Nipissing and Temiskaming (95% CI) regions. Toronto and York were cold spots. Concurrently, metal (p=0.039), paper and publishing (p=0.0062), and wood and furniture (p<0.0001) industries had increased rates of BC. Notably, these industries had high employment density in our hot spot areas and low density in our cold spots. Conclusions: Significant geographical and industrial BC trends were found in Northern Ontario regions reliant on heavy employment in natural resource-based industries, such as forestry, agriculture, and wood/paper. These findings may inform future screening guidelines and aid in identifying individuals at risk of BC development. [ABSTRACT FROM AUTHOR]

This paper provides a theoretical and empirical intervention into housing research by applying the geospatial lens of the rural-urban space (RUS) to the social problem of homelessness, a conceptual linkage absent in the Canadian context. Drawing on original data from 80 surveys, four focus groups, and a community feedback session, we identify and interrogate key local impacts of systemic shifts in the housing market and associated policy responses in Dufferin County, Ontario, a RUS community located 80km northwest of Toronto. We find that for people experiencing homelessness within RUS communities, the intersecting consequences of multiple forms of structural marginalization, such as low wages and social assistance rates and discrimination, can quickly destabilize housing. We emphasize the importance of attending to housing in RUS communities and developing housing policy strategies. [ABSTRACT FROM AUTHOR]

Investigations of the soil–foundation interaction behaviour of wind turbine foundations and transfer of energy from the wind to the ground have not been reported in Canada. Indeed, very few vibration monitoring studies have been conducted globally around wind farms. It has been found that turbines predominantly produce vibrations related to structural resonances and blade-passing frequencies. Energy is found to be modified with distance and is dominated by surface waves. This paper describes a study of the effect of wind–structure interaction on the behaviour of a turbine foundation and the generation of ground-based vibrations around a working commercial wind turbine in Ontario. The field monitoring system and meteorological instrumentation are described in this paper and the responses of the structure and surrounding ground due to the fluctuating wind-field are discussed. The spectral analysis shows that the higher frequency vibrations attenuate more rapidly than the lower frequency vibrations. The tilted elliptical particle motions are found to be non-Gaussian because of the non-Gaussian wind conditions. The response attenuation with distance indicates that both geometric and material attenuation may dominate the vibration attenuation in the near field and only geometric attenuation occurs in the far field. [ABSTRACT FROM AUTHOR]

This paper develops a framework for a financial, economic, and stakeholder analysis of a residential rooftop solar net-metering program. The empirical focus of the paper is the net-metering program in Ontario, Canada, but the methodology is applicable to evaluating other public programs. The results highlight that without the Federal Government's subsidy for the initial investment cost, net-metered solar systems are not financially viable for representative households. Moreover, the stakeholder analysis reveals that for each additional net-metered system installed in Ontario, non-net-metered households experience financial losses of six times the benefits to the net-metered households. The net losses to the Federal Government of Canada and the Canadian economy are five and nine times the benefit to the net-metered households, respectively. The only stakeholder who benefits marginally is the Government of Ontario. In terms of environmental benefits, our estimate of the cost of greenhouse gas abatement by residential net-metered solar is 325 CAD per ton of CO 2 , which is significantly higher than the current (65 CAD in 2023) and future (170 CAD by 2030) national carbon price set by the Government of Canada. [ABSTRACT FROM AUTHOR]

"Short-term load forecasting (STLF)" is increasingly significant because of the extensive use of distributed energy resources, the incorporation of intermitted RES, and the implementation of DSM. This paper provides a novel ensemble forecasting model with wavelet transform for the STLF depending on the decomposition principle of load profiles. The model can effectively capture the portion of daily load profiles caused by seasonal variations. The results indicate that it is possible to improve STLF accuracy with the proposed method. The proposed approach is tested with the data taken from Ontario's electricity market in Canada. The results show that the proposed technique performs well in-terms of prediction when compared to existing traditional and cutting-edge methods. The performance of the model was validated with different datasets. Moreover, this approach can provide accurate load forecasting using ensemble models. Therefore, utilities and smart grid operators can use this approach as an additional decision-making tool to improve their real-time decisions. [ABSTRACT FROM AUTHOR]

This paper examines the political history of the failed struggle to require companies to justify their plant closing decisions in Canada's industrial heartland of Ontario. Demands for the public review of plant closing decisions began, locally, in the auto town of Windsor in the 1950s and 1960s and reached Toronto with the closure of Dunlop Tire in 1970. Another wave of closures struck in 1980, this time reaching deep into rural and small-town Ontario as well as larger industrial towns and cities, generalizing concern. The resulting Select Committee on Plant Shutdowns and Employee Adjustment, created by the Ontario legislature, took it upon itself to conduct the kind of public review of recent closures that was long demanded. Due to the strength of the political opposition to any interference with management rights, it was essential that proponents could point to precedents in Western Europe. Trade unionists also grounded their argument in favour of government regulation in the moral economy idea that long-service workers accrued a proprietary right to their jobs. [ABSTRACT FROM AUTHOR]

Aim: This study aims to present a general bibliometric overview of the development status of global nursing research from 2000 to 2019. Design: A longitudinal bibliometric analysis of nursing research was conducted. Methods: Nursing research publications (N = 88,665) were obtained from Web of Science. Bibliometric method was used to map the output and citation impact trends of countries/regions, institutions, disciplines, and journals and analyse the research collaboration among countries/regions and institutions. Results: The global paper output in nursing research increased steadily over the past two decades and it varied in different countries/regions with the USA being far ahead of the others. The paper output and cross‐border collaboration are mainly distributed in several developed countries like the USA, the UK, Australia, and Canada. The University of Pennsylvania, Harvard University, University of Toronto, and University of North Carolina at Chapel Hill have high academic influence in the field of nursing. Increasing attention from academic fields has been paid to research on nursing. Journal of Advanced Nursing is the most prolific and most cited journal in nursing field. Conclusion: Nursing research has developed steadily over the last two decades. Both the scientific output and research collaboration are disproportionally distributed between high‐income countries/regions and low‐ and middle‐income countries/regions. Most research and collaboration have taken place in a few developed countries across North America, Europe, and Oceania. Impact: The study highlighted the need for policy makers and funding agencies, especially those from low‐ and middle‐income countries/regions, to allocate research funding that supports the nursing higher education and international cooperation so as to promote the development of high‐quality nursing research in those countries/regions. At the same time, researchers from non‐English‐speaking countries/regions should attach more importance to publishing papers in English, strengthening the academic exchanges with international nursing colleagues and better integrating into the international academic community. [ABSTRACT FROM AUTHOR]

Background: Homelessness is becoming an international public health issue in most developed countries, including Canada. Homelessness is regarded as both political and socioeconomic problems warranting broad and consistent result-oriented approaches.Methods: This paper represents the qualitative findings of a project that explored risk factors associated with family homelessness and strategies that could mitigate and prevent homelessness among families using a focused ethnographic study guided by the principles of participatory action research (PAR). The sample includes 36 family members residing at a family shelter who participated in focus groups over two years (between April 2016 and December 2017). Most of the participants were single-parent women.Results: The analysis yielded five major themes including, life challenges, lack of understanding of the system, existing power differentials, escaping from hardship, and a theme of proposed solutions for reducing family homelessness in the community.Conclusion: The findings illustrated the complex nature of family homelessness in Ontario; that the interaction of multiple systems can put families at risk of homelessness. Findings from this study underscore the need for urgent housing protocols aimed at educating homeless families on how to navigate and understand the system, enhance their conflict resolution skills, and develop strategies beyond relocation to help them to cope with difficulties with housing. [ABSTRACT FROM AUTHOR]

Unexpected observations of strong radiowave scatter at a ~85–90 km altitude with very high frequency radars were explained in the early 1990s, when it was demonstrated that these were due to special turbulent and small-scale scatterers with high Schmidt number. Studies of these phenomena have primarily been concentrated in polar regions, and the events seem most prominent in regions of very cold air (below 140 K). Such radar echoes are referred to as polar mesosphere summer echoes (PMSE), and are rare at lower latitudes. In this paper we report observations of similar scatterers at sites below 50° latitude. The nature of these scatterers is discussed and results are compared to observations at the polar site of Eureka, Canada. Mid-latitude observations at frequencies of 48.92 and 45.47 MHz were made, respectively, at Abitibi Canyon (49.9° N latitude) and Markstay (46.5° N latitude) in Ontario, Canada. In particular, we look at the relationship of these scatterers to geophysical parameters, especially the Ap index. Our results suggest that mesospheric air with temperatures less than 140 K now exists below 50° latitude. This may be an indication of an equator-ward creep of global mesospheric cooling (which is associated with the well-known tropospheric global warming), but the scatterers at lower latitudes also demonstrate correlation with the Ap index. On the other hand, the polar scatterers at Eureka demonstrated no correlation of any significance with Ap. The importance of these results in regard to the global distribution of mesospheric temperatures is discussed, and comparisons to other measurements are made. [ABSTRACT FROM AUTHOR]

• The uncertainty of wind power has a significant impact on power load forecasting. • LASSO-QR is presented for power load probability density forecasting considering the wind power. • LASSO and GCV methods are adopted to extract the important explanatory variables. • Two cases of Canada in summer and winter display the performance of proposed method. Short-term load forecasting (STLF) is the foundation of safe and stable operation for power systems. In recent years, large amount of intermittent wind power has integrated into the power system, which significantly increases the uncertainties of power load forecasting. Along with the gradual increase for the proportion of wind power in the power grid, the frequency stability problem attributed to wind power connection attracts increasing attention from various aspects. Fully considering the impact of the wind power factor, a method of probability density forecasting based on Least Absolute Shrinkage and Selection Operator-Quantile Regression (LASSO-QR) is proposed in this paper. Firstly, the significant explanatory variables are screened out from the historical power load and wind power factors based on LASSO algorithm via generalized cross validation (GCV), and the LASSO-QR model is established. Secondly, in combination with kernel density estimation (KDE) method, short-term power load probability density forecasting based on LASSO-QR is implemented utilizing Epanechnikov kernel function. Thirdly, the paper appraises the exactitude of the prediction interval (PI) in accordance with two criteria, prediction interval coverage probability (PICP) and prediction interval normalized average width (PINAW). Two real datasets from Ontario of Canada in summer and winter, are exploited to validate the LASSO-QR method. Fully considering the impact of wind power factor on the power load, experiment results demonstrate that the LASSO-QR method can construct more accurate PI and obtain more precise probability density forecasting results than quantile regression (QR). Contrastive analysis with the existing state-of-the-art methods further verifies superiority of the method proposed, which reduces the nondeterminacy of the prediction process to avoid large prediction errors and economic losses. [ABSTRACT FROM AUTHOR]

In an era of rural service decline and population aging, some rural libraries rely on volunteers to keep them open within the community. This paper outlines the challenges of sustaining such volunteer-based rural libraries, drawing on a case study of a volunteer-based library in rural Ontario, Canada. Findings suggest that age of volunteers, volunteer participation, territoriality, branch polarization and the burden of volunteering present challenges in sustaining the volunteer program at the library, yet the library contributes to the community through community engagement, enabling aging in place and through economic development. The paper concludes with recommendations from the case study on how the sustain such a volunteer program. [ABSTRACT FROM AUTHOR]

Accurate wind speed forecasting ensures the controllability for the wind power system. In this paper, a structure with density-weighted active learning (DWAL)-based model selection strategy from the perspective of meteorological factors is proposed to improve the accuracy and stability for wind speed deterministic and probabilistic forecasting. To improve training efficiency and accelerate the sample selection process, DWAL is employed. The multi-objective flower pollination algorithm is used to combine best models selected from model space with optimal weights for higher accuracy and stability. Except deterministic forecasts, as large-scale wind power generation integrated into power grid, the wind direction should also be forecasted and the estimation of the wind speed and direction uncertainty is vital, offering various aspects of forecasts for risk management. Thus, both deterministic and probabilistic forecasting for the wind speed vector are included in this paper. Eight datasets from Ontario Province, Canada, are utilized to evaluate forecasting performance of the model selection and the proposed structure. Results demonstrated: (a) the proposed structure is suitable for wind speed vector forecasting; (b) the proposed structure obtains more precise and stable forecasting performance; (c) the proposed structure improves the accuracy of deterministic forecasting and provides probabilistic information for wind speed vector forecasting. • Propose a novel forecasting structure based on meteorological analysis. • The model selection is employed. • The multi-objective flower pollination algorithm is used. • Density-weighted active learning algorithm is applied. • Both deterministic forecasting and probabilistic forecasting are applied. [ABSTRACT FROM AUTHOR]

The research pertaining to racial disparities for Black families in child welfare is relatively limited in Canada. Recent research reveals that the overrepresentation of Black families in Canadian child welfare systems typically begins at the reporting or investigation stage and continues throughout the child welfare service and decision-making continuum. This research is occurring against the backdrop of increasing public acknowledgement of Canada's historic anti-Black policy-making and institutional relationships to Black communities. Though there is increased awareness about anti-Black racism, there has been limited exploration of the connection between anti-Black racism in child welfare legislation and how this policy generates disparities for Black families in both child welfare involvement and outcomes – this paper seeks to fill this gap in knowledge. The objective of this paper is to explore the entrenchment of anti-Black racism within the child welfare system by critically assessing the language and absence of language within the guiding legislative and implementation policies. Utilizing a critical race discourse analysis method, this study explores the entrenchment of anti-Black racism within the Ontario child welfare system by critically assessing the language and absence of language within the guiding legislative policies that shape practice for Black children, youth, and families. The findings revealed that though the legislation does not explicitly address anti-Black racism, there were instances where the legislation indicated that race and culture may be considered in responding to children and families. The lack of specificity, particularly in the Duty to Report, has the potential to contribute to disparate reporting and decision-making for Black families. Policy makers should acknowledge the history of anti-Black racism that informed the development of the legislation in Ontario and move towards tackling systemic injustices that disproportionately affect Black families. More explicit language will shape future policies and practices to ensure that the impact of anti-Black racism is considered across the child welfare continuum. [ABSTRACT FROM AUTHOR]

Objectives This scoping review aims to systematically map the empirical evidence on publicly funded medication reviews provided by community pharmacists in Canada and identify gaps that could inform future research directions. Methods We used a scoping review framework and PRISMA guidelines for Scoping Reviews to conduct the study. Three electronic databases were searched for papers published between January 2000 until August 2020. Data was charted on study characteristics, and a thematic synthesis was performed. Key findings Of 41 original studies included, most were conducted in Ontario (n = 21). Majority of the studies employed quantitative designs (70%). Five major themes identified were program uptake, patient health outcomes, stakeholder beliefs and attitudes, processes and collaboration and pharmacy workplace culture, which varied considerably. At the individual, organizational and policy levels, many factors were interrelated and influenced the implementation of reimbursed medication reviews by community pharmacists. Gaps in eligibility policy highlighted some patients who may have complex needs are excluded. Variation in clinical outcomes may relate to different types of medication review and pharmacist practice across Canada. Few researchers evaluated eligibility criteria, the impact of policy changes, strategies to engage patients and healthcare professionals, patient–pharmacist communication or compared practice models of medication reviews. About 12% of the research applied a theoretical framework. Summary Publicly funded medication reviews in Canadian community pharmacies reduce medication-related problems and potentially improve patient health outcomes. Future research and policies could consider addressing barriers and exploring models for sustainable delivery of high-quality medication reviews internationally. [ABSTRACT FROM AUTHOR]

Human health and well-being benefits have increasingly been associated with contact with nature. However, limited research has focused on the influence of ecosystem type and quality on these outcomes. This paper reports on the results of an in-situ survey of 467 visitors to an Ontario protected area. Results revealed high overall restorative outcomes across all ecosystem types, with greater benefits reported for women than men. Perceived ecosystem quality, including species richness, naturalness, and ecological integrity, had the greatest impact on restorative outcomes, while the type of ecosystem and time spent had surprisingly little influence. Greater restorative outcomes for women were also associated with specific ecosystem types. The study advances our limited understanding of the nuanced relationship between human health and well-being outcomes and exposure to diverse ecosystems, and by extenstion the unique aspects of biodiversity and ecosystem condition that Canada's protected areas exhibit. [ABSTRACT FROM AUTHOR]

In an era when reported hate crimes are increasing dramatically, it is troubling that there appears to be, at best, an uneven response to the problem from law enforcement in Canada. Our pilot study of policing hate crime in Ontario is the first attempt to understand whether and how law enforcement think about and act on hate crime. Interviews with officers in eight police forces across eastern and southern Ontario (N = 38) uncovered three clusters of factors that appear to shape how they manage hate crime: environmental, organizational, and individual. What we offer in this paper is a series of related recommendations for enhancing police responses to hate crime along each of the three dimensions. [ABSTRACT FROM AUTHOR]

In this paper, we present a study of women (n = 10) in game design and game development programs in Ontario, Canada. The study, described herein, is an investigation of the lived experiences of women in these programs, their own experiences with gaming culture, and the kinds of female video game characters they design. Here, we are interested in whether women in post-secondary game programs are producing more nuanced playable female game characters than those typically seen in commercial video games. Preliminary results of this study indicate that women are producing generally more nuanced depictions of women in their character designs. [ABSTRACT FROM AUTHOR]

Abstract The concept of biographical disruption has now enjoyed nearly 40 years of use in medical sociology. This paper argues that taking an embodied approach to biographical disruption helps to explain the concept's enduring efficacy. Drawing on the work of Maurice Merleau-Ponty and contemporary theories of embodiment inspired by his phenomenology, this paper advances that biographical disruption involves, in the first instance, a disruption to the ability to enact an embodied orientation towards the world. Biographical disruption does not, from this perspective, result from illness as such, but from the ways that illness impinges on one's physical ability to engage with daily life. This paper examines the experiences of solid organ transplant recipients for the purpose of shedding light on the conditions under which biographical disruption arises in experience. The analysis includes interviews with 36 post-operative solid organ transplant recipients (heart, liver, lung, and kidney) living in British Columbia or Ontario, Canada. These participants exhibit a wide range of illness experiences, some of which manifest as biographical disruption and others that do not. Tracing the contours of these experiences, this paper argues that the efficacy of biographical disruption for describing the illness experience depends not only on the illness experience but also, fundamentally, on the content of embodiment prior to the onset of that experience. Highlights • The embodiment perspective improves the efficacy of biographical disruption. • The embodied context of an experience structures the illness experience. • Organ transplant recipients present variable experiences of biographical disruption. [ABSTRACT FROM AUTHOR]

In an era when reported hate crimes are increasing dramatically, it is troubling that there appears to be, at best, an uneven response to the problem from law enforcement in Canada. Our pilot study of policing hate crime in Ontario is the first attempt to understand whether and how law enforcement think about and act on hate crime. Interviews with officers in eight police forces across eastern and southern Ontario (N = 38) uncovered three clusters of factors that appear to shape how they manage hate crime: environmental, organizational, and individual. What we offer in this paper is a series of related recommendations for enhancing police responses to hate crime along each of the three dimensions. [ABSTRACT FROM AUTHOR]

Canada's access to neutron beams for neutron scattering was significantly curtailed in 2018 with the closure of the National Research Universal (NRU) reactor in Chalk River, Ontario, Canada. New sources are needed for the long-term; otherwise, access will only become harder as the global supply shrinks. Compact Accelerator-based Neutron Sources (CANS) offer the possibility of an intense source of neutrons with a capital cost significantly lower than spallation sources. In this paper, we propose a CANS for Canada. The proposal is staged with the first stage offering a medium neutron flux, linear accelerator-based approach for neutron scattering that is also coupled with a boron neutron capture therapy (BNCT) station and a positron emission tomography (PET) isotope production station. The first stage will serve as a prototype for a second stage: a higher brightness, higher cost facility that could be viewed as a national centre for neutron applications. [ABSTRACT FROM AUTHOR]

Background: Indigenous communities in Canada face significant challenges with intergenerational trauma, which manifests in substance use disorders. There is consensus that connecting treatment approaches to culture, land, community, and spiritual practices is a pathway to healing trauma and substance use disorders for Indigenous peoples. Indigenous residential addiction treatment programs have been established as the primary intervention to provide healing for Indigenous peoples with substance use disorders and intergenerational trauma. However, there is limited evidence demonstrating the effectiveness of these programs. In collaboration with the Benbowopka Treatment Centre, this paper describes a study protocol which aims to evaluate the effectiveness of blending Indigenous Healing Practices and Seeking Safety for the treatment of Indigenous patients with intergenerational trauma and substance use disorders. Methods: We will conduct a pre/post Quasi Experimental Community trial, to compare historical treatment outcomes for patients following the implementation of Indigenous Healing and Seeking Safety. We will conduct quantitative and qualitative analyses to understand the differences before and after the intervention is implemented. The pre- Indigenous Healing and Seeking Safety intervention study window will span from 2013 to 2016; n = 343, and the post-Indigenous Healing and Seeking Safety intervention study window from 2018 to 2020; n > 300. All participants will be enrolled in the Benbowopka residential treatment for the first time during the study periods. All data will be anonymized at the time of data entry. Propensity matching will be undertaken for patient characteristics, including sex/gender, age, and substance use type. Results and conclusions: The study findings could be used to inform intergenerational trauma and substance use disorders residential treatment programming for Indigenous communities across Canada. Our work will contribute to the field of community-based intergenerational trauma and substance use disorders programming by addressing objectives that consider: (a) the patient perspective, (b) the program perspective, and (c) the community perspective. The study findings may validate an innovative approach for evaluating the effectiveness of residential addiction treatment and particularly the effective and appropriate care for Indigenous patients with intergenerational trauma and substance use disorders. [ABSTRACT FROM AUTHOR]

Recent shifts in energy infrastructure siting have seen movement toward more procedurally just participatory decision-making processes. The energy justice literature emphasises both the normative need for fairness and justice in energy decision-making, while recognising the instrumental value of procedural justice for more favourable siting outcomes. Against a global nuclear backdrop of historically closed decision-making and public controversy, Canada's high-level nuclear waste siting process has sought to offer a more participatory and community-driven process. Drawing from ethnographic observation and interviews in Ontario, Canada, this paper seeks to evaluate the NWMO's siting process according to principles of energy justice, focusing on how local context and nuclear landscape may problematise normative applications of procedural justice. Through this analysis, I address a perceived deficit in studies of the spatial implications of procedural justice, examining how local geography can shape how procedurally just a process is, at times translating well-intended policy into unintended outcomes. Ultimately, I argue that effective mobilisation of local knowledge for more localised practices is key to informing fairer and more just siting processes and eventual outcomes. [ABSTRACT FROM AUTHOR]

The probabilistic distribution of wind speed is critical information required in evaluating wind resources, designing wind farms, and mitigating the possible risks in wind power expansion. Various distributions have been used in the research literature to estimate wind speed distribution. In this paper, we propose a flexible family of mixture distributions, whose elements are convex linear combinations of the skew-t-normal Birnbaum-Saunders distributions and is suitable for modelling heavy-tailed data with a heterogeneous population. These distributions are then used to estimate the wind speed distribution. The performance of the proposed family has been compared with five mixture models of the already used distributions, using wind speed data collected at nine stations across Ontario, Canada. The results indicate that mixture models generally provide a better fit than unimodal distributions, according to the model selection criterion. Based on the obtained results, the proposed family provides highly flexible models at all selected stations. It functions better than the other considered distributions at seven of the stations, whereas it is ranked second in the remaining two stations. The proposed family can be utilized in a widespread manner to describe the wind speed in Canada, as well as other regions with similar features. • The Weibull distribution may be inadequate for wind speed data that have heavy-tailed distributions. • The mixture models of STNBS distributions can have one, two or more peak points. • The results indicate that FM-STNBS model provides a better fit than the considered distributions. [ABSTRACT FROM AUTHOR]

This paper evaluates the sociocultural integration of newcomers, paying special attention to language proficiency while taking into account the importance of the assimilation, cultural fit, and social network perspectives. Analyses are based on administrative data collected by the YMCA of South Western Ontario regarding 2,493 of their clients. Results reveal that newcomers' length of residency, ethnic origin, and social networks play a significant role in the sociocultural integration of newcomers. The longer the newcomers have resided in Canada, the higher their level of sociocultural integration. Non-Europeans displayed a lower level of sociocultural integration than Europeans. However, the most important predictor of sociocultural integration was language proficiency. Not only did language proficiency have a strong and independent effect, but it also tended to level out differences in sociocultural integration of those who had resided in Canada for a short period compared to those living in Canada for a longer period. Similarly, language proficiency decreased sociocultural integration differences between Europeans and ethnic minority newcomers. The policy implications of the results are discussed. [ABSTRACT FROM AUTHOR]

This paper is about the clinical principle of informed choice-the hallmark feature of the midwifery model of care in Ontario, Canada. Drawing on ethnographic history interviews with midwives, I trace the origins of the idea of informed choice to its roots in the social movement of midwifery in North America in the late 1960s and 1970s. At that time informed choice was not the distinctive feature of midwifery but was deeply embedded what I call midwifery's feminist experiment in care. But as midwifery in Ontario transitioned from a social movement to a full profession within the formal health care system, informed choice was strategically foregrounded in order to make the midwifery model of care legible and acceptable to a skeptical medical profession, conservative law makers, and a mainstream clientele. As mainstream biomedicine now takes up the rhetoric of patient empowerment and informed choice, this paper is at once a nuanced history of the making of the concept and also a critique of the ascendant 'regime of choice' in contemporary health care, inspired by the reflections of the midwives in my study for whom choice is impossible without care. [ABSTRACT FROM AUTHOR]

Purpose: The prevalence of substance use disorders among incarcerated individuals in Canada is substantially higher than in the general population. Many incarcerated individuals with opioid use disorder remain untreated due to inadequate access to opioid agonist therapy (OAT). A considerable proportion of overdose-related deaths in the province of Ontario are individuals who have recently been released from prison. The purpose of this paper is to highlight that discontinuation of OAT as a disciplinary measure remains an active concern within prisons in Canada and places individuals with opioid use disorder at increased risk of relapse and resultant overdose death.Design/methodology/approach: This case report describes an incarcerated client with opioid use disorder who was initially stable on OAT, but was forcibly tapered off OAT as a disciplinary measure and subsequently relapsed to illicit opioid use while in custody.Findings: This case calls attention to concerns regarding treatment of opioid use disorder during incarceration, as forcible detoxification from OAT as a disciplinary measure is a highly dangerous practice. The authors discuss concerns regarding diversion and ways in which prison-based OAT programs can be improved to increase their safety and acceptability among correctional staff. Ongoing advocacy is required on the part of health-care workers and policymakers to ensure that individuals are able to appropriately access this life-saving therapy while incarcerated.Originality/value: To the best of the authors' knowledge, this is the first case report to describe forcible tapering of OAT as a disciplinary measure during incarceration. Despite existing evidence emphasizing the significant risk of overdose associated with detoxification from opioids, this case highlights the need for further research into the causes and prevalence of this practice. [ABSTRACT FROM AUTHOR]

Background: This paper provides a critical review of the decision‐making process of the Ontario Ministry of Health and Long‐Term Care (MOHLTC) regarding which migraine treatment drugs will be covered under the Ontario Drug Benefit Formulary (ODB). Main Text: Under MOHLTC policy, triptans and OnabotulinumtoxinA are available to patients only through the Exceptional Access Program (EAP). This policy, and justifications for it, are examined with reference to clinical guidelines, patient experiences, and health policy literature. The contexts and consequences of compromised access are outlined. Improvements in access to these treatments are suggested by highlighting how a country with similar healthcare infrastructure – Australia – employs policies that more adequately meet the needs of migraine patients as they secure treatments. Conclusions: Despite clinically significant gains in the discovery of safe and effective migraine‐specific treatments the ODB thus far has failed to align its practice with current clinical recommendations. This forces patients to rely heavily on medication that, while still effective for some, is potentially suboptimal. This review concludes it is prudent, at minimum, to follow clinical recommendations that advocate for the removal of triptans from EAP and recategorize them as Limited Use drugs. Ideally, moving them to a general benefit would further remove the barriers experienced by patients attempting to access this treatment. [ABSTRACT FROM AUTHOR]

Modern methods for detecting changes in the scale or covariance of multivariate distributions rely primarily on testing for the constancy of the covariance matrix. These depend on higher‐order moment conditions, and also do not work well when the dimension of the data is large or even moderate relative to the sample size. In this paper, we propose a nonparametric change point test for multivariate data using rankings obtained from data depth measures. As the data depth of an observation measures its centrality relative to the sample, changes in data depth may signify a change of scale of the underlying distribution, and the proposed test is particularly responsive to detecting such changes. We provide a full asymptotic theory for the proposed test statistic under the null hypothesis that the observations are stable, and natural conditions under which the test is consistent. The finite sample properties are investigated by means of a Monte Carlo simulation, and these along with the theoretical results confirm that the test is robust to heavy tails, skewness and high dimensionality. The proposed methods are demonstrated with an application to structural break detection in the rate of change of pollutants linked to acid rain measured in Turkey lake, a lake in central Ontario, Canada. Our test suggests a change in the rate of acid rain in the late 1980s/early 1990s, which coincides with clean air legislation in Canada and the US. The Canadian Journal of Statistics 48: 417–446; 2020 © 2020 Statistical Society of Canada [ABSTRACT FROM AUTHOR]

This paper describes an approach for combining Landsat and Radarsat satellite images to generate national statistics for urban ecosystem accounting. These accounts will inform policy related to the development of mitigation measures for climatic and hydrologic events in Canada. Milton, Ontario was used as a test case for the development of an approach identifying urban ecosystem types and assessing change from 2001 to 2019. Methods included decomposition of Radarsat images into polarimetric parameters to test their usefulness in characterizing urban areas. Geographic object-based image analysis (GEOBIA) was used to identify urban ecosystem types following an existing classification of local climate zones. Three supervised classifiers: decision tree, random forest and support vector machine, were compared for their accuracy in mapping urban ecosystems. Ancillary geospatial datasets on roads, buildings, and Landsat-based vegetation were used to better characterize individual ecosystem assets. Change detection focused on the occurrence of changes that can impact ecosystem service supply – i.e., conversions from less to more built-up urban types. Results demonstrate that combining Radarsat polarimetric parameters with the Landsat images improved urban characterization using the GEOBIA random forest classifier. This approach for mapping urban ecosystem types provides a practical method for measuring and monitoring changes in urban areas. [ABSTRACT FROM AUTHOR]

This paper describes findings from an institutional ethnography that arose out of the concerns of women living with HIV in Ontario, Canada, regarding the disclosure of their HIV status while accessing perinatal care. The enquiry traces the connections between women's experiences of perinatal care, the activities of healthcare providers delivering such care and the ruling relations that organise women's experiences and healthcare providers' activities. Focusing on HIV disclosure as a concern expressed by women, the findings make visible the day-to-day, routinised practices of healthcare providers working in perinatal care for women living with HIV, as well as the ideological discourses of 'fear of contagion' and 'AIDS hysteria' that contributed to producing the kinds of care experiences that were articulated by women. Opportunities to strengthen perinatal care policies and practices for women living with HIV are discussed. [ABSTRACT FROM AUTHOR]

Background: Over the last three decades, there has been worldwide recognition of peer support contributions to improve mental healthcare provision. However, in the current literature, little attention has been paid to exploring perspectives of peer supporters on their involvement in mental health services provision. The purpose of the present study was to examine peer supporters' perspectives on the implementation of a transitional discharge model (TDM), an intervention for the community integration of people with mental illness. Methods: This paper represents ethnographic qualitative data collected as part of a study that used mixed methods to evaluate the implementation of TDM across nine hospitals from the Province of Ontario, in Canada. The study involved a sample of 66 peer supporters, who were recruited from participating Consumer/Survivor Initiative Organizations and Peer Support Programs. The study collected data using two sets of focus groups, which were held at 6 months and 1-year post implementation. Data analysis used an ethnography model of qualitative analysis. Results: Peer supporters expressed that their involvement in mental healthcare enhanced clients' autonomy and hope about their recovery, as well as established a safety net and reduced hospital readmissions. Peer supporters articulated that they assumed several roles to facilitate clients' transition from hospital to the community. These roles included: assisting clients in building their capacity and developing healthy routines; attending regular on-ward and community meetings; accompanying clients to their appointments; and working with clients to set goals for their recovery. The study showed hindrances to effective implementation of peer support programs, such as a lack of understanding and appreciation of peer supporter roles, lack of careful allocation of peer supporters to clients, and an absence of appropriate protocols for ensuring the safety and supervision of the peer supporters. Conclusions: Results of the TDM implementation demonstrated that involving peer supporters in mental healthcare delivery may benefit clients by enhancing autonomy and hope about their recovery, as well as establishing a safety net and reducing hospital readmissions. Results from the study have the potential to inform healthcare professionals and managers of strategies for developing effective peer support programs. [ABSTRACT FROM AUTHOR]

Set within the framework of the birthplace effect literature and the seminal work of Curtis and Birch, this paper draws information from the publicly available database www.hockeydb.com and from the Census to examine the hometowns of Canadian National Hockey League (NHL) players from 1970 to 2015. It found that from a regional perspective, the distribution of players' hometowns remained fairly stable over the 46-year period with Ontario and the three Prairie provinces being prominent. Players from small centres have been well represented in the NHL. While larger urban areas have historically produced the most players, there has been a marked increase in 'big city' players while the odds of making it are low. However, when the analysis is adjusted according to the population aged 10-19, boys growing up in small and mid-sized centres were at advantage in reaching the NHL until 2009. Finally, we discuss whether the growing presence of big city players in the NHL will affect the image of hockey as a national sport, as for many, small-town hockey remains at the heart of Canadian sporting culture. [ABSTRACT FROM AUTHOR]

This paper explores a grey area of psychiatric practice and, as with other challenging practices, the law is called upon to navigate conflicting legal issues. In particular, this paper explores the covert administration of medication: the concealment of medication in food or drink so that it will be consumed undetected. Rights-based approaches support nuanced understanding of the practices. Few policies, protocols or guidelines govern the practice in Ontario's psychiatric settings. While covert medication is understood to have "something to do" with rights, there is confusion about how those rights play out on the ground. Institutional silences underlie and reinforce the practice. Most pressing, the covert administration of medication warrants an overt discussion, including of its impact on the rights-experience of persons in psychiatric settings. [ABSTRACT FROM AUTHOR]

The paper contributes to the literature on black students and racial disparities in high school completion in Canada and makes original use of the 2006 Census to analyze the educational attainment of 18- to 19-year-olds in Ontario and Quebec. Results of a logistic regression indicate that in both provinces, black/white disparities in graduation rates disappear when income, family structure, language, gender, and place of residence are taken into account. Higher rates of socioeconomic disadvantage among black children pose challenges for high school completion. These findings do not imply that racism has no impact; indeed, the paper concludes that high school completion may not be the outcome most suitable for evaluating the effects of racism on educational attainment. Future studies should examine the causes of racial disparities in intermediate outcomes of school success (i.e., grades, special education placement, academic tracking, and disciplinary sanctions), and their effects on the graduation rates and postsecondary pathways of black students. [ABSTRACT FROM AUTHOR]

This paper examines the employment experiences of racialized social workers, many of whom were immigrants, in Ontario in recent years. This article has four central objectives. First, to provide an overview of the perceptions of racialized social workers regarding the ways they are perceived and treated by supervisors, co-workers, other professionals, as well as clients and the effect that such views and treatment has on them. Second, the perceptions of racialized workers regarding the ghettoization, marginalization and disempowerment they may experience in the workplace. Third, to explain three strategies they use in managing power relations within the workplace (i.e., conformity, collaboration, and conflict). Fourth, to provide some suggestions on what must be done to improve the perceptions and treatment of racialized social workers by supervisors, co-workers, other professionals and clients. The major findings are that negotiating power relations is a complex process and includes experiences of tensions and awkward silences due to the sensitivity of the topic of race. The paper concludes that in moving forward constructively it is imperative to engage in difficult but crucial conversations that can contribute to the identification of ways to address tensions and awkward silences on matters of race in the context of social work, as well as in other contexts. [ABSTRACT FROM AUTHOR]

Floating Catchment Area (FCA) methods are a popular tool to investigate accessibility to public facilities, in particular health care services. FCA approaches are attractive because, unlike other accessibility measures, they take into account the potential for congestion of facilities. This is done by 1) considering the population within the catchment area of a facility to calculate a variable that measures level of service, and then 2) aggregating the level of service by population centers subject to catchment area constraints. In this paper we discuss an effect of FCA approaches, an artifact that we term demand and level of service inflation. These artifacts are present in previous implementations of FCA methods. We argue that inflation makes interpretation of estimates of accessibility difficult, which has possible deleterious consequences for decision making. Next, we propose a simple and intuitive approach to proportionally allocate demandand and level of service in FCA calculations. The approach is based on a standardization of the impedance matrix, similar to approaches popular in the spatial statistics and econometrics literature. The result is a more intiuitive measure of accessibility that 1) provides a local version of the provider-to-population ratio; and 2) preserves the level of demand and the level of supply in a system. We illustrate the relevant issues with some examples, and then empirically by means of a case study of accessibility to family physicians in the Hamilton Census Metropolitan Area (CMA), in Ontario, Canada. Results indicate that demand and supply inflation/deflation affect the interpretation of accessibility analysis using existing FCA methods, and that the proposed adjustment can lead to more intuitive results. [ABSTRACT FROM AUTHOR]

A developing body of theory and empirical evidence suggest that feeding behaviour as measured by the functional response (FR) can assist researchers in assessing the relative potential, ecological impacts and competitive abilities of native and introduced species. Here, we explored the FRs of two land snails that occur in south-western Ontario, one native (Mesodon thyroidus) and one non-indigenous (Cepaea nemoralis) to Canada. The non-indigenous species appears to have low ecological impact and inferior competitive abilities. Consistent with theory, while both species conformed to Type II functional responses, the native species had a significantly higher attack rate (5.30 vs 0.41, respectively) and slightly lower handling time (0.020 vs 0.023), and hence a higher maximum feeding rate (50.0 vs 43.5). The non-indigenous species exhibited a significantly longer time to contact for a variety of food types, and appeared less discriminating of paper that was offered as a non-food type. The non-indigenous species also ate significantly less food when in mixed species trials with the native snail. These feeding patterns match the known low ecological impact of the introduced snail and are consistent with the view that it is an inferior competitor relative to the native species. However, field experimentation is required to clarify whether the largely microallopatric distributions of the two species in south-western Ontario reflect competitive dominance by the native species or other factors such as habitat preference, feeding preferences or predator avoidance. The relative patterns of feeding behaviour and ecological impact are, however, fully in line with recent functional response theory and application. [ABSTRACT FROM AUTHOR]

Background: Most studies that examine comorbidity and its impact on health service utilization focus on a single index-condition and are published in disease-specific journals, which limit opportunities to identify patterns across conditions/disciplines. These comparisons are further complicated by the impact of using different study designs, multimorbidity definitions and data sources. The aim of this paper is to share insights on multimorbidity and associated health services use and costs by reflecting on the common patterns across 3 parallel studies in distinct disease cohorts (diabetes, dementia, and stroke) that used the same study design and were conducted in the same health jurisdiction over the same time period.Methods: We present findings that lend to broader Insights regarding multimorbidity based on the relationship between comorbidity and health service use and costs seen across three distinct disease cohorts. These cohorts were originally created using multiple linked administrative databases to identify community-dwelling residents of Ontario, Canada with one of diabetes, dementia, or stroke in 2008 and each was followed for health service use and associated costs.Results: We identified 376,434 indviduals wtih diabetes, 95,399 wtih dementia, and 29,671 with stroke. Four broad insights were identified from considering the similarity in comorbidity, utilization and cost patterns across the three cohorts: 1) the most prevalent comorbidity types were hypertension and arthritis, which accounted for over 75% of comorbidity in each cohort; 2) overall utilization increased consistently with the number of comorbidities, with the vast majority of services attributed to comorbidity rather than the index conditions; 3) the biggest driver of costs for those with lower levels of comorbidity was community-based care, e.g., home care, GP visits, but at higher levels of comorbidity the driver was acute care services; 4) service-specific comorbidity and age patterns were consistent across the three cohorts.Conclusions: Despite the differences in population demographics and prevalence of the three index conditions, there are common patterns with respect to comorbidity, utilization, and costs. These common patterns may illustrate underlying needs of people with multimorbidity that are often obscured in literature that is still single disease-focused. [ABSTRACT FROM AUTHOR]

Background: This study reports on physicians’ experiences with chronic pain management. For over a decade prescription opioids have been a primary treatment for chronic pain in North America. However, the current opioid epidemic has complicated long-standing practices for chronic pain management which historically involved prescribing pain medication. Caring for patients with chronic pain occurs within a context in which a growing proportion of patients suffer from chronic rather than acute conditions alongside rising social inequities. Methods: Our team undertook an ethnographic approach known as institutional ethnography in the province of Ontario, Canada in order to explore the social organization of chronic pain management from the standpoint of primary care physicians. This paper reports on a subset of this study data, specifically interviews with 19 primary care clinicians and 8 nurses supplemented by 40 hours of observations. The clinicians in our sample were largely primary care physicians and nurses working in urban, rural and Northern settings. Findings: In their reflections on providing care for patients with chronic pain, many providers describe being most challenged by the work involved in helping patients who also struggled with poverty, mental health and addiction. These frustrations were often complicated by concerns that they could lose their license for inappropriate prescribing, thus shifting their work from providing treatment and care to policing their patients for malingering and opioid abuse. Interpretation: Our findings show that care providers find the treatment of patients with chronic pain–especially those patients also experiencing poverty–to be challenging at best, and at worst frustrating and overwhelming. In many instances, their narratives suggested experiences of depersonalization, loss of job satisfaction and emotional exhaustion in relation to providing care for these patients, key dimensions of burnout. In essence, the work that they performed in relation to their patients’ social rather than medical needs seems to contribute to these experiences. Their experiences were further exacerbated by the fact that restricting and reducing opioid dosing in patients with chronic pain has become a major focus of care provision. [ABSTRACT FROM AUTHOR]