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Primary care providers are the main point of contact with the healthcare system for individuals with intellectual disability, and they may have pre-existing attitudes towards this group that impacts care. We examined whether participants' gender, age, professional status and experience with individuals with intellectual disability were associated with attitudes by surveying 95 family physicians, family medicine trainees and advanced practice nursing students across a Canadian province. Younger participants were more likely to feel that those with intellectual disability are similar to themselves and that individuals with intellectual disability should be empowered to take control of their lives. Older participants were more likely to believe that individuals with intellectual disability are vulnerable. These findings suggest there may be a generational difference in attitudes, and educational interventions may be needed to ameliorate attitudes among older primary care providers to reduce the impact of pre-existing attitudes on the provision of care.

Researchers have proposed that autism spectrum disorder (ASD) is characterized, at least in part, by executive function (EF) difficulties associated with the integrity of the frontal lobe. Given the paucity of research regarding EFs in young adults with high functioning ASD (HF-ASD), this research involves an examination of various indices of EF related to inhibition, planning, and generativity. Results indicate that although young adults with HF-ASD as a group met normative expectations on all measures of EF, they also exhibited considerable individual variability relative to their age- and sex-matched typically developing peers. These findings have important research and clinical implications, including the need to carefully consider the impact of the research comparison group, and to recognize individual variability in executive functioning among young adults with HF-ASD.

Alternative education programmes have acted as a disciplinary practice used by schools in Prince Edward Island (PEI), Canada, as a response to providing students, especially those identified with challenging behaviours, who do not fit into "mainstream" schools. This article highlights the emergence of alternative education in PEI and brings to light the complexities underpinning how a child with challenging behaviour is viewed. Through the use of Foucauldian genealogical analysis and critical discourse analysis, this research centres on the discourse of "alternative education" and problematises how alternative education programmes have been put in place as a solution to the problem of the child with challenging behaviour in "mainstream" schools as constituted in the 1990s in PEI, Canada. Using data generated from educational policies, government documents, and interviews with educators who worked in alternative placements and practitioners who worked with students identified as having problematic behaviour, I propose that alternative education programmes are hybrid programmes emerging from an overlapping of understanding from "mainstream" education and "special education."

The effectiveness of dual-language book reading in culturally and linguistically diverse classrooms is largely uncontested. Yet there are repeated calls for more research to determine how this resource can be used more broadly and effectively by teachers, especially in emergent-literacy learning contexts. In the present study we analysed culturally and linguistically responsive teaching and learning in dual-language book reading vignettes to demonstrate how teachers and volunteer readers build on linguistic and cultural repertoires of emergent-literacy learners to help them gain metalinguistic awareness, cultural empowerment and identities as capable learners. We argue that diversity can be embraced and multilingualism can be positioned as normal by using dual-language books to motivate discussion about language and cultural artefacts. The findings suggest a rethinking of classroom practices based on family involvement in the classroom and a subtle shift in the balance of authority and expertise among teachers, children and families.

Research has determined that dual language books have a positive effect on literacy achievement, motivation, and family involvement in children’s schooling. In this study we used quantitative methods to complement the largely qualitative extant research. We analyzed the early literacy skills of 105 kindergarten children (45 comparison, 60 treatment) with diverse language backgrounds (35 percent English, 31 percent Punjabi, 16 percent Urdu, 18 percent other languages) from eight kindergarten classes in four suburban Canadian schools. Statistical analyses indicated that children who were read to using dual language books, written in French, Punjabi, and Urdu, demonstrated significantly greater gains in graphophonemic knowledge than children who were read to in English only.This gain occurred specifically in children who spoke the targeted languages at home; children who did not speak the targeted languages were not negatively affected. Findings are discussed in terms of developing metalinguistic awareness and directions for practice and research are discussed. (Contains 2 tables, 3 notes, and an appendix.)

Given the number of negative influences on youth and the resultant potential for adverse outcomes, it is crucial to support their positive development. Leadership training programs can promote the development of adaptive intrapersonal qualities. The Teen Leadership Breakthrough (TLB) program claims to create sustainable changes in youth using experiential activities, direct instruction, and feedback to teach leadership skills. This study evaluated the TLB program's efficacy in developing intrapersonal skills in 10th- and 11th-grade students. Participants were randomly assigned to a control or treatment group. Assessment of emotional intelligence and self-concept occurred prior to, immediately after, 6 weeks and 6 months following the intervention. Results indicated that the TLB program created sustainable changes emotional intelligence and self-concept. Although these results are encouraging, further research is needed to investigate the effectiveness of the TLB program in broader demographic groups and to examine different outcomes. (Contains 3 tables.)

A professional self-concept instrument was completed by 127 nursing students, including masters' candidates and three groups of undergraduates. Professional self-concept appeared to strengthen as students proceeded through the academic hierarchy. (SK)

Study Objective: The Canadian C-Spine Rule has been widely applied by emergency physicians to safely reduce use of cervical spine imaging. Our objective is to evaluate the clinical effect and safety of real-time Canadian C-Spine Rule implementation by emergency department (ED) triage nurses to remove cervical spine immobilization.Methods: We conducted this multicenter, 2-phase, prospective cohort program at 9 hospital EDs and included alert trauma patients presenting with neck pain or with cervical spine immobilization. During phase 1, ED nurses were trained and then had to demonstrate competence before being certified. During phase 2, certified nurses were empowered by a medical directive to "clear" the cervical spine of patients, allowing them to remove cervical spine immobilization and to triage to a less acute area. The primary outcomes were clinical effect (cervical spine clearance by nurses) and safety (missed clinically important cervical spine injuries).Results: In phase 1, 312 nurses evaluated 3,098 patients. In phase 2, 180 certified nurses enrolled 1,408 patients (mean age 43.1 years, women 52.3%, collision 56.5%, and cervical spine injury 1.1%). In phase 2 and for the 806 immobilized ambulance patients, the primary outcome of immobilization removal by nurses was 41.1% compared with 0% before the program. The primary safety outcome of cervical spine injuries missed by nurses was 0. Time to discharge was reduced by 26.0% (3.4 versus 4.6 hours) for patients who had immobilization removed. In only 1.3% of cases did nurses indicate their discomfort with applying the Canadian C-Spine Rule.Conclusion: We clearly demonstrated that ED triage nurses can successfully implement the Canadian C-Spine Rule, leading to more rapid and comfortable management of patients without any threat to patient safety. Widespread adoption of this approach should improve care and comfort for trauma patients, and could decrease length of stay in our very crowded EDs. [ABSTRACT FROM AUTHOR]

This study presents the energy, water, and carbon (C) flux dynamics of a young afforested temperate white pine ( Pinus strobus L.) forest in southern Ontario, Canada during the initial fourteen years (2003–2016) of establishment. Energy fluxes, namely, net radiation (Rn), latent heat (LE), and sensible heat (H) flux increased over time, due to canopy development. Annual values of ground heat flux (G) peaked in 2007 and then gradually declined in response to canopy closure. The forest became a consistent C-sink only 5 years after establishment owing in part to low respiratory fluxes from the former agricultural, sandy soils with low residual soil organic matter. Mean annual values of gross ecosystem productivity (GEP), ecosystem respiration (RE), and net ecosystem productivity (NEP) ranged from 494 to 1913, 515 to 1774 and −126 to 216 g C m −2  year −1 respectively, over the study period. Annual evapotranspiration (ET) values ranged from 328 to 429 mm year −1 over the same period. Water use efficiency (WUE) increased with stand age with a mean WUE value of 3.92 g C kg −1 H 2 O from 2008 to 2016. Multivariable linear regression analysis conducted using observed data suggested that the overall, C and water dynamics of the stand were primarily driven by radiation and temperature, both of which explained 77%, 48%, 28%, and 76% of the variability in GEP, RE, NEP, and ET, respectively. However, late summer droughts, which were prevalent in the region, reduced NEP. The reduction in NEP was enhanced when summer drought events were accompanied by increased heat such as those in 2005, 2012 and 2016. This study contributes to our understanding of the energy, water and C dynamics of afforested temperate conifer plantations and how these forests may respond to changing climate conditions during the crucial initial stage of their life cycle. Our findings also demonstrate the potential of pine plantation stands to sequester atmospheric CO 2 in eastern North America. [ABSTRACT FROM AUTHOR]

OBJECTIVE. Gel pads are commonly used by occupational therapists in acute care settings to reduce pressure on the coccyx and sacrum in supine. The purpose of this study was to determine the pressure-reducing capabilities of gel pads used in supine and the resultant potential impact on pressure ulcer management. METHOD. A pressure-mapping system was used to measure interface pressures between the participant's buttocks and the mattress, with and without the gel pad. RESULTS. The gel pad did not have a significant effect on interface pressure for most participants. No obvious clinical indicators were identified. CONCLUSION. Use of the gel pad is not recommended to decrease pressure in supine. Because potential adverse effects may result from using the gel pad in supine and no clinical indicators were identified to direct practice, use of the gel pad in supine is not recommended as an intervention for decreasing interface pressure. [ABSTRACT FROM AUTHOR]

Patient and healthcare provider communication is vital in cancer care and aspects of the patients' experiences provide valuable insight to what constitutes effective cancer communication. In this article we describe the communication experiences of patients from nondominant cultures who accessed Canadian-based cancer services. The findings enabled us to thoughtfully reflect on Western ideals about autonomy and responsibility and their relationship to informed consent in the context of cancer communication. [ABSTRACT FROM AUTHOR]