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Objective: To help address the high concussion burden in Canadian youth ice hockey, our primary objective was to examine the concurrent validity of youth ice hockey referees' ability to assess head contacts (HCs) and associated penalties using video analysis methods after implementation of the "zero tolerance for HC" policy by Hockey Canada. Study Design: Cross-sectional study. Participants: Certified Level II-III referees in Alberta, Canada. Intervention: A secured online survey with 60 videos (10 to 15 seconds) containing a player-to-player physical contact with or without a HC from elite U15 (ages 13 to 14) youth ice hockey games. OutcomeMeasures: Survey questions were completed by all referees for each video, including (1). 'Did you see a player-toplayer contact?', (2). 'Should a penalty be assessed?', and if yes, (3). 'Which player, penalty type, and penalty intensity?' Referee assessments were compared with a consensus agreement from 2 national and member (top level) gold standard referees for concurrent validity through percent agreement and sensitivity/specificity measures. Results: Complete-case analysis of 100 referees (131 recruited) showed an overall median agreement of 83.5% (sensitivity 5 0.74; specificity 5 0.69) with the gold standard. Agreement with the gold standard was highest for HC infractions [85.1% (sensitivity 50.80; specificity50.69)], followed by HC penalty type (81.5%) and penalty intensity (53.7%). Conclusions: Concurrent validity through percent agreement was high (.80%) compared with the gold standard for identifying both HC and other infractions; however, it was moderate for penalty intensity. Although knowledge of identifying HCs and penalties in this survey was acceptable, this study suggests in-game factors (eg, game management and positioning) may be a primary limitation for HC enforcement. [ABSTRACT FROM AUTHOR]

Children with disabilities were especially vulnerable during the COVID-19 pandemic, and policies designed to mitigate its effects were limited in addressing their needs. We analyzed Canadian policies related to children with disabilities and their families during the COVID-19 pandemic to identify the extent to which these policies aligned with the United Nations Convention on the Rights of Persons with Disabilities (UN CRPD) and responded to their mental health needs by conducting a systematic collection of Canadian provincial/territorial policies produced during the pandemic, building a categorization dictionary based on the UN CRPD, using text mining, and thematic analysis to identify policies' alignment with the UN CRPD and mental health supports. Mental health was addressed as a factor of importance in many policy documents, but specific interventions to promote or treat mental health were scarce. Most public health policies and recommendations are related to educational settings, demonstrating how public health for children with disabilities relies on education and community that may be out of the healthcare system and unavailable during extended periods of the pandemic. Policies often acknowledged the challenges faced by children with disabilities and their families but offered few mitigation strategies with limited considerations for human rights protection. [ABSTRACT FROM AUTHOR]

Background: Heterogeneous studies have demonstrated ethnic inequalities in the risk of SARS-CoV-2 infection and adverse COVID-19 outcomes. This study evaluates the association between ethnicity and COVID-19 outcomes in two large population-based cohorts from England and Canada and investigates potential explanatory factors for ethnic patterning of severe outcomes. Methods: We identified adults aged 18 to 99 years in the QResearch primary care (England) and Ontario (Canada) healthcare administrative population-based datasets (start of follow-up: 24th and 25th Jan 2020 in England and Canada, respectively; end of follow-up: 31st Oct and 30th Sept 2020, respectively). We harmonised the definitions and the design of two cohorts to investigate associations between ethnicity and COVID-19-related death, hospitalisation, and intensive care (ICU) admission, adjusted for confounders, and combined the estimates obtained from survival analyses. We calculated the 'percentage of excess risk mediated' by these risk factors in the QResearch cohort. Results: There were 9.83 million adults in the QResearch cohort (11,597 deaths; 21,917 hospitalisations; 2932 ICU admissions) and 10.27 million adults in the Ontario cohort (951 deaths; 5132 hospitalisations; 1191 ICU admissions). Compared to the general population, pooled random-effects estimates showed that South Asian ethnicity was associated with an increased risk of COVID-19 death (hazard ratio: 1.63, 95% CI: 1.09-2.44), hospitalisation (1.53; 1.32-1.76), and ICU admission (1.67; 1.23-2.28). Associations with ethnic groups were consistent across levels of deprivation. In QResearch, sociodemographic, lifestyle, and clinical factors accounted for 42.9% (South Asian) and 39.4% (Black) of the excess risk of COVID-19 death. Conclusion: International population-level analyses demonstrate clear ethnic inequalities in COVID-19 risks. Policymakers should be cognisant of the increased risks in some ethnic populations and design equitable health policy as the pandemic continues. [ABSTRACT FROM AUTHOR]

A longitudinal study of 31 babies in their twelfth through twenty-third weeks of age tested the Neo-Piagetian theory of a shift or spurt in infants' cognitive development at the age of 4 months. Results were consistent with this neo-Piagetian concept of stage change. (MDM)

Objective: The risk of concussion is high in Canadian youth ice hockey. Aiming to reduce this burden, in 2011, Hockey Canada implemented a national "zero tolerance for head contact (HC)" policy mandating the penalization of any player HC. In 2018 to 2020, Hockey Canada further amended this HC policy including stricter enforcement of severe HCs. This study aimed to compare HC rates, head impact location, and HC enforcement prepolicy, postpolicy, and after policy amendments in elite U15 Canadian youth ice hockey. Design: This is a prospective cohort study. Setting: A collection of events with the video camera located at the highest point near center ice in public ice hockey arenas in Calgary, Alberta. Participants: A convenience sample of 10 AA U15 games prepolicy (2008-2009), 8 games postpolicy (2013-2014), and 10 games after policy amendments (2020-2021). Independent Variables: An analysis of 3 cohort years regarding the HC-policy implementation and amendments. Main Outcome Measures: Using Dartfish video-analysis software, all player contacts and HCs [direct (HC1), indirect (eg, boards, ice) (HC2)] were tagged using validated criteria. Univariate Poisson regression clustering by team-game offset by game length (minutes) was used to estimate incidence rates (IR) and incidence rate ratios (IRR) between cohorts. Results: With additional rule modifications, a 30% reduction in HC1s emerged (IRR2013-2020 = 0.70, 95% CI, 0.51-0.95). Since the HC-policy implementation, HC1s decreased by 24% (IRR2008-2020 = 0.76, 95% CI, 0.58-0.99). The proportion of HC1s penalized was similar across cohorts (P2008-2009 = 14.4%; P2013-2014 = 15.5%; P2020-2021 = 16.2%). Conclusions: The HC-policy amendments have led to decreased HC1 rates. However, referee enforcement can further boost the HC-policy effectiveness. These findings can help future referee training and potential rule modifications to increase player safety nationally. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Surgery is the property of CMA Impact Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim To document current practice by dietitians in Australia and Canada in the nutrition management of Parkinson's disease. This will help identify priority areas for review and development of practice guidelines and direct future research. Methods Current practice in the phases of the Nutrition Care Plan was captured using an online survey distributed to Dietitians Association of Australia members and Practice-Based Evidence in Nutrition subscribers through their email newsletters. The results of the diagnosis, intervention and monitoring phases are presented here. Results Eighty-four dietitians responded. There was consistency in practice for nutrition issues that are encountered in other populations, such as malnutrition and constipation. There was more variation in practice in the nutrition issues that are more specific to Parkinson's disease, such as nutrition and meal interactions with medication. A lack of awareness of emerging treatments, such as deep brain stimulation surgery, appears to exist in the responding dietitians. Conclusions The variation in practice that was present for the nutrition issues specific to Parkinson's disease may reflect the lack of quality evidence and subsequently evidence-based guidelines in these areas. Work to provide background information about treatment options and to translate current evidence for the nutrition issues that are specific to Parkinson's disease into practice recommendations should be completed. [ABSTRACT FROM AUTHOR]

Aim To document and compare current practice in nutrition assessment of Parkinson's disease by dietitians in Australia and Canada in order to identify priority areas for review and development of practice guidelines and direct future research. Methods An online survey was distributed to DAA (Dietitians Association of Australia) members and PEN (Practice-based Evidence in Nutrition) subscribers through their email newsletters. The survey captured current practice in the phases of the Nutrition Care Plan. The results of the assessment phase are presented here. Results Eighty-four dietitians responded. Differences in practice existed in the choice of nutrition screening and assessment tools, including appropriate body mass index ranges. Nutrition impact symptoms were commonly assessed, but information about Parkinson's disease medication interactions was not consistently assessed. Conclusions The variation in practice related to the use of screening and assessment methods may result in the identification of different goals for subsequent interventions. Even more practice variation was evident for those items more specific to Parkinson's disease and may be due to the lack of evidence to guide practice. Further research is required to support decisions for nutrition assessment of Parkinson's disease. [ABSTRACT FROM AUTHOR]

BACKGROUND: Traumatic events often occur in workplace settings and can lead to stress reactions such as Post-Traumatic Stress Disorder (PTSD). One such workplace is the transportation industry, where employees are often exposed to trauma. However, extant research shows that a considerable proportion of people with PTSD do not seek specialty mental health treatment.OBJECTIVE: In this qualitative study, we sought to better understand the experience of a traumatic event at work and the barriers and motivating factors for seeking mental health treatment. PARTICIPANTS: Twenty-nine Toronto Transit Commission (TTC) employees participated in a one-on-one interview, 18 soon after the traumatic event and 11 after entering a specialized treatment program. METHODS: Semi-structured, one-on-one interviews were conducting using qualitative description and analyzed using content analysis. RESULTS: Participants described emotional responses after the trauma such as guilt, anger, disbelief as particularly difficult, and explained that barriers to seeking help included the overwhelming amount and timing of paperwork related to the incident as well as negative interactions with management. Motivating factors included family and peer support, as well as financial and emotional issues which persuaded some to seek help. CONCLUSIONS: Seeking treatment is a multifactorial process. Implications and recommendations for the organization are discussed. [ABSTRACT FROM AUTHOR]

This article interrogates and historicises the positioning of polygamy in current Australian politico-legal discourse, using the example of the two federal government inquiries into the 2009 and 2012 'marriage equality' bills. It problematises the political and cultural presumption that polygamy is inherently immoral by arguing that this presumption is premised on the racialisation of polygamy as an (oppressive) Islamic practice. I will argue that this practice of racialisation can be utilised in the process of border maintenance-preventing the entry of undesirable (i.e. non-Western) immigrants. I will first situate polygamy in a historical context by drawing on the history of the legal status of polygamy in Australian law, which is largely based on British legal precedent. This Australian context will then be compared with the development of the law in Canada, which followed a different trajectory from its similarly British common law beginnings. Finally, I will demonstrate how recent events such as 'the War on Terror' have led to increased border maintenance in Australia, which in turn has shifted the political characterisation of polygamy closer to the Canadian approach. [ABSTRACT FROM AUTHOR]

Background Psychological morbidity following trauma occurring in the workplace can impact return to work but few studies have investigated this. Methods This study was a secondary analysis of administrative data from a specialized workers' compensation board psychological trauma program in Toronto, Canada. Unadjusted and adjusted logistic regression analyses were used to examine factors associated with working status at the time of assessment for workers referred within 1 year of traumatic event. Results Having a disrupted marriage (OR = 3.06, 95% CI 1.14-8.20), sustaining a permanently impairing physical injury (OR = 2.76, 95% CI 1.01-7.55) and the presence of secondary psychiatric diagnoses (OR = 2.55, 95% CI 1.34-4.83) were significantly associated with not working at the time of assessment. When the analyses were subset to workers without permanently impairing physical injuries, only the presence of additional psychiatric diagnoses was significantly associated with not working (OR = 3.81, 95% CI 1.48-9.83). Conclusions Return to work after trauma can be a complicated and difficult to treat problem. Social supports, physical rehabilitation and treatment of complex mental health problems likely play a crucial role in improving outcomes [ABSTRACT FROM AUTHOR]

At present, four organizations serve biologists in Alberta: The Alberta Chapter of the Wildlife Society (ACTWS), The Alberta Native Plants Council (ANPC), The Alberta Society of Professional Biologists (ASPB), and The Canadian Society of Environmental Biologists (CSEB). Only the ASPB is a professional regulatory organization, two of the others (CSEB and ACTWS) have their origins in the Canadian Society of Wildlife and Fisheries Biologists (CSWFB) while ANPC is a non-regulatory society with independent origin. A fifth organization, the Canadian Chapter of Society for Conservation Biology, is being organized through initiatives resulting from the 24th International Congress for Conservation Biology, held in Edmonton in July 2010. Its role in Canada is not yet defined. The first biological society to function in Alberta was a chapter of The Canadian Society of Wildlife and Fisheries Biologists (CSWFB). After 10 years this organization morphed into the CSEB when the hopes of creating a professional status faded. This change forced the CSPB towards forming a professional voice on resource use, and towards a communication medium for biological resource management. Biological consulting firms proliferated in the late 1960s and early 1970s, coinciding with provincial and federal governments forming departments of the environment. Pressures from these events created a perceived need by some biologists for a self-regulating, professional organization, which comes under provincial jurisdiction. To this end, the Alberta Society of Professional Biologists (ASPB) formed in 1975, and in 1991 received its Professional Biologist title status (P.Biol.) for members under the Societies Act of Alberta. The Alberta Chapter of The Wildlife Society (ACTWS) was formed in 1989; its focus was on research, science and wildlife management. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Tax Journal / Revue Fiscale Canadienne is the property of Canadian Tax Foundation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper describes the framework of the StatCan Daily Translation Extraction System (SDTES), a computer system that maps and compares web-based translation texts of Statistics Canada (StatCan) news releases in the StatCan publication The Daily. The goal is to extract translations for translation memory systems, for translation terminology building, for cross-language information retrieval and for corpus-based machine translation systems. Three years of officially published statistical news release texts at http://www.statcan.ca were collected to compose the StatCan Daily data bank. The English and French texts in this collection were roughly aligned using the Gale-Church statistical algorithm. After this, boundary markers of text segments and paragraphs were adjusted and the Gale-Church algorithm was run a second time for a more fine-grained text segment alignment. To detect misaligned areas of texts and to prevent mismatched translation pairs from being selected, key textual and structural properties of the mapped texts were automatically identified and used as anchoring features for comparison and misalignment detection. The proposed method has been tested with web-based bilingual materials from five other Canadian government websites. Results show that the SDTES model is very efficient in extracting translations from published government texts, and very accurate in identifying mismatched translations. With parameters tuned, the text-mapping part can be used to align corpus data collected from official government websites; and the text-comparing component can be applied in prepublication translation quality control and in evaluating the results of statistical machine translation systems. [ABSTRACT FROM AUTHOR]

This article focuses on the Atlas of North American English: Phonetics, Phonology, and Sound Change. The Linguistic Atlas of the U.S. and Canada had been conceived in 1929 and had produced numerous substantial reports on the phonetics and phonology of American English, but there had been no national survey. Furthermore, the fieldwork of the Linguistic Atlas projects had been conducted over a period of time long enough that no one sample of American dialects could be claimed. The goal of ANAE was to sample the entire population of North American urban speakers of English within a short time, so as to obtain a snapshot of all of North American English. Over the years, the interview schedule was revised, and variants were developed to target the variables of interest in different regions: the Midwest, the Northeast, the East, the South, the West, and Canada. Recording techniques were updated to digital tape recorders rather than open-reel. About 850 speakers were recorded in all, and acoustic analysis of the vowel systems was carried out for 439 speakers. The last speaker was interviewed in November 2001, less than a decade after the first interview. For the pilot project, the sample was stratified by population of the town, from those of more than a million down to those of 2,000 to 10,000. As the project expanded, however, the target was limited to urban dialects: those places defined by the Census Bureau as Urbanized Areas, with a population over 50,000.

Purpose/goals: The purpose of this session is to discuss ways in our quickly changing and demanding environments, that we can use the principles of quality improvement and the core components of our accreditation standards, to support everyday best practice. We will share our experience implementing a practice change, ICU early mobility. We will explain how this single intervention has been used as an integrating strategy for critical care best practice. Outcome 1: Describe how Accreditation Canada Standards can be used in quality improvement to support best practice. Outcome 2: Describe how change can be supported by melding the key components of best practice into a manageable overarching intervention, ICU Early Mobility. Outcome 3: Describe how both formal leadership and frontline inter-professional leadership are essential to shift the culture of care. Session description: Sometimes it feels like our work life can be one big test of our juggling skills: keeping abreast of practice changes, ensuring our daily work aligns with organizational and Accreditation Canada Standards, and meeting the everyday operational demands of hectic Intensive Care Units (ICUs). Over the past five years, our ICUs have strategically developed solutions to mitigate some of this chaos, by adopting an integrated approach to quality improvement. We would like to share some of what we have learned by embedding core Accreditation Canada components into manageable change (Accreditation Canada, 2017), weaving it into daily practice; in this manner, it becomes second nature. During the recent Accreditation Canada Survey visit, we were strongly encouraged to ‘rapidly and aggressively' share our approach with others; how we implemented our early mobility program into daily practice, and how this intervention evolved into an ‘integrating strategy' for critical care best practices. In this presentation, we will outline our key strategies for a goal-directed approach to quality improvement; incorporation of the Accreditation Canada Standards into everyday quality improvement and everyday practice; leveraging the knowledge and leadership capacity of our inter-professional ICU team to support positive change; maintaining a firm commitment to evidence-based practice; and designing and implementing a quality improvement role (Quality Leader) with citical care content knowledge. One of our chief interventions has been to shift our ICU culture to one where early mobility in the ICU is a standard of care, i.e., a paradigm shift from ‘too sick to move’ to ‘too sick to NOT move’. Early mobility is the single most effective intervention to mitigate ICU delirium and its inherent morbidity and mortality (Barr et al„ 2013; http://icudelirium.org). As an integrating strategy, early mobility pulls together key care components: sedation best practices (analgesia first approach, sedating to target, spontaneous awakening and spontaneous breathing trials), delirium awareness and mitigation, family engagement and empowerment, pressure injury prevention, venous thromboembolism prevention, and ventilator-associated pneumonia prevention. Please join us, as we share our story of change; a story of perseverance, teamwork, and learning. [ABSTRACT FROM AUTHOR]

Objectives: To examine factors associated with rates of game and practice-related concussion in youth ice hockey. Design: Five-year prospective cohort (Safe2Play). Setting: Community arenas (2013-2018). Participants: Four thousand eighteen male and 405 female ice hockey players (6584 player-seasons) participating in Under-13 (ages 11-12), Under-15 (ages 13-14), and Under-18 (ages 15-17) age groups. Assessment of Risk Factors: Bodychecking policy, age group, year of play, level of play, previous injury in the previous year, lifetime concussion history, sex, player weight, and playing position. Main Outcome Measurements: All game-related concussions were identified using validated injury surveillance methodology. Players with a suspected concussion were referred to a study sport medicine physician for diagnosis and management. Multilevel Poisson regression analysis including multiple imputation of missing covariates estimated incidence rate ratios (IRRs). Main Results: A total of 554 game and 63 practice-related concussions were sustained over the 5 years. Female players (IRRFemale/Male51.79; 95% CI: 1.26-2.53), playing in lower levels of play (IRR51.40; 95% CI: 1.10-1.77), and those with a previous injury (IRR51.46; 95% CI: 1.13, 1.88) or lifetime concussion history (IRR 5 1.64; 95% CI: 1.34-2.00) had higher rates of game-related concussion. Policy disallowing bodychecking in games (IRR50.54; 95% CI: 0.40-0.72) and being a goaltender (IRRGoaltenders/Forwards50.57; 95% CI: 0.38-0.87) were protective against game-related concussion. Female sex was also associated with a higher practice-related concussion rate (IRRFemale/Male 5 2.63; 95% CI: 1.24-5.59). Conclusions: In the largest Canadian youth ice hockey longitudinal cohort to date, female players (despite policy disallowing bodychecking), players participating in lower levels of play, and those with an injury or concussion history had higher rates of concussion. Goalies and players in leagues that disallowed bodychecking had lower rates. Policy prohibiting bodychecking remains an effective concussion prevention strategy in youth ice hockey. [ABSTRACT FROM AUTHOR]

Calls attention to the unauthorized Canadian printings in the early 1880s of two of Mark Twain's sketches. Unauthorized publication of the French translation of 'The Prince and the Pauper,' in 'L'Opinion Publique'; Discrepancy between the pirated Canadian edition of Twain's 'Memoranda' sketches in the 'Galaxy' entitled 'Mark Twain's Memoranda' and the authorized printings by Twain.

Objective: Ringette and female ice hockey are high participation sports in Canada. Despite policies disallowing body checking, both sports have high injury and concussion rates. This study aimed to compare physical contact (PC), head contact (HC), and suspected injury and concussion incidence rates (IRs) in female varsity ringette and ice hockey. Design: Cross-sectional. Setting: Canadian ice arenas. Participants: Eighteen Canadian female university ringette and ice hockey tournament/playoff games in the 2018-2019/2019-2020 seasons. Assessment of Risk Factors: Game video-recordings were analyzed using Dartfish video-analysis software to compare both sports. Main Outcome Measures: Univariate Poisson regression analyses (adjusted for cluster by team, offset by game-minutes) were used to estimate PC, HC, and suspected injury IRs and incidence rate ratios (IRRs) to compare rates across sports. Proportions of body checks (level 4-5 trunk PC) and direct HC (HC1) penalized were reported. Results: Analyses of 36 team-games (n = 18 ringette, n = 18 hockey) revealed a 19% lower rate of PCs in ringette than ice hockey {IRR = 0.81 [95% confidence interval (CI), 0.73-0.90]}, but a 98% higher rate of body checking [IRR = 1.98 (95% CI, 1.27-3.09)] compared to ice hockey. Ringette had a 40% higher rate of all HC1s [IRR = 1.40 (95% CI, 1.00-1.96)] and a 3-fold higher rate of suspected injury [IRR = 3.11 (95% CI, 1.13-8.60)] than ice hockey. The proportion of penalized body checks and HC1s were low across sports. Conclusions: Body checking and HC1 rates were significantly higher in ringette compared to ice hockey, despite rules disallowing both, and very few were penalized. These findings will inform future injury prevention research in ringette and female ice hockey. [ABSTRACT FROM AUTHOR]

The article presents the Canadian microelectromechanical systems (MEMS) research, which was published in the Canadian Journal of Electrical and Computer Engineering. Novel technologies and real-world applications are being accomplished by Canadian researchers. The published research was a follow-up of the 2005 Canadian Workshop on MEMS, organized by the Canadian Microelectronics Corporation on August 19, 2005.

Introduction: The COVID-19 pandemic brought unprecedented challenges for youth with neurodevelopmental disabilities (NDD) and their families. Although health measures were implemented to contain the COVID-19 virus, they disrupted public service, profoundly impacting youth and their families' access to services. This study sought to better understand the perspectives and experiences of parents and caregivers of youth with NDD across Canada in accessing services and their mental health needs during the pandemic., Method: The study used a qualitative research design in which we interviewed 40 parents and caregivers across Canada., Results: The results enabled us to understand the impact of service disruptions in significant areas of life, including health, education, employment, and risk mitigation., Discussion: Policymakers must consider a disability-inclusive lens during public health emergency planning and response to reduce the disproportionate impacts faced by youth with NDD and their families., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: To determine the efficacy and safety of sildenafil citrate to improve outcomes in pregnancies complicated by early-onset, dismal prognosis, fetal growth restriction (FGR). Eligibility: women ≥ 18 years, singleton, 18 + 0-27 + 6 weeks' gestation, estimated fetal weight < 700 g, low PLFG, and ≥ 1 of (i) abdominal circumference < 10th percentile for gestational age (GA); or (ii) reduced growth velocity and either abnormal uterine artery Doppler or prior early-onset FGR with adverse outcome. Ineligibility criteria included: planned termination or reversed umbilical artery end-diastolic flow. Eligibility confirmed by placental growth factor (PLGF) < 5 th percentile for GA measured post randomization. Women randomly received (1:1) either sildenafil 25 mg three times daily or matched placebo until either delivery or 31 + 6 weeks., Primary Outcome: delivery GA. The trial stopped early when Dutch STRIDER signalled potential harm; despite distinct eligibility criteria and IRB and DSMB support to continue, because of futility. NCT02442492 [registered 13/05/2015]., Results: Between May 2017 and June 2018, 21 (90 planned) women were randomised [10 sildenafil; 11 placebo (1 withdrawal)]. Baseline characteristics, PLGF levels, maternal and perinatal outcomes, and adverse events did not differ. Delivery GA: 26 + 6 weeks (sildenafil) vs 29 + 2 weeks (placebo); p = 0.200. Data will contribute to an individual participant data meta-analysis., (© 2022. The Author(s).)

Purpose: A preliminary survey of pediatric neurosurgeons working at different centers around the world suggested differences in clinical practice resulting in variation in the risk of pediatric cerebellar mutism (CM) and cerebellar mutism syndrome (CMS) after posterior fossa (PF) tumor resection. The purposes of this study were (1) to determine the incidence and severity of CM and CMS after midline PF tumor resection in children treated at these centers and (2) to identify potentially modifiable factors related to surgical management (rather than tumor biology) that correlate with the incidence of CM/CMS., Methods: Attending pediatric neurosurgeons at British Columbia's Children's Hospital (BCCH) and neurosurgeons who completed a pediatric neurosurgery fellowship at BCCH were invited to provide data from the center where they currently practiced. Children aged from birth to less than 18 years who underwent initial midline PF tumor resection within a contemporary, center-selected 2-year period were included. Data was obtained by retrospective chart and imaging review. Modifiable surgical factors that were assessed included pre-resection surgical hydrocephalus treatment, surgical positioning, ultrasonic aspirator use, intraoperative external ventricular drain (EVD) use, surgical access route to the tumor, and extent of resection. CM was defined as decreased or absent speech output postoperatively and CMS as CM plus new or worsened irritability., Results: There were 263 patients from 11 centers in 6 countries (Canada, Germany, the Netherlands, India, Indonesia, and the USA). Median age at surgery was 6 years (range < 1 to 17 years). The overall incidence of postoperative CM was 23.5% (range 14.7-47.6% for centers with data on ≥ 20 patients). The overall incidence of CMS was 6.5% (range 0-10.3% for centers contributing data on ≥ 20 patients). A multivariate logistic regression on the full data set showed no significant association between pre-resection surgical hydrocephalus treatment, prone position, ultrasonic aspirator use, EVD use, telovelar approach, complete or near total resection, or treating center and either postoperative CM or CMS., Conclusions: While there was variation in surgical management of midline PF tumors among centers participating in this study, the factors in management that were examined did not predict postoperative CM or CMS.

Background: The Institute of Medicine calls for the use of clinical guidelines and practice parameters to promote "best practices" and improve patient outcomes. In 2006, The Trauma Association of Canada Pediatric Committee set out to create an evidence-based, national pediatric cervical spine (c-spine) clearance guideline based on the literature, existing algorithms from each pediatric trauma center and from expert opinion from across Canada., Methods: A review of the literature took place in September 2006 using the PubMed database. Search criteria were "cervical spine," "c-spine," "clearance," and "trauma." Limits that were applied were "Languages: English," "Humans," "Type of Article: Meta-Analysis, Practice Guidelines, Randomized Control Trial, Review," and "Ages: all child 0-18 years." These search criteria were repeated in December 2007, April 2009, and October 2009. A total of 248 articles were identified. Existing guidelines were identified and their practices examined as models of care. Two draft guidelines were created for discussion: one for the pediatric patient with a reliable clinical examination and the other for the pediatric patient with an unreliable clinical examination. Via email, telephone, and two national videoconferences, the content of the guidelines was reviewed, discussed, and amended. The final article was prepared and circulated for author input until consensus was reached., Results: A consensus was reached on two pathways to evaluate the pediatric cervical spine: a patient with a reliable clinical examination and a patient with an unreliable examination., Conclusion: Presented herein are the consensus Trauma Association of Canada, National Pediatric Cervical Spine Evaluation Pathways for the patient with a reliable clinical examination, and the patient with and unreliable clinical examination.

Objective: Digital ulcers are a common complication of systemic sclerosis (SSc; scleroderma). Approximately half of SSc patients have had a digital ulcer, but information is lacking on whether digital ulcers are associated with patient demographics and clinical outcomes. We wanted to determine the associations between digital ulcers and other SSc vascular complications and organ involvement., Methods: Data from the Canadian Scleroderma Research Group are collected annually on SSc patients, including presence, location, and number of digital ulcers; complications from digital ulcers; internal organ involvement; skin score; and laboratory results. Correlation coefficients, chi-square test, and logistic regression modeling were done to determine the associations of digital ulcers with other factors, including internal organ complications., Results: A total of 938 patients were included; 86% were women, the mean age was 55 years, the mean disease duration was 13.6 years, and 50% had limited cutaneous SSc. Eight percent had a digital ulcer currently and 44% had a digital ulcer ever; 53.1% had digital pitting scars. Digital ulcers were associated with increased modified Rodnan skin score (P = 0.0001), hand and finger skin score (P = 0.0001), Health Assessment Questionnaire score (P = 0.0001) and disease duration (P = 0.001), younger age of SSc onset (P = 0.0001), interstitial lung disease (ILD; P = 0.0001), and topoisomerase I (Scl-70) antibodies (P = 0.0001) in limited and diffuse cutaneous SSc subsets. Digital ulcers were not associated with sex (P = 0.95), smoking (P = 0.9), pulmonary arterial hypertension (PAH; P = 0.35), and scleroderma renal crisis (SRC; P = 0.569). Digital ulcers were further associated with reduced diffusing capacity for carbon monoxide (DLCO; P = 0.0001) and esophageal involvement (P = 0.0001) in diffuse cutaneous SSc only., Conclusion: Digital ulcers are associated with worse disease, including skin and lung involvement, but are not associated with PAH and SRC. However, the low DLCO that is associated with SRC could represent ILD or microvasculopathy., (Copyright © 2011 by the American College of Rheumatology.)

Within a remote Canadian Indigenous community, at least 11* of people had antibodies against Echinococcus granulosus and E. granulosus eggs were detected in 6* of environmentally collected canine fecal samples. Dog ownership, hunting, and trapping were not risk factors for seropositivity, suggesting that people are most likely exposed to E. granulosus through indirect contact with dog feces in the environment. In this situation, human exposure could be most effectively curtailed by preventing consumption of cervid viscera by free-roaming dogs.

There has been considerable interest recently in the relationship between depression and the workplace. This interest is driven by the growing recognition that depressive disorders are highly prevalent in the workplace and have an enormously negative impact on performance, productivity, absenteeism, and disability costs. A variety of clinical research with occupational-related samples has helped to define those at risk for depression and has led to a better understanding of the overlap of the construct of clinical depression with more longstanding occupational health and organizational psychology models such as stress, burnout, and job satisfaction. From an employer perspective, depression's impact remains largely unmitigated due to stigma, uncertainty about treatment's cost effectiveness, and lack of effective interventions delivered in a workplace setting. Progress in these areas is reviewed with suggestions for future directions.