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An essential consideration in urban transit facility planning is service efficiency and accessibility. Previous research has shown that reducing the number of facilities along a route may increase efficiency but decrease accessibility. Striking a balance between these two is a critical consideration in transit planning. Transit facility consolidation is a cost-effective way to improve the quality of service by strategically determining the desirable allocation of a limited number of facilities. This paper develops an optimization framework that integrates Geographical Information systems (GIS), decision-making analysis, and quantum technologies for addressing the problem of facility consolidation. Our proposed framework includes a novel mathematical model that captures non-linear interactions between facilities and surrounding demand nodes, inter-facility competition, ridership demand and spatial coverage. The developed model can harness the power of quantum effects such as superposition and quantum tunnelling and enables transportation planners to utilize the most recent hardware solutions such as quantum and digital annealers, coherent Ising Machines and gate-based universal quantum computers. This study presents a real-world application of the framework to the public transit facility redundancy problem in the British Columbia Vancouver metropolitan area. We demonstrate the effectiveness of our framework by reducing the number of facilities by 40% while maintaining the same service accessibility. Additionally, we showcase the ability of the proposed mathematical model to take advantage of quantum annealing and classical optimization techniques. [ABSTRACT FROM AUTHOR]

Whereas much research has been conducted on rats in their roles as pests and laboratory animal models, little is known about rats in their role as companion animals. However, rats have become the third most common companion animal admitted to the British Columbia Society for the Prevention of Cruelty to Animals (BC SPCA) shelter system after cats and dogs. This paper analyses 5 years of province-wide rat admission and outcome data (n = 3,392) at the BC SPCA. Most rats that entered BC SPCA shelters were white, sexually intact, and pups less than 6 months old. Rats were mostly relinquished by their owners, and the most common surrender reasons were due to owner-related issues and housing issues. Reasons for euthanasia were primarily poor health and neonatal age. A multiple linear regression model found that rats that were either senior, albino, unhealthy, seized by humane officers, or born onsite tended to stay longer in shelters (F[12, 1466] = 9.565, p <.001, adjusted R2 =.06). Time to adoption for albino rats was 79% longer than for white rats. These findings help us understand the preferences of rat adopters and why the rat-human relationship may fail. Results may also be useful to improve the quality of life for pet rats by identifying programs to reduce their length of stay in animal shelters. Finally, our study highlights new questions for welfare research in an understudied companion animal–the pet rat. [ABSTRACT FROM AUTHOR]

The uptake of technologies such as airborne laser scanning (ALS) and more recently digital aerial photogrammetry (DAP) enable the characterization of 3-dimensional (3D) forest structure. These forest structural attributes are widely applied in the development of modern enhanced forest inventories. As an alternative to extensive ALS or DAP based forest inventories, regional forest attribute maps can be built from relationships between ALS or DAP and wall-to-wall satellite data products. To date, a number of different approaches exist, with varying code implementations using different programming environments and tailored to specific needs. With the motivation for open, simple and modern software, we present FOSTER (Forest Structure Extrapolation in R), a versatile and computationally efficient framework for modeling and imputation of 3D forest attributes. FOSTER derives spectral trends in remote sensing time series, implements a structurally guided sampling approach to sample these often spatially auto correlated datasets, to then allow a modelling approach (currently k-NN imputation) to extrapolate these 3D forest structure measures. The k-NN imputation approach that FOSTER implements has a number of benefits over conventional regression based approaches including lower bias and reduced over fitting. This paper provides an overview of the general framework followed by a demonstration of the performance and outputs of FOSTER. Two ALS-derived variables, the 95th percentile of first returns height (elev_p95) and canopy cover above mean height (cover), were imputed over a research forest in British Columbia, Canada with relative RMSE of 18.5% and 11.4% and relative bias of -0.6% and 1.4% respectively. The processing sequence developed within FOSTER represents an innovative and versatile framework that should be useful to researchers and managers alike looking to make forest management decisions over entire forest estates. [ABSTRACT FROM AUTHOR]

(XLSX) References 1 Morton A, Routledge R, Hrushowy S, Kibenge M, Kibenge F (2017) The effect of exposure to farmed salmon on piscine orthoreovirus infection and fitness in wild Pacific salmon in British Columbia, Canada. The supplementary datafiles for this paper did not include Ct values for the PRV tests. [Extracted from the article]

The role of forest management in mitigating climate change is a central concern for the Canadian province of British Columbia. The successful implementation of forest management activities to achieve climate change mitigation in British Columbia will be strongly influenced by public support or opposition. While we now have increasingly clear ideas of the management opportunities associated with forest mitigation and some insight into public support for climate change mitigation in the context of sustainable forest management, very little is known with respect to the levels and basis of public support for potential forest management strategies to mitigate climate change. This paper, by describing the results of a web-based survey, documents levels of public support for the implementation of eight forest carbon mitigation strategies in British Columbia’s forest sector, and examines and quantifies the influence of the factors that shape this support. Overall, respondents ascribed a high level of importance to forest carbon mitigation and supported all of the eight proposed strategies, indicating that the British Columbia public is inclined to consider alternative practices in managing forests and wood products to mitigate climate change. That said, we found differences in levels of support for the mitigation strategies. In general, we found greater levels of support for a rehabilitation strategy (e.g. reforestation of unproductive forest land), and to a lesser extent for conservation strategies (e.g. old growth conservation, reduced harvest) over enhanced forest management strategies (e.g. improved harvesting and silvicultural techniques). We also highlighted multiple variables within the British Columbia population that appear to play a role in predicting levels of support for conservation and/or enhanced forest management strategies, including environmental values, risk perception, trust in groups of actors, prioritized objectives of forest management and socio-demographic factors. [ABSTRACT FROM AUTHOR]

Introduction: Cases of the novel coronavirus disease (COVID-19) continue to spread around the world even one year after the declaration of a global pandemic. Those with weakened immune systems, due to immunosuppressive medications or disease, may be at higher risk of COVID-19. This includes individuals with autoimmune diseases, cancer, transplants, and dialysis patients. Assessing the risk and outcomes of COVID-19 in this population has been challenging. While administrative databases provide data with minimal selection and recall bias, clinical and behavioral data is lacking. To address this, we are collecting self-reported survey data from a randomly selected subsample with and without COVID-19, which will be linked to administrative health data, to better quantify the risk of COVID-19 infection associated with immunosuppression. Methods and analysis: Using administrative and laboratory data from British Columbia (BC), Canada, we established a population-based case-control study of all individuals who tested positive for SARS-CoV-2. Each case was matched to 40 randomly selected individuals from two control groups: individuals who tested negative for SARS-CoV-2 (i.e., negative controls) and untested individuals from the general population (i.e., untested controls). We will contact 1000 individuals from each group to complete a survey co-designed with patient partners. A conditional logistic regression model will adjust for potential confounders and effect modifiers. We will examine the odds of COVID-19 infection according to immunosuppressive medication or disease type. To adjust for relevant confounders and effect modifiers not available in administrative data, the survey will include questions on behavioural variables that influence probability of being tested, acquiring COVID-19, and experiencing severe outcomes. Ethics and dissemination: This study has received approval from the University of British Columbia Clinical Research Ethics Board [H20-01914]. Findings will be disseminated through scientific conferences, open access peer-reviewed journals, COVID-19 research repositories and dissemination channels used by our patient partners. [ABSTRACT FROM AUTHOR]

Introduction: Outreach care has long been used in Canada to address the lack of access to specialist care in rural settings, but research on the experiences of specialists providing these services is lacking. This descriptive survey study aimed to understand 1) specialists' motivation for engaging in outreach work, (2) their perceptions of the quality of care at their rural outreach hospital, and (3) the supports they receive for their outreach work, in order to create a supportive framework to encourage specialist outreach contributions. Methods: In July 2022, specialist physicians who provide outreach operating room services at rural hospitals participating in the Rural Surgical and Obstetrical Networks initiative in the province of British Columbia were invited to complete an anonymous survey. Results: 21 of 45 invited outreach specialists completed the survey (47% response rate). Three-quarters of respondents had a surgical specialty. The opportunity to deliver care to underserved patients was the most common motivator for outreach work. Rural hospitals received high ratings from respondents on overall safety and various aspects of communication and teamwork. Postoperative care was a concern for a minority (one-fifth) of respondents, and about half had experienced unnecessary delays between procedures some or most of the time. Generally, respondents felt integrated into rural teams and reported receiving adequate nursing and anesthetic support. The two most common desired additional supports were better/more equipment and space and additional staffing. All 19 respondents not planning to retire soon intended to provide outreach services for at least three more years. Conclusion: Specialists providing outreach OR services in small volume rural hospitals in BC usually have altruistic motives for outreach work. For the most part, these specialists have positive experiences in rural hospitals, but they can be better supported through investment in infrastructure and health human resources. Specialists intend to provide outreach services long-term, indicating a stable outreach workforce. More research on the facilitators and barriers of specialist outreach work is needed. [ABSTRACT FROM AUTHOR]

Over the past two decades, increasing numbers of humpback whales have been returning to feed in the inshore waters of British Columbia (BC) where marine aquaculture farms are situated. This has led to growing concerns that the presence of aquaculture farms may pose an entanglement threat to humpback whales. However, it is not known whether aquaculture facilities attract humpback whales, or whether there are factors that increase the likelihood of humpback whale, becoming entangled and dying. We examined eight reports of humpback whales interacting with Atlantic salmon farms in BC from 2008 to 2021 to evaluate the conditions that may have contributed to their entanglements. Of the eight entangled humpbacks, three individuals died and five were successfully disentangled and released. All were young animals (1 calf, 7 subadults). Multiple factors were associated with two or more of the reported incidents. These included facility design, environmental features, seasonality, humpback whale age, and feeding behaviour. We found that humpback whales were most commonly entrapped in the predator nets of the aquaculture facilities (6/8 incidents), and were less often entangled in anchor support lines (2/8). The presence of salmon smolts did not appear to be an attractant for humpback whales given that half of the reported entanglements (4/8) occurred at fallowed salmon farms. Almost all of the entanglements (7/8) occurred in late winter (prior to the seasonal return of humpbacks) and during late fall (after most humpbacks have migrated south). Overall, the number of humpback whales impacted by fish farms was small compared to the numbers that return to BC (> 7,000) and accounted for <6% of all types of reported entanglements in BC. Human intervention was required to release humpback whales at fish farms, which points to the need to have well-established protocols to minimize entanglements and maximize successful releases. [ABSTRACT FROM AUTHOR]

Along the northeast Pacific coast, the salmon-eating southern resident killer whale population (SRKW, Orcinus orca) have been at very low levels since the 1970s. Previous research have suggested that reduction in food availability, especially of Chinook salmon (Oncorhynchus tshawytscha), could be the main limiting factor for the SRKW population. Using the ecosystem modelling platform Ecopath with Ecosim (EwE), this study evaluated if the decline of the Pacific salmon populations between 1979 and 2020 may have been impacted by a combination of factors, including marine mammal predation, fishing activities, and climatic patterns. We found that the total mortality of most Chinook salmon populations has been relatively stable for all mature returning fish despite strong reduction in fishing mortality since the 1990s. This mortality pattern was mainly driven by pinnipeds, with increases in predation between 1979 and 2020 mortality ranging by factors of 1.8 to 8.5 across the different Chinook salmon population groups. The predation mortality on fall-run Chinook salmon smolts originating from the Salish Sea increased 4.6 times from 1979 to 2020, whereas the predation mortality on coho salmon (Oncorhynchus kisutch) smolts increased by a factor of 7.3. The model also revealed that the north Pacific gyre oscillation (NPGO) was the most important large-scale climatic index affecting the stock productivity of Chinook salmon populations from California to northern British Columbia. Overall, the model provided evidence that multiple factors may have affected Chinook salmon populations between 1979 and 2020, and suggested that predation mortality by marine mammals could be an important driver of salmon population declines during that time. [ABSTRACT FROM AUTHOR]

Conflict between humans and black bears (Ursus americanus) occurs throughout North America with increasing public demand to replace lethal management with non-lethal methods, such as aversive conditioning (AC). AC aims to teach animals to associate negative stimuli with humans or their infrastructure. We sought to test the efficacy of AC using radio-collared black bears in Whistler, British Columbia, by monitoring individuals and assigning those in conflict with people to control or treatment groups. We measured wariness using overt reaction distance, displacement distance, and reaction to researchers before, during and after executing 3–5-day AC programs that consisted of launching projectiles at bears in the treatment group. We also assessed predictors of successful AC events (i.e., leaving at a run), changes in bear use of human-dominated habitat during the day and at night, and the effects of including a sound stimulus to signal the beginning and end of AC events. Among treated bears, overt reaction distance increased by 46.5% and displacement distance increased by 69.0% following AC programs, whereas both overt reaction distance and displacement distance decreased over time among control group bears. Each additional AC event during the previous 30 days increased likelihood of bear departure in response to researcher presence by 4.5%. The success of AC events varied among individuals, declined with distance to cover, and increased with exposure to previous AC events. Projectiles launched from guns were slightly more effective at causing bears to displace compared to those launched from slingshots, and sound stimuli decreased the likelihood of a successful AC event. AC did not alter diurnal use by bears of human-dominated habitat. Our results suggest that AC effectively increases short-term wariness in black bears but does not alter bear use of human-dominated spaces, highlighting the importance of proactive attractant management and prevention of food conditioning. [ABSTRACT FROM AUTHOR]

Background: The British Columbia (BC) Hepatitis Testers Cohort (BC-HTC) was established to assess and monitor hepatitis C (HCV) epidemiology, cost of illness and treatment effectiveness in BC, Canada. In this paper, we describe the cohort construction, data linkage process, linkage yields, and comparison of the characteristics of linked and unlinked individuals. Methods: The BC-HTC includes all individuals tested for HCV and/or HIV or reported as a case of HCV, hepatitis B (HBV), HIV or active tuberculosis (TB) in BC linked with the provincial health insurance client roster, medical visits, hospitalizations, drug prescriptions, the cancer registry and mortality data using unique personal health numbers. The cohort includes data since inception (1990/1992) of each database until 2012/2013 with plans for annual updates. We computed linkage rates by year and compared the characteristics of linked and unlinked individuals. Results: Of 2,656,323 unique individuals available in the laboratory and surveillance data, 1,427,917(54%) were included in the final linked cohort, including about 1.15 million tested for HCV and about 1.02 million tested for HIV. The linkage rate was 86% for HCV tests, 89% for HCV cases, 95% for active TB cases, 48% for HIV tests and 36% for HIV cases. Linkage rates increased from 40% for HCV negatives and 70% for HCV positives in 1992 to ~90% after 2005. Linkage rates were lower for males, younger age at testing, and those with unknown residence location. Linkage rates for HCV testers co-infected with HIV, HBV or TB were very high (90–100%). Conclusion: Linkage rates increased over time related to improvements in completeness of identifiers in laboratory, surveillance, and registry databases. Linkage rates were higher for HCV than HIV testers, those testing positive, older individuals, and females. Data from the cohort provide essential information to support the development of prevention, care and treatment initiatives for those infected with HCV. [ABSTRACT FROM AUTHOR]

Introduction: Understanding the inequitable impacts of the ongoing COVID-19 pandemic on youth mental health are leading priorities. Existing research has linked income inequality in schools to adolescent depression, however, it is unclear if the onset of the pandemic exacerbated the effects of income inequality on adolescent mental health. The current study aimed to quantify the association between income inequality and adolescent mental health during COVID-19. Material and methods: Longitudinal data were taken from three waves (2018/19 to 2020/21) of the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary behaviour (COMPASS) school-based study. Latent Growth Curve modelling was used to assess the association between Census District (CD)-level income inequality and depressive symptoms before and after the onset of COVID-19. Results: The study sample included 29,722 students across 43 Census divisions in British Columbia, Alberta, Ontario, and Quebec. The average age of the sample at baseline was 14.9 years [standard deviation (SD) = 1.5] and ranged between 12 and 19 years of age. Most of the sample self-reported as white (76.3%) and female (54.4%). Students who completed the COMPASS survey after the onset of COVID reported 0.20-unit higher depressive scores (95% CI = 0.16, 0.24) compared to pre-COVID. The adjusted analyses indicated that the association between income inequality on anxiety scores was strengthened following the onset of COVID-19 (β = 0.02, 95% CI = 0.0004, 0.03), indicating that income inequality was associated with a greater increase in anxiety scores during COVID-19. Discussion: The adjusted results indicate that the association between income inequality and adolescent anxiety persisted and was heightened at the onset of COVID-19. Future studies should use quasi-experimental methods to strengthen this finding. The current study can inform policy and program discussions regarding the effects of the COVID-19 pandemic and pandemic recovery for young Canadians and relevant social policies for improving adolescent mental health. [ABSTRACT FROM AUTHOR]

Background: Increasing attention is being paid to variations in the use of prescription drugs because their role in health care has grown to the point where their use can be considered a proxy for health system performance. Studies have shown that prescription drug use varies across regions in the US, UK, and Canada by more than would be predicted based on age and health status alone. In this paper, we explore the determinants of variations in the use of prescription drugs, drawing on health services theories of access to care. Methods: We conducted a cross-sectional analysis using population-based administrative health care data for British Columbia (BC), Canada. We used logistic and hierarchical regressions to analyze the effects of individual- and area-level determinants of use of prescriptions overall and rates of purchase of prescriptions from five therapeutic categories representing a range of indications: antihypertensives, statins, acid reducing drugs, opioid drugs, and antidepressants. To indicate the relative scale of regional variations and the importance of individual- and area-level variables in explaining them, we computed standardized rates of utilization for 49 local health areas in BC. Results: We found that characteristics of individuals and the areas in which they live affect likelihood of prescription drug purchase. Individual-level factors influenced prescription drug purchases in ways generally consistent with behavioral models of health services use. Contextual variables exerted influences that differed by type of drug studied. Population health, education levels, and ethnic composition of local areas were associated with significant differences in the likelihood of purchasing medications. Relatively modest regional variations remained after both individual-level and area-level determinants were taken into account. Conclusions: The results of this study suggest that individual- and area-level factors should be considered when studying variations in the use of prescription drugs. Some sources of such variations, including individual- and area-level socioeconomic status, warrant further investigation and possible intervention to address inequities. [ABSTRACT FROM AUTHOR]

Introduction: The aim of our study was to assess the initial impact of COVID-19 on total publicly-funded direct healthcare costs and health services use in two Canadian provinces, Ontario and British Columbia (BC). Methods: This retrospective repeated cross-sectional study used population-based administrative datasets, linked within each province, from January 1, 2018 to December 27, 2020. Interrupted time series analysis was used to estimate changes in the level and trends of weekly resource use and costs, with March 16–22, 2020 as the first pandemic week. Also, in each week of 2020, we identified cases with their first positive SARS-CoV-2 test and estimated their healthcare costs until death or December 27, 2020. Results: The resources with the largest level declines (95% confidence interval) in use in the first pandemic week compared to the previous week were physician services [Ontario: -43% (-49%,-37%); BC: -24% (-30%,-19%) (both p<0.001)] and emergency department visits [Ontario: -41% (-47%,-35%); BC: -29% (-35%,-23%) (both p<0.001)]. Hospital admissions declined by 27% (-32%,-23%) in Ontario and 21% (-26%,-16%) in BC (both p<0.001). Resource use subsequently rose but did not return to pre-pandemic levels. Only home care and dialysis clinic visits did not significantly decrease compared to pre-pandemic. Costs for COVID-19 cases represented 1.3% and 0.7% of total direct healthcare costs in 2020 in Ontario and BC, respectively. Conclusions: Reduced utilization of healthcare services in the overall population outweighed utilization by COVID-19 patients in 2020. Meeting the needs of all patients across all services is essential to maintain resilient healthcare systems. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and related school disruptions have led to increased concerns for the mental health of teachers. This study investigated how the challenges and systemic supports perceived by teachers during the COVID-19 pandemic were associated with their mental health and workplace well-being. This cross-sectional, survey-based study was conducted in February 2021, just prior to the third wave of the pandemic in British Columbia (BC), Canada (N = 1,276). Four multivariable linear regression models examined the associations between teachers' pandemic-related challenges (pandemic-related personal stressors, teacher workload, difficulty implementing safety measures, meeting students' needs), systemic supports (education system mental health and well-being support), and four mental health (psychological distress, and quality of life) and workplace well-being outcomes (job-related positive affect, turnover intentions), adjusting for sociodemographic and school characteristics. The Pratt index (d) was used to assess the relative importance of each predictor. A thematic qualitative analysis was conducted on teachers' open-ended responses. Teachers' workplace well-being (job-related positive affect and turnover intentions) was predominantly associated with their perceptions of education system support for their mental health and well-being (d = 46%, d = 41%, respectively). The most important predictor of general mental health (psychological distress and quality of life) was the number of COVID-19 related personal stressors teachers reported (d = 64%, d = 43%, respectively). The qualitative analyses corroborated and expanded upon the quantitative findings. Understanding pandemic-related challenges and supports impacting teacher mental health and workplace well-being equips us to make evidence-informed policy decisions to support teachers now and in future school disruptions. [ABSTRACT FROM AUTHOR]

Environmental sustainability in agriculture is a key component of discussions to address the current climate crisis; unfortunately, many people (including researchers) presume that only certain types of agriculture (e.g., organic, local) are environmentally sustainable. Non-farmers also fail to acknowledge that many farm practices, including grazing animals, mitigate climate change. Farmers' perceptions about environmental sustainability are important because their livelihoods, and those of future generations, depend on their commitment to sustainable environmental practices. The purpose of this qualitative research was to understand Canadian farmers' perceptions of environmental sustainability, how they are implementing strategies that contribute to sustainable food production, and the challenges they face. Fifty-two farmers, representing 48 farms and over 1000 years of farming experience, participated in comprehensive in-depth interviews. Four farms were in British Columbia; 13 in the Prairies; 26 in Central Canada; and five in Eastern Canada. A wide variety of farm types (e.g., fruit/vegetables, livestock, grains) and sizes (2 to 6500 acres) were included in the study. Farmers' perceptions of environmental sustainability coalesced into four main themes: (1) definitions of sustainability and environmental sustainability, (2) current practices, (3) farming as an identity, and (4) challenges. Many participants explained that they already use sustainable practices and technology, contrary to prevailing opinion that entire food systems need to be transformed to be sustainable. As new agricultural policies and educational curricula are developed, information provided to students, policy makers, and the public must be accurate, balanced, evidence-based, and respectfully consider all perspectives, especially those of farmers. [ABSTRACT FROM AUTHOR]

Recent developments in radiocarbon dating have enabled archaeologists to re-examine the question of population dynamism in the Salish Sea. This study expands on Taylor and colleagues (2011) using Kernel Density Estimation (KDE) and an expanded data set of 538 radiocarbon dates from academic and cultural resource management literature. The expanded sample suggests a pattern of population growth from 3200–2800 cal BP in coastal Northwestern Washington, with population growth in the San Juan islands during 2600–2200 cal BP. A subsequent decrease in radiocarbon frequencies and large sites suggests shifts in use of the San Juan Islands, followed by peak large-scale occupation from 650–300 cal BP. This pattern is robust whether marine or terrestrial dates are considered. However, marine dates are less sensitive to questions at smaller temporal scales. The broad scale radiocarbon frequency patterns observed are also consistent with those observed in southwest coastal British Columbia (Ritchie et al., 2016; Morin et al., 2018). [ABSTRACT FROM AUTHOR]

The outbreak of the severe acute respiratory syndrome coronavirus 2 started in Wuhan, China, towards the end of 2019 and spread worldwide. The rapid spread of the disease can be attributed to many factors including its high infectiousness and the high rate of human mobility around the world. Although travel/movement restrictions and other non-pharmaceutical interventions aimed at controlling the disease spread were put in place during the early stages of the pandemic, these interventions did not stop COVID-19 spread. To better understand the impact of human mobility on the spread of COVID-19 between regions, we propose a hybrid gravity-metapopulation model of COVID-19. Our modeling framework has the flexibility of determining mobility between regions based on the distances between the regions or using data from mobile devices. In addition, our model explicitly incorporates time-dependent human mobility into the disease transmission rate, and has the potential to incorporate other factors that affect disease transmission such as facemasks, physical distancing, contact rates, etc. An important feature of this modeling framework is its ability to independently assess the contribution of each factor to disease transmission. Using a Bayesian hierarchical modeling framework, we calibrate our model to the weekly reported cases of COVID-19 in thirteen local health areas in Metro Vancouver, British Columbia (BC), Canada, from July 2020 to January 2021. We consider two main scenarios in our model calibration: using a fixed distance matrix and time-dependent weekly mobility matrices. We found that the distance matrix provides a better fit to the data, whilst the mobility matrices have the ability to explain the variance in transmission between regions. This result shows that the mobility data provides more information in terms of disease transmission than the distances between the regions. Author summary: Mathematical modelling was at the forefront of the fight against COVID-19. Many models were used to study the disease dynamics and the effectiveness of intervention strategies to control the disease spread. Due to the high infectiousness of COVID-19 and the high rate of human mobility, understanding the disease spread between regions became important. Many of the previously developed models for studying disease dynamics between regions described human mobility based on either the distances between the regions or using other forms of mobility data. In addition, some of these models can only be used to study the spread of COVID-19 from an epicentre to neighbouring regions/cities. These models are suitable for only the early stages of the disease outbreak. We developed a hybrid gravity-metapopulation modelling framework for studying the spread of diseases between regions. Our model provides the flexibility of using the distances between the regions and mobile device data as a proxy for human mobility between regions. Furthermore, our framework is suitable for studying disease dynamics at any epidemic stage. It accounts for disease spread from each region to the remaining regions, irrespective of the number of reported cases in each region and their population sizes. [ABSTRACT FROM AUTHOR]

Background: Choose to Move (CTM), an effective health-promoting intervention for older adults, was scaled-up across British Columbia, Canada. Adaptations that enable implementation at scale may lead to 'voltage drop'—diminished positive effects of the intervention. For CTM Phase 3 we assessed: i. implementation; ii. impact on physical activity, mobility, social isolation, loneliness and health-related quality of life (impact outcomes); iii. whether intervention effects were maintained; iv) voltage drop, compared with previous CTM phases. Methods: We conducted a type 2 hybrid effectiveness-implementation pre-post study of CTM; older adult participants (n = 1012; mean age 72.9, SD = 6.3 years; 80.6% female) were recruited by community delivery partners. We assessed CTM implementation indicators and impact outcomes via survey at 0 (baseline), 3 (mid-intervention), 6 (end-intervention) and 18 (12-month follow-up) months. We fitted mixed-effects models to describe change in impact outcomes in younger (60–74 years) and older (≥ 75 years) participants. We quantified voltage drop as percent of effect size (change from baseline to 3- and 6-months) retained in Phase 3 compared with Phases 1–2. Results: Adaptation did not compromise fidelity of CTM Phase 3 as program components were delivered as intended. PA increased during the first 3 months in younger (+1 days/week) and older (+0.9 days/week) participants (p<0.001), and was maintained at 6- and 18-months. In all participants, social isolation and loneliness decreased during the intervention, but increased during follow-up. Mobility improved during the intervention in younger participants only. Health-related quality of life according to EQ-5D-5L score did not change significantly in younger or older participants. However, EQ-5D-5L visual analog scale score increased during the intervention in younger participants (p<0.001), and this increase was maintained during follow-up. Across all outcomes, the median difference in effect size, or voltage drop, between Phase 3 and Phases 1–2 was 52.6%. However, declines in social isolation were almost two times greater in Phase 3, compared with Phases 1–2. Conclusion: Benefits of health-promoting interventions—like CTM—can be retained when implemented at broad scale. Diminished social isolation in Phase 3 reflects how CTM was adapted to enhance opportunities for older adults to socially connect. Thus, although intervention effects may be reduced at scale-up, voltage drop is not inevitable. [ABSTRACT FROM AUTHOR]

The coastal waters of southern British Columbia, Canada, encompass habitat of international conservation significance to coastal and marine birds, including sizeable areas designated in the early 1900s as Migratory Bird Sanctuaries (MBS) to protect overwintering waterfowl from hunting near urban centres. Two of these, Shoal Harbour (SHMBS) and Victoria Harbour (VHMBS), have seen significant marine infrastructure development in recent decades and experience considerable vessel traffic. Vessel-related stressors are known to affect waterbirds, but traffic characteristics in coastal urban areas are poorly understood for the smaller vessels not tracked by Automatic Identification Systems (AIS). We conducted a pilot study using shore-based observers to develop small-vessel baselines for the winter months, when regional waterbird numbers are highest. During our surveys we recorded considerable inter-site variability in vessel traffic characteristics, with one site (SHMBS) a source of nearly twice as many vessel transits as the other (VHMBS). Most recorded vessels were small watercraft (mean length 26 ± 17′, mode 18′), and vessels at the high-traffic site were both shorter and faster on average. One in six vessels were classified as 'noisy', of interest given that noise is an important component of vessel disturbance of waterbirds and other marine animals. Few vessels (7% of all recorded) were of the type required to carry AIS transponders, which highlights the monitoring gap created by using AIS-based approaches alone in nearshore waters, and allows for correction of AIS-derived vessel counts. Waterbird community composition also varied by locality, with one site dominated by gulls (Laridae), cormorants (Phalacrocoracidae), and seaducks (Tribe Mergini), and the other by gulls, cormorants, and alcids (Alcidae). Our results demonstrate that fine-scale local variability must be taken into account when managing for vessel traffic disturbance of waterbirds, particularly at sites of high human population density and increasing coastal development. [ABSTRACT FROM AUTHOR]

Research has shown that refugees in a foreign country often experience physical and mental health challenges upon resettlement (Ahmad et al., 2021; Salam et al., 2022). In Canada, refugee women experience a range of physical and mental barriers, including poor access to interpreter services and transportation, and a lack of accessible childcare, all of which can negatively affect their successful integration (Stirling Cameron et al., 2022). Social factors that support Syrian refugees to settle successfully in Canada have been unexplored systematically. This study examines these factors from the perspectives of Syrian refugee mothers living in the province of British Columbia (BC). Framed by principles of intersectionality and community-based participatory action research (PAR), the study draws on Syrian mothers' perspectives of social support in early, middle, and later phases of resettlement. A qualitative longitudinal design consisting of a sociodemographic survey, personal diaries, and in-depth interviews was used to gather information. Descriptive data were coded, and theme categories were assigned. Six themes emerged from data analysis: (1) Steps in the Migration Journey; (2) Pathways to Integrated Care; (3) Social Determinants of Refugee Health; (4) COVID-19 Pandemic Impacts and Ongoing Resettlement; (5) Strength-Based Capabilities of Syrian mothers; (6) Peer Research Assistant's Research (PRAs) Experience. Results from themes 5 and 6 are published separately. Data obtained in this study contribute to the development of support services that are culturally appropriate and accessible to refugee women living in BC. Our objectives are to promote the mental health and improve the quality of life of this female population, and to enable it to access healthcare services and resources in a timely manner. [ABSTRACT FROM AUTHOR]

Phytophthora species are primary causal agents of raspberry root rot and wilting complex (RRWC), a disease complex that is of major concern to raspberry producers worldwide. Accurate identification of the causal agents is a first step for effective disease management. Advancements in molecular diagnostics can facilitate the detection of multiple pathogen species associated with this disease complex. We developed multiplex targeted-sequencing methods using degenerate primers for heat shock protein 90, elongation factor 1α and β-tubulin genes to identify Phytophthora species causing RRWC. One hundred and twenty-eight isolates recovered during 2018 to 2020 from diverse fields in major raspberry growing areas of British Columbia (BC) were sequenced and identified by comparing with known reference sequences of 142 Phytophthora species, 111 Pythium species, and nine Phytopythium species in the NCBI database. This multiplex targeted-sequencing method was highly specific and identified two species of Phytophthora associated with RRWC. These were P. rubi (85% of isolates) and P. gonapodyides (15% of isolates). Phytophthora rubi was predominantly isolated from the cultivars 'Chemainus' (51%), 'Rudi' (27%) and 'Meeker' (15%), whereas P. gonapodyides was predominately isolated from the moderately resistant cultivar 'Cascade Bounty'. Pathogenicity studies on intact plants and detached leaves confirmed that P. rubi and P. gonapodyides can cause symptoms of RRWC on raspberry, thus fulfilling Koch's postulates. To our knowledge, this is the first report of P. gonapodyides as a causal agent of RRWC on raspberry in BC. This study provides novel insights into the identification and species composition of Phytophthora associated with RRWC in raspberry production systems. [ABSTRACT FROM AUTHOR]

Background: Persons with disability (PWD) experience disproportionately high poverty rates in Canada. This trend is apparent especially among youth compared to those who develop disabilities later in life. PWD in poverty have additional needs that increase barriers to full participation in society and translate to higher basic costs for daily living. Despite the existence of income assistance programs in Canada to mitigate income inequalities faced by PWDs, access to these programs can be limited. Objective: To describe use of income assistance for young adults with disability in British Columbia for the development of potential approaches to improve realized access to these programs. Methods: We conducted a population-based retrospective cohort study using British Columbia linked administrative data. We described differences in income assistance use among PWD by the level of special education funding received during primary school education (from most to least; Level 1, Level 2, Level 3, Unfunded, and no special education) and family composition. We also provided longitudinal patterns of income assistance use. Results: Of 218,324 young adults, 88% received no special education, 0.1% used Level One, 1.6% used Level Two, 2.9% used Level Three, and 7.1% used Unfunded special education coding. Young adults with Level One special education funding had the highest rates of hospitalizations and continuing care, with no hospitalization due to homelessness. Those with Level Three special education coding had higher rates of hospitalization and hospitalization due to homelessness than Level Two young adults. When transitioning to adulthood initially, Level One and Two funded individuals used relatively more disability income assistance than individuals from the other funding levels. Nearly all BCEA users with higher funded special education codes used this disability-specific program, while lesser funded special education codes used the Temporary Assistance more frequently, for a longer duration and were more likely to be persistent Temporary Assistance users. Conclusions: Sustainable and reliable access to income assistance programs remains an issue across the heterogeneity of needs faced by young adults with disability. [ABSTRACT FROM AUTHOR]

Nighttime lights (NTL) are the procurement of remotely sensed artificial illumination from the Visible Infrared Imaging Radiometer Suite (VIIRS) satellite. NTL provides a unique perspective on anthropogenic activity by characterizing spatial and temporal patterns related to economic trends and human development. In this study, we assess the ability of NTL to characterize trends associated with industrial lumber production in British Columbia, Canada. We establish the presence of a logarithmic relationship between NTL and lumber mill production capacity (R2 = 0.69–0.82). The ability of NTL to temporally identify mill closures is then demonstrated by differentiating pairs of active and closed mills. We also identify Granger causality and co-integration between NTL and monthly lumber production, highlighting the predictive capability of NTL to forecast production. We then utilize this relationship to build linear regression models that utilize NTL data to estimate monthly (R2 = 0.33), quarterly (R2 = 0.58), and annual (R2 = 0.90) lumber production without reported data. [ABSTRACT FROM AUTHOR]

Introduction: Peer workers (those with lived/living experience of substance use) are at the forefront of overdose response initiatives in British Columbia, Canada. The onset of the coronavirus disease pandemic has significantly compounded the impact of the overdose crisis. Peer workers are integral in supporting people who use substances. However, despite the important work they do, peer workers often lack formalized credibility and do not have the same resources available to them as service providers without lived experience. The peer-led project titled the Peer2Peer Project implemented several support programs for peer workers, including providing pulse oximeters to peer workers to supplement their overdose response procedures. Materials and methods: This study was a component of a larger evaluation of the pulse oximeter program at two organizations in BC. The study aims to highlight the competencies of peer workers who use pulse oximeters. Telephone interviews were conducted with seven peer workers who were given pulse oximeters. The transcripts were thematically coded using Covert et al.'s framework of core competencies of community health workers to compare our sample with other widely recognized professions. Findings: We found that peer workers who used pulse oximeters described several core competencies in their work and these were aligned with Covert et al.'s core competencies for community health workers, including assessment, community health practice, communication, diversity and inclusion, professional practice, and disease prevention and management. Conclusion: By aligning peer workers' skills to those of community health workers, we create awareness on the competencies of peer workers in using oximeters to supplement overdose response and advocate for them to receive more recognition and respect within the workplace. Further, our findings act as groundwork for future research in identifying the professional proficiencies of peer workers. [ABSTRACT FROM AUTHOR]

Trace mineral imbalances can have significant effects on animal health, reproductive success, and survival. Monitoring their status in wildlife populations is, therefore, important for management and conservation. Typically, livers and kidneys are sampled to measure mineral status, but biopsies and lethal-sampling are not always possible, particularly for Species at Risk. We aimed to: 1) determine baseline mineral levels in Northern Mountain caribou (Rangifer tarandus caribou; Gmelin, 1788) in northwestern British Columbia, Canada, and 2) determine if hair can be used as an effective indicator of caribou mineral status by evaluating associations between hair and organ mineral concentrations. Hair, liver, and kidney samples from adult male caribou (nHair = 31; nLiver, nKidney = 43) were collected by guide-outfitters in 2016–2018 hunting seasons. Trace minerals and heavy metals were quantified using inductively-coupled plasma mass spectrometry, and organ and hair concentrations of same individuals were compared. Some organ mineral concentrations differed from other caribou populations, though no clinical deficiency or toxicity symptoms were reported in our population. Significant correlations were found between liver and hair selenium (rho = 0.66, p<0.05), kidney and hair cobalt (rho = 0.51, p<0.05), and liver and hair molybdenum (rho = 0.37, p<0.10). These findings suggest that hair trace mineral assessment may be used as a non-invasive and easily-accessible way to monitor caribou selenium, cobalt, and molybdenum status, and may be a valuable tool to help assess overall caribou health. [ABSTRACT FROM AUTHOR]

Introduction: The pathophysiology behind the association between obesity and perinatal death is not fully understood but may be in part due to higher rates of pregnancy complications at earlier gestation amongst obese women. We aimed to quantify the proportion of perinatal deaths amongst obese and overweight women mediated by gestational age at stillbirth or live birth. Methods: The study included all singleton births at ≥20 weeks' gestation in British Columbia, 2004–2017, and excluded pregnancy terminations. The proportion of the association between BMI and perinatal death mediated by gestational age at delivery (in weeks) was estimated using natural effect models, with adjustment for potential confounders. Sensitivity analyses for unmeasured confounding and women missing BMI were conducted. Results: Of 392,820 included women, 20.6% were overweight and 12.8% obese. Women with higher BMI had a lower gestational age at delivery. Perinatal mortality was 0.5% (1834 pregnancies); and was elevated in overweight (adjusted odds ratio [AOR] = 1.22, 95% confidence interval [CI] 1.08–1.37) and obese women (AOR = 1.55, 95% CI 1.36–1.77). Mediation analysis showed that 63.1% of the association between obesity and perinatal death was mediated by gestational age at delivery (natural indirect effect AOR = 1.32, 95% CI 1.23–1.42, natural direct effect AOR = 1.18, 95% CI 1.05–1.32). Similar, but smaller effects were seen when comparing overweight women vs. women with a normal BMI. Estimated effects were not affected by adjustment for additional risk factors for perinatal death or sensitivity analyses for missing data. Conclusion: Obese pregnancies have a higher risk of perinatal death in part mediated by a lower gestational age at delivery. [ABSTRACT FROM AUTHOR]

Background: On 14 April 2016, British Columbia's Provincial Medical Health Officer declared the overdose crisis a public health emergency, sanctioning the implementation of new overdose prevention sites (OPS) and supervised consumption sites (SCS) across the province. Methods: We used the BC Centre for Disease Control's Provincial Overdose Cohort of all overdose events between 1 January 2015 and 31 December 2017 to evaluate the population-level effects of OPSs and SCSs on acute health service use and mortality. We matched local health areas (LHA) that implemented any site with propensity score matched controls and conducted controlled interrupted time series analysis. Results: During the study period, twenty-five OPSs and SCSs opened across fourteen of British Columbia's 89 LHAs. Results from analysis of LHAs with matched controls (i.e. excluding Vancouver DTES) were mixed. Significant declines in reported overdose events, paramedic attendance, and emergency department visits were observed. However, there were no changes to trends in monthly hospitalization or mortality rates. Extensive sensitivity analyses found these results persisted. Conclusions: We found OPSs and SCSs reduce opioid-related paramedic attendance and emergency department visit rates but no evidence that they reduce local hospitalization or mortality rates. [ABSTRACT FROM AUTHOR]

Background: Vaccine uptake rates have been historically low in correctional settings. To better understand vaccine hesitancy in these high-risk settings, we explored reasons for COVID-19 vaccine refusal among people in federal prisons. Methods: Three maximum security all-male federal prisons in British Columbia, Alberta, and Ontario (Canada) were chosen, representing prisons with the highest proportions of COVID-19 vaccine refusal. Using a qualitative descriptive design and purposive sampling, individual semi-structured interviews were conducted with incarcerated people who had previously refused at least one COVID-19 vaccine until data saturation was achieved. An inductive–deductive thematic analysis of audio-recorded interview transcripts was conducted using the Conceptual Model of Vaccine Hesitancy. Results: Between May 19-July 8, 2021, 14 participants were interviewed (median age: 30 years; n = 7 Indigenous, n = 4 visible minority, n = 3 White). Individual-, interpersonal-, and system-level factors were identified. Three were particularly relevant to the correctional setting: 1) Risk perception: participants perceived that they were at lower risk of COVID-19 due to restricted visits and interactions; 2) Health care services in prison: participants reported feeling "punished" and stigmatized due to strict COVID-19 restrictions, and failed to identify personal benefits of vaccination due to the lack of incentives; 3) Universal distrust: participants expressed distrust in prison employees, including health care providers. Interpretation: Reasons for vaccine refusal among people in prison are multifaceted. Educational interventions could seek to address COVID-19 risk misconceptions in prison settings. However, impact may be limited if trust is not fostered and if incentives are not considered in vaccine promotion. [ABSTRACT FROM AUTHOR]

The Wapiti Formation of northwest Alberta and northeast British Columbia, Canada, preserves an Upper Cretaceous terrestrial vertebrate fauna that is latitudinally situated between those documented further north in Alaska and those from southern Alberta and the contiguous U.S.A. Therefore, the Wapiti Formation is important for identifying broad patterns in vertebrate ecology, diversity, and distribution across Laramidia during the latest Cretaceous. Tracksites are especially useful as they provide a range of palaeoecological, palaeoenvironmental, and behavioural data that are complementary to the skeletal record. Here, we describe the Tyrants Aisle locality, the largest in-situ tracksite known from the Wapiti Formation. The site occurs in the lower part of Unit 4 of the formation (~72.5 Ma, upper Campanian), exposed along the southern bank of the Redwillow River. More than 100 tracks are documented across at least three distinct track-bearing layers, which were deposited on an alluvial floodplain. Hadrosaurid tracks are most abundant, and are referable to Hadrosauropodus based on track width exceeding track length, broad digits, and rounded or bilobed heel margins. We suggest the hadrosaurid trackmaker was Edmontosaurus regalis based on stratigraphic context. Tyrannosaurids, probable troodontids, possible ornithomimids, and possible azhdarchid pterosaurs represent minor but notable elements of the ichnofauna, as the latter is unknown from skeletal remains within the Wapiti Formation, and all others are poorly represented. Possible social behaviour is inferred for some of the hadrosaurid and small theropod-like trackmakers based on trackway alignment, suitable spacing and consistent preservation. On a broad taxonomic level (i.e., family or above), ichnofaunal compositions indicate that hadrosaurids were palaeoecologically dominant across Laramidia during the late Campanian within both high-and low-latitude deposits, although the role of depositional environment requires further testing. [ABSTRACT FROM AUTHOR]

Introduction: Take-Home Naloxone programs have been introduced across North America in response to rising opioid overdose deaths. There is currently limited real-world data on bystander naloxone administration, overdose outcomes, and evidence related to adverse events following bystander naloxone administration. Methods: The research team used descriptive statistics from Take-Home Naloxone administration forms. We explored reported demographic variables and adverse events among people who received by-stander administered naloxone in a suspected opioid overdose event between August 31, 2012 and December 31, 2018 in British Columbia. We examined and contextualized differences across years given policy, program and drug toxicity changes. We used multivariate logistic regression to examine whether an association exists between number of ampoules of naloxone administered and the odds that the recipient will experience withdrawal symptoms. Results: A large majority (98.1%) of individuals who were administered naloxone survived their overdose and 69.2% had no or only mild withdrawal symptoms. Receiving three (Adjusted Odds Ratio (AOR) 1.64 (95% Confidence Interval (CI): 1.08–2.48)) or four or more (AOR 2.19 (95% CI: 1.32–3.62)) ampoules of naloxone was significantly associated with odds of moderate or severe withdrawal compared to receiving one ampoule of naloxone. Conclusions: This study provides evidence from thousands of bystander reversed opioid overdoses using Take-Home Naloxone kits in British Columbia, and suggests bystander-administered naloxone is safe and effective for opioid overdose reversal. Data suggests an emphasis on titration during bystander naloxone training in situations where the person experiencing overdose can be adequately ventilated may help avoid severe withdrawal symptoms. We identified a decreasing trend in the likelihood of moderate or severe withdrawal over the study period. [ABSTRACT FROM AUTHOR]

Although wildfires are an important ecological process in forested regions worldwide, they can cause significant economic damage and frequently create widespread health impacts. We propose a network optimization approach to plan wildfire fuel treatments that minimize the risk of fire spread in forested landscapes under an upper bound for total treated area. We used simulation modeling to estimate the probability of fire spread between pairs of forest sites and formulated a modified Critical Node Detection (CND) model that uses these estimated probabilities to find a pattern of fuel reduction treatments that minimizes the likely spread of fires across a landscape. We also present a problem formulation that includes control of the size and spatial contiguity of fuel treatments. We demonstrate the approach with a case study in Kootenay National Park, British Columbia, Canada, where we investigated prescribed burn options for reducing the risk of wildfire spread in the park area. Our results provide new insights into cost-effective planning to mitigate wildfire risk in forest landscapes. The approach should be applicable to other ecosystems with frequent wildfires. [ABSTRACT FROM AUTHOR]

The COVID-19 global incidence rate among young adults (age 19–40) drastically increased since summer 2020, and young adults were often portrayed by popular media as the "main spreader" of the pandemic. However, young adults faced unique challenges during the pandemic due to working in high-risk, low-paying essential service occupations, as well as having higher levels of financial insecurity and mental burden. This qualitative study aims to examine the attitudes and perceptions of health orders of young adults to better inform public health messaging to reach this demographic and increase compliance to public health orders. A total of 50 young adults residing in British Columbia, Canada, were recruited to participate in focus group in groups of four to six. Focus group discussions were conducted via teleconferencing. Thematic analysis revealed four major themes: 1) risks of contracting the disease, 2) the perceived impact of COVID-19, 3) responsibility of institutions, 4) and effective public health messaging. Contrary to existing literature, our findings suggest young adults feel highly responsible for protecting themselves and others. They face a higher risk of depression and anxiety compared to other age groups, especially when they take on multiple social roles such as caregivers and parents. Our findings suggest young adults face confusion due to inconsistent messaging and are not reached due to the ineffectiveness of existing strategies. We recommend using evidence-based strategies proven to promote behaviour change to address the barriers identified by young adults through tailoring public health messages, specifically by using positive messaging, messaging that considers the context of the intended audiences, and utilizing digital platforms to facilitate two-way communication. [ABSTRACT FROM AUTHOR]

Online charitable crowdfunding has become an increasingly prevalent way for Canadians to deal with costs that they would otherwise not be able to shoulder on their own. With the onset of COVID-19 and related lockdown measures, there is evidence of a surge in crowdfunding use relating to the pandemic. This study gathered, classified, and analysed Canadian crowdfunding campaigns created in response to COVID-19 from GoFundMe.com, a popular crowdfunding platform. Spatio-temporal analysis of classified campaigns allowed for observation of emergent trends in the distribution of pandemic-related need incidence and financial support throughout the pandemic. Campaigns raising money on behalf of established charities were the most common in the sample, and accounted for the greatest portion of funding raised, while campaigns for businesses made up a small proportion. Dense metropolitan areas accounted for the vast majority of campaign locations, and total sample funding was disproportionately raised by campaigners in Ontario and British Columbia. [ABSTRACT FROM AUTHOR]

Background: The 2016 WHO Standards for improving quality of maternal and newborn care in health facilities established patient experience of care as a core indicator of quality. Global health experts have described loss of autonomy and disrespect as mistreatment. Risk of disrespect and abuse is higher when patient and care provider opinions differ, but little is known about service users experiences when declining aspects of their maternity care. Methods: To address this gap, we present a qualitative content analysis of 1540 written accounts from 892 service users declining or refusing care options throughout childbearing with a large, geographically representative sample (2900) of childbearing women in British Columbia who participated in an online survey with open-ended questions eliciting care experiences. Findings: Four themes are presented: 1) Contentious interactions: "I fought my entire way", describing interactions as fraught with tension and recounting stories of "fighting" for the right to refuse a procedure/intervention; 2) Knowledge as control or as power: "like I was a dim girl", both for providers as keepers of medical knowledge and for clients when they felt knowledgeable about procedures/interventions; 3) Morbid threats: "do you want your baby to die?", coercion or extreme pressure from providers when clients declined interventions; 4) Compliance as valued: "to be a 'good client'", recounting compliance or obedience to medical staff recommendations as valuable social capital but suppressing desire to ask questions or decline care. Conclusion: We conclude that in situations where a pregnant person declines recommended treatment, or requests treatment that a care provider does not support, tension and strife may ensue. These situations deprioritize and decenter a woman's autonomy and preferences, leading care providers and the culture of care away from the principles of respect and person-centred care. [ABSTRACT FROM AUTHOR]

Introduction: Increased use of crystal methamphetamine ("crystal meth") has been observed across North America and international jurisdictions, including a notable increase in the presence of methamphetamines in illicit drug toxicity deaths in British Columbia (BC), Canada. We used data from a cross-sectional survey and urine toxicology screening to report the prevalence, correlates, and validity of self-reported crystal meth use among clients of harm reduction sites in BC. Materials and methods: Survey data were collected from 1,107 participants across 25 communities in BC, through the 2018 and 2019 Harm Reduction Client Survey. We described reported substance use and used a multivariate logistic regression model to characterize crystal meth use. Urine samples provided by a subset of participants were used to derive validity of self-reported three-day crystal meth use compared to urine toxicology screening. Results: Excluding tobacco, crystal meth was the most frequently reported substance used in the past three days in 2018 and 2019 (59.7% and 71.7%, respectively). Smoking was the dominant route of administration for crystal meth, crack, heroin, and fentanyl. Multivariate analysis determined significantly higher odds of crystal meth use among those who used opioids (Adjusted Odds Ratio [AOR] = 3.13), cannabis (AOR = 2.10), and alcohol (1.41), and among those who were not regularly housed (AOR = 2.08) and unemployed (AOR = 1.75). Age ≥50 was inversely associated with crystal meth use (AOR = 0.63). Sensitivity of self-reported crystal meth use was 86%, specificity was 86%, positive predictive value was 96%, and negative predictive value was 65%. Conclusions: Crystal meth was the most commonly used substance among clients of harm reduction sites in BC in 2018 and 2019, and was frequently used concurrently with opioids. Comparison to urine samples demonstrated high validity of self-reported crystal meth use. Understanding evolving patterns of substance use will be imperative in tailoring harm reduction and substance use services for individuals that use crystal meth. [ABSTRACT FROM AUTHOR]

Scholars have only just begun to examine elements of young adolescents' social ecologies that explain naturalistic variation in trait mindfulness and its development over time. We argue that trait mindfulness develops as a function of chronically encountered ecologies that are likely to foster or thwart the repeated enactment of mindful states over time. Using data from 4,593 fourth and seventh grade students (50% female; MageG4 = 9.02; 71% English first language) from 32 public school districts in British Columbia (BC), Canada, we examined links from peer belonging, connectedness with adults at home, and peer victimization to mindfulness over time. Variable-centered analyses indicated that young adolescents with lower victimization in fourth grade reported higher mindfulness in seventh grade, and that cross-sectionally within seventh grade victimization, peer belonging, and connectedness with adults at home were each associated with mindfulness. Contrary to our hypothesis, connectedness with adults at home moderated the longitudinal association between victimization and mindfulness such that the negative association was stronger among young adolescents with high (vs. low) levels of connectedness with adults at home. Person-centered analysis of the fourth graders' data confirmed our variable-centered findings, yielding four latent classes of social ecology whose mindfulness levels in seventh grade largely tracked with their victimization levels (from highest to lowest mindfulness): (1) flourishing relationships, (2) unvictimized but weak relationships with adults, (3) moderately victimized but strong relationships, and (4) victimized but strong relationships. Overall, our findings contribute to a growing body of evidence indicating that trait mindfulness may develop as a function of ecologically normative experiences in young adolescents' everyday lives. [ABSTRACT FROM AUTHOR]

Several species of bears are known to rub deliberately against trees and other objects, but little is known about why bears rub. Patterns in rubbing behavior of male and female brown bears (Ursus arctos) suggest that scent marking via rubbing functions to communicate among potential mates or competitors. Using DNA from bear hairs collected from rub objects in southwestern Alberta from 2011–2014 and existing DNA datasets from Montana and southeastern British Columbia, we determined sex and individual identity of each bear detected. Using these data, we completed a parentage analysis. From the parentage analysis and detection data, we determined the number of offspring, mates, unique rub objects where an individual was detected, and sampling occasions during which an individual was detected for each brown bear identified through our sampling methods. Using a Poisson regression, we found a positive relationship between bear rubbing behavior and reproductive success; both male and female bears with a greater number of mates and a greater number of offspring were detected at more rub objects and during more occasions. Our results suggest a fitness component to bear rubbing, indicate that rubbing is adaptive, and provide insight into a poorly understood behaviour. [ABSTRACT FROM AUTHOR]

Understanding diet is critical for conservation of endangered predators. Southern Resident killer whales (SRKW) (Orcinus orca) are an endangered population occurring primarily along the outer coast and inland waters of Washington and British Columbia. Insufficient prey has been identified as a factor limiting their recovery, so a clear understanding of their seasonal diet is a high conservation priority. Previous studies have shown that their summer diet in inland waters consists primarily of Chinook salmon (Oncorhynchus tshawytscha), despite that species' rarity compared to some other salmonids. During other times of the year, when occurrence patterns include other portions of their range, their diet remains largely unknown. To address this data gap, we collected feces and prey remains from October to May 2004–2017 in both the Salish Sea and outer coast waters. Using visual and genetic species identification for prey remains and genetic approaches for fecal samples, we characterized the diet of the SRKWs in fall, winter, and spring. Chinook salmon were identified as an important prey item year-round, averaging ~50% of their diet in the fall, increasing to 70–80% in the mid-winter/early spring, and increasing to nearly 100% in the spring. Other salmon species and non-salmonid fishes, also made substantial dietary contributions. The relatively high species diversity in winter suggested a possible lack of Chinook salmon, probably due to seasonally lower densities, based on SRKW's proclivity to selectively consume this species in other seasons. A wide diversity of Chinook salmon stocks were consumed, many of which are also at risk. Although outer coast Chinook samples included 14 stocks, four rivers systems accounted for over 90% of samples, predominantly the Columbia River. Increasing the abundance of Chinook salmon stocks that inhabit the whales' winter range may be an effective conservation strategy for this population. [ABSTRACT FROM AUTHOR]

Background: Sofosbuvir and ledipasvir-sofosbuvir are both newer direct-acting antiviral agents for the treatment of hepatitis C. The high list prices for both drugs have led to concern about the budget impact for public drug coverage programs. Therefore, we studied the impact of public prescription drug coverage for both drugs on utilization, adherence, and public and private expenditure in British Columbia, Canada. Methods: We used provincial administrative claims data from January 2014 to June 2017 for all individuals historically tested for either hepatitis C and/or human immunodeficiency virus. Using interrupted time series analysis, we examined the impact of public insurance coverage on treatment uptake, adherence (proportion of days covered), and public and private expenditures. Results: Over our study period, 4,462 treatment initiations were eligible for analysis (1,131 sofosbuvir and 3,331 ledipasvir-sofosbuvir, which include 19 patients initiated on both treatments). We found the start of public coverage for sofosbuvir and ledipasvir-sofosbuvir increased treatment uptake by 154%. Adherence rates were consistently high and did not change with public coverage. Finally, public expenditure increased after the policy change, and crowded out some private expenditure. Conclusion: Public coverage for high-cost drugs for hepatitis C dramatically increased use of these drugs, but did not reduce adherence. From a health policy perspective, public payers should be prepared for increased treatment uptake following the availability of public coverage. However, they should not be concerned that populations without private insurance coverage will be less adherent and not finish their treatment course. [ABSTRACT FROM AUTHOR]

Dams and reservoirs alter natural water flow regimes with adverse effects on natural ecosystems. Quantifying and reducing these effects are important as global demands for energy and water, and the number of dams and reservoir, increase. However, costs and logistic constraints typically preclude experimental assessment of reservoir effects on the environment. We developed a stochastic individual-based model (IBM), parameterized using empirical data, to estimate the annual productivity of yellow warblers that breed in riparian habitat within the footprint of the Arrow Lakes Reservoir in British Columbia, Canada. The IBM incorporated information on breeding phenology, nest site selection, brood parasitism, daily nest survival, re-nesting probabilities and post-fledging survival. We used the IBM to estimate the effect of four different water management scenarios on annual productivity. We found that the IBM accurately estimated average nest success (0.39 ± 0.10 SD), the proportion of females that produced at least one fledgling during a breeding season (0.56 ± 0.11), and annual fledging success (2.06 ± 0.43) under current conditions. The IBM estimated that reservoir operations currently reduce the annual productivity of this population by 37%, from an average of 1.62 to 1.06 independent young/female. Delaying when reservoir water levels reach 435m asl (the minimum elevation occupied by yellow warblers) by approximately 2 weeks was predicted to increase annual productivity to 1.44 independent young/female. The standardized effect on annual productivity of reducing the maximum elevation of the reservoir so that yellow warbler habitat is not inundated (Cohen's d = 1.52) or delaying when water is stored (Cohen's d = 0.83) was primarily driven by inundation effects on post-fledging survival. Reservoir operation effects on breeding birds will be species specific, but this IBM can easily be modified to allow the environmental impacts on the entire breeding bird community to be incorporated into water management decisions. [ABSTRACT FROM AUTHOR]

Introduction: Several methods have been proposed to estimate the time of HIV seroconversion, including those based on CD4 cell depletion models. However, previous models have failed to consider the heterogeneity that exists in CD4 trajectories among different sub-populations. Our objective was to estimate the time from HIV seroconversion relative to the HIV diagnosis date in a population-based cohort of people living with HIV (PLWH) in the province of British Columbia, Canada. Methods: We used linked administrative and clinical data from the British Columbia Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS) cohort, which contains longitudinal individual-level data on all PLWH ever diagnosed in the province. Eligible participants were aged ≥18 years and diagnosed with HIV between 1989 and 2013. The outcome was pre-antiretroviral treatment CD4 cell count measurements assessed every six months. Models were stratified by age and stage of HIV infection at diagnosis. Several explanatory variables were considered including longitudinal viral load measurements. Longitudinal CD4, square root transformed, was modeled via a non-linear mixed effects model; time was modeled using an exponential decay function. We assumed a Gaussian distribution (identity link), an AR(1) correlation structure, and a random intercept and slope for the longitudinal viral load measurements. Due to the population variation in CD4 count among uninfected individuals, we assumed 500 to 1500 cells/mm3 as the normal range when estimating the time of HIV seroconversion. Results: Longitudinal data on 1,253 individuals were analysed: 80% male, 33% White, and the median age at diagnosis was 38 years (25th-75th percentile [Q1-Q3], 31 to 45). CD4 decay differed by stage of infection at diagnosis and age, with those ≥50 years in Stages 1 and 2 experiencing a faster decline in CD4 over time. The median duration of infection from seroconversion until HIV diagnosis was 6.9 (Q1-Q3, 3.9 to 10.1) years. Conclusions: Considering the heterogeneity that exists in individual CD4 cell trajectories in a population, we presented a methodology that only relies on routinely collected HIV-related data, which can be further extended to estimate other epidemic measures. [ABSTRACT FROM AUTHOR]

Some but not all of the species of 'little brown mushrooms' in the genus Galerina contain deadly amatoxins at concentrations equaling those in the death cap, Amanita phalloides. However, Galerina's ~300 species are notoriously difficult to identify by morphology, and the identity of toxin-containing specimens has not been verified with DNA barcode sequencing. This left open the question of which Galerina species contain toxins and which do not. We selected specimens for toxin analysis using a preliminary phylogeny of the fungal DNA barcode region, the ribosomal internal transcribed spacer (ITS) region. Using liquid chromatography/mass spectrometry, we analyzed amatoxins from 70 samples of Galerina and close relatives, collected in western British Columbia, Canada. To put the presence of toxins into a phylogenetic context, we included the 70 samples in maximum likelihood analyses of 438 taxa, using ITS, RNA polymerase II second largest subunit gene (RPB2), and nuclear large subunit ribosomal RNA (LSU) gene sequences. We sequenced barcode DNA from types where possible to aid with applications of names. We detected amatoxins only in the 24 samples of the G. marginata s.l. complex in the Naucoriopsis clade. We delimited 56 putative Galerina species using Automatic Barcode Gap Detection software. Phylogenetic analysis showed moderate to strong support for Galerina infrageneric clades Naucoriopsis, Galerina, Tubariopsis, and Sideroides. Mycenopsis appeared paraphyletic and included Gymnopilus. Amatoxins were not detected in 46 samples from Galerina clades outside of Naucoriopsis or from outgroups. Our data show significant quantities of toxin in all mushrooms tested from the G. marginata s.l. complex. DNA barcoding revealed consistent accuracy in morphology-based identification of specimens to G. marginata s.l. complex. Prompt and careful morphological identification of ingested G. marginata s.l. has the potential to improve patient outcomes by leading to fast and appropriate treatment. [ABSTRACT FROM AUTHOR]

Large-scale atmospheric conditions in the Northeast Pacific Ocean affect both the freshwater environment in the Columbia River Basin and marine conditions along the coasts of Oregon, Washington, and British Columbia, resulting in correlated conditions in the two environments. For migrating species, such as salmonids that move through multiple habitats, these correlations can amplify the impact of good or poor physical conditions on growth and survival, as movements among habitats may not alleviate effects of anomalous conditions. Unfortunately, identifying the mechanistic drivers of salmon survival in space and time is hindered by these cross-habitat correlations. To address this issue, we modeled the marine survival of Snake River spring/summer Chinook salmon with multiple indices of the marine environment and an explicit treatment of the effect of arrival timing from freshwater to the ocean, and found that both habitats contribute to marine survival rates. We show how this particular carryover effect of freshwater conditions on marine survival varies by year and rearing type (hatchery or wild), with a larger effect for wild fish. As environmental conditions change, incorporating effects from both freshwater and marine habitats into salmon survival models will become more important, and has the additional benefit of highlighting how management actions that affect arrival timing may improve marine survival. [ABSTRACT FROM AUTHOR]

Objective: Current guidelines in British Columbia recommend prenatal screening for hepatitis C antibodies (anti-HCV) if risk factors are present. We aimed to estimate frequency of prenatal anti-HCV testing, new diagnoses, repeated and follow-up testing among BC women. Methods: BC Centre for Disease Control Public Health Laboratory data estimated the number of BC women (assigned female at birth or unknown sex) aged 13–49 who received routine prenatal serological screening (HIV, hepatitis B, syphilis and rubella) from 2008–2019. Anti-HCV tests ordered the same day as routine prenatal screens were considered prenatal anti-HCV tests. Assessment of follow-up was based on HCV RNA and/or genotype testing within one year of new prenatal anti-HCV diagnoses. Results: In 2019, 55,202 routine prenatal screens were carried out for 50,392 BC women. Prenatal anti-HCV tests increased significantly, from 19.6% (9,704/49,515) in 2008 to 54.6% (27,516/50,392) in 2019 (p<0.001). New prenatal anti-HCV diagnoses (HCV positive diagnoses at first test or seroconversions) declined from 14.3% in 2008 to 10.1% in 2019. The proportion of women with new prenatal anti-HCV diagnoses that were a result of a first HCV test declined from 0.3% (29/9,701) in 2008 to 0.03% (8/27,500) in 2019. For women known to be anti-HCV positive at the time of prenatal screening, the proportion who had a prenatal anti-HCV test increased from 35.6% in 2008 to 50.8% in 2019. Conclusion: Prenatal anti-HCV testing increased substantially over the study period. However, new HCV diagnoses remained relatively stable, suggesting that a considerable proportion of BC women with low or no risk are being screened as part of prenatal care. The vast majority of women with new HCV diagnoses receive appropriate follow-up HCV RNA and genotype testing, which may indicate interest in HCV treatment. These findings contribute to the discussion around potential for prenatal anti-HCV screening in an effort to eliminate HCV. [ABSTRACT FROM AUTHOR]

Extensive non-pharmaceutical and physical distancing measures are currently the primary interventions against coronavirus disease 2019 (COVID-19) worldwide. It is therefore urgent to estimate the impact such measures are having. We introduce a Bayesian epidemiological model in which a proportion of individuals are willing and able to participate in distancing, with the timing of distancing measures informed by survey data on attitudes to distancing and COVID-19. We fit our model to reported COVID-19 cases in British Columbia (BC), Canada, and five other jurisdictions, using an observation model that accounts for both underestimation and the delay between symptom onset and reporting. We estimated the impact that physical distancing (social distancing) has had on the contact rate and examined the projected impact of relaxing distancing measures. We found that, as of April 11 2020, distancing had a strong impact in BC, consistent with declines in reported cases and in hospitalization and intensive care unit numbers; individuals practising physical distancing experienced approximately 0.22 (0.11–0.34 90% CI [credible interval]) of their normal contact rate. The threshold above which prevalence was expected to grow was 0.55. We define the "contact ratio" to be the ratio of the estimated contact rate to the threshold rate at which cases are expected to grow; we estimated this contact ratio to be 0.40 (0.19–0.60) in BC. We developed an R package 'covidseir' to make our model available, and used it to quantify the impact of distancing in five additional jurisdictions. As of May 7, 2020, we estimated that New Zealand was well below its threshold value (contact ratio of 0.22 [0.11–0.34]), New York (0.60 [0.43–0.74]), Washington (0.84 [0.79–0.90]) and Florida (0.86 [0.76–0.96]) were progressively closer to theirs yet still below, but California (1.15 [1.07–1.23]) was above its threshold overall, with cases still rising. Accordingly, we found that BC, New Zealand, and New York may have had more room to relax distancing measures than the other jurisdictions, though this would need to be done cautiously and with total case volumes in mind. Our projections indicate that intermittent distancing measures—if sufficiently strong and robustly followed—could control COVID-19 transmission. This approach provides a useful tool for jurisdictions to monitor and assess current levels of distancing relative to their threshold, which will continue to be essential through subsequent waves of this pandemic. [ABSTRACT FROM AUTHOR]

Introduction: British Columbia's (BC) Take-Home Naloxone (THN) program provides naloxone to bystanders for use in cases of suspected opioid overdose. This study seeks to provide trends and analysis from the provincial BC THN program since inception in 2012 to the end of 2018. Materials and methods: BC THN shipment and distribution records from 2012–2018 were retrieved. Frequency distributions were used to describe characteristics of individuals accessing the program. To evaluate correlates of distribution after the addition of hundreds of pharmacy distribution sites, an analytic sample was limited to records from 2018, and multivariate logistic regression was used to evaluate correlates of collecting naloxone at a pharmacy site. Results: Since program inception to the end of 2018, there were 398,167 naloxone kits shipped to distribution sites, 149,999 kits reported distributed, and 40,903 kits reported used to reverse an overdose in BC. There was a significant increasing trend in the number of naloxone kits used to reverse an overdose over time (p<0.01), and more than 90% of kits that were reported used were distributed to persons at risk of an overdose. Individuals not personally at risk of overdose had higher odds of collecting naloxone at a pharmacy site, compared to other community sites (including harm reduction supply distribution sites, peer led organizations, drop-in centers, and supportive housing sites) (Adjusted Odds Ratio (AOR): 2.69; 95% CI: 2.50–2.90). Conclusions: This study documents thousands of opioid overdose reversals facilitated through the BC THN program. While those at highest risk of overdose may preferentially access naloxone through community sites, naloxone distribution through pharmacies has allowed the BC THN program to expand dramatically, increasing naloxone availability through longer opening hours on evenings and weekends. and in rural and remote regions. A diversity of naloxone distribution sites and strategies is crucial to prevent rising opioid overdose deaths. [ABSTRACT FROM AUTHOR]

Background: Nurse turnover is a significant issue and complex challenge for all healthcare sectors and is exacerbated by a global nursing shortage. Nurse-Family Partnership is a community health program for first-time pregnant and parenting girls and young women living in situations of social and economic disadvantage. In Canada, this program is delivered exclusively by public health nurses and only within a research context. The aim of this article is to explore and describe factors that contribute to recruitment, retention, and turnover of public health nurses delivering Nurse-Family Partnership in British Columbia, Canada between 2013 and 2018. Methods: Interpretive description was used to guide sampling, data collection and analytic decisions in this qualitative component drawn from the British Columbia Healthy Connections Project mixed methods process evaluation. Semi-structured, individual interviews were conducted with 28 public health nurses who practiced in and then exited Nurse-Family Partnership. Results: Nurses were motivated to join this program because they wanted to deliver an evidence-based program for vulnerable young mothers that fit with their personal and professional philosophies and offered nurse autonomy. Access to program resources attracted nursing staff, while delivering a program that prioritizes maintaining relationships and emphasizes client successes was a positive work experience. Opportunities for ongoing professional development/ education, strong team connections, and working at full-scope of nursing practice were significant reasons for nurses to remain in Nurse-Family Partnership. Personal circumstances (retirement, family/health needs, relocation, career advancement) were the most frequently cited reasons leading to turnover. Other factors included: involuntary reasons, organizational and program factors, and geographical factors. Conclusions: Public health organizations that deliver Nurse-Family Partnership may find aspects of job embeddedness theory useful for developing strategies for supporting recruitment and retention and reducing nurse turnover. Hiring nurses who are the right fit for this type of program may be a useful approach to increasing nurse retention. Fostering a culture of connectivity through team development along with supportive and communicative supervision are important factors associated with retention and may decrease turnover. Many involuntary/external factors were specific to being in a study environment. Program, organizational, and geographical factors affecting nurse turnover are modifiable. [ABSTRACT FROM AUTHOR]

We explore the possibility of using the varnish (Nutallia obscurata) and Manila (Venerupis philippinarum) clams as biomonitors of microplastics (MPs) pollution. A short review is first provided on the use of bivalves for biomonitoring MPs in aquatic ecosystems. From the conclusions drawn from our review we determine if the sediment dwelling varnish and Manila clam could possibly be good choices for this purpose. We sampled 8 intertidal sites located within two distinct regions of coastal British Columbia, Burrard Inlet (5 sites) and Baynes Sound (3 sites). Each intertidal region had its own particular use; within Burrard Inlet, BMP a heavily used marine park, CP, EB, J, and AP, popular local beaches, and within Baynes Sound, Met and NHB, two intertidal regions heavily exploited by the shellfish industry and RU an intertidal region with limited aquaculture activity. Microfragments were recovered from bivalves collected from all intertidal regions except for AP. Microspheres were recovered primarily from bivalves sampled from Baynes Sound at NHB where high numbers of spheres within sediments had previously been reported. BMP and Met had the highest number of particles present within individual clams which were predominantly high density polyethylene (HDPE) and a polypropylene composite (PPC). Both polymers are extensively used by the shellfish industry in all gear types, as well as in industrial and recreational marine activities. The spatial distribution of recovered MPs was indicative of the anthropogenic use of the intertidal region suggesting these bivalves, for microfragments and microspheres, may be suitable as biomonitors and could prove to be useful tools for determining whether reduction policies for plastics use are having a positive effect on their release into marine environments. [ABSTRACT FROM AUTHOR]

Ecosystem services are impacted through restricting service supply, through limiting people from accessing services, and by affecting the quality of services. We map cumulative impacts to 8 different ecosystem services in coastal British Columbia using InVEST models, spatial data, and expert elicitation to quantify risk to each service from anthropogenic activities. We find that impact to service access and quality as well as impact to service supply results in greater severity of impact and a greater diversity of causal processes of impact than only considering impact to service supply. This suggests that limiting access to services and impacts to service quality may be important and understanding these kinds of impacts may complement our knowledge of impacts to biophysical systems that produce services. Some ecosystem services are at greater risk from climate stressors while others face greater risk from local activities. Prominent causal pathways of impact include limiting access and affecting quality. Mapping cumulative impacts to ecosystem services can yield rich insights, including highlighting areas of high impact and understanding causes of impact, and should be an essential management tool to help maintain the flow of services we benefit from. [ABSTRACT FROM AUTHOR]