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The effects of randomization to mindfulness training (MT) or to a waitlist-control condition on psychological and physiological indicators of teachers' occupational stress and burnout were examined in 2 field trials. The sample included 113 elementary and secondary school teachers (89% female) from Canada and the United States. Measures were collected at baseline, post-program, and 3-month follow-up; teachers were randomly assigned to condition after baseline assessment. Results showed that 87% of teachers completed the program and found it beneficial. Teachers randomized to MT showed greater mindfulness, focused attention and working memory capacity, and occupational self-compassion, as well as lower levels of occupational stress and burnout at post-program and follow-up, than did those in the control condition. No statistically significant differences due to MT were found for physiological measures of stress. Mediational analyses showed that group differences in mindfulness and self-compassion at post-program mediated reductions in stress and burnout as well as symptoms of anxiety and depression at follow-up. Implications for teaching and learning are discussed.

Background: During the first year of the COVID-19 pandemic, the proportion of reported cases of COVID-19 among Canadians was under 6%. Although high vaccine coverage was achieved in Canada by fall 2021, the Omicron variant caused unprecedented numbers of infections, overwhelming testing capacity and making it difficult to quantify the trajectory of population immunity. Methods: Using a time-series approach and data from more than 900 000 samples collected by 7 research studies collaborating with the COVID-19 Immunity Task Force (CITF), we estimated trends in SARS-CoV-2 seroprevalence owing to infection and vaccination for the Canadian population over 3 intervals: prevaccination (March to November 2020), vaccine roll-out (December 2020 to November 2021), and the arrival of the Omicron variant (December 2021 to March 2023). We also estimated seroprevalence by geographical region and age. Results: By November 2021, 9.0% (95% credible interval [CrI] 7.3%–11%) of people in Canada had humoral immunity to SARS-CoV-2 from an infection. Seroprevalence increased rapidly after the arrival of the Omicron variant — by Mar. 15, 2023, 76% (95% CrI 74%–79%) of the population had detectable antibodies from infections. The rapid rise in infection-induced antibodies occurred across Canada and was most pronounced in younger age groups and in the Western provinces: Manitoba, Saskatchewan, Alberta and British Columbia. Interpretation: Data up to March 2023 indicate that most people in Canada had acquired antibodies against SARS-CoV-2 through natural infection and vaccination. However, given variations in population seropositivity by age and geography, the potential for waning antibody levels, and new variants that may escape immunity, public health policy and clinical decisions should be tailored to local patterns of population immunity. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) and kidney failure in childhood are associated with significant and life-altering morbidities and lower quality of life. Emerging evidence suggests that management should be guided in part by symptom burden; however, there is currently no standardized assessment tool for quantifying symptom burden in this pediatric population. This study aimed to develop and refine a patient-reported symptom assessment tool for children with CKD/kidney failure (PRO-Kid), to evaluate the frequency and impact of symptoms. Methods: This was a prospective observational study of children and caregivers of children with CKD/kidney failure at two Canadian pediatric care centers. Building on previously published patient-reported outcome measures (PROs) for the assessment of symptom burden in other populations, we drafted a 13-item questionnaire. Cognitive interviews were performed with children and caregivers of children with CKD/kidney failure to iteratively refine the questionnaire. Results: Twenty-four participants completed cognitive interviewing (11 children, 13 caregivers). The most common symptoms endorsed were feeling left out, feeling sad/depressed, inability to focus, tiredness, nausea, vomiting, not wanting to eat, and changes in the taste of food. Feeling left out was added to the questionnaire as almost all participants voiced this as a frequent and impactful symptom, resulting in a 14-item questionnaire. Conclusions: PRO-Kid is the first pediatric CKD/kidney failure-specific PRO tool to assess symptom burden. Future work should validate this tool in a larger cohort so that it may be used to improve the care of children living with CKD/kidney failure. A higher resolution version of the Graphical abstract is available as Supplementary information [ABSTRACT FROM AUTHOR]

Proper knowledge of potential groundwater recharge (PGR) and its spatiotemporal distribution are essential for sustainable groundwater management, especially within the context of climate change. Here, a robust GIS‐based water budget framework was developed to estimate PGR at a regional scale and map its spatial distribution. This framework is demonstrated over the Saguenay‐Lac‐Saint‐Jean region (13 200 km2) of Quebec (Canada). The PGR mapping process was based on a model incorporating water budget components. The vertical inflows (VI) include water amounts from rainfall and snowmelt, whereby the latter was assessed using HYDROTEL model. VI were combined with the maximum and minimum temperatures to estimate actual evapotranspiration (AET), while the surface runoff (RuS) was assessed using the curve number method. Field observations of annual variation in temperatures and the water budget components, over a period of 100 years (1910–2009), were used to provide a comprehensive overview of the effects of climate change on PGR. The last 10 years of the observation period (i.e., 2000–2009) indicate that 6% of the study area has PGR rates of 35%–50%. PGR rates of 20%–35% occur in 58% of the study area, while 36% have PGR of 5%–20%. The trend analysis of temperature time series reveals an average of 1.1 ± 0.6°C increase over 100 years. Also, an increase in the water budget components is observed. Despite the increasing trends of RuS and AET, PGR still showed an increasing trend with an average increase of 0.7 ± 0.4 mm/year over the past 100 years. This observation indicates that the increase in VI was enough to compensate for the increases in AET and RuS. This finding of an increasing PGR in the study area provides useful information for future studies focusing on predicting long‐term PGR evolution and for the development of efficient long‐term groundwater management strategies. [ABSTRACT FROM AUTHOR]

Background: Modern health surveillance and planning requires an understanding of how preventable risk factors impact population health, and how these effects vary between populations. In this study, we compare how smoking, alcohol consumption, diet and physical activity are associated with all-cause mortality in Canada and the United States using comparable individual-level, linked population health survey data and identical model specifications.Methods: The Canadian Community Health Survey (CCHS) (2003-2007) and the United States National Health Interview Survey (NHIS) (2000, 2005) linked to individual-level mortality outcomes with follow up to December 31, 2011 were used. Consistent variable definitions were used to estimate country-specific mortality hazard ratios with sex-specific Cox proportional hazard models, including smoking, alcohol, diet and physical activity, sociodemographic indicators and proximal factors including disease history.Results: A total of 296,407 respondents and 1,813,884 million person-years of follow-up from the CCHS and 58,232 respondents and 497,909 person-years from the NHIS were included. Absolute mortality risk among those with a 'healthy profile' was higher in the United States compared to Canada, especially among women. Adjusted mortality hazard ratios associated with health behaviours were generally of similar magnitude and direction but often stronger in Canada.Conclusion: Even when methodological and population differences are minimal, the association of health behaviours and mortality can vary across populations. It is therefore important to be cautious of between-study variation when aggregating relative effect estimates from differing populations, and when using external effect estimates for population health research and policy development. [ABSTRACT FROM AUTHOR]

Random population-based surveys to estimate prevalence of SARS-CoV2 infection causing coronavirus disease (COVID-19) are useful to understand distributions and predictors of the infection. In April 2020, the first-ever nationally representative survey in Canada polled 4,240 adults age 18 years and older about self-reported COVID experience in March, early in the epidemic. We examined the levels and predictors of COVID symptoms, defined as fever plus difficulty breathing/shortness of breath, dry cough so severe that it disrupts sleep, and/or loss of sense of smell; and testing for SARS-CoV-2 by respondents and/or household members. About 8% of Canadians reported that they and/or one or more household members experienced COVID symptoms. Symptoms were more common in younger than in older adults, and among visible minorities. Overall, only 3% of respondents and/or household members reported testing for SARS-CoV-2. Being tested was associated with having COVID symptoms, Indigenous identity, and living in Quebec. Periodic nationally representative surveys of symptoms, as well as SARS-CoV-2 antibodies, are required in many countries to understand the pandemic and prepare for the future. [ABSTRACT FROM AUTHOR]

Paleoproterozoic Bijawars of the Sonrai basin consists of (a) Sonrai (mostly carbonate carbonaceous shale and phosphatic breccia) and (b) Solda Formations (commonly chloritic and ferruginous shale) with well-developed clay-organo-rich facies, often marked with hydrothermal activities. Previous studies revealed abundance order of kaolinite > chlorite > illite > smectite; and kaolinite > illite > chlorite in clay (0.2–2.0 µm) fractions separated from the Sonrai and Solda Formations, respectively. To understand atomic substitutions and trace elemental concentrations, clay minerals were analyzed by fusion ICP-MS and SEM–EDS. PAAS normalized data plots show U, Th, Rb, Ba, Pb Sr, and large-ion lithophiles enrichment, whereas, Bandai sandstone and Rohini carbonate clays show HREE enrichment with asymmetrical patterns, similar to those reported from the well-established McArthur River, Cigar Lake, and Sue UTUD of Canada. For Rohni carbonate, chondrite-normalized REE data plots revealed M shape REE patterns, ascribed to Gd–Tb–Dy–Ho tetrad effect and anomalous Y, Zr, and Hf concentrations. Owing to HREE incorporation in the clay inter-layers, linear and flattened REE trends were noticed. Flat REE patterns associated with the highly altered chlorite and illite represent negative Eu anomaly related to the dilational nature of the uraninite structure and is suggestive of anoxic conditions. [ABSTRACT FROM AUTHOR]

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Importance: Health care spending in the United States is a major concern and is higher than in other high-income countries, but there is little evidence that efforts to reform US health care delivery have had a meaningful influence on controlling health care spending and costs.Objective: To compare potential drivers of spending, such as structural capacity and utilization, in the United States with those of 10 of the highest-income countries (United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland, and Denmark) to gain insight into what the United States can learn from these nations.Evidence: Analysis of data primarily from 2013-2016 from key international organizations including the Organisation for Economic Co-operation and Development (OECD), comparing underlying differences in structural features, types of health care and social spending, and performance between the United States and 10 high-income countries. When data were not available for a given country or more accurate country-level estimates were available from sources other than the OECD, country-specific data sources were used.Findings: In 2016, the US spent 17.8% of its gross domestic product on health care, and spending in the other countries ranged from 9.6% (Australia) to 12.4% (Switzerland). The proportion of the population with health insurance was 90% in the US, lower than the other countries (range, 99%-100%), and the US had the highest proportion of private health insurance (55.3%). For some determinants of health such as smoking, the US ranked second lowest of the countries (11.4% of the US population ≥15 years smokes daily; mean of all 11 countries, 16.6%), but the US had the highest percentage of adults who were overweight or obese at 70.1% (range for other countries, 23.8%-63.4%; mean of all 11 countries, 55.6%). Life expectancy in the US was the lowest of the 11 countries at 78.8 years (range for other countries, 80.7-83.9 years; mean of all 11 countries, 81.7 years), and infant mortality was the highest (5.8 deaths per 1000 live births in the US; 3.6 per 1000 for all 11 countries). The US did not differ substantially from the other countries in physician workforce (2.6 physicians per 1000; 43% primary care physicians), or nursing workforce (11.1 nurses per 1000). The US had comparable numbers of hospital beds (2.8 per 1000) but higher utilization of magnetic resonance imaging (118 per 1000) and computed tomography (245 per 1000) vs other countries. The US had similar rates of utilization (US discharges per 100 000 were 192 for acute myocardial infarction, 365 for pneumonia, 230 for chronic obstructive pulmonary disease; procedures per 100 000 were 204 for hip replacement, 226 for knee replacement, and 79 for coronary artery bypass graft surgery). Administrative costs of care (activities relating to planning, regulating, and managing health systems and services) accounted for 8% in the US vs a range of 1% to 3% in the other countries. For pharmaceutical costs, spending per capita was $1443 in the US vs a range of $466 to $939 in other countries. Salaries of physicians and nurses were higher in the US; for example, generalist physicians salaries were $218 173 in the US compared with a range of $86 607 to $154 126 in the other countries.Conclusions and Relevance: The United States spent approximately twice as much as other high-income countries on medical care, yet utilization rates in the United States were largely similar to those in other nations. Prices of labor and goods, including pharmaceuticals, and administrative costs appeared to be the major drivers of the difference in overall cost between the United States and other high-income countries. As patients, physicians, policy makers, and legislators actively debate the future of the US health system, data such as these are needed to inform policy decisions. [ABSTRACT FROM AUTHOR]

Flooding in Canada is often caused by heavy rainfall during the snowmelt period. Hydrologic forecast centers rely on precipitation forecasts obtained from numerical weather prediction (NWP) models to enforce hydrological models for streamflow forecasting. The uncertainties in raw quantitative precipitation forecasts (QPFs) are enhanced by physiography and orography effects over a diverse landscape, particularly in the western catchments of Canada. A Bayesian post-processing approach called rainfall post-processing (RPP), developed in Australia (Robertson et al., 2013; Shrestha et al., 2015), has been applied to assess its forecast performance in a Canadian catchment. Raw QPFs obtained from two sources, Global Ensemble Forecasting System (GEFS) Reforecast 2 project, from the National Centers for Environmental Prediction, and Global Deterministic Forecast System (GDPS), from Environment and Climate Change Canada, are used in this study. The study period from January 2013 to December 2015 covered a major flood event in Calgary, Alberta, Canada. Post-processed results show that the RPP is able to remove the bias and reduce the errors of both GEFS and GDPS forecasts. Ensembles generated from the RPP reliably quantify the forecast uncertainty. [ABSTRACT FROM AUTHOR]

Background: Skewed male:female ratios at birth have been observed among certain immigrant groups. Data on abortion practices that might help to explain these findings are lacking.Methods: We examined 1 220 933 births to women with up to 3 consecutive singleton live births between 1993 and 2012 in Ontario. Records of live births, and induced and spontaneous abortions were linked to Canadian immigration records. We determined associations of male:female infant ratios with maternal birthplace, sex of the previous living sibling(s) and prior spontaneous or induced abortions.Results: Male:female infant ratios did not appreciably depart from the normal range among Canadian-born women and most women born outside of Canada, irrespective of the sex of previous children or the characteristics of prior abortions. However, among infants of women who immigrated from India and had previously given birth to 2 girls, the overall male:female ratio was 1.96 (95% confidence interval [CI] 1.75-2.21) for the third live birth. The male:female infant ratio after 2 girls was 1.77 (95% CI 1.26-2.47) times higher if the current birth was preceded by 1 induced abortion, 2.38 (95% CI 1.44-3.94) times higher if preceded by 2 or more induced abortions and 3.88 (95% CI 2.02-7.50) times higher if the induced abortion was performed at 15 weeks or more gestation relative to no preceding abortion. Spontaneous abortions were not associated with male-biased sex ratios in subsequent births.Interpretation: High male:female ratios observed among infants born to women who immigrated from India are associated with induced abortions, especially in the second trimester of pregnancy. [ABSTRACT FROM AUTHOR]

Background: The recognition of medical professionalism as a complex social construct makes context, geographical location and culture important considerations in any discussion of professional behaviour. Medical students, medical educators and practitioners are now much more on the move globally, exposing them to cultural and social attitudes, values and beliefs that may differ from their own traditional perceptions of professionalism. Aims and Methods: This paper uses the model of the intercultural development continuum and the concept of 'cultural fit' to discuss what might transpire when a student, teacher or doctor is faced with a new cultural environment. Using our own experiences as medical educators working abroad and supported by evidence in the literature, we have developed four anecdotal scenarios to highlight some of the challenges that different cultural contexts bring to our current (Western) understanding of professionalism. Results and Conclusions: The scenarios highlight some of the potentially different regional and/or cultural perspectives and nuances of professional behaviours, attitudes or values that many of us either take for granted or find difficult, depending on our training and socio-cultural upbringing. With this paper, we hope to start a long overdue conversation about global professionalism amongst medical educators, identify potential areas for research and highlight a need for medical schools to embrace a 'global' approach to how professionalism is embedded in their curricula. [ABSTRACT FROM AUTHOR]

Background: Tobacco and low socioeconomic status have been acknowledged as potential risk factors for upper aero-digestive tract (UADT) cancers in North America. In context of reducing adult male smoking prevalence (by over 50%), in the past few decades in Canada, this study tried to document changes in smoking-attributable UADT cancer mortality rates, among Canadian males of different social strata, between 1986 and 2001. Methods: The contribution of smoking to UADT cancer mortality was estimated indirectly by using lung cancer mortality as an indicator of the accumulated mortality from smoking in a population. This method was applied to UADT cancer death rates of 35-69 year old socially stratified males. Data, stratified by neighborhood income quintile, could be obtained from Statistics Canada, for four census years, 1986, 1991, 1996, and 2001. Results: A total of 2704 male deaths were analyzed. Between 1986 and 2001, UADT cancer deaths reduced by 30% (32 to 22 per 100,000) but the proportion of these deaths attributable to smoking reduced much more, by 41% (22 to 13 per 100,000). In the span of fifteen years, absolute social inequality (measured by rate difference between the highest and the lowest stratum) in smoking-attributable male UADT cancer mortality in Canada reduced by 47% and relative social inequality (measured by rate ratios) reduced by 9%. Conclusion: The present analyses reveal that between 1986 and 2001, smoking-attributable UADT cancer mortality rates among adult males (35-69 years) in Canada reduced in all social strata and the social inequalities in these rates have narrowed. Analysis of more current data will be of interest to confirm these trends. [ABSTRACT FROM AUTHOR]

The aim of this paper is to explore regional variation in the implementation of Environmental Impact Assessment follow-up in India and to identify causes of such variations. In doing so, forty-three semi-structured interviews were carried out across the Indian mining and environment sector. The findings from the interviews confirm that regional variation in follow-up implementation is a result of social, environmental, economical and political factors. To further explore these factors, three case studies of open cast coal mining were conducted. The findings of the case studies offer insight as to how the factors identified during the interviews influence follow-up outcomes. Furthermore, it reflects how the nature of such variation is not always true to what is perceived about them. Subsequently, the findings from the interviews and case studies help in contributing to the existing best practice of EIA follow-up and developing recommendations for achieving better follow-up outcomes in India. [ABSTRACT FROM AUTHOR]

Tripling real cigarette prices would approximately halve cigarette consumption worldwide.[1] Although high excise taxes could increase smuggling, weak customs enforcement (rather than high price) is the main determinant of illegal cigarette sales. By 2004, France had tripled real prices since the early 1990s through industry price hikes and tax increases, and consumption had fallen by a third. [Extracted from the article]

Examines the past and present of the Indian community in Canada in the light of the Canadian immigration policy. Resolution in the 1966 Canadian government white paper; Indian diaspora in Canada; Factors affecting Canada's immigration policy.

Countries around the globe are investing in health information and communications technologies (ICTs) as critical tools for improving care for chronically ill patients. We profiled four high-income nations with varied health ICT strategies—Australia, Canada, Denmark, and the United States—to describe their use of ICTs to improve chronic care. Our goal was to identify common challenges and opportunities for cross-national learning. We found four key themes. First, although all four countries have a national strategy for health ICT adoption, strategies are implemented and adapted to chronic care needs regionally, which creates the challenge of spreading successful efforts across regions. Second, each country struggles with how to ensure that clinical information follows patients seamlessly between care settings. Third, although each nation is pursuing telehealth solutions as a component of chronic care, the telehealth initiatives are usually stand-alone efforts that are not well integrated into other ICT solutions, such as electronic health records. Finally, countries have made progress in improving patients' access to their clinical data but have not fully succeeded in engaging patients to apply the data to improve care. These common themes suggest that although the four nations have different health care systems and ICT strategies, all of them face a similar set of challenges, creating an opportunity for cross-national learning. [ABSTRACT FROM AUTHOR]