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The study investigated the extent to which 20 regular education teachers modified the mainstream learning environment for visually impaired children attending public day schools in British Columbia, Canada. Elementary teachers tried to make modifications to a greater extent than did secondary teachers, but both types of teachers made both "typical" and "substantial" modifications. (DB)

Aquatic invasive species (AIS) pose a significant threat to Canadian fresh, estuarine, and marine waters and threaten Canada's biodiversity, economy, and society. To prevent the introduction and spread of AIS by water-based commercial and recreational activities, many government and non-government organizations encourage owners and operators to voluntarily Clean, Drain, and Dry (CDD) their watercraft, trailers, and equipment. In some cases, an additional Decontamination step may be applied (CDD+D) which has species-specific treatment parameters to achieve AIS mortality and/or removal. To date, a comprehensive evaluation of the effectiveness of CDD+D protocols used in Canada for marine and freshwater AIS has not been conducted. This research document provides a review, by species, of effective decontamination treatments identified in the scientific literature and suggests treatment guidelines aimed to kill the greatest number of target AIS taxa. The effectiveness of recommendations in existing freshwater and marine CDD+D protocols used in AIS management across Canada or abroad were also assessed. Lethal decontamination treatments for AIS of interest from different functional and taxonomic groups (e.g., bivalves, gastropods, zooplankton, macrophytes, macroalgae, crabs, and tunicates) were evaluated and included physical (e.g., hot water spray/immersion, pressure washing, air-drying, and freezing) and chemical (e.g., sodium hypochlorite, acetic acid, quaternary ammonium compounds, salt water, Virkon©, brine, and hydrated lime) sprays/immersions or a combination of these. The scientific literature showed that several decontamination treatments can be lethal for AIS but only if applied for specific exposure times and conditions. Recommendations in government or state protocols mostly echoed the scientific literature and underline that CDD campaigns should continue to be supported across the country. In some cases, when additional decontamination is required, (e.g., a watercraft is at high risk of transporting AIS), temperature, pressure, and/or chemical treatments may need to be adjusted to ensure 100% mortality of a greater number of target AIS. Although numerous species-or environment-specific decontamination treatments were identified as effective at killing or removing AIS, no single decontamination treatment was applicable to all freshwater and marine AIS or to all watercraft and equipment. The results from this study will help develop national CDD+D recommendations and provide advice to Fisheries and Oceans Canada's regulatory programs and to the Canadian public. [ABSTRACT FROM AUTHOR]

Objective: To compare the vaginal microbiota of women living with HIV (WLWH) with the vaginal microbiota of women with recurrent bacterial vaginosis (BV) and healthy women without HIV to determine if there are differences in the vaginal microbiome, what factors influence these differences, and to characterise HIV clinical parameters including viral load and CD4 count in relation to the vaginal microbiome.Design: Observational cohort study.Setting: Canada.Population: Women aged 18-49 years who were premenopausal and not pregnant were recruited into three cohorts: healthy women, WLWH and women with recurrent BV.Methods: Demographic and clinical data were collected via interviews and medical chart reviews. Vaginal swabs were collected for Gram-stain assessment and microbiome profiling using the cpn60 barcode sequence.Main Outcome Measures: To compare overall community composition differences, we used compositional data analysis methods, hierarchical clustering and Kruskal-Wallis tests where appropriate.Results: Clinical markers such as odour and abnormal discharge, but not irritation, were associated with higher microbial diversity. WLWH with unsuppressed HIV viral loads were more likely than other groups to have non-Gardnerella-dominated microbiomes. HIV was associated with higher vaginal microbial diversity and this was related to HIV viral load, with unsuppressed women demonstrating significantly higher relative abundance of Megasphaera genomosp. 1, Atopobium vaginae and Clostridiales sp. (all P < 0.05) compared with all other groups.Conclusions: In WLWH, unsuppressed HIV viral loads were associated with a distinct dysbiotic profile consisting of very low levels of Lactobacillus and high levels of anaerobes.Tweetable Abstract: Vaginal microbiomes in WLWH with viral load >50 copies/ml have distinct dysbiotic profiles with high levels of anaerobes. [ABSTRACT FROM AUTHOR]

The underlying natural relationship between conductivity and alkalinity was used to identify surface water quality monitoring sites that are in a 'reference' or minimally disturbed condition. Data from over 40,500 freshwater samples from 1,230 sites were combined for the time period of 2005-2015 from various federal, provincial, and joint federal--provincial/territorial freshwater monitoring programs (e.g., Freshwater Quality Monitoring and Surveillance Program, Ontario's Provincial Water Quality Monitoring Network). Of the samples, 30,347 provided conductivity and alkalinity data. Surface water samples with a measured conductivity that deviated (by more than 41 μS/cm) from the predicted conductivity calculated from the sample's alkalinity were deemed to be non-representative of a reference condition, while samples within 41 μS/cm of the predicted value were deemed representative of a reference condition. The 41 μS/cm cutoff value was determined using signal detection theory. The conductivity--alkalinity model was validated through a comparison with land cover data by demonstrating that samples identified as 'reference' were typically from catchments that had minimal anthropogenic disturbances. The proposed approach provides a rapid means of evaluating the reference condition of a watercourse, and of identifying data that provide an estimate of reference condition. [ABSTRACT FROM AUTHOR]

Background In 2006, the federal government committed funding of $250 million over 5 years for the Canadian Partnership Against Cancer Corporation to begin implementation of the Canadian Strategy for Cancer Control (cscc). The Partnership was established as a not-for-profit corporation designed to work actively with a broad range of stakeholders and organizations that had been engaged in the development of the cscc and with the public more broadly. A policy experiment unto itself, the Partnership was the first disease-based organization funded at the federal level outside of government. It was charged with a mandate to enable transfer of knowledge and to catalyze coordinated and accelerated action across the country to reduce the burden of cancer. Implementation Implementation has involved establishing shared goals, objectives, and plans with participating partners. Knowledge management—incorporating pan- Canadian approaches to the identification of content, processes, technology, and culture change—was used to enable that work across the federated health care delivery system. Evaluation of the organization through independent review, the ability to achieve initiative-level targets by 2012, and progress measured using indicators of system performance was used to examine the effectiveness of the strategy and approach overall. Discussion and Conclusions Evaluation findings support the conclusions that Canada has made progress in achieving immediate outcomes (achievable in <5 years) associated with advancing its cancer control goals and that there is evidence that, with sustained effort, those goals will translate into a long-term (>25 years) impact on cancer. The mechanism of funding the Partnership to develop collaboration among stakeholders in cancer control to achieve coordinated action has been possible and has been enabled through the Partnership's knowledge-to-action mandate. Opportunities are available to further engage and clarify the roles of stakeholders in action, to clearly define outcomes, and to further quantify the economic benefits that have resulted from a coordinated approach. With the ongoing funding commitment to support coordinated action within a federated environment of health care delivery, there is opportunity to reduce the impact that cancer may have in the long term in Canada. [ABSTRACT FROM AUTHOR]

The proportion of female radiation oncology residents in Canada remains disproportionately low. The objective of this study was to examine 15 years of resident match data to assess trends in gender-specific medical student interest and match characteristics in radiation oncology (RO). Public Canadian Residency Matching Service (CaRMS) data between 2007-21 were compiled. Gender-based analysis focused on Canadian medical graduates (CMGs) ranking RO as their first-choice discipline in the first iteration of the match. Gender data were not available for applicants and match characteristics for second iteration outcomes. Pearson's chi-square test was used to compare 15-year average female medical student interest in RO versus all training programs. Paired t-test was used to compare total, female, and male applicant numbers over five-year increments (2007-11; 2012-16; 2017-21). Statistical analysis was performed using statistical software. Total applicants to RO programs ranged between 24-51 per year over the study period. The mean number of applicants ranking RO as their first-choice discipline significantly decreased from 24 (range: 20-27) in 2007-11 to 16 (12-18) in 2012-16 (p<0.01), with an increase to 22 (9-28) in 2017-21 (p<0.05). The 15-year average of female RO applicants was 9 per year, ranging from 2/9 (22%) in 2017 to 12/18 (67%) applicants in 2015. Female applicant numbers were lower in 2012-16 (mean 7; 4-12) compared to 2007-11 (mean 14; 11-16; p<0.01). Female applicant numbers in 2017-21 (mean 7; 2-10) were comparable to 2012-16 (p=0.46), but remained lower than 2007-11 (p<0.01). Male applicant numbers were similar (p=0.12) in 2007-11 (mean 10; 9-12) and 2012-16 (mean 8; 5-11), but increased in 2017-21 (mean= 15; 7-20) compared to 2007-11 (p=0.03) and 2012-16 (p=0.01). Overall, 308 CMG applicants ranked RO as their first choice over the past 15 years; 141 females (46%) and 167 males (54%). Over the same period, 56% (24472/43667) of CMG applicants who participated in the CaRMS match were female. Female CMG application rates to RO were significantly lower compared to application rates to all specialties combined (p<0.01). Despite increasing male applicant numbers, the number of RO-preferring female medical students remains disproportionately low. Female medical student interest in RO over the last ten years has also fallen significantly from 2007-11 levels. These findings highlight the need for early exposure of female medical students and improved mentorship efforts. A deeper understanding of factors influencing female medical students' career selection and CaRMS ranking decisions is required to improve female representation in RO. These data have led to a special interest group proposal for women in RO, now being considered by the Canadian Association of Radiation Oncology. [ABSTRACT FROM AUTHOR]

In an era of increasing virtual communication, we aimed to investigate current formats used by radiation oncology residents for reviewing radiation treatment plans with attendings, preferences for formats, and reasons contributing to preferences. Residents enrolled in Canadian radiation oncology programs received questionnaires examining training level, typical review formats, preferred format, and reasons for preference. Analysis excluded PGY-1s due to insufficient exposure. Fifty-two residents participated. National response rate was 55%. Overall, hybrid review was the most used format (77%). Virtual review was the most preferred format (44%). Preference for virtual review was most common among junior residents (57%), while in-person review was most preferred by senior residents (45.4%). Few residents typically use their preferred format (35%). Reasons for preference varied between groups in convenience (p < 0.01), interactivity (p < 0.01), and teaching quality (p = 0.04). The persistence of e-learning suggests that virtual treatment planning education will continue to some degree. Junior residents prefer virtual review, while a clearly preferred review format was less apparent among senior residents. Preferences are multifactorial, and the trends seen in reasons for preference between formats may reflect advantages inherent to each. Progress is still needed in optimizing treatment planning education, as suggested by few residents using their preferred format. Residents and staff should collectively decide which educational format for treatment planning best meets educational needs., (© 2023. The Author(s) under exclusive licence to American Association for Cancer Education.)

Cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and mindfulness-based stress reduction (MBSR) have demonstrated effectiveness for improving outcomes in chronic pain. These evidence-based psychotherapies (EBPs) remain underutilized in clinical practice, however. To identify research gaps and next steps for improving uptake of EBPs, we conducted a systematic review of patient-, provider-, and system-level barriers and facilitators of their use for chronic pain. We searched MEDLINE, Embase, PsycINFO, and CINAHL databases from inception through September 2022. Prespecified eligibility criteria included outpatient treatment of adults with chronic pain; examination of barriers and facilitators and/or evaluation of implementation strategies; conducted in the United States (US), United Kingdom (UK), Ireland, Canada or Australia; and publication in English. Two reviewers independently assessed eligibility and rated quality. We conducted a qualitative synthesis of results using a best-fit framework approach building upon domains of the Consolidated Framework for Implementation Research (CFIR). We identified 34 eligible studies (33 moderate or high quality), most (n = 28) of which addressed patient-level factors. Shared barriers across EBPs included variable patient buy-in to therapy rationale and competing responsibilities for patients; shared facilitators included positive group or patient-therapist dynamics. Most studies examining ACT and all examining MBSR assessed only group formats. No studies compared barriers, facilitators, or implementation strategies of group CBT to individual CBT, or of telehealth to in-person EBPs. Conceptual mismatches of patient knowledge and beliefs with therapy principles were largely analyzed qualitatively, and studies did not explore how these mismatches were addressed to support engagement. Future research on EBPs for chronic pain in real-world practice settings is needed to explore provider and system-level barriers and facilitators, heterogeneity of effects and uptake, and both effects and uptake of EBPs delivered in various formats, including group vs individual therapy and telehealth or asynchronous digital approaches. PERSPECTIVE: This systematic review synthesizes evidence on barriers and facilitators to uptake of cognitive behavioral therapy, acceptance and commitment therapy, and mindfulness-based stress reduction for chronic pain. Findings can guide future implementation work to increase availability and use of evidence-based psychotherapies for treatment of chronic pain. REGISTRATION: PROSPERO number CRD42021252038., (Published by Elsevier Inc.)

Objective: To compare the vaginal microbiota of women living with HIV (WLWH) with the vaginal microbiota of women with recurrent bacterial vaginosis (BV) and healthy women without HIV to determine if there are differences in the vaginal microbiome, what factors influence these differences, and to characterise HIV clinical parameters including viral load and CD4 count in relation to the vaginal microbiome., Design: Observational cohort study., Setting: Canada., Population: Women aged 18-49 years who were premenopausal and not pregnant were recruited into three cohorts: healthy women, WLWH and women with recurrent BV., Methods: Demographic and clinical data were collected via interviews and medical chart reviews. Vaginal swabs were collected for Gram-stain assessment and microbiome profiling using the cpn60 barcode sequence., Main Outcome Measures: To compare overall community composition differences, we used compositional data analysis methods, hierarchical clustering and Kruskal-Wallis tests where appropriate., Results: Clinical markers such as odour and abnormal discharge, but not irritation, were associated with higher microbial diversity. WLWH with unsuppressed HIV viral loads were more likely than other groups to have non-Gardnerella-dominated microbiomes. HIV was associated with higher vaginal microbial diversity and this was related to HIV viral load, with unsuppressed women demonstrating significantly higher relative abundance of Megasphaera genomosp. 1, Atopobium vaginae and Clostridiales sp. (all P < 0.05) compared with all other groups., Conclusions: In WLWH, unsuppressed HIV viral loads were associated with a distinct dysbiotic profile consisting of very low levels of Lactobacillus and high levels of anaerobes., Tweetable Abstract: Vaginal microbiomes in WLWH with viral load >50 copies/ml have distinct dysbiotic profiles with high levels of anaerobes., (© 2019 Royal College of Obstetricians and Gynaecologists.)

Background: Cortisol level in hair is increasingly being used as a biomarker of chronic stress. Members of First Nation communities in Canada are experiencing stress related to a higher incidence of chronic diseases, socioeconomic factors, the state of their environment, and cultural oppression. This study aimed to investigate hair cortisol as a biomarker of stress in this population., Materials and Methods: Hair samples were collected from the posterior vertex of 55 Walpole Island First Nation (WIFN) volunteers and compared with white volunteers living in and around London, ON, Canada. An enzyme-linked immunosorbent assay technique was used to measure cortisol content in 1 cm of hair, considered to represent 1 month of growth. In parallel, the Perceived Stress Scale (PSS), which measures short-term stress, was also completed., Results: Median hair cortisol level (range) in WIFN volunteers was 177 (93-273) ng/g, significantly higher than the median hair cortisol in the healthy white controls of 116 (26-204) ng/g (P < 0.0001, Mann-Whitney U test). Hair cortisol correlated positively with gender, smoking status, and self-reported diabetes. Unlike hair cortisol, the Perceived Stress Scale did not differentiate between the First Nation and control population., Conclusions: The increased hair cortisol concentrations among WIFN volunteers compared with volunteers from a non-First Nation community suggests higher levels of chronic stress. The causes for this apparent increased stress are likely due to factors such as socioeconomic and poorer health and are worthy of further evaluation. The results highlight the difference between acute stress measured for short periods of time compared with chronic stress, measured by hair analysis.

Methylmercury [MeHg(I) in the aerobic surface water of lakes is thought to be rapidly degraded, but contrary to expectations, we show that MeHg(I) concentrations often increase during sunlight hours or remain relatively constant. We hypothesized that there were water column processes that generated MeHg(I) and that these processes were linked to dissolved organic matter (DOM) and solar radiation. A 2-day diurnal pattern of MeHg(I) in surface water with corresponding bottled controls was assessed for two contrasting lakes in Kejimikujik, Nova Scotia, Canada. Following this study, a tangential ultrafiltrator was used to size-fractionate and generate a concentration gradient of DOM from four different lakes located near Lac Berthelot, Quebec, Canada. The watersheds of two of these lakes were not substantially logged whereas the other two had been extensively logged. Different size fractions of DOM as well as different concentrations of DOM were exposed to sunlight for varying periods of time. We observed that, in Keiimikujik, the concentration of MeHg(I) in surface waters peaked in the early afternoon. Furthermore, this also occurred in bottled water for one of the lakes, Puzzle, eliminating the possibility that in-lake mixing played a role in this pattern. The formation of MeHg(I) was found to be dependent on the size fraction and amount of DOM present in the water. Specifically, DOM less than 5 kDa or between 30 and 300 kDa generated MeHg(I) when exposed to sunlight, but larger fractions did not. Furthermore, although data are limited, we found that water from lakes with logged watersheds generated MeHg(I) when exposed to sunlight, whereas water from lakes with low levels of logging in the undisturbed watersheds did not. Our results demonstrate that MeHg(I) can be formed in freshwaters of certain lakes in response to solar radiation. This photoproduction of MeHg(I) is dependent on DOM concentrations and type, with the importance of water chemistry not yet clear. The significance of this process to freshwater lakes and the mechanism responsible for MeHg(I) photoproduction is still unclear, but a correction in the conventional wisdom that MeHg(I) is rapidly photodegraded is timely.

Previously published Type I (insulin-dependent) diabetes mellitus incidence in 0 to 14-year-old children from 10 countries or areas was compared with the national annual cow milk protein consumption. Countries which were selected for study had appropriate milk protein polymorphism studies, herd breed composition information and low dairy imports from other countries. Total protein consumption did not correlate with diabetes incidence (r = +0.402), but consumption of the beta-casein A1 variant did (r = +0.726). Even more pronounced was the relation between beta-casein (A1+B) consumption and diabetes (r = +0.982). These latter two cow caseins yield a bioactive peptide beta-casomorphin-7 after in vitro digestion with intestinal enzymes whereas the common A2 variant or the corresponding human or goat caseins do not. beta-casomorphin-7 has opioid properties including immunosuppression, which could account for the specificity of the relation between the consumption of some but not all beta-casein variants and diabetes incidence.