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The 2016 Alberta wildfires resulted in widespread destruction of property and displacement of residents. Research aimed to identify the roles and responsibilities of social work practitioners and human service professionals in long-term disaster recovery. This article presents the findings from interviews, focus groups, and a survey with a total of 140 participants in Alberta, Canada. Implications for disaster social work planning, and response and recovery efforts in Canada and internationally, will inform the development of programs and policies to support and make visible the contribution of social workers and human service professionals in long-term disaster recovery. [ABSTRACT FROM AUTHOR]

Slovenian missionaries working in the United States of America, because of their knowledge of Indian languages, also took up missionary tasks among Native American tribes in the Canadian province of Ontario. They were asked to do so by the Canadian bishops. The Native Americans also used books prepared by Slovenian missionaries. The aim was to establish contacts at the level of the development of religious life, the creation of church structures, and the incorporation into the life of the Native American tribes of elements which the missionaries understood as an expression of the improvement of their living conditions and the assertion of their rights as an ethnic community. The contribution of Slovenian missionaries is still commemorated today in some cultural and religious monuments and printed material, as well as in commemorative events. [ABSTRACT FROM AUTHOR]

Older adults are significantly impacted by natural hazards and disasters that are exacerbated by climate change. Understanding their awareness and preparedness is essential for enhancing disaster resilience. This study investigated the attitudes, actions, and recommendations of older adults regarding natural hazards that pose risks in their geographic area—specifically floods, wildfires, and/or earthquakes in Canada. Methods for this study included survey and focus groups with older adults (n = 161 and n = 10, respectively) and other high-risk groups from across Canada, that are vulnerable to these natural hazards. The main findings from this study are that current awareness and preparedness among older adults is low, though stronger perceptions of risks are associated with risks specific to geographic locations where respondents live. Several barriers, such as hazard vulnerability misperceptions, cost-related reasons, and lack of hazard awareness have resulted in low awareness and preparedness among these populations. The two main recommendations arising from this research are: (1) improve awareness and preparedness with tailor-made emergency preparedness materials for older adults; and (2) adopt community-based approaches to disaster preparedness through existing community groups to strengthen social connections with a focus on locally specific hazards. The findings from this research can be applied to other hazards, including heatwaves and pandemics. [ABSTRACT FROM AUTHOR]

The purpose of this study is to empirically investigate the relationship between the self-regulatory variable of goal orientation and the extent to which job seekers reach out to and use weak ties in their job search. Weak ties, as defined by Granovettor, are connections to densely knit networks outside the individual's direct contacts who could provide nonredundant information. The study builds on the previous conceptual work that discussed how learning and performance goal orientation, as a part of a larger system of self-regulatory variables, may affect the extent to which individuals seek feedback and network during job search. Using a sample of Canadian job seekers, this study examines whether learning goal-oriented individuals contact weak ties more often than performance goal-oriented individuals. The results indicate that both performance and learning goal orientation are significant predictors of weak tie counts.

The study of the adoption of activities to protect the natural environment has tended to focus on the role of organizational fields. This article advances existing research by simultaneously examining conflicting processes that operate in nested organizational fields at local, national and supra-national levels. It examines the recent spread of an environmental program for reducing emissions of greenhouse gases among local governments in three countries: United States, Canada and Australia. Qualitative data is used to identify the main factors that contribute to municipalities' decision to adopt this program, while event history analysis is used to test hypotheses regarding the effect of local governments' attributes, as well as of ties to state and global associations. Results show that widespread adoption of this environmental program is contingent on the development of national change agencies. (Contains 1 figure, tables and 24 notes.)

Canadians have expressed concern that access to family physicians (FP) has declined. Anonymized physician services data for 1991/1992 to 2000/2001 were used to evaluate changes in supply and age-specific rates of use of FPs and specialists in Winnipeg, Manitoba. Physician-to-population ratios declined 7.5 per cent, FP-to-population ratios declined 4.8 per cent, and specialist-to-population ratios declined 10.0 per cent. Among the general population, FP visit rates declined 3 per cent. Among older adults, physician visit rates increased 2.3 per cent, FP visit rates increased 10.9 per cent, and specialist visit rates declined 15.7 per cent. By comparison, we document declines in FP use by those younger than 5 years (25.5%) and those 6 to 19 years of age (18.6%). Increases in FP and declines in specialist use occurred primarily among those aged 65 to 84 years. By 2000/2001 older adults accounted for 25 per cent of all FP encounters. Gains in FP use among older adults was less attributable to the presence of more seniors and more related to the fact that a higher proportion of them are visiting a FP each year and, potentially, substituting primary for secondary care.

The COVID-19 pandemic had a profound impact on transit ridership around the world, including in Metro Vancouver, Canada. The regional transit agency there, TransLink, faced the challenge of not only tackling the sudden revenue loss but also ensuring the safety and comfort of its riders that could be affected by crowding. As the tide of restrictions subsided, and riders are gradually coming back to public transport, their feelings of safety and comfort must be ensured so that they do not deflect to other modes. To guide TransLink and agencies alike in this process, this study aimed to understand the factors that affected the decision to board a bus and level of comfort of riding it for different behavioral classes of transit riders before and during the COVID-19 pandemic. It employed a classification of transit riders based on their attitudes towards personal safety and flexibility both before and during the COVID-19 pandemic and investigated the effect of crowding on their decision to board and the comfort of boarding a bus at various crowding levels. The findings of this study are expected to guide the development of relevant policy interventions that can engage diverse groups of riders to continue using transit in a way that is convenient, comfortable, and safe for them. • Six behavioral classes were identified based on riders' sentiment towards crowding and flexibility when commuting to and from work or education. • Riders who are more concerned with crowding are less likely to board a bus in general, and this remains true with the increase in the level of crowding during the COVID-19 pandemic. • Compared to December 2020, all riders were more likely to board a bus in May 2021 (likely due to the drop in hospitalizations and uptake in vaccination). • Members of all behavioral classes are less likely to feel comfortable as the crowding level onboard increases, however, the disutility of riders in the high concern classes (with both low and high flexibility) is significantly larger. [ABSTRACT FROM AUTHOR]

This paper describes the challenges that were encountered during the collection of Sustainable Development Goal (SDG) indicators for water (SDG 6), energy (SDG 7), and food (SDG 2) security in northern Canada. Our findings indicate only 49% of indicator data were publicly available, while 21% had to be calculated using alternative sources or methods, 18% had to be replaced with proxy indicators for which data were available, and 12% of indicators were deemed unavailable entirely. The most common types of data challenges were associated with completeness, timeliness, and granularity. Given the current challenges faced by residents of northern Canada, with their livelihoods closely intertwined with the accessibility and availability of water, energy and food (WEF) resources, a comprehensive plan for data collection, storage, and management of WEF-related SDGs is required to advance WEF security from an aspirational to a transformative policy agenda. [ABSTRACT FROM AUTHOR]

In this paper we present the results from a systematic literature review of subsistence research that was conducted in northern Canada between 1950 and 2019. Our analysis identified trends in subsistence research, including the breadth of research topics, influential scholars and scholarship, and the emergence of research networks. Our results identified 245 publications authored by a multidisciplinary network of 365 scholars. Research conducted through ArcticNet and the International Polar Year is responsible for 75% (n = 183 of 245) of all subsistence-related publications during this period. Subsistence publications cover a wide range of topics, including climate change, nutrition, and wildlife management, but Indigenous food culture and the roles of women in subsistence have received comparatively less scholarly attention. Given the profound changes occurring in northern Canada, whether a result of anthropogenic or non-anthropogenic disturbances, greater attention to the cultural and gendered dimensions of subsistence will be particularly valuable to northern scholarship and the public policies it can inform. This attention will be increasingly necessary in a time when critical thinking about the future of subsistence in northern Canada is of critical need. [ABSTRACT FROM AUTHOR]

Background: Currently, in Canada, existing health administrative data and hospital-inputted portal systems are used to measure the wait times to receiving a procedure or therapy after a specialist visit. However, due to missing and inconsistent labelling, estimating the wait time prior to seeing a specialist physician requires costly manual coding to label primary care referral notes. Methods: In this work, we represent the notes using word-count vectors and develop a logistic regression machine learning model to automatically label the target specialist physician from a primary care referral note. These labels are not available in the administrative system. We also study the effects of note length (measured in number of tokens) and dataset size (measured in number of notes per target specialty) on model performance to help other researchers determine if such an approach may be feasible for them. We then calculate the wait time by linking the specialist type from a primary care referral to a full consultation visit held in Ontario, Canada health administrative data. Results: For many target specialties, we can reliably (F1Score ≥ 0.70) predict the target specialist type. Doing so enables the automated measurement of wait time from family physician referral to specialist physician visit. Of the six specialties with wait times estimated using both 2008 and 2015 data, two had a substantial increase (defined as a change such that the original value lay outside the 95% confidence interval) in both median and 75th percentile wait times, one had a substantial decrease in both median and 75th percentile wait times, and three has non-substantial increases. Conclusions: Automating these wait time measurements, which had previously been too time consuming and costly to evaluate at a population level, can be useful for health policy researchers studying the effects of policy decisions on patient access to care. [ABSTRACT FROM AUTHOR]

Background: Canadians are known to be frequent users of emergency department (ED) care. However, the exchange of information from ED visits to family physicians (FPs) is not well known. Our objectives were to determine whether Canadian FPs received information about their patient's ED visit and the patient characteristics related to the receipt of ED information. Methods: This study was a descriptive record linkage study of FP Electronic Medical Record (EMR) data linked to health administrative data. Our study cohort included patients who had at least one ED visit in 2010 or 2015 in Ontario, Canada. An ED visit could include a transfer to or from another ED. The receipt of information from an ED note was examined in relation to patient age, sex, neighbourhood income quintiles, rurality and comorbidity. Results: There were 26,609 patients in 2010 and 50,541 patients in 2015 with at least one ED visit. In 2010, 53.3% of FPs received an ED note for patients having a single ED visit compared to 41.0% in 2015. For patients with multiple ED visits, 58.2% of FPs received an ED note in 2010 compared to 45.7% in 2015. FPs were more likely to receive an ED note for patients not living in low income neighbourhoods, older patients, patients living in small urban areas and for patients having moderate comorbidity. FPs were less likely to receive a note for patients living in rural areas. Conclusions: Community-based FPs are more likely to get information after an ED visit for their older and sicker patients. However, FPs do not receive any information from EDs for over half their patients. Electronic health record technologies and their adoption by ED providers need to improve the seamless transfer of information about the care provided in EDs to FPs in the community. [ABSTRACT FROM AUTHOR]

Climate change challenges agricultural production in Eastern Canada by affecting water resource availability. Farmers' adoption of improved water management practices and technologies can play an important part in the region's climate change adaptation strategy. To facilitate the diffusion of agricultural beneficial management practices (BMPs), it is essential to examine the factors that influence farmers' decision-making, and the barriers and facilitators of adoption. While determinants of adoption have been studied extensively, past research suggests that they are context dependent and that a gap exists in relation to understanding how BMP characteristics are perceived and how they shape adoption. Therefore, this article identifies some of the key factors in the adoption of improved water management systems in Ontario and Québec by focusing on differences between adopters and non-adopters. This study uses data from a survey of 70 fruit and vegetable growers. Results show that Canadian growers find important being good stewards of the land – being interested in minimizing their farms' impact on the environment and making good use of scarce resources. Farmers also believe society should help support the costs associated with safeguarding the environment. Growers interested in adopting the BMPs were likely to have less farming experience, diverse farming goals, higher educational attainment, and a higher degree of specialization in the production of tomatoes, cranberries or onions. While the majority of growers perceived the BMPs to be profitable, a better alternative and having capacity to reduce water use and improve yields, growers not interested in adopting these BMPs identified several issues that in their view act as barriers – initial cost of investment, and market instability. Policy responses aimed at enhancing diffusion of the BMPs, can be better targeted on priority regions and growers, incorporating in their communication strategy messages that resonate with growers' needs and take note of concerns they raise. • SBasd on a a survey of 70 fruit and vegetable growers n eastern Canada. • Farmers believed society should support costs of safeguarding environment. • BMPs were conveived as profitable, and have capacity to reduce water use. • Initial cost of investment, and market instability identified as barriers to adoption. [ABSTRACT FROM AUTHOR]

Cardioaortic embolism to the brain accounts for approximately 15–30% of ischaemic strokes and is often referred to as 'cardioembolic stroke'. One-quarter of patients have more than one cardiac source of embolism and 15% have significant cerebrovascular atherosclerosis. After a careful work-up, up to 30% of ischaemic strokes remain 'cryptogenic', recently redefined as 'embolic strokes of undetermined source'. The diagnosis of cardioembolic stroke remains difficult because a potential cardiac source of embolism does not establish the stroke mechanism. The role of cardiac imaging—transthoracic echocardiography (TTE), transoesophageal echocardiography (TOE), cardiac computed tomography (CT), and magnetic resonance imaging (MRI)—in the diagnosis of potential cardiac sources of embolism, and for therapeutic guidance, is reviewed in these recommendations. Contrast TTE/TOE is highly accurate for detecting left atrial appendage thrombosis in patients with atrial fibrillation, valvular and prosthesis vegetations and thrombosis, aortic arch atheroma, patent foramen ovale, atrial septal defect, and intracardiac tumours. Both CT and MRI are highly accurate for detecting cavity thrombosis, intracardiac tumours, and valvular prosthesis thrombosis. Thus, CT and cardiac magnetic resonance should be considered in addition to TTE and TOE in the detection of a cardiac source of embolism. We propose a diagnostic algorithm where vascular imaging and contrast TTE/TOE are considered the first-line tool in the search for a cardiac source of embolism. CT and MRI are considered as alternative and complementary tools, and their indications are described on a case-by-case approach. [ABSTRACT FROM AUTHOR]

A factor that has long complicated the enactment of conservation policies in Canada is that First Nations harvesting data are often missing or incomplete. Consequently conservation policies are based on population estimates that First Nations often regard as excessively precautionary and economically, politically, and racially motivated. We present the results of a regional study documenting the extent to which First Nations households from 13 First Nations communities in the Peace River region of British Columbia and Alberta participate in subsistence moose (Alces alces) hunting. Since the 1990s, the moose population in the Peace River region has exhibited episodic decline. This is a particular concern to First Nations who depend on moose as their primary source of wild food and a critical component of their culture and identity. First Nations leaders are now calling upon provincial governments to engage with them directly in a form of collaborative conservation that can build trust, cross-cultural competencies, and the co-production of new knowledge that can inform conservation policies that protect rather than restrict First Nation subsistence rights. [ABSTRACT FROM AUTHOR]

Examines a high school literature censorship case, and challenges the assumption that values can be "absorbed" through emotional engagement with a "transparent" text. Concludes with guidelines for avoiding indoctrination by viewing literature as the construction of fictional worlds whose values are decoded by calculated acts of literary criticism. (JDH)

Focuses on the censorship controversy in Peterborough County, Ontario, from 1976 to 1985, and examines the attack on, defense of, and counter argument to teaching Margaret Laurence's "The Diviners." Generalizes the anticensorship stance often taken by English teachers to defend the teaching of controversial literary works. (JK)

There is growing recognition that gender diversity within research organizations can result in innovative research outcomes. It has also been recognized that gender homogeneity can undermine the quality and breadth of the research and may allow some to cast doubt on the legitimacy of scientific findings. In this paper, we present the results of a gender-based analysis of Canada's ArcticNet Networks Centers of Excellence. Representing Canada's single largest commitment to climate change science, ArcticNet has involved 761 researchers who have published >2400 peer-reviewed publications on the impacts of climate change in the Canadian Arctic. Our results indicate that, despite outnumbering their male peers at the graduate levels, the representation of women within ArcticNet exhibits a marked decline to only 21% (N = 51) of all ArcticNet investigators (N = 246). In addition to being numerically under-represented, female investigators in ArcticNet have fewer research collaborators and are generally less integrated into the network as compared to their male colleagues. Male investigators tend to form homophilious ties—publishing predominately with other males, whereas female investigators have heterophilious collaborations, with fewer peer-reviewed journal articles. Given the complexities of climate change research, particularly in the Arctic where the impacts of climate change are projected to be most extreme, the equitable inclusion of female scientists and other under-represented groups is crucial if sustainable solutions are to be found. [ABSTRACT FROM AUTHOR]

The article deals with the analysis of requirements of the International Organization for Standardization, other intergovernmental organizations and Canada's national requirements for standardization as a means of confirming the quality and innovation of products. The analysis revealed the peculiarities and regularities in the legal regulation of standardization at the international level. Considerable attention was paid to the analysis of the economic and legal provision of standardization in Canada, where the high-quality application of modern rules of standardization by business entities significantly increased the quality of products at the microeconomic level and the main macroeconomic indicators at the state level through the introduction of innovations as standards. The GDP of other economically developed countries increased due to the application of modern standards. The analysis carried out using comparative studies, statistical and economic comparison and modelling provided an opportunity to formulate the basic principles of developing a national standardization system in Ukraine. They include voluntariness and freedom of standardization; support and updating of legislation; balancing between the requirements that determine the essential requirements for human health, environmental safety and product quality, and self-regulation for the business entity; utility and efficiency of standards in determining responsibility; assisting a consumer or other interested person to determine whether the product is faultless; provision of the right of parties to the contractor an end-user to eliminate the malfunction, delivery of a faultless product or compensation for any losses incurred due to lack of guaranteed characteristics; popularization of the standardization for economic entities. [ABSTRACT FROM AUTHOR]

Research since the 1960s has consistently found that lay volunteers are better at helping suicidal callers than professionals. Yet, professional degrees are increasingly becoming requirements for helpline workers. In our first study, we conducted post hoc comparisons of U.S. helplines with all professional paid staff, all lay volunteers, and a mix of both, using silent monitoring and standardized assessments of 1,431 calls. The volunteer centers more often conducted risk assessments, had more empathy, were more respectful of callers, and had significantly better call outcome ratings. A second study of five Quebec suicide prevention centers used silent monitoring to compare telephone help in 1,206 calls answered by 90 volunteers and 39 paid staff. Results indicate no significant differences between the volunteers and paid employees on outcome variables. However, volunteers and paid staff with over 140 hours of call experience had significantly better outcomes. Unlike the United States, Quebec paid employees were not required to have advanced professional degrees. We conclude from these results and previous research that there is no justification for requiring that suicide prevention helpline workers be mental health professionals. In fact, the evidence to date indicates that professionals may be less effective in providing telephone help to suicidal individuals when compared to trained lay volunteers. [ABSTRACT FROM AUTHOR]

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Scopul cercetării a fost de a stabili dacă încălzirea dielectrică la frecvențe radio poate fi o alternativă fezabilă pentru tratamentul fitosanitar al cherestelei verzi de răşinoase. Rezultatele sunt prezentate pentru două specii de răşinoase din Canada, respectiv pin (Pinus contorta) şi cedru roşu (Thujaplicata Donn.). De asemenea, rezultatele sunt prezentate pe baza unei configurații care a presupus pentru fiecare experiment introducerea unei singure piese în instalație. Această piesă cu secțiunea de 40x90mm a fost izolată la partea superioară, inferioară şi o laterală cu ajutorul a trei piese de cherestea uscate şi cu secțiunea identică cu cea a piesei analizate. Din punct de vedere al proprietăților dielectrice, lemnul de cedru roşu are însuşirea de a absorbi mult mai uşor câmpurile electromagnetice de înaltă frecvență. Vitezele de încălzire nu au fost corelate cu conținutul de umiditate pentru nicio specie studiată. Ceea ce evidențiază caracterul versatil al încălzirii dielectrice la frecvențe radio, respectiv creşterea simultană a temperaturii atât în zonele uscate cât şi în cele umede. Pierderile de căldură prin convecție în mediul înconjurător pot reduce viteza medie de încălzire a straturilor exterioare ale piesei cu aproximativ 40%. [ABSTRACT FROM AUTHOR]

The potential for reflexive modernization is defined by multiple factors, but the acknowledgment of risk is crucial, particularly among social groups that play a key role in risk minimization. This study offers an examination of the role of local media in response to the outbreak of bovine spongiform encephalopathy (BSE) in beef-producing communities in rural Alberta. BSE is one of several global risk issues that reflexive modernization theorists argue have the potential to trigger a transformation toward a critically reflexive society in which such risks are minimized. Content analysis of newspapers in beef-producing regions in Alberta, however, shows how local media framed BSE in a manner that maximized community cohesion and protection of local culture. This selective coverage of BSE in rural Alberta is quite likely to have contributed to, or at least reinforced, support for the current institutional structure of Canadian agriculture in beef-producing regions, through the constriction of discourse. [ABSTRACT FROM AUTHOR]

This article address public funding, free markets, and contemporary art in Canada as shaped by forces integral to the formation of Canada as a nation state and its continual development. Canada has a network of publicly funded institutions in support of contemporary art. Public funding for the arts is direct and plural: it operates at three levels of government - federal, provincial and municipal - and is distributed by government departments and arts councils. Canadian institutions in receipt of public funding relevant to contemporary art include art schools, artist-run centres, non-collecting exhibition venues and art museums. A perception that this creates and maintains a circular system for contemporary art that is co-ordinated via state funding is reconsidered. In addition, it is misleading to consider a boundary divide, with state and not-for-profit sector organizations separated from private and commercial ones. The role of art market intermediaries, namely contemporary art dealers (or gallerists), who are responsible for representing artists and promoting their work for the first time (on the primary art market) to collectors, is integral. It also represents one measure of the overall health of Canada's contemporary art market system. Attention is drawn to the situation where few contemporary art dealers based in Canada have the economic resources to compete in the international arena, with one consequence being the adoption of non-Canadian dealers to represent leading contemporary artists from Canada. The emergence of a generation of aboriginal artists living and working in Canada is another development, one that speaks to the hybrid representations of Canadian identity. [ABSTRACT FROM AUTHOR]

The Kaskapau Formation spans Late Cenomanian to Middle Turonian time and was deposited on a low-gradient, shallow, storm-dominated muddy ramp. Dense well log control, coupled with exposure on both proximal and distal margins of the basin allows mapping of sedimentary facies over about 35 000 km2. The studied portion of the Kaskapau Formation is a mudstone-dominated wedge that thins from 700 m in the proximal foredeep to 50 m near the forebulge about 300 km distant. Regional flooding surfaces permit mapping of 28 allomembers, each of which represent an average of ca 125 kyr. More than 200 km from shore, calcareous silty claystone predominates, whereas 100 to 200 km offshore, mudstone and siltstone predominate. From about 30 to 100 km offshore, centimetre-bedded very fine sandstone and mudstone record along-shelf (SSE)-directed storm-generated geostrophic flows. Five to thirty kilometres from shore, decimetre-bedded hummocky cross-stratified fine sandstone and mudstone record strongly oscillatory, wave-dominated flows whereas some gutter casts indicate shore-oblique, apparently mostly unidirectional geostrophic flows. Nearshore facies are dominated by swaley cross-stratified or intensely bioturbated clean fine sandstone, interpreted as recording, respectively, areas strongly and weakly affected by discharge from distributary mouths. Shoreface sandstones grade locally into river-mouth conglomerates and sandstones, including conglomerate channel-fills up to 15 m thick. Locally, brackish lagoonal shelly mudstones are present on the extreme western margin of the basin. There is no evidence for clinoform stratification, which indicates that the Kaskapau sea floor had extremely low relief, lacked a shelf-slope break, and was probably nowhere more than a few tens of metres deep. The absence of clinoforms probably indicates a long-term balance between rates of accommodation and sediment supply. Mud is interpreted to have been transported >250 km offshore in a sea-bed nepheloid layer, repeatedly re-suspended by storms. Fine-grained sediment accumulated up to a ‘mud accommodation envelope’, perhaps only 20 to 40 m deep. Continuous re-working of the sea floor by storms ensured that excess sediment was redistributed away from areas that had filled to the ‘accommodation envelope’, being deposited in areas of higher accommodation further down the transport path. The facies distributions and stratal geometry of the Kaskapau shelf strongly suggest that sedimentary facies, especially grain-size, were related to distance from shore, not to water depth. As a result, the ‘100 to >300 m’ depth interpreted from calcareous claystone facies for the more central parts of the Interior Seaway, might be a significant overestimate. [ABSTRACT FROM AUTHOR]

Background: Current perceptions of family physician (FP) shortages in Canada have prompted policies to expand medical schools. Our objective was to assess how FP supply, work-loads and access to care have changed over the past decade. Methods: We used an anonymized physician and population registry and administrative health service data from Winnipeg for the period 1991/92 to 2000/01. We calculated the following measures of supply and workload: ratios of FPs to population, of population to FPs and of FP full-time equivalents (FTEs) to population, as well as FP activity ratios (sum of FTEs/number of FPs), annual number of visits per FP and visits per FP per full-time day of work. Trends in FP remuneration were analyzed by age and sex. We also measured standardized visit rates and stratified the analysis by populations deemed at risk of needing FP services. Results: In 2000/01 FPs between 30 and 49 years of age (64% of the workforce) provided 20% fewer visits per year than their same-age peers did 10 years previously. Conversely, FPs 60 to 69 years of age (11% of the workforce) provided 33% more visits per year than the corresponding group a decade earlier. On a per capita basis, the number of FPs declined by 5%, from 97 per 100 000 population in 1991/92 to 92 per 100 000 population in 2000/01, which paralleled changes in national estimates of FP supply. Per capita visit rates among Winnipeg citizens (3.5 per year in 2000/01) and average workloads among FPs (4193 visits per year in 2000/01) were stable over the decade. Interpretation: Despite relative homeostasis in aggregate FP supply and use, there have been substantial temporal shifts in the volume of services provided by FPs of different age groups. Younger FPs are providing many fewer visits and older FPs are providing many more visits than their same-age predecessors did 10 years ago, a finding that was independent of physician sex. Given these data, the perpetual focus of policy-makers and care provides on... [ABSTRACT FROM AUTHOR]

Objectives: Registration of patients with a physician is increasingly being considered across Canada as part of a reform of the primary health care system. This study aims to determine how much 'informal registration' currently exists; that is, to identify the number/proportion of patients who, given existing utilization patterns, already receive the majority of their care from one practice, in order to assess the potential for formal registration. Methods: Administrative data were used to classify patients (n = 528 905) as being informally registered with a clinic if they received the majority of their care (75% or more of their total ambulatory visits) from the same practice over a three-year period (1994-1996). The proportion and number of informally registered patients were examined. Results: Substantial variability emerged across practices in the proportion of informally registered patients (15-68%) and the number of informally registered patients per physician (544-1378 patients per full-time equivalent physician). Informal registration was higher among rural practices (60%) than among urban practices (38%). Conclusions: While formal registration of patients with physicians is increasingly being considered in Canada as a means to improve the primary care system, the potential disruption to both patients and physicians in moving towards registration should not be underestimated. The relatively low levels of existing informal registration suggest a need to enhance access by, for example, providing after-hours services. [ABSTRACT FROM AUTHOR]

Background: Little is known about the quality and impact of Canadian-produced research relative to that of other developed nations. The purpose of this study was to determine the contribution of Canadian authors to the orthopedic literature globally and nationally as well as Canada's research productivity in orthopedics. We hypothesized that Canada ranks among the most impactful countries in terms of orthopedic research productivity., Methods: We performed a bibliometric analysis to identify articles published between 2001 and 2020 in the category of orthopedics. We identified Canada's global rank in terms of overall productivity and assessed the contributions of individual Canadian authors. We also examined the quality of publications as determined by category normalized citation impact (CNCI) and publication in the top quartile of journals (%Q1) in terms of impact factor. In addition, we calculated the percentage of Canadian publications that were in orthopedics., Results: We identified 10 821 orthopedic publications from 2001 to 2020. Canada placed sixth globally in terms of productivity in orthopedic research. The annual productivity of Canadian orthopedic researchers increased over the study period by a factor of 3.2. In terms of research quality, with a %Q1 of 36.5% and a CNCI of 1.22, Canada outperformed Asian countries and the United States; the latter country had a %Q1 of 35.3% and a CNCI of 1.14 over the study period., Conclusion: The body of Canadian orthopedic literature has grown consistently over the past 20 years. Despite the overall leadership of the United States and other developed nations such as China and Japan, Canada ranks among the most influential countries in terms of the quality and quantity of orthopedic research., Competing Interests: Competing interests: B. Matache has received consulting fees from Arthrex and honoraria from Pendopharm. E. Belzile has received royalties from Bodycad, consulting fees from Pendopharm and Victhom and honoraria from Stryker, CONMED, Johnson & Johnson and Pendopharm., (© 2023 CMA Impact Inc. or its licensors.)

Cardioaortic embolism to the brain accounts for approximately 15-30% of ischaemic strokes and is often referred to as 'cardioembolic stroke'. One-quarter of patients have more than one cardiac source of embolism and 15% have significant cerebrovascular atherosclerosis. After a careful work-up, up to 30% of ischaemic strokes remain 'cryptogenic', recently redefined as 'embolic strokes of undetermined source'. The diagnosis of cardioembolic stroke remains difficult because a potential cardiac source of embolism does not establish the stroke mechanism. The role of cardiac imaging-transthoracic echocardiography (TTE), transoesophageal echocardiography (TOE), cardiac computed tomography (CT), and magnetic resonance imaging (MRI)-in the diagnosis of potential cardiac sources of embolism, and for therapeutic guidance, is reviewed in these recommendations. Contrast TTE/TOE is highly accurate for detecting left atrial appendage thrombosis in patients with atrial fibrillation, valvular and prosthesis vegetations and thrombosis, aortic arch atheroma, patent foramen ovale, atrial septal defect, and intracardiac tumours. Both CT and MRI are highly accurate for detecting cavity thrombosis, intracardiac tumours, and valvular prosthesis thrombosis. Thus, CT and cardiac magnetic resonance should be considered in addition to TTE and TOE in the detection of a cardiac source of embolism. We propose a diagnostic algorithm where vascular imaging and contrast TTE/TOE are considered the first-line tool in the search for a cardiac source of embolism. CT and MRI are considered as alternative and complementary tools, and their indications are described on a case-by-case approach., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.)

Background: This large multicenter, international bicuspid aortic valve (BAV) registry aimed to define the sex differences in prevalence, valve morphology, dysfunction (aortic stenosis/regurgitation), aortopathy, and complications (endocarditis and aortic dissection)., Methods and Results: Demographic, clinical, and echocardiographic data at first presentation of 1992 patients with BAV (71.5% men) were retrospectively analyzed. BAV morphology and valve function were assessed; aortopathy configuration was defined as isolated dilatation of the sinus of Valsalva or sinotubular junction, isolated dilatation of the ascending aorta distal to the sinotubular junction, or diffuse dilatation of the aortic root and ascending aorta. New cases of endocarditis and aortic dissection were recorded. There were no significant sex differences regarding BAV morphology and frequency of normal valve function. When presenting with moderate/severe aortic valve dysfunction, men had more frequent aortic regurgitation than women (33.8% versus 22.2%, P <0.001), whereas women were more likely to have aortic stenosis (34.5% versus 44.1%, P <0.001). Men had more frequently isolated dilatation of the sinus of Valsalva or sinotubular junction (14.2% versus 6.7%, P <0.001) and diffuse dilatation of the aortic root and ascending aorta (16.2% versus 7.3%, P <0.001) than women. Endocarditis (4.5% versus 2.5%, P =0.037) and aortic dissections (0.5% versus 0%, P <0.001) occurred more frequently in men., Conclusions: Although there is a male predominance among patients with BAV, men with BAV had more frequently moderate/severe aortic regurgitation at first presentation compared with women, whereas women presented more often with moderate/severe aortic stenosis compared with men. Furthermore, men had more frequent aortopathy than women., (© 2017 American Heart Association, Inc.)