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

Little is known about the lived experience of the dyad following a fetal death and the impact on relationships. The purpose of this paper is to explore the dyadic relationship between partners, with health care providers, and with the baby's memory after birth. This qualitative study utilized hermeneutic phenomenology. The sample included 10 heterosexual dyads from the United States and Canada. All experienced a fetal death between 6 months and 7 years prior to their interviews. The data revealed three themes: (a) The Dyad Relationship: Moving Through the Experience Together; (b) Keeping the Memory Alive: Memorializing the Baby; and (c) Relationships With Health Care Providers: A Spectrum of Caring. The findings from this study provide the beginning knowledge needed to improve the care of dyads who have experienced a fetal death and for future studies to improve care delivery for dyads as their relationships change after fetal death. [ABSTRACT FROM AUTHOR]

Annual turnover of home care workers represents a huge loss of revenue and is a key source of inefficiency in the home health care industry. In this article, we propose a data-driven approach to monitor employee churn and to capture the evolution of employee intent to leave. Unlike most papers in the literature, we use machine learning techniques to analyze over 2 million visits in the US, Canada, and Australia between 2016 and 2019. Results show that the gap between the number of hours worked and in the contract is the most important factor to predict employee intent to leave, which means an employee should be given as many hours as requested in the contract to improve retention. Secondary results show that having diverse shift lengths and continuity in services and patients seem to be associated with less turnover. [ABSTRACT FROM AUTHOR]

Introduction: The prescribing of opioids has increased internationally in developed countries in recent decades within primary and secondary care. The majority of patients with chronic non-malignant pain (CNMP) are managed by their general practitioner (GP). Recent qualitative studies have examined the issue of opioid prescribing for CNMP from a GP viewpoint. The aim of this study is to identify and synthesise the qualitative literature describing the factors influencing the nature and extent of opioid prescribing by GPs for patients with CNMP in primary care. Methods: MEDLINE, Embase, PsycINFO, Cochrane Database, International Pharmaceutical Abstracts, Database of Abstracts of Reviews of Effects, CINAHL and Web of Science were systematically searched from January 1986 to February 2018. The full text of included articles was reviewed using the Critical Appraisal Skills Programme (CASP) tool for qualitative research. The papers were coded by two researchers and themes organised using Thematic Network Analysis. Themes were constructed in a hierarchical manner, basic themes informed organising themes which informed global themes. A theoretical model was derived using global themes to explain the interplay between factors influencing opioid prescribing decisions. Results: From 7020 records, 21 full text papers were assessed, and 13 studies included in the synthesis; 9 were from the United States, 3 from the United Kingdom and 1 from Canada. Four global themes emerged: suspicion, risk, agreement and encompassing systems level factors. These global themes are inter-related and capture the complex decision-making processes underlying opioid prescribing whereby the physician both consciously and unconsciously quantifies the risk–benefit relationship associated with initiating or continuing an opioid prescription. Conclusion: Recognising the inherent complexity of opioid prescribing and the limitations of healthcare systems is crucial to developing opioid stewardship strategies to combat the rise in opioid prescription morbidity and mortality. [ABSTRACT FROM AUTHOR]

In the context of sub-global participation in greenhouse gas mitigation efforts, this paper investigates the effectiveness of a Canada-U.S. emissions bubble under their existing regional trade agreement. It also explores the potential economic impact of carbon tariff harmonization through the implementation of a common Canada-U.S. external border tariff adjustment as a mean to address competitiveness issues. Using a multi-region, multi-sector computable general equilibrium model the paper finds that the creation of an emission bubble between the two countries could improve efficiency. The findings also suggest that a carbon tariff harmonization policy could give rise to distributional issues among Annex I regions and could fail to mitigate the negative competitiveness impacts of carbon abatement policies. [ABSTRACT FROM AUTHOR]

This paper explores whether there has been a recent decline in helping behavior in the United States. In a lost letter experiment, 7,466 letters were 'lost' in 63 urban areas in the United States and Canada in 2001 and 2011. There has been a 10 percent decline in helping behavior in the United States, but not in Canada. Two arguments anticipate change in the level of help provided to strangers: the rise of new technologies, and neighborhood racial and ethnic diversity. Findings exclude increased privatism as a source for the decline in helping. In 2001 there was no variation in altruistic behavior based on neighborhood diversity. However, areas of the United States where the proportion of noncitizens increased since 2001 experienced reduced helping; the opposite was found in Canada. Possible explanations include changing attitudes toward noncitizens, and differences in public policy related to economic inequality, social inclusion, and the acceptance of multiculturalism. [ABSTRACT FROM AUTHOR]

In this paper we argue that nonprofit, nongovernmental organisations (NGO5) constitute crucial sites at which welfare state restructuring and neoliberalism are enacted and materialised in everyday life practices. This paper responds to recent calls from geographers to move to finer scales of analysis that enrich our understanding about the geographies of welfare state restructuring and neoliberalism. Our response is based on case-study research of NGOs that provide social services to migrants in Minneapolis-St Paul, USA, and Toronto, Canada. We draw on the concept of `translation' to show the agency of NGOs in articulating macroscale programmes of governance into concrete regulations that govern the conduct of everyday life. The case studies demonstrate the usefulness of seeing NGOs as translation mechanisms to current debates about the role of NGOs amidst welfare state restructuring and the rise of neoliberalism. [ABSTRACT FROM AUTHOR]

In this paper two gaps in North American immigrant homeownership research are addressed. The first concerns the lack of studies (especially in Canada) that identify changes in homeownership rates by skin color over time, and the second relates to the shortage of comparative research between Canada and the United States on this topic. In this paper the homeownership levels and attainment rates of Black, Chinese, Filipino, White, and South Asian immigrants are compared in Canada and the United States for 1970/1971–2000/2001. For the most part, greater similarities than differences are found between the two countries. Both Canadian and U.S. Chinese and White immigrants have the highest adjusted homeownership rates of all groups, at times even exceeding comparably positioned native-born households. Black immigrants, on the other hand, tend to have the lowest ownership rates of all groups, particularly in the United States, with Filipinos and South Asians situated between these extremes. Most of these differences stem from disparities that exist at arrival, however, and not from differential advancement into homeownership. [ABSTRACT FROM AUTHOR]

In recent years, many social workers have joined the ranks of virtual or e-therapists. While this offers exciting new opportunities for social work practice, the advent of e-therapy has come with a host of challenges particular to Internet communication that may not be reconcilable with current social work regulation. This paper reviews the social work codes of ethics in both the United States and Canada, legislation governing treatment, and case law with respect to several important issues related to e-therapy. The paper begins with a discussion of jurisdictional issues and expertise to practice e-therapy. Next, it suggests that if e-therapy fits within the purview of acceptable social work practice, the establishment of therapist-patient relationships creates professional duties of care owed to patients and to the public. Four of the most critical duties in a therapeutic encounter are considered: the duty to obtain informed consent, the duty to maintain confidentiality, the duty to warn third parties of harm, and the duty to maintain professional boundaries. [ABSTRACT FROM AUTHOR]

Background: Speech and language therapists can improve the quality of life of people receiving palliative care through the management of communication and swallowing difficulties (dysphagia). However, their role in this domain is poorly defined and little is understood about the current international professional practice in this field. Aims: To examine how speech and language therapists perceive their role in the delivery of palliative care to clients, to discover current international speech and language therapist practices and to explore the similarities and differences in speech and language therapists’ practice in palliative care internationally. This will inform professional clinical guidelines and practice in this area.Design:Anonymous, non-experimental, cross-sectional survey design.Participants:Speech and language therapists working with adult and paediatric palliative care populations in Republic of Ireland, United Kingdom, United States, Canada, Australia and New Zealand where the speech and language therapist profession is well established. Method: Purposive and snowball sampling were used to recruit participants internationally using gatekeepers. An online survey was disseminated using Survey Monkey (http://www.surveymonkey.com). Results: A total of 322 speech and language therapists responded to the survey. Speech and language therapist practices in palliative care were similar across continents. Current speech and language therapist practices along with barriers and facilitators to practice were identified. The need for a speech and language therapist professional position paper on this topic was emphasised by respondents. Conclusion: Internationally, speech and language therapists believe they have a role in palliative care. The speech and language therapist respondents highlighted that this area of practice is under-resourced, under-acknowledged and poorly developed. They highlighted the need for additional research as well as specialist training and education for speech and language therapists and other multidisciplinary team members in the area of palliative care. [ABSTRACT FROM AUTHOR]

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

Scholars and practitioners from multiple perspectives, including developmental science, sociology, business, medicine, and public health, have considered the implications of employment for young people. We summarize a series of meetings designed to synthesize information from these perspectives and derive recommendations to guide research, practice, and policy with a focus on young worker safety and health. During the first three meetings, participants from the United States and Canada considered invited white papers addressing developmental issues, public health data and findings, as well as programmatic advances and evaluation needs. At the final meeting, the participants recommended both research and policy directions to advance understanding and improve young worker safety. [ABSTRACT FROM AUTHOR]

This paper undertakes three tasks: (1) to consider monetary policy’s role in contemporary capitalism and state governance; (2) to introduce the fundamentals of contemporary monetary policy; and (3) to outline some of the material and ideological stakes in the social, political, and economic geographies of monetary policy and central banking as practised in advanced capitalist nation states. I focus on subnational and class effects, arguing that the precarious relation between central banks and national democratic processes has become increasingly tenuous. Empirical examples are drawn from Canada and the USA. [ABSTRACT FROM AUTHOR]

The objective of this study was to review the literature on depression in palliative cancer care in order to identify which assessment methods and classification systems have been used in studies of depression. Extensive electronic database searches in PubMed, CancerLit, CINAHL, PsychINFO, EMBASE and AgeLine as well as hand search were carried out. In the 202 included papers, 106 different assessment methods were used. Sixty-five of these were only used once. All together, the Hospital Anxiety and Depression Scale (HADS) was the most commonly used assessment method. However, there were regional differences and while the HADS dominated in Europe it was quite seldom used in Canada or in the USA. Few prevalence and intervention studies used assessment methods with an explicit reference to a diagnostic system. There were in total few case definitions of depression. Among these, the classifications were in general based on cut-off scores (77%) and not according to diagnostic systems. The full range of the DSM-IV diagnostic criteria was seldom assessed, i.e. less than one-third of the assessments in the review took into account the duration of symptoms and 18% assessed consequences and impact upon patient functioning. A diversity of assessment methods had been used. Few studies classified depression by referring to a diagnostic system or by using cut-off scores. Evidently, there is a need for a consensus on how to assess and conceptualize depression and related conditions in palliative care. [ABSTRACT FROM AUTHOR]

This paper offers a comparison of the activities of the Canadian Pacific Railway and the Great Northern Railway to secure access to a Pacific terminus at Vancouver and Seattle respectively. Its focus on the actions of company managers sets it apart from accounts of terminus activities of other lines on the Pacific coast of North America. Its method, the examination of terminus entry conflict through the prism of a select group of company officers that illuminates the role of the railroad local lawyer in particular, melds traditional perspectives on railroad management with the organizational approach championed by A.D. Chandler, Jr. Its conclusion, that both firms sustained significant setbacks in this process, departs from the received interpretation in histories of the concerns. [ABSTRACT FROM AUTHOR]

In this paper the political fortunes and identities of Irish Catholics in US and Canadian cities are explored through a comparative study of Buffalo and Toronto. Local spaces of political administration in the urban arena, such as wards, were significant in affecting the generation of sociopolitical networks of power which in turn had implications for the sense of political identity and involvement felt by Irish Catholics within these two places. The importance of such spaces, however, was also contingent on the interaction between these cities' Irish Catholic populations and wider geographies of social, economic, and ethnoreligious relations over time as well as on the topographies and traditions of political power that extended beyond the municipal scale in both societies. [ABSTRACT FROM AUTHOR]

Despite the curriculum changes during the past decade, there is paucity of information regarding the structure and evaluation processes in pediatric clerkships. Information regarding the educational components of the pediatric clerkship and student evaluation practices was obtained from the pediatric clerkship directors via a paper/electronic survey. Completed surveys were received from 97 US and Canadian medical schools and were analyzed. The average length of a clerkship was 7 weeks. Most clerkships required a 4-week ward, a 1-week newborn rotation, and a 2- week ambulatory rotation. Students were evaluated on each component of the clerkship in 93.5% of the programs. All programs evaluated student's clinical performance and fund of knowledge; 85.6% evaluated student's written record. Student's clinical performance was evaluated by direct observation in 57% of the programs. Penalties for failing in clinical performance were harsher. In 56% of programs, a student failing in clinical performance failed the entire clerkship in contrast to 21.8% or 7% of the programs where a student failed the entire clerkship if they failed in the examination for the fund of knowledge or written record evaluation, respectively. The survey demonstrated a fair amount of consistency in clerkships across programs when compared with data obtained in 1981 and 1986. There was a noticeable increase in the well-baby nursery rotation; however, there was a decline in direct observation to assess physical examination or clinical performance. [ABSTRACT FROM AUTHOR]

Objectives: The present paper aims to: (i) describe how the Mental Health Commission in New Zealand works and has contributed to the substantial enhancement of mental health resources and services; (ii) determine whether mental health reform policies will ever be implemented properly without an independent monitor with official influence at the highest levels of government; and (iii) demonstrate how variants on this model work in other Western countries and how it can be adapted to the Federated system in Australia.Conclusions: It is recommended that the Australian National Mental Health Plan 2003-2008 should be complemented by a long-standing national mental health commission (or similarly constituted body), which is also able to report independently from and to the government, with direct access to the Prime Minister, Premiers and Australian Health Ministers. Its aims would be to monitor service effectiveness and identify gaps in service provision, training and performance of the work force, management and government. It would be informed by consumer, carer and provider experience, and by reviews of evidence-based research regarding health needs and cost-effective services. It should accurately cost such service gaps, and advise government on a strategy for implementing them. It could also promote and advise formally on enhancing community awareness, decreasing stigma and discrimination and improving workforce recruitment and retention. [ABSTRACT FROM AUTHOR]

Objectives: Research on the mental health and service needs of homeless seniors has been scant. This paper reviews the available literature and presents findings of a Toronto survey in an effort to describe the demographics of homeless seniors, their level of impairment, and their mental and physical health needs.Methods: We searched the Medline, AgeLine, and PsycINFO databases, using the following key words: elderly homeless, elderly hostel users, and urban geriatrics. To better describe the service needs of the elderly homeless, we obtained demographic data from the Community and Neighbourhood Services Department and distributed a survey questionnaire to 11 Toronto hostel directors. The questionnaire elicited data relating to reasons for shelter use, problem behaviours, and mental health needs of those over age 65 years.Results: Although seniors represent a small percentage of the homeless population, their numbers are growing. The available literature suggests a high prevalence of psychiatric disorders and cognitive impairment in this population, with a greater proportion of older women than men having severe mental illness. Further, our survey suggests that the service needs of elderly hostel users in Toronto differ from those of their younger counterparts.Conclusion: The homeless elderly are the most vulnerable of this impoverished population. Although more research is needed to define their mental and physical health needs and ways of meeting them, their characteristics appear to be unique. Geriatric psychiatrists could play a significant role in evaluating and treating this population more comprehensively. [ABSTRACT FROM AUTHOR]

The article comments on the research papers presented by Michael J. Churgin and Howard Adelman regarding the government policies of countries toward refugees which appeared in the Spring 1996 issue of International Migration Review. Adelman examines in detail efforts by Tutsi refugees from Rwanda to exercise their right of repatriation between 1991 and 1996 and the varying attitudes of different Canadian ministries and agencies toward that objective. Churgin takes a longer historical perspective to assess changes and continuity in patterns of response by the U.S. government to mass migrations. The common feature of these two articles is a focus upon the perspectives of decisionmakers in advanced democracies and their ability to affect migration flows. An implicit issue suggested by both articles is the moral relevance of numbers of claimants in determining an acceptable response to particular migration flows. Adelman is concerned with the right of refugees to membership in their state of origin and the process by which they might seek to exercise a right to repatriation. He chooses to examine this issue not from the refugees' viewpoint but from that of a third country, Canada. The Canadian perspective proves to be a fractured one, as six different ministries and agencies of the Canadian government pursued often contradictory objectives in their interactions with the previous Rwandan regime and with representatives of Tutsi exiles.

Theoretical understanding of survey nonresponse is implicitly heavily behaviourist, concentrating upon researchers' inputs such as follow-up arrangements, and predetermining social role characteristics of sample listings. With the decline over time in response rates, however, the possible importance of social values concerning privacy invasion has been more seriously entertained by methodologists. The paper describes evidence indicating that, in both the USA and Canada, the post-1960's decline in response is not accounted for simply by input explanations. A privacy index is generated by content analyzing British, Canadian, and American newspapers for privacy-related objections to the decennial census. Decade and country, scored according to the privacy index, are then entered into an empirical model for predicting response rate on a survey. [ABSTRACT FROM AUTHOR]

This paper is an analysis of functionary skills and prerogatives deployed in process of framing, negotiating and establishing conditions for action in pentecostal assemblies. It is based upon overt non-participant observation and interviewing in 66 pentecostal institutions in England and Wales, Canada and the United States. Its focus is upon the crises that arise either when the prerogative of definition is contested by two or more 'special definers' or when there is a compelling resemblance of phenomena in the sacred domain to realities familiar in the profane. The skills which enable the professional functionary to sustain sacred definitions during such conflicts include competence in the sacred language, the management of laughter and the sacred gift of `discernment'. [ABSTRACT FROM AUTHOR]

This paper provides an analysis of media portrayals of male and female athletes in the 1984 and the 1988 Summer Olympics Games as reflected in the Globe and Mail in Canada and the New York Times in the United States. Quantitative content analyses, supplemented by some qualitative analysises, are employed to test the general hypothesis that men receive more attention, and more favourable portrayals than women in sports news in the mass media. [ABSTRACT FROM AUTHOR]

The strongest empirical evidence of dependency has been the finding of an increasingly negative effect of extensive foreign capital penetration on the subsequent economic growth of the host. This long-run structural effect of foreign direct investment is based on cross-national comparisons over the period 1960-75, with samples of up to ninety-one countries. To date, the structural effect has not been replicated for rich (core) country samples. We suggest that the failure of researchers to substantiate the dependency effects in the core hinges on two problems: I) the need to identify "mature economic dependency" as a variation in the structure of core economic development, and 2; the need to model mature dependency with longitudinal rather than cross-national research designs. In this paper, we use time series data to illustrate the long-term negative effects of Amen can direct investment on post-World War!! economic growth in Canada. [ABSTRACT FROM AUTHOR]