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Skeptics of Programme for International Student Assessment (PISA) and Trend for International Math and Science Study (TIMSS) argue that while US elementary and high school students are behind their peers in other nations, the US workforce is still excellent because of the high quality post-secondary educational institutions in the US. However, the Programme for the International Assessment of Adult Competencies (PIAAC) indicates that US adults are in fact far behind their international peers in literacy, numeracy, and technology-based problem solving. Through the use of data mining, this study explored the possible association between PIAAC scores and several constructs. Since the US, Canada, and New Zealand were considered culturally similar nations, according to cluster analysis, patterns between PIAAC scores and selected constructs were analyzed by a variety of big data analytical methods, including cluster analysis, bootstrap forest, boosted tree, and data visualization. Given that PIAAC used multiple computerized adaptive testing, the consequential plausible values were randomly selected when the ensemble approach was used. Additionally, model comparison was utilized to decide between bagging and boosting in order to select the optimal model for each sample. In these samples, cultural engagement, readiness to learn, and social trust, respectively emerged as strong predictors for learning outcomes as they were assessed by PIAAC.

We implemented two different approaches of using peer review to support undergraduate essay assignments for students taking large second-year courses in life sciences and biology: a web-based online peer review (OPR) approach and a more traditional face-to-face peer review (FPR) approach that was conducted in tutorial settings. The essays consisted of a review of current literature to discuss the molecular involvement of cancer development or stem-cell growth. Following implementation of the peer reviews, we conducted a preliminary analysis of the pros and cons of using the two methods. Student and instructor feedback suggested that the activity of peer review was generally perceived as valuable regardless of which approach was used. OPR was convenient and saved time and resources relative to FPR, but the technical drawbacks using the OPR approach made it challenging for some students to use. A subsequent investigation using alternative OPR programs that offer additional functionality is planned.

Forestry offsets, recognized for their diverse environmental and social co-benefits, are gaining a growing interest as nature-based solutions to combat climate change. Despite Canada's extensive forest resources, its potential for carbon credit remains largely untapped. This study aims to unveil the prevailing challenges in developing forestry offsets in Canada and propose potential solutions, drawing on insights from in-depth semi-structured interviews (SSIs) with 23 experts in the field. A qualitative thematic analysis highlighted 14 challenges under four major frequently discussed themes: methodological (37%), social (29%), economic (22%), and implementation challenges (12%). Our findings highlighted the urgency of addressing key obstacles, including the impermanent nature of forestry carbon offsets, substantial public knowledge gaps, uncertainties in the cost-effectiveness impacting financial viability, and the need for enhanced capacity for project implementation. Building on the discussions on the identified challenges, this study further presented a comprehensive analysis of the future directions for Canada, emphasizing the importance of addressing key methodological issues, enhancing public and Indigenous education and engagement, and leveraging advanced technologies and innovative approaches like ton-year accounting for economic viability. This paper delivers pivotal insights that have the potential to shape the direction and integrity of the forestry offset markets in both Canada and globally. [ABSTRACT FROM AUTHOR]

This study explores the experiences of Taiwanese, Hong Konger, Malaysian, Singaporean, and Vietnamese community members as invisible Asian communities in Canada before and after COVID-19. Ten interviewees participated online in semi-structured interviews, and results showed that minoritised Asian communities had a different experience from hegemonic 'Asian' community members in Canada because of their ethnocultural identities. Society's attempts to homogenise the experience of 'Asians' has rendered the interviewees' ethnocultural experience invisible in Canadian society. These experiences stirred polarising sentiments among interviewees towards their ethnocultural identity. As COVID-19 hit, daily anxieties surrounding both the pandemic and ethnic-related attacks came to the fore of minoritised Asian community members' concerns. Community members have been ambivalent about the impact of organised solidarity movements against anti-Asian racism. Given the findings from this study, researchers should consider disaggregating broad categories like the 'Asian' category for future research as well as policymaking. [ABSTRACT FROM AUTHOR]

In this study, we explore academic procrastination and associated motivation variables in 612 adolescents from Canada and Singapore. Few studies have explored adolescent procrastination and no previous studies have investigated adolescent procrastination using a cross-cultural framework. Singaporean adolescents reported higher levels of procrastination and lower levels of self-efficacy for self-regulation than Canadian adolescents. Males across settings reported higher levels of procrastination and lower levels of self-efficacy for self-regulation than females. Bivariate relationships between procrastination and the motivation variables showed similar patterns in Singapore and Canada. Multigroup structural equation modeling revealed that self-efficacy for self-regulation showed the strongest multivariate relationship with procrastination for adolescents in both settings. The article concludes with implications for practitioners and researchers.

We provide further evidence for the two-factor structure of the 9-item Academic Expectations Stress Inventory (AESI) using confirmatory factor analysis on a sample of 289 Canadian adolescents and 310 Singaporean adolescents. Examination of measurement invariance tests the assumption that the model underlying a set of scores is directly comparable across groups. This study also examined the cross-cultural validity of the AESI using multigroup confirmatory factor analysis across both the Canadian and Singaporean adolescent samples. The results suggested cross-cultural invariance of form, factor loadings, and factor variances and covariances of the AESI across both samples. Evidence of AESI's convergent and discriminant validity was also reported. Findings from t-tests revealed that Singaporean adolescents reported a significantly higher level of academic stress arising from self expectations, other expectations, and overall academic stress, compared to Canadian adolescents. Also, a larger cross-cultural effect was associated with academic stress arising from other expectations compared with academic stress arising from self expectations. (Contains 2 tables and 2 figures.)

The purpose of this article was twofold. The first purpose was to test the validity of the Teachers' Sense of Self-Efficacy Scale (TSES) in five settings--Canada, Cyprus, Korea, Singapore, and the United States. The second purpose was, by extension, to establish the importance of the teacher self-efficacy construct across diverse teaching conditions. Multi-group confirmatory factor analysis was used to better understand the measurement invariance of the scale across countries, after which the relationship between the TSES, its three factors, and job satisfaction was explored. The TSES showed convincing evidence of reliability and measurement invariance across the five countries, and the relationship between the TSES and job satisfaction was similar across settings. The study provides general evidence that teachers' self-efficacy is a valid construct across culturally diverse settings and specific evidence that teachers' self-efficacy showed a similar relationship with teachers' job satisfaction in five contrasting settings. (Contains 4 tables.)

A mixed methods approach was used to explore secondary teachers' motivation beliefs in Canada and Singapore. Results from Study 1 revealed that socio-economic status (SES) was the strongest predictor of school climate in Canada, and that collective efficacy mediated the effect of SES on school climate in Singapore, but not in Canada. In Study 2, interviews were conducted with 10 teachers in Canada and 14 teachers in Singapore. Teachers in both settings discussed students' social and behavior problems, but the range of the social problems was greater in Canada than in Singapore, and had a stronger impact on teachers' motivation beliefs. (Contains 5 tables.)

The prevalence of behavioral inhibition in toddlers was examined in five cultures. Participants in this study included 110 Australian, 108 Canadian, 151 Chinese, 104 Italian, and 113 South Korean toddlers and their mothers who were observed during a structured observational laboratory session. Matched procedures were used in each country, with children encountering an unfamiliar stranger with a truck and a robot. Indicators of inhibition included the length of time toddlers delayed before approaching the stranger and the duration of contact with their mother while the stranger was in the room. Results were generally consistent with expectations and showed differences between eastern and western cultures; Italian and Australian toddlers were less inhibited than toddlers from the other countries, whereas Chinese and South Korean toddlers were more inhibited. The implications of these findings are discussed and a research agenda for further exploration of inhibition is outlined. (Contains 4 tables.)

We examined the categorization of relationships between child complainants and accused perpetrators in cases of child sexual abuse (CSA). Researchers that have focused on complainant-accused relationships and other case variables, often combining two extrafamilial complainant-accused relationship categories: Relationships where the accused is connected to the child through their position in the community (i.e. community connections) and relationships where the non-relative accused is known to the child through a connection to the child's family (i.e. non-relative family connections). Using a database of 4,237 Canadian judicial decisions in cases of CSA, we reviewed a subset of 1,515 judicial decisions to explore differences between these two relationship categories. Compared to cases involving non-relative family connections, cases involving community connections had more male complainants, more multiple complainants, older complainants, higher frequencies of abuse, longer durations, and longer delays. We conclude that community and non-relative family connections are distinct relationships that should be separated for analyses in future research. Practical implications of recognizing the distinctiveness of non-relative family and community connection relationship categories in the context of abuse prevention and treatment are also discussed. [ABSTRACT FROM AUTHOR]

Background: Cardioversion of acute-onset atrial fibrillation (AF) via electrical or pharmacological means is a common procedure performed in many emergency departments. While these procedures appear to be very safe, the rarity of subsequent adverse outcomes such as stroke would require huge sample sizes to confirm that conclusion. Big data can supply such sample sizes. Objective: We aimed to validate several potential codes for successful emergency department cardioversion of AF patients. Methods: This study combined 3 observational datasets of emergency department AF visits seen at one of 26 hospitals in Ontario, Canada, between 2008 and 2012. We linked patients who were eligible for emergency department cardioversion to several province-wide health administrative datasets to search for the associated cardioversion billing and procedural codes. Using the observational data as the gold standard for successful cardioversion, we calculated the test characteristics of a billing code (Z437) and of procedural codes 1.HZ.09JAFS and 1.HZ.09JAJS. Both include pharmacological and electrical cardioversions, as well as unsuccessful attempts; the latter is <10% using electricity (in Canada, standard practice is to proceed to electrical cardioversion if pharmacological cardioversion is unsuccessful). Results: Of 4557 unique patients in the three datasets, 2055 (45.1%) were eligible for cardioversion. Nine hundred thirty-three (45.4%) of these were successfully cardioverted to normal sinus rhythm. The billing code had slightly better test characteristics overall than the procedural codes. Positive predictive value (PPV) of a billing was 89.8% (95% CI, 87.0–92.2), negative predictive value (NPV) 70.5% (95% CI, 68.1–72.8), sensitivity 52.1% (95% CI, 48.8–55.3), and specificity 95.1% (95% CI, 93.7–96.3). Conclusions: AF patients who have been successfully cardioverted in an emergency department can be identified with high PPV and specificity using a billing code. Studies that require high sensitivity for cardioversion should consider other methods to identify cardioverted patients. [ABSTRACT FROM AUTHOR]

Background: The overdose crisis in North America has prompted system-level efforts to restrict opioid prescribing for chronic pain. However, little is known about how discontinuing or tapering prescribed opioids for chronic pain shapes overdose risk, including possible differential effects among people with and without concurrent opioid use disorder (OUD). We examined associations between discontinuation and tapering of prescribed opioids and risk of overdose among people on long-term opioid therapy for pain, stratified by diagnosed OUD and prescribed opioid agonist therapy (OAT) status.Methods and Findings: For this retrospective cohort study, we used a 20% random sample of residents in the provincial health insurance client roster in British Columbia (BC), Canada, contained in the BC Provincial Overdose Cohort. The study sample included persons aged 14 to 74 years on long-term opioid therapy for pain (≥90 days with ≥90% of days on therapy) between October 2014 and June 2018 (n = 14,037). At baseline, 7,256 (51.7%) persons were female, the median age was 55 years (quartile 1-3: 47-63), 227 (1.6%) persons had been diagnosed with OUD (in the past 3 years) and recently (i.e., in the past 90 days) been prescribed OAT, and 483 (3.4%) had been diagnosed with OUD but not recently prescribed OAT. The median follow-up duration per person was 3.7 years (quartile 1-3: 2.6-4.0). Marginal structural Cox regression with inverse probability of treatment weighting (IPTW) was used to estimate the effect of prescribed opioid treatment for pain status (discontinuation versus tapered therapy versus continued therapy [reference]) on risk of overdose (fatal or nonfatal), stratified by the following groups: people without diagnosed OUD, people with diagnosed OUD receiving OAT, and people with diagnosed OUD not receiving OAT. In marginal structural models with IPTW adjusted for a range of demographic, prescription, comorbidity, and social-structural exposures, discontinuing opioids (i.e., ≥7-day gap[s] in therapy) was associated with increased overdose risk among people without OUD (adjusted hazard ratio [AHR] = 1.44; 95% confidence interval [CI] 1.12, 1.83; p = 0.004), people with OUD not receiving OAT (AHR = 3.18; 95% CI 1.87, 5.40; p < 0.001), and people with OUD receiving OAT (AHR = 2.52; 95% CI 1.68, 3.78; p < 0.001). Opioid tapering (i.e., ≥2 sequential decreases of ≥5% in average daily morphine milligram equivalents) was associated with decreased overdose risk among people with OUD not receiving OAT (AHR = 0.31; 95% CI 0.14, 0.67; p = 0.003). The main study limitations are that the outcome measure did not capture overdose events that did not result in a healthcare encounter or death, medication dispensation may not reflect medication adherence, residual confounding may have influenced findings, and findings may not be generalizable to persons on opioid therapy in other settings.Conclusions: Discontinuing prescribed opioids was associated with increased overdose risk, particularly among people with OUD. Prescribed opioid tapering was associated with reduced overdose risk among people with OUD not receiving OAT. These findings highlight the need to avoid abrupt discontinuation of opioids for pain. Enhanced guidance is needed to support prescribers in implementing opioid therapy tapering strategies with consideration of OUD and OAT status. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Plant Science is the property of Canadian Science Publishing 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.)

David Webster's I Challenge the Strong Wind: Canada and East Timor, 1975-99 i is a significant scholarly work on Canada-East Timor relations. While the Canadian government was greatly influenced by the Australian government that strongly believed that the invasion was inevitable and irreversible, Oxfam Canada supported Australian NGOs' relief efforts in East Timor. This is a significant contribution of the book because although non-state actors do not represent a government, they could significantly influence a government's foreign policy behavior via lobbying and mobilization. [Extracted from the article]

In Canada, many mines have adopted the sublevel stoping method, such a blasthole stoping (BHS), to extract steeply deposited minerals. Sill pillars are usually kept in place in this mining method to support the weight of the overburden in underground mining. To prolong the mine's life, sill pillars will be recovered, and sill pillar recovery could cause failures, fatality, and equipment loss in the stopes. In this paper, three sill pillar recovery schemes—SBS, SS1, and SS2—were proposed and conducted to assess the feasibility of recovering two sill pillars in a hard rock mine by developing a full-sized three-dimensional (3D) analysis model employing the finite element method (FEM). The numerical model was calibrated by comparing the model computed ground settlement with the in situ monitored ground settlement data. The rockburst tendency of the stope accesses caused by the sill pillar recovery was assessed by employing the tangential stress (Ts) criterion and burst potential index (BPI) criterion. All three proposed sill pillar recovery schemes were feasible and safe to recover the sill pillars in this hard rock mine, and the scheme SBS was the optimum one among the three schemes. [ABSTRACT FROM AUTHOR]

This study draws on Michel Foucault's framework on power relations to explore the power of parents, as evidenced by various resistance strategies, in relating to teachers of their children with attention-deficit hyperactivity disorder (ADHD). This qualitative study had seven focus group interviews, involving 58 caregivers from 47 Chinese families of children with ADHD. Thematic analysis was used and three themes were identified: (1) cognitive resistance, (2) behavioral resistance, and (3) the transcendent vision of education. Resulting from the study, a culturally sensitive three-dimensional empowerment model is proposed for social workers to engage in advocacy that can facilitate a transformation of family–school power relations. [ABSTRACT FROM AUTHOR]

The great threat and destructiveness brought by a rock burst make its prediction and prevention crucial in engineering. The rock burst hazard evaluation at project locations is an effective way of preventing rock burst since currently real-time prediction is not available. Since different control factors and discrimination conditions of rock burst were accepted by conventional risk determination methods, the rock burst risk determination in the same area may produce conflicting results. In this study, Naive Bayes statistical learning models based on different model prior distributions representing highly complicated nonlinear relationship between rock burst hazard and impact factors were built to evaluate the rock burst hazards. The results suggested that the Bayes statistical learning model based on a Gaussian prior has the strongest performance over four preset prior distributions. Combining the rock mechanics parameters measured in the laboratory and the stress data collected on the project sites, the proposed model was successfully employed to evaluate the kimberlite rock burst risk of a diamond mine in Canada. The Bayes statistical learning model exhibits its robustness and generalization in rock burst hazard evaluation, which can be generalized for similar engineering cases with enough supported data. [ABSTRACT FROM AUTHOR]

BACKGROUND: Since 2015, illicit drug overdose has been one of British Columbia's most pressing public health issues. Our objective was to assess prescription history in the context of postmortem toxicology among people who had a fatal illicit drug overdose in BC. METHODS: Toxicology results from drug overdose deaths involving 1 or more illicit drugs, as identified by the BC Coroners Service in 2015–2017, were linked to the prescription drug histories of individuals as recorded in BC's PharmaNet database for a descriptive analysis. Substances identified in toxicology were considered prescribed if the individual had an active dispensation for a matching medication within 60 days before overdose. RESULTS: There were 2872 deaths from illicit drug toxicity during the study period; 1789 (62.3%) were closed cases with toxicology results available. In 85.5% of cases, 1 or more opioids were found to be relevant to death. Prescribed opioids in the absence of nonprescribed opioids were detected in only 2.0% of cases, and 6.7% had a combination of prescribed and nonprescribed opioids. Among those with 1 or more nonprescribed opioids, 78.5% had fentanyl or fentanyl analogues detected. Medications used in opioid agonist therapy (methadone and buprenorphine) were found to be relevant to death in 7.4% of cases, with methadone (130 cases) much more common than buprenorphine (< 5 cases). Stimulants were detected in 70.6% of cases. INTERPRETATION: Our data show a high prevalence of nonprescribed fentanyl and stimulants, and a low prevalence of prescribed opioids detected on toxicology in people who died from illicit drug overdose. These results suggest that strategies to address the current overdose crisis in Canada must do much more than target deprescribing of opioids. [ABSTRACT FROM AUTHOR]

Engineering education research in Canada is, in many ways, still establishing itself as a discipline, yet much is already being asked of it. The diversity of career pathways for engineering graduates, along with the increased complexity of global engineering challenges and the ramifications of technological opportunities, is raising important questions about current engineering education foci and practices. This paper brings together issues surfaced through the process of compiling a Special Theme on engineering education research in Canada, positioning the collection of papers in terms of the challenges and opportunities faced by this maturing Canadian research community. We seek to reconcile how this research can incorporate the theoretical and methodological depth valued in the social sciences while honoring the focus on effective instructional practices that has become an important strand of inquiry in engineering education. Challenges to the growth of engineering education research, such as funding and graduate student inclusion, are also discussed. In addition, we explore the emergence of teaching stream engineering faculty and problematize the role of research and scholarship in their career trajectories. Finally, we call for more strategic thinking to guide the evolution of engineering education research in Canada. We hope that, collectively, this editorial and the other four papers in this Special Theme will help to stimulate discussion about how we define and recognize excellence in the domain of engineering education research in Canada. [ABSTRACT FROM AUTHOR]

Effectiveness of direct‐acting antiviral (DAA) therapies could be influenced by patient characteristics such as comorbid conditions, which could lead to premature treatment discontinuation and/or irregular medical follow‐ups. Here, we evaluate loss to follow‐up and treatment effectiveness of sofosbuvir/ledipasvir ± ribavirin (SOF/LDV ± RBV), ombitasvir/paritaprevir/ritonavir + dasabuvir ± ribavirin (OBV/PTV/r + DSV ± RBV) for hepatitis C virus (HCV) genotype 1 (GT1) and sofosbuvir + ribavirin (SOF + RBV) for genotype 3 (GT3) in British Columbia Canada: The British Columbia Hepatitis Testers Cohort includes data on individuals tested for HCV since 1992, integrated with medical visit, hospitalization and prescription drug data. HCV‐positive individuals who initiated DAA regimens, irrespective of treatment completion, for GT1 and GT3 until 31 December, 2017 were included. Factors associated with sustained virological response (SVR) and loss to follow‐up were assessed by using multivariable logistic regression models. In total 4477 individuals initiated DAAs. The most common prescribed DAA was SOF/LDV ± RBV with SVR of 95%. The highest SVR of 99.5% was observed among OBV/PTV/r + DSV‐treated patients. Overall, 453 (10.1%) individuals were lost to follow‐up. Higher loss to follow‐up was observed among GT1 patients treated with OBV (17.8%) and GT3 patients (15.7%). The loss to follow‐up rate was significantly higher among individuals aged <60 years, those with a history of injection drug use (IDU), on opioid substitution therapy and with cirrhosis. Our findings indicate that loss to follow‐up exceeds viral failure in HCV DAA therapy and its rate varies significantly by genotype and treatment regimen. Depending on the aetiology of lost to follow‐up, personalized case management for those with medical complications and supporting services among IDU are needed to achieve the full benefits of effective treatments. [ABSTRACT FROM AUTHOR]

Previous research on gender differences and delay of disclosure of child sexual abuse is inconclusive; some research has found that male victims are more likely to delay disclosure than female victims, while other studies have found no gender difference. The present archival study investigated this inconsistency by examining factors that interact with delay. Judicial outcomes of child sexual abuse cases were coded (N = 4237) for variables related to the offense, the complainant-accused relationship, and court proceedings. Males and females differed with respect to delay only when the relationship between the complainant and the accused was established in the community (e.g., sports coach) or was a stranger to the child. When the accused was a parent, other relative, or a non-relative connected to the child through the family, there was no difference in delay between males and females. Further, males were more vulnerable in the community, as evidenced by a higher proportion of accused community members with male than female complainants, even though males represented fewer than 25% of cases in the database. These findings may help explain inconsistencies in gender differences in delayed disclosure. Implications regarding education about child sexual abuse are discussed, with a focus on male victims. [ABSTRACT FROM AUTHOR]

Introduction: Respiratory disease remains one of the leading causes of mortality and morbidity worldwide. Objectives: In this study, we aimed to compare the quantity and quality of scientific publications in the field of respirology from the United States, the United Kingdom, Germany, Canada and China. Methods: Articles published in 58 respiratory journals from 2007 to 2017 were screened with Science Citation Index Expanded database. The number of total and annual articles, article types, impact factor (IF), h‐index, citations and articles in the high‐impact journals from the corresponding country were collected for quantity and quality comparisons. The correlation of socioeconomic factors and annual publications was also analysed. Results: A total of 93078 articles were published worldwide in respiratory journals from 2007 to 2017. The United States contributed the largest proportion (34399 (37.0%)), followed by the United Kingdom (9494 (10.2%)), Germany (6918 (7.4%)) and Canada (6574 (7.1%)). Publications from China represented the 6th, but this quantity is rapidly increasing. The United States occupies the dominant place in all kinds of article types under investigation in the study, except in the category of meta‐analysis. For total and average citations, China still lags behind the other 4 countries in the study. The annual numbers of articles from China, Canada and the United States were positively correlated with gross domestic product (P < 0.05). Conclusions: The United States has played predominant role in respiratory research for the last 11 years. Although China has made great progress in the number of published articles over the past decade, the quality of these publications needs further improvement. [ABSTRACT FROM AUTHOR]

We tested 104 residents and 141 staff for coronavirus disease 2019 who failed daily symptom screening in homeless shelters in Hamilton, Canada. We detected 1 resident (1%), 7 staff (5%), and 1 case of secondary spread. Shelter restructuring to allow physical distancing, testing, and isolation can decrease outbreaks in shelters. [ABSTRACT FROM AUTHOR]

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

Although HIV screening is needed at a wider range of sites, dentists have shown reluctance to incorporate screening in their practices, but dental hygiene settings may be better suited for such screenings. The aim of this mixed-methods study was to determine the feasibility and acceptability of point-of-care (POC) HIV screening in dental hygiene education community settings from the patient, faculty, and student perspectives. After training, dental hygiene students and faculty at a Canadian dental school offered POC HIV screening to patients as part of routine dental hygiene care over 36 weeks at four sites in 2015-16. Of the 199 patients offered screening, 78 agreed; no positive results were found. Of the 199 patients, 97 completed an 11-item survey (49% response rate), with 80 (82%) agreeing HIV screening was within the scope of practice of a dental professional. Of the 57 patients who were screened, 48 (84%) agreed POC HIV screening should be part of regular dental check-ups, and 52 (91%) perceived dental settings were appropriate sites for screening. The main reasons for patients' agreeing to screening were that it was free and convenient and the results were delivered quickly. Those who refused screening had been tested recently or did not perceive themselves at risk for HIV. In two focus groups with 12 dental hygiene students, one focus group with five faculty members, and individual interviews with five other faculty members, participants agreed on the importance of offering POC HIV screening in the dental setting as a public health service. Faculty members thought students were well prepared and increased in confidence with testing. Students expressed a desire to offer screening throughout their careers and to educate patients about the importance of HIV testing. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Anaesthesia / Journal Canadien d'Anesthésie is the property of Springer Nature 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.)

We aimed to develop an in-depth understanding about factors that influence cardiac medication adherence among South Asian, Chinese, and European White cardiac patients. Sixty-four patients were purposively sampled from an ongoing study cohort. Interviews were audio-recorded and transcribed for analyses. Physicians’ culturally sensitive communication and patients’ motivation to live a symptom-free and longer life enhanced adherence. European Whites were motivated to enhance personal well-being and enjoy family life. South Asians’ medication adherence was influenced by the desire to fulfill the will of God and family responsibilities. The Chinese were motivated to avoid pain, illness, and death, and to obey a health care provider. The South Asians and Chinese wanted to ultimately reduce medication use. Previous positive experiences, family support, and establishing a routine also influenced medication adherence. Deterrents to adherence were essentially the reverse of the motivators/facilitators. This analysis represents an essential first step forward in developing ethno-culturally tailored interventions to optimize adherence. [ABSTRACT FROM AUTHOR]

In patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention, contrast-induced nephropathy (CIN) is a serious complication associated with poor outcomes. We assessed the predictive value of the Canada Acute Coronary Syndrome (C-ACS) score for CIN in these patients. A total of 394 consecutive patients with STEMI were enrolled and divided into 3 groups according to their C-ACS scores--group 1, score 0; group 2, score 1; and group 3, score ≥2. The clinical outcomes were CIN and major adverse clinical events (MACEs) during hospital and follow-up; 8.4% of patients developed CIN. Patients with high C-ACS scores were more likely to develop CIN, in-hospital death, and MACEs (P < .001). The C-ACS score was an independent predictor of CIN (odds ratio = 2.87; 95% confidence interval = 1.78-4.63; P < .001) and risk factor for long-term MACEs. The C-ACS score had good predictive values for CIN, in-hospital morality, MACEs, and long-term mortality. Patients with high C-ACS risk scores exhibited a worse survival rate than those with low scores (death, P = .02; MACEs, P = .006). In conclusion, in patients with STEMI, the C-ACS could predict CIN and clinical outcomes. [ABSTRACT FROM AUTHOR]

Surprisingly, little research exists on the determination of sentence length in cases of child sexual assault. This is striking given the profound short-term and long-term consequences this crime can have on victims and their families. Previous research shows that severity of the offense commonly accounts for much of the variability in sentences in this context. A critical point, however, is that the definition of offense severity varies widely and is often confounded with the age of the complainant. The current archival study, through the examination of 1,783 judicial sentencing decisions, evaluated the effects of key variables on length of sentence in cases of child sexual assault in Canada. Length of sentence increased as intrusiveness of the offense increased, as frequency increased, and as age decreased for children who experienced the most intrusive forms of abuse. In addition, offenders who pleaded guilty received shorter sentences than offenders who pleaded not guilty. [ABSTRACT FROM PUBLISHER]

Background & Aims Evidence is limited on hepatocellular carcinoma (HCC) risk after sustained virological response (SVR) to interferon-based treatment of hepatitis C virus (HCV) infection. We evaluated the effect of SVR on the risk of HCC and estimated its incidence in post-SVR HCV patients from a large population-based Canadian cohort. Methods The British Columbia Hepatitis Testers Cohort includes individuals tested for HCV between 1990–2013 linked with data on their medical visits, hospitalizations, cancers, prescription drugs and mortality. Patients receiving interferon-based HCV treatments were followed from the end of treatment to HCC diagnosis, death or December 31, 2012. We examined HCC risk among those who did and did not achieve SVR using multivariable proportional hazard models with the Fine and Gray modification for competing risks. Results Of 8147 individuals who received HCV treatment and were eligible for analysis, 4663 (57%) achieved SVR and 3484 (43%) did not. Each group was followed for a median of 5.6 years (range: 0.5–12.9) for an HCC incidence rate of 1.1/1000 person-years (PY) among the SVR and 7.2/1000 PY among the no SVR group. The HCC incidence rate was higher among those with cirrhosis (SVR: 6.4, no SVR: 21.0/1000 PY). In the multivariable model, SVR was associated with a lower HCC risk (subdistribution hazard ratio [SHR] = 0.20, 95% CI: 0.13–0.3), while cirrhosis (SHR = 2.61, 95% CI: 1.68–4.04), age ⩾50 years, being male and genotype 3 infection were associated with a higher HCC risk. Among those who achieved SVR, cirrhosis, age ⩾50 years and being male were associated with a higher HCC risk. Conclusion SVR after interferon-based treatment substantially reduces but does not eliminate HCC risk, which is markedly higher among those with cirrhosis and age ⩾50 years at treatment initiation. Treatment of patients at an advanced fibrosis stage with new highly effective drugs will warrant continued surveillance for HCC post-SVR. Lay summary We assessed the effect of successful hepatitis C treatment with older interferon-based treatment on the occurrence of liver cancer (hepatocellular carcinoma) and found that successful treatment prevents liver cancer. However, more people with cirrhosis and older age continued to develop liver cancer after successful treatment. Thus, treatment with new drugs among those with cirrhosis will require continued monitoring for liver cancer. [ABSTRACT FROM AUTHOR]

A recent issue highlights the need for a wildlife corridor to mitigate habitat fragmentation and biodiversity degradation caused by intensive urbanization in the country, such as the development of infrastructure, roads, and highways. Indeed, the issues of frequent road and vehicle-animals collisions are ever-increasing in urban corridors. As a result, flora and fauna populations can become isolated, leading to an unbalanced ecosystem. This study developed the Wildlife Corridor Design and Conservation (WCDC) index, assessment model. The study has investigated the wildlife corridor design and conservation features through a systematic literature review, clustered them into three criteria (biophysical, structural, and environmental designs) and twenty-one sub-criteria. The study applied the Analytic Network Process method to measure the weights of features; habitat preservation (W C1.1 = 0.280), species varieties control (W C1.2.= 0187), and conduit for movement (W C1.3. = 0.100) play critical roles in wildlife corridor design and conservation. The Weighted Sum Method verified the WCDC model through a case study (Red Earth overpass, Canada). The model assigns certification labels (Gold, Silver, Bronze, or not-certified); accordingly, it ranked the evaluated site as Gold, which means the Red Earth overpass performs intimately in biophysical, structural, and environmental preservation of mammal habitat. The study conducted regression analysis for model validation, determining a significant association between the base and case-study models. [ABSTRACT FROM AUTHOR]

Objectives: The impact of command hallucinations on patients and the determinants of patients' compliance with them are still poorly understood. The extant literature is also divided on their association with violence. This study aimed to establish the prevalence of command hallucinations and to identify the factors that affect compliance with the commands, together with patients' coping methods.Methods: We recruited 50 consecutive male and 50 consecutive female schizophrenia inpatients who reported hearing voices in the 6 months prior to admission. We interviewed these patients, using a semistructured questionnaire. We collected information on the contents of their auditory hallucinations and their coping methods.Results: Of the patients, 53 (53%) reported command hallucinations. Of these 53 patients, 58% were women and 48% were men; 62% reported complying with the commands. They were also more likely to comply with nonviolent commands. A history of self-harm predicted compliance. Those patients who did not comply with the commands adopted various methods of coping, of which praying was the most common.Conclusion: Command hallucinations are common in patients with schizophrenia. Patients with a history of self-harm need closer monitoring because they may be more likely to comply with these hallucinations. Assessment should also include the patient's own coping strategies, which can be incorporated into the treatment. [ABSTRACT FROM AUTHOR]

A systematic study on the fine particular matter emissions from coal combustion of four kinds of coals of different ranks (lignite, sub-bituminous, bituminous, coking coal), including three typical Canadian coals and a Chinese coal have been presented. The results show that a tri-modal mass size distribution (coarse, fine and ultrafine mode) was commonly identified, and it was confirmed by size-segregated elemental distributions. The tri-modal distribution is of temperature and coal ranks independence. Coarse particles (Da ∼ 5 μm) presented as round-shaped sphere with smooth surface. Both round-shaped particles and irregular-shaped particles were observed in fine particles (Da ∼ 0.5 μm). Clusters of nano-particles (Da ∼ 0.05 μm) were identified in the ultrafine mode. The concentration of fine particles (Da < 1 μm) generated from the TECK coal is the highest (about 150 mg/Nm 3 ), while fine particles (Da < 10 μm) generated from Boundary coal (about 580 mg/Nm 3 ) is highest among the four coals. Higher volatile content in coals gives priority for enhancing the formation of fine particles. Excluded minerals would mostly fragmented to form ash residual with irregular shapes, while part of them would experience coalescence individually to form round-shaped particles with size larger than 10 μm. Included minerals adhered firmly on the surface of char particles contribute greater in the irregular-shaped particles in fine mode, while the shedding included minerals from char particles should take the major responsibility for the round shaped particles in fine mode. [ABSTRACT FROM AUTHOR]

Until the latter part of the 20th century, legal doctrines made it almost impossible to successfully prosecute in criminal court a case involving child sexual abuse (CSA), whether the complaint was timely or delayed. Many English-speaking countries have abrogated most formal legal barriers to prosecuting CSA cases, and courts are faced with the singular challenge of adjudicating sexual offenses against children that are reported to have happened years or decades earlier. We conducted analyses of 4,237 criminal complaints of CSA heard in Canadian criminal courts. There were several differences between timely and delayed prosecutions that led us to conclude that delayed prosecutions of CSA are common and due, in part, to the nature of the offense. Offense duration was associated with longer delays to prosecution. When the accused had access to the child through his position in the community, length of delay to prosecution was very long, particularly for male complainants. More research is needed on delayed CSA prosecutions, particularly given an apparent trend for jurisdictions to abolish barriers to criminal prosecutions of CSA that occurred years or decades earlier. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aim To determine the prescribing of and adherence to oral hypoglycaemic agents, insulin, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and statin therapy among South-Asian, Chinese and white people with newly diagnosed diabetes. Methods The present study was a population-based cohort study using administrative and pharmacy databases to include all South-Asian, Chinese and white people aged ≥ 35 years with diabetes living in British Columbia, Canada (1997-2006). Adherence to each class of medication was measured using proportion of days covered over 1 year with optimum adherence defined as ≥ 80%. Results The study population included 9529 South-Asian, 14 084 Chinese and 143 630 white people with diabetes. The proportion of people who were prescribed angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, statin or oral hypoglycaemic agents was ≤ 50% for all groups. South-Asian and Chinese people had significantly lower adherence for all medications than white people, with the lowest adherence to angiotensin-converting enzyme inhibitor treatment (South-Asian people: adjusted odds ratio 0.37, 95% CI 0.34-0.39; P<0.0001; Chinese people: adjusted odds ratio 0.50, 95% CI 0.47-0.54; P<0.0001) and statin therapy (South-Asian people: adjusted odds ratio 0.47, 95% CI 0.41 - 0.53, P < 0.0001; Chinese people: adjusted odds ratio 0.72, 95% CI 0.67 - 0.77; P<0.0001) compared with white people. Conclusion Adherence to evidence-based pharmacotherapy was substantially worse among the South-Asian and Chinese populations. Care providers need to be alerted to the high levels of non-adherence in these groups and the underlying causes need to be investigated. [ABSTRACT FROM AUTHOR]

Background: Despite the growth of hospitalist programs in Canada, little is known about their effectiveness for improving quality of care and use of scarce healthcare resources. The objective of this study is to compare measures of cost and quality of care (in-hospital mortality, 30-day same-facility readmission, and length of stay)of hospitalists vs. traditional physician providers in a large Canadian community hospital setting.Methods: We performed a retrospective analysis of data from the Canadian Institute for Health Information (CIHI)Discharge Abstract Database, using multivariate logistic and linear regression analyses comparing performance off our provider groups of traditional family physicians (FPs), traditional internal medicine subspecialists (other-IM),family physician-trained hospitalists (FP-Hospitalist), and general internal medicine-trained hospitalists(GIM-Hospitalist).Results: Compared to traditional FPs, FP-Hospitalists and GIM-Hospitalists demonstrate lower mortality [OR 0.881,(CI 0.779 - 0.996); and OR 0.355, (CI 0.288 - 0.436)] and readmission rates [OR 0.766, (CI 0.678 - 0.867); and OR 0.800,(CI 0.675 - 0.948)]. Compared to traditional FPs, GIM-Hospitalists appear to improve length of stay [OR−2.975,(CI −3.302 - -2.647)] while FP-Hospitalists perform similarly [OR 0.096, (CI −0.136 - 0.329)]. Compared to other-IM,GIM-Hospitalists have similar performance on all measures while FP-Hospitalists show a mixed impact.Conclusions: Compared to traditional family physicians, hospitalists appear to improve measures of quality and resource utilization. Specifically, hospitalists demonstrate lower in-hospital mortality and 30-day readmission rates while improving (or at least showing similar) length of stay. Compared to traditional subspecialists, hospitalistsdemonstrate similar performance despite looking after sicker and more complex medical patients. [ABSTRACT FROM AUTHOR]

Objectives: The study objective was to summarize and critically assess the evidence available from randomized controlled trials (RCTs) of qigong exercise for patients with fibromyalgia (FM). Methods: Thirteen (13) databases were searched up to February 2011. RCTs testing the effects of qigong exercise among patients with FM were included. For each included study, data were extracted and study quality was evaluated using the Jadad Scale. Results: Four (4) RCTs met the inclusion criteria. One (1) RCT demonstrated beneficial effects of qigong exercise for FM. Two (2) RCTs testing the effectiveness of qigong as a part of a treatment package compared with group education or daily activities failed to show favorable effects of qigong exercise for adult patients with FM. Another RCT comparing qigong with aerobic exercise among children with FM showed effects in favor of aerobic exercise. Conclusions: Given methodological flaws in the included studies, it is still too early to draw a conclusion about the effectiveness of qigong exercise for FM. Further rigorously designed RCTs are warranted. [ABSTRACT FROM AUTHOR]

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Background: Heart failure contributes to millions of emergency department (ED) visits, but hospitalization-versus-discharge decisions are often not accompanied by prognostic risk quantification. Objective: To derive and validate a model for acute heart failure mortality applicable in the ED. Design: Clinical data abstraction with development of a broadly applicable multivariate risk index for 7-day death using initial vital signs, clinical and presentation features, and readily available laboratory tests. Setting: Multicenter study of 86 hospitals in Ontario, Canada. Patients: Population-based random sample of 12 591 patients presenting to the ED from 2004 to 2007. Measurements: Death within 7 days of presentation. Results: In the derivation cohort (n = 7433; mean age, 75.4 years [SD, 11.4]; 51.5% men), mortality risk increased with higher triage heart rate (adjusted odds ratio [OR], 1.15 [95% CI, 1.03 to 1.30] per 10 beats/min) and creatinine concentration (OR, 1.35 [CI, 1.14 to 1.60] per 1 mg/dL [88.4 mol/L]), and lower triage systolic blood pressure (OR, .52 [CI, 1.31 to 1.77] per 20 mm Hg) and initial oxygen saturation (OR, 1.16 [CI, 1.01 to 1.33] per 5%). Nonnormal serum troponin levels (OR, 2.75 [CI, 1.86 to 4.07]) were associated with increased mortality risk. Areas under the receiver-operating characteristic curves of the multivariate model were 0.805 for the derivation data set (bootstrap-corrected, 0.811) and 0.826 for validation data set (n = 5158; mean age, 75.7 years [SD, 11.4]; 51.6% men). In the derivation cohort, a multivariate index score stratified 7-day mortality with rates of 0.3%, 0.3%, 0.7%, and 1.9% in quintiles 1 to 4, respectively. Mortality rates in the 2 highest risk groups were 3.5% and 8.2% in deciles 9 and 10, respectively. Limitation: Left ventricular ejection fraction was not included in the model. Conclusion: A multivariate index comprising routinely collected variables stratified mortality risk with high discrimination in a broad group of patients with acute heart failure presenting to the ED. Primary Funding Source: Canadian Institutes of Health Research. [ABSTRACT FROM AUTHOR]

Background Non-small-cell lung cancer (NSCLC) tumours with activating mutations of the epidermal growth factor receptor (EFGR) tyrosine kinase are highly sensitized to the effects of oral tyrosine kinase inhibitors such as gefitinib and erlotinib, suggesting the possibility of targeted treatment of nsclc based on EFGR mutation status. However, no standardized method exists for assessing the EGFR mutation status of tumours. Also, it is not known if available methods are feasible for routine screening. To address that question, we conducted a validation study of methods used for detecting EGFR mutations in exons 19 and 21 at molecular laboratories located in five specialized Canadian cancer centres. Methods The screening methods were first optimized using cell lines harbouring the mutations in question. A validation phase using anonymized patient samples followed. Results The methods used at the sites were highly specific and sensitive in detecting both mutations in cell-line DNA (specificity of 100% and sensitivity of at least 1% across all centres). In the validation phase, we observed excellent concordance between the laboratories for detecting mutations in the patient samples. Concordant results were obtained in 26 of 30 samples (approximately 87%). In general, the samples for which results were discordant were also less optimal, containing small amounts of tumour. Conclusions Our results suggest that currently available methods are capable of reliably detecting exon 19 and exon 21 mutations of EFGR in tumour samples (provided that sufficient tumour material is available) and that routine screening for those mutations is feasible in clinical practice. [ABSTRACT FROM AUTHOR]

Background: The extent to which uncomplicated obesity among an otherwise healthy middle-aged population is associated with higher longitudinal health-care expenditures remains unclear. Methods: To examine the incremental long-term health service expenditures and outcomes associated with uncomplicated obesity, 9398 participants of the 1994-1996 National Population Health Survey were linked to administrative data and followed longitudinally forward for 11.5 years to track health service utilization costs and death. Patients with pre-existing heart disease, those who were 65 years of age and older, and those with selfreported body mass indexes of <18.5 kg/m2 at inception were excluded. Propensity-matching was used to compare obesity (+/? other baseline risk-factors and lifestyle behaviours) with normal-weight healthy controls. Cost-analyses were conducted from the perspective of Ontario's publicly-funded health care system. Results: Obesity as an isolated risk-factor was not associated with significantly higher health-care costs as compared with normal weight matched controls (Canadian $8,294.67 vs. Canadian $7,323.59, P = 0.27). However, obesity in combination with other lifestyle factors was associated with significantly higher cumulative expenditures as compared with normal-weight healthy matched controls (CAD$14,186.81 for those with obesity + 3 additional risk-factors vs. CAD$7,029.87 for those with normal BMI and no other risk-factors, P < 0.001). The likelihood that obese individuals developed future diabetes and hypertension also rose markedly when other lifestyle factors, such as smoking, physical inactivity and/or psychosocial distress were present at baseline. Conclusions: The incremental health-care costs associated with obesity was modest in isolation, but increased significantly when combined with other lifestyle risk-factors. Such findings have relevance to the selection, prioritization, and cost-effective targeting of therapeutic lifestyle interventions. [ABSTRACT FROM AUTHOR]

The article focuses on a randomized trial in Canada and Brazil comparing the efficacy of expectant management and immediate treatment for low-grade cervical intraepithelial neoplasia (CIN) in women. The study involves women with grade 1 CIN confirmed with biopsy who have been administered with either regular colposcopic follow-up (CFup) or immediate treatment (IT) via loop electrosurgical excisional procedure (LEEP). Results show that CFup with intervention for disease progression over 18 months does not stand inferior to IT with LEEP.

Unfavourable environmental conditions for crown rust [Puccinia coronata f. sp. avenae] during 2007-2009 resulted in light incidence of crown rust on oat (Avena sativa) in Manitoba and eastern Saskatchewan. The first appearance of crown rust on 11 August in 2008 and on 15 August in 2009 was the latest ever seen in this region over the past three decades. Using 19 oat crown rust differentials, a large number of races were identified from isolates from wild oat each year, and a large proportion of the races were represented by a single isolate. There were significant differences between isolates from wild oat and cultivated oat in frequency of virulence to several genes in some years. Virulence frequency to Pc48, a gene in 'Triple Crown', was between 8.2-14.1% in isolates from wild oat and between 11.5-18.2% in isolates from cultivated oat during 2007-2009. Frequency of virulence to Pc68 was between 42.3-45.9% and 70.8-81.8% in isolates from wild oat and cultivated oat, respectively. As cultivars with the Pc38, 39, 68-gene combination were still commonly grown during these years, races with virulence to this gene combination were abundant. These cultivars were gradually replaced by new cultivars with different resistance genes. By 2009, 'Leggett' (Pc68, 94) accounted for 17.9% of the total oat hectarage, and 'HiFi' (Pc91) accounted for 3.0%. During 2007-2009, virulence to Pc94 was low (≤ 1.8%) or not detected, virulence to Pc91 was found in a single isolate, and virulence to gene temp_pc97 or temp_Pc98 was either low or not detected. The huge increase in frequency of virulence to Pc45 in 2008 and 2009 was most likely a result of isolates with this virulence migrating into the prairie region from the USA. [ABSTRACT FROM AUTHOR]

The article presents the views of several politicians regarding the motion of question period in Canada. Parliament member Michael Chong states that parliamentary reform begins with the reform of question period. Liberal Party member Marlene Jennings and her group intend to support the motion and believe its commendable initiative. While New Democratic Party member Libby Davies agrees with Jennings and points out that the said motion is a genuine attempt to be thoughtful around question period.

Two studies are reported examining academic procrastination and motivation in 1,145 university students from Canada and Singapore. In Study 1, relationships between procrastination and motivation variables were found to be similar across contexts, with self-efficacy for self-regulated learning most strongly associated with procrastination in both contexts. In Study 2, patterns of procrastinating behavior and the negative impact of procrastination were examined and compared in Canadian and Singaporean undergraduates. Participants in both contexts reported writing to be the academic task most prone to procrastination. More Singaporeans than Canadians were classified as negative procrastinators (i.e. rated procrastination as a negative influence on academic functioning). In both contexts, negative procrastinators spent more time procrastinating than neutral procrastinators and displayed lower self-efficacy for self-regulated learning. On décrit deux recherches portant sur la motivation et la procrastination universitaire (tendance à remettre au lendemain) de 1145 étudiants du Canada et de Singapour. Dans la première étude, les relations entre la motivation et la procrastination sont apparues être analogues dans les deux pays, la variable la plus fortement associéà la procrastination étant l'auto-efficience pour l'apprentissage autorégulé. Dans la deuxième étude, les schémas comportementaux de procrastination et son impact négatif ont été analysés et comparés chez les étudiants de 1° cycle canadiens et singapouriens. Les sujets des deux pays ont mentionné la rédaction comme étant la tâche universitaire la plus soumise à la procrastination. Davantage de Singapouriens que de Canadiens été classés en procrastinateurs négatifs (c'est-à-dire que la procrastination est considérée comme étant un handicap pour les études). Dans les deux cas, les procrastinateurs négatifs gaspillaient plus de temps que les procrastinateurs neutres et manifestaient une moindre auto-efficience pour l'apprentissage autorégulé. [ABSTRACT FROM AUTHOR]

Language serves two key functions. It enables communication between agents, which allows the set-up and functioning of formal and informal institutions. It also serves a less obvious function, as it provides a reassuring quality more closely related with issues linked with trust, social capital, and cultural identification. While research on the role of language as a learning process is widespread, there is no evidence on the role of language as a signal of cultural affinity. We pursue this latter avenue of research and show that subtle language affinity is positively linked with change in earnings when using English-speaking data for cities in the Golden Horseshoe area in Southern Ontario during the period 1991 to 2001. The results are robust to changes in specification, and a broad number of empirical tests. [ABSTRACT FROM AUTHOR]