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Sample records for canadian naturalistic study

  1. A Canadian naturalistic study of a community-based cohort treated for bipolar disorder

    Directory of Open Access Journals (Sweden)

    Chandresena Ranjith

    2010-03-01

    Full Text Available Abstract Background Bipolar illness is associated with significant psychosocial morbidity and health resource utilization. Second generation antipsychotics, used alone or in combination with mood stabilizers are effective in treating acute mania in community settings. This study was designed to compare the change in clinical parameters and resource utilization at one month in a group of patients who required treatment intervention for exacerbation of mania. The clinical response at one year was also evaluated. Methods 496 patients were enrolled at 75 psychiatric practices across Canada. The Olanzapine cohort (n = 287 included patients who had olanzapine added to their medication regimen or the dose of olanzapine increased. The Other cohort (n = 209 had a medication other than olanzapine added or the dose adjusted. Changes from baseline in the Young Mania Rating Scale (YMRS, Montgomery Asberg Depression Rating Scale, Beck Anxiety Inventory and SF-12 Health Survey were compared at one month using ANCOVA. Categorical variables at one month for health resource utilization, employment status, abuse/dependency, and the number of suicide attempts were compared using Fisher's Exact test. Patients were followed for one year and a subgroup was evaluated. Results At one month, patients in the Olanzapine cohort recorded a mean reduction in the YMRS of 11.5, significantly greater than the mean reduction in the Other cohort of 9.7 (ANCOVA P = 0.002. The Olanzapine cohort was significantly improved compared to the Other cohort on the scales for depression and anxiety and did not experience the deterioration in physical functioning seen in the Other cohort. No significant differences were detected in health-related quality-of-life measures, employment status, drug abuse/dependency, number of suicide attempts, mental functioning, emergency room visits or inpatient psychiatric hospitalizations. In a subgroup treated for 12 months with a single second generation

  2. Naturalistic Study of Truck Following Behavior

    Science.gov (United States)

    2016-04-01

    Volpe conducted the Naturalistic study of truck following behavior to gain a better understanding of how trucks follow other vehicles in the real world, with the ultimate goal of supporting the Federal Highway Administration in the development of aut...

  3. Naturalistic study of olanzapine in treatment-resistaant ...

    African Journals Online (AJOL)

    Naturalistic study of olanzapine in treatment-resistaant schizophrenia and acute mania, depression and obsessional disorder. ... Whereas the Fiji government provides all aspects of mental health care services free of charge to its citizens, many schizophrenics have failed to respond to classical antipsychotic drugs.

  4. Science of the Particular: An Advocacy of Naturalistic Case Study in Health Research

    NARCIS (Netherlands)

    Abma, T.A.; Stake, R.E.

    2014-01-01

    Case studies can provide us with in-depth understanding of a single demarcated entity. Cases can be corporations and clinics, but are usually people. There are several approaches to case study. Naturalistic case study constitutes the science of the particular. The aim of naturalistic case study is

  5. Naturalist Sentimentalism

    DEFF Research Database (Denmark)

    Wohlmann, Anita

    2018-01-01

    This article examines four short stories by the American writer Rebecca Harding Davis (1831-1910), who became a nationally acclaimed writer with the stylistically innovative novella Life in the Iron Mills (1861). Using the double perspective of age studies and ‘naturalist sentimentalism’, the essay...... analyses Davis’s representation of the paradoxes of old age. Davis blends sentimental ideals of sympathy, sacrifice, and hope with naturalist themes of entrapment, the inevitability of decline, and biological determinism. Four short stories by Davis will serve as cases in point: ‘At Noon’ (1887), ‘At...

  6. Naturalistic Teenage Driving Study: Findings and Lessons Learned

    Science.gov (United States)

    Simons-Morton, Bruce G.; Klauer, Sheila G.; Ouimet, Marie Claude; Guo, Feng; Albert, Paul S.; Lee, Suzanne E.; Ehsani, Johnathon P.; Pradhan, Anuj K.; Dingus, Thomas A.

    2015-01-01

    Problem This paper summarizes the findings on novice teenage driving outcomes (e.g., crashes and risky driving behaviors) from the Naturalistic Teenage Driving Study. Method Survey and driving data from a data acquisition system (Global Positioning System, accelerometers, cameras) were collected from 42 newly-licensed teenage drivers and their parents during the first 18 months of teenage licensure; stress responsivity was also measured in teenagers. Result Overall teenage crash and near crash (CNC) rates declined over time, but were >4 times higher among teenagers than adults. Contributing factors to teenage CNC rates included secondary task engagement (e.g., distraction), kinematic risky driving, low stress responsivity, and risky social norms. Conclusion The data support the contention that the high novice teenage CNC risk is due both to inexperience and risky driving behavior, particularly kinematic risky driving and secondary task engagement. Practical Applications Graduated driver licensing policy and other prevention efforts should focus on kinematic risky driving, secondary task engagement, and risky social norms. PMID:26403899

  7. Political Socialization Research and Canadian Studies

    Science.gov (United States)

    Tomkins, George S.

    1977-01-01

    Presents a review of the burgeoning field of Canadian political socialization research as it applies to children and youth, and considers some implications of recent findings for the Canadian studies curriculum. (Editor)

  8. Basic Aspects of Infant-Grandparent "Interaction": An Eight-Month Longitudinal and Naturalistic Study

    Science.gov (United States)

    Pratikaki, Anastasia; Germanakis, Ioannis; Kokkinaki, Theano

    2011-01-01

    This longitudinal and naturalistic study aims to describe basic aspects of early imitative exchanges in dyadic infant-grandfather and infant-grandmother free interactions, from the second to the 10th month of age. Sixteen infants were video-recorded at home in the course of spontaneous dyadic interactions with maternal grandfathers and…

  9. Pathways to Language: A Naturalistic Study of Children with Williams Syndrome and Children with Down Syndrome

    Science.gov (United States)

    Levy, Yonata; Eilam, Ariela

    2013-01-01

    This is a naturalistic study of the development of language in Hebrew-speaking children with Williams syndrome (WS) and children with Down syndrome (DS), whose MLU extended from 1[multiplied by]0 to 4[multiplied by]4. Developmental curves over the entire span of data collection revealed minor differences between children with WS, children with DS,…

  10. Naturalistic nursing.

    Science.gov (United States)

    Hussey, Trevor

    2011-01-01

    Where nurse education aims to provide an overarching intellectual framework, this paper argues that it should be the framework of naturalism. After an exposition of the chief features of naturalism and its relationship to science and morality, the paper describes naturalistic nursing, contrasting it with some other perspectives. There follows a defence of naturalism and naturalistic nursing against several objections, including those concerning spirituality, religion, meaning, morality, and alternative sources of knowledge. The paper ends with some of the advantages of the naturalistic approach. © 2010 Blackwell Publishing Ltd.

  11. South African novice driver behaviour: findings from a naturalistic driving study

    CSIR Research Space (South Africa)

    Venter, Karien

    2014-07-01

    Full Text Available experienced drivers in similar circumstances;  Informing the development of approaches that could improve driver training methods and systems in South Africa. 4. METHODOLOGY 4.1. Naturalistic Driving Studies NDS is a fairly new methodology... important that novice drivers should be able to not only obey the law, but should be able to recognise hazards associated with stop streets. Scan behaviour especially to the left and the right is considered important to cross and clear the intersection...

  12. CASID and Canadian Journal of Development Studies ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    CASID and Canadian Journal of Development Studies : Organizational Strengthening 2007- ... with its Executive Council, as well as an external organizational assessment. ... Sharing opportunities for innovation in climate change adaptation.

  13. Driving characteristics and adaptive cruise control : A naturalistic driving study

    NARCIS (Netherlands)

    Schakel, W.J.; Gorter, C.M.; de Winter, J.C.F.; van Arem, B.

    2017-01-01

    With the increasing number of vehicles equipped with Adaptive Cruise Control (ACC), it becomes important to assess its impact on traffic flow efficiency, in particular with respect to capacity and queue discharge rate. Simulation studies and surveys suggest that ACC has both positive and negative

  14. Approaching French Language Literature in Canadian Studies

    OpenAIRE

    Mansfield, Charlie

    2005-01-01

    This book forms a self-study pack and teaching guide to help English speakers start using computers and the web to support their studies of French Canadian Literature, song, film and multimedia. Readers will need access to the Internet so that they can experience ‘Electronic Encounters’ with Canadian media in French and English. The approach is underpinned with ideas drawn from the analysis of travel writing.

  15. Switching away from pipotiazine palmitate: a naturalistic study.

    Science.gov (United States)

    Mustafa, Feras Ali

    2017-01-01

    In March 2015, pipotiazine palmitate depot antipsychotic was globally withdrawn due to the shortage of its active ingredient. Thus, all patients receiving this medication had to be switched to an alternative antipsychotic drug. In this study we set to evaluate the process of switching away from pipotiazine palmitate within our clinical service, and its impact on hospitalization. Demographic and clinical data on patients who were receiving pipotiazine palmitate in Northamptonshire at the time of its withdrawal were anonymously extracted from their electronic records and analyzed using descriptive statistics. A total of 17 patients were switched away from pipotiazine palmitate at the time of its withdrawal, all of whom had a prior history of nonadherence with oral treatment. A total of 14 patients were switched to another depot antipsychotic drug, while three patients chose an oral alternative which they subsequently discontinued resulting in relapse and hospitalization. There was a five-fold increase in mean hospitalization among patients who completed a year after the switch. Switching away from pipotiazine palmitate was associated with significant clinical deterioration in patients who switched to an oral antipsychotic, whereas most patients who switched to another depot treatment maintained stability. Clinicians should exercise caution when switching patients with schizophrenia away from depot antipsychotic drugs, especially in cases of patients with a history of treatment nonadherence who prefer to switch to oral antipsychotics.

  16. [A naturalistic study: 100 consecutive episodes of acute agitation in a psychiatric emergency department].

    Science.gov (United States)

    Pascual, J C; Madre, M; Puigdemont, D; Oller, S; Corripio, I; Díaz, A; Faus, G; Perez, V; Alvarez, E

    2006-01-01

    Psychomotor agitation is a common event in psychiatric emergency services (PES) with a prevalence of approximately 10 %. There is no general consensus on to how to manage psychomotor agitation; benzodiazepines, typical antipsychotics and now atypical antipsychotics have demonstrated similar efficacy. The aim of our study was to describe the epidemiology and clinical management of agitation in "real-life" in a psychiatric emergency service. A naturalistic study was performed in acutely agitated patients recruited consecutively in a psychiatric emergency service. Demographics, clinical and therapeutic characteristics were analyzed. Efficacy was assessed by the Excitement Component of the Positive and Negative Syndrome Scale (PANSS-EC) and the Agitation-Calmness Evaluation Scale (ACES). Pragmatic variables such as the need for second pharmacological intervention and the need for physical restraints were assessed. The study included 100 patients with psychomotor agitation. Mean age was 36.2 % and 54% were women. The most prevalent diagnoses were psychotic disorder (48 %) and personality disorder (24 %). Physical restraint was required in 39 % of patients and 52 % accepted oral treatment. Haloperidol was the most frequent oral treatment and olanzapine was the most frequent intramuscular treatment. A naturalistic approach provides data based on clinical reality in psychiatric emergency services. Strict research designs of clinical trials of efficacy imply sample selection biases and are generally distanced from the clinical reality. Atypical antipsychotics have become the first-line treatment in acute agitation

  17. Course of illness in depressive and bipolar disorders. Naturalistic study, 1994-1999

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Hansen, Mette Gerster; Andersen, Per Kragh

    2004-01-01

    BACKGROUND: Newer antidepressants have increasingly been used during the past decade. These drugs may increase compliance and reduce the risk of cycle acceleration in affective disorders. AIMS: To investigate the naturalistic longitudinal course of illness in patients with depressive or bipolar d...... of episodes was not significant for men. The rate of relapse did not decline during the study period. CONCLUSIONS: The course of severe depressive and bipolar disorders has remained roughly the same despite introduction of new treatments.......BACKGROUND: Newer antidepressants have increasingly been used during the past decade. These drugs may increase compliance and reduce the risk of cycle acceleration in affective disorders. AIMS: To investigate the naturalistic longitudinal course of illness in patients with depressive or bipolar...... patients had a diagnosis of depressive disorder and 1106 patients had a diagnosis of mania or bipolar disorder, at first-ever discharge. RESULTS: The rate of relapse leading to hospitalisation increased with the number of previous episodes in both depressive and bipolar disorders. However, the effect...

  18. Driver Behavior During Overtaking Maneuvers from the 100-Car Naturalistic Driving Study.

    Science.gov (United States)

    Chen, Rong; Kusano, Kristofer D; Gabler, Hampton C

    2015-01-01

    Lane changes with the intention to overtake the vehicle in front are especially challenging scenarios for forward collision warning (FCW) designs. These overtaking maneuvers can occur at high relative vehicle speeds and often involve no brake and/or turn signal application. Therefore, overtaking presents the potential of erroneously triggering the FCW. A better understanding of driver behavior during lane change events can improve designs of this human-machine interface and increase driver acceptance of FCW. The objective of this study was to aid FCW design by characterizing driver behavior during lane change events using naturalistic driving study data. The analysis was based on data from the 100-Car Naturalistic Driving Study, collected by the Virginia Tech Transportation Institute. The 100-Car study contains approximately 1.2 million vehicle miles of driving and 43,000 h of data collected from 108 primary drivers. In order to identify overtaking maneuvers from a large sample of driving data, an algorithm to automatically identify overtaking events was developed. The lead vehicle and minimum time to collision (TTC) at the start of lane change events was identified using radar processing techniques developed in a previous study. The lane change identification algorithm was validated against video analysis, which manually identified 1,425 lane change events from approximately 126 full trips. Forty-five drivers with valid time series data were selected from the 100-Car study. From the sample of drivers, our algorithm identified 326,238 lane change events. A total of 90,639 lane change events were found to involve a closing lead vehicle. Lane change events were evenly distributed between left side and right side lane changes. The characterization of lane change frequency and minimum TTC was divided into 10 mph speed bins for vehicle travel speeds between 10 and 90 mph. For all lane change events with a closing lead vehicle, the results showed that drivers change

  19. Diagnostic accuracy of the Eurotest for dementia: a naturalistic, multicenter phase II study

    Directory of Open Access Journals (Sweden)

    Frank Ana

    2006-04-01

    Full Text Available Abstract Background Available screening tests for dementia are of limited usefulness because they are influenced by the patient's culture and educational level. The Eurotest, an instrument based on the knowledge and handling of money, was designed to overcome these limitations. The objective of this study was to evaluate the diagnostic accuracy of the Eurotest in identifying dementia in customary clinical practice. Methods A cross-sectional, multi-center, naturalistic phase II study was conducted. The Eurotest was administered to consecutive patients, older than 60 years, in general neurology clinics. The patients' condition was classified as dementia or no dementia according to DSM-IV diagnostic criteria. We calculated sensitivity (Sn, specificity (Sp and area under the ROC curves (aROC with 95% confidence intervals. The influence of social and educational factors on scores was evaluated with multiple linear regression analysis, and the influence of these factors on diagnostic accuracy was evaluated with logistic regression. Results Sixteen neurologists recruited a total of 516 participants: 101 with dementia, 380 without dementia, and 35 who were excluded. Of the 481 participants who took the Eurotest, 38.7% were totally or functionally illiterate and 45.5% had received no formal education. Mean time needed to administer the test was 8.2+/-2.0 minutes. The best cut-off point was 20/21, with Sn = 0.91 (0.84–0.96, Sp = 0.82 (0.77–0.85, and aROC = 0.93 (0.91–0.95. Neither the scores on the Eurotest nor its diagnostic accuracy were influenced by social or educational factors. Conclusion This naturalistic and pragmatic study shows that the Eurotest is a rapid, simple and useful screening instrument, which is free from educational influences, and has appropriate internal and external validity.

  20. An open-label naturalistic pilot study of acamprosate in youth with autistic disorder.

    Science.gov (United States)

    Erickson, Craig A; Early, Maureen; Stigler, Kimberly A; Wink, Logan K; Mullett, Jennifer E; McDougle, Christopher J

    2011-12-01

    To date, placebo-controlled drug trials targeting the core social impairment of autistic disorder (autism) have had uniformly negative results. Given this, the search for new potentially novel agents targeting the core social impairment of autism continues. Acamprosate is U.S. Food and Drug Administration-approved drug to treat alcohol dependence. The drug likely impacts both gamma-aminobutyric acid and glutamate neurotransmission. This study describes our initial open-label experience with acamprosate targeting social impairment in youth with autism. In this naturalistic report, five of six youth (mean age, 9.5 years) were judged treatment responders to acamprosate (mean dose 1,110 mg/day) over 10 to 30 weeks (mean duration, 20 weeks) of treatment. Acamprosate was well tolerated with only mild gastrointestinal adverse effects noted in three (50%) subjects.

  1. Duration of untreated illness and suicide in bipolar disorder: a naturalistic study.

    Science.gov (United States)

    Altamura, A Carlo; Dell'Osso, Bernardo; Berlin, Heather A; Buoli, Massimiliano; Bassetti, Roberta; Mundo, Emanuela

    2010-08-01

    The aim of this naturalistic study was to evaluate the potential influence of the duration of untreated illness (DUI)--defined as the time elapsed between the occurrence of the first mood episode and the first adequate pharmacological treatment with mood stabilizers--on the clinical course of bipolar disorder (BD). Three hundred and twenty outpatients (n = 320) with a DSM-IV diagnosis of BD--either Type I or Type II--were interviewed; their clinical features were collected and they were naturalistically followed-up for 5 years. At the end of the follow-up observation, the sample was subdivided into two groups: one group with a DUI 2 years (n = 255). The main demographic and clinical variables were analyzed and compared between the two subgroups of patients using chi-square tests for dichotomous variables or Mann-Whitney U tests for continuous variables. Patients with a longer DUI showed a higher frequency of suicide attempts (Z = -2.11, P = 0.035), a higher number of suicide attempters (chi(2) = 4.13, df = 1, P = 0.04), and a longer duration of illness (Z = -6.79, P < 0.0001) when compared to patients with a shorter DUI. Moreover, patients with a longer DUI had a depressive first episode more frequently than patients with a shorter DUI (chi(2) = 11.28, df = 2, P = 0.004). A further analysis performed dividing the total sample into two subgroups on the basis of a DUI of 6 years (corresponding to the median value of the DUI in the study sample) confirmed prior findings. Results indicate a potential association between a longer DUI and a worse outcome in BD, particularly in terms of suicidality, and confirm the clinical relevance of early diagnosis and pharmacological intervention with mood stabilizers in BD.

  2. Recurrence of panic disorder during pregnancy: a 7-year naturalistic follow-up study.

    Science.gov (United States)

    Dannon, Pinhas N; Iancu, Iulian; Lowengrub, Katherine; Grunhaus, Leon; Kotler, Moshe

    2006-01-01

    The aim of this naturalistic follow-up study was to examine the effect of pregnancy as a predicting factor of relapse in patients with panic disorder (PD). Eighty-five female patients with PD (between the ages of 20 and 35 years) were included in this study. They were divided into 2 groups based on whether the onset of PD had been during pregnancy (PD-pregnancy [PD-P]) or whether the onset of PD had been while not pregnant (PD-nonpregnant [PD-NP]). Patients were treated with paroxetine up to 40 mg/day for 12 months, and the full responders were tapered off their medication and were monitored for an additional 6 years. Treatment response was assessed using the Panic Self-Questionnaire (PSQ) with full response being defined as "0" panic attacks. Assessments using the PSQ were made at baseline and every 4 weeks for the first twelve months. During the 6-year drug-free follow-up period, patients were assessed using the PSQ every 3 months. Relapse was defined as the occurrence of a panic attack in any phase of the study. The effect of group membership (PD-P vs. PD-NP) and new pregnancies as risk factors for relapse were explored. Sixty-eight patients completed the 6-year follow-up, and each of the study groups (PD-P and PD-NP) was composed of 34 patients. Twenty-six of 34 (76.6%) patients in the PD-P group had another pregnancy, and 15/26 (57%) in this group experienced a relapse during the subsequent pregnancy. Three of 8 (37%) PD-P patients experienced a relapse without pregnancy. Among the second group (PD-NP), 18/34 (52.9%) became pregnant and 8/18 (44.4%) experienced a relapse at the time of pregnancy, whereas 4/16 (25%) experienced a relapse while not pregnant. Patients who relapsed during pregnancy had a more severe relapse (as defined by the severity of the PSQ score) compared with nonpregnant relapsers. Our naturalistic follow-up study demonstrated that pregnancy might confer an increased risk of relapse in PD. Moreover, when compared with patients who develop

  3. Short-Term Cognitive-Behavioural Group Treatment for Hoarding Disorder: A Naturalistic Treatment Outcome Study.

    Science.gov (United States)

    Moulding, Richard; Nedeljkovic, Maja; Kyrios, Michael; Osborne, Debra; Mogan, Christopher

    2017-01-01

    The study aim was to test whether a 12-week publically rebated group programme, based upon Steketee and Frost's Cognitive Behavioural Therapy-based hoarding treatment, would be efficacious in a community-based setting. Over a 3-year period, 77 participants with clinically significant hoarding were recruited into 12 group programmes. All completed treatment; however, as this was a community-based naturalistic study, only 41 completed the post-treatment assessment. Treatment included psychoeducation about hoarding, skills training for organization and decision making, direct in-session exposure to sorting and discarding, and cognitive and behavioural techniques to support out-of-session sorting and discarding, and nonacquiring. Self-report measures used to assess treatment effect were the Savings Inventory-Revised (SI-R), Savings Cognition Inventory, and the Depression, Anxiety and Stress Scales. Pre-post analyses indicated that after 12 weeks of treatment, hoarding symptoms as measured on the SI-R had reduced significantly, with large effect sizes reported in total and across all subscales. Moderate effect sizes were also reported for hoarding-related beliefs (emotional attachment and responsibility) and depressive symptoms. Of the 41 participants who completed post-treatment questionnaires, 14 (34%) were conservatively calculated to have clinically significant change, which is considerable given the brevity of the programme judged against the typical length of the disorder. The main limitation of the study was the moderate assessment completion rate, given its naturalistic setting. This study demonstrated that a 12-week group treatment for hoarding disorders was effective in reducing hoarding and depressive symptoms in an Australian clinical cohort and provides evidence for use of this treatment approach in a community setting. Copyright © 2016 John Wiley & Sons, Ltd. A 12-week group programme delivered in a community setting was effective for helping with

  4. Naturalistic driving study of rear seat child occupants: Quantification of head position using a Kinect™ sensor.

    Science.gov (United States)

    Arbogast, Kristy B; Kim, Jinyong; Loeb, Helen; Kuo, Jonny; Koppel, Sjaan; Bohman, Katarina; Charlton, Judith L

    2016-09-01

    Restraint performance is evaluated using anthropomorphic test devices (ATDs) positioned in prescribed, optimal seating positions. Anecdotally, humans-children in particular-assume a variety of positions that may affect restraint performance. Naturalistic driving studies (NDSs), where cameras and other data acquisition systems are placed in a vehicle used by participants during their regular transportation, offer means to collect these data. To date, these studies have used conventional video and analysis methods and, thus, analyses have largely been qualitative. This article describes a recently completed NDS of child occupants in which their position was monitored using a Kinect sensor to quantify their head position throughout normal, everyday driving trips. A study vehicle was instrumented with a data acquisition system to measure vehicle dynamics, a set of video cameras, and a Kinect sensor providing 3D motion capture at 1 Hz of the rear seat occupants. Participant families used the vehicle for all driving trips over 2 weeks. The child occupants' head position was manually identified via custom software from each Kinect color image. The 3D head position was then extracted and its distribution summarized by seat position (left, rear, center) and restraint type (forward-facing child restraint system [FFCRS], booster seat, seat belt). Data from 18 families (37 child occupants) resulted in 582 trips (with children) for analysis. The average age of the child occupants was 45.6 months and 51% were male. Twenty-five child occupants were restrained in FFCRS, 9 in booster seats, and 3 in seat belts. As restraint type moved from more to less restraint (FFCRS to booster seat to seat belt), the range of fore-aft head position increased: 218, 244, and 340 mm on average, respectively. This observation was also true for left-right movement for every seat position. In general, those in the center seat position demonstrated a smaller range of head positions. For the first

  5. Characterizing Smartphone Engagement for Schizophrenia: Results of a Naturalist Mobile Health Study.

    Science.gov (United States)

    Torous, John; Staples, Patrick; Slaters, Linda; Adams, Jared; Sandoval, Luis; Onnela, J P; Keshavan, Matcheri

    2017-08-04

    Despite growing interest in smartphone apps for schizophrenia, little is known about how these apps are utilized in the real world. Understanding how app users are engaging with these tools outside of the confines of traditional clinical studies offers an important information on who is most likely to use apps and what type of data they are willing to share. The Schizophrenia and Related Disorders Alliance of America, in partnership with Self Care Catalyst, has created a smartphone app for schizophrenia that is free and publically available on both Apple iTunes and Google Android Play stores. We analyzed user engagement data from this app across its medication tracking, mood tracking, and symptom tracking features from August 16 th 2015 to January 1 st 2017 using the R programming language. We included all registered app users in our analysis with reported ages less than 100. We analyzed a total of 43,451 mood, medication and symptom entries from 622 registered users, and excluded a single patient with a reported age of 114. Seventy one percent of the 622 users tried the mood-tracking feature at least once, 49% the symptom tracking feature, and 36% the medication-tracking feature. The mean number of uses of the mood feature was two, the symptom feature 10, and the medication feature 14. However, a small subset of users were very engaged with the app and the top 10 users for each feature accounted for 35% or greater of all entries for that feature. We find that user engagement follows a power law distribution for each feature, and this fit was largely invariant when stratifying for age or gender. Engagement with this app for schizophrenia was overall low, but similar to prior naturalistic studies for mental health app use in other diseases. The low rate of engagement in naturalistic settings, compared to higher rates of use in clinical studies, suggests the importance of clinical involvement as one factor in driving engagement for mental health apps. Power law

  6. Canadian retail petroleum markets study

    International Nuclear Information System (INIS)

    Ervin, M.J.

    1998-02-01

    A retail petroleum market study was conducted to provide a comprehensive overview of the competitiveness of the downstream petroleum industry in Canada and to set a foundation for effective policy development. The downstream petroleum industry, which includes the petroleum refining and marketing sectors, faces a poor public image, competitive pressures from U.S. and offshore refiners, and a broad range of environmental challenges. In this study, 19 markets representing a wide range of conditions were chosen for a detailed review of outlet economics. A market-by-market and regional comparisons of key competitiveness indicators was made in order to identify market and regional competitive differences as potential issues or opportunities within the industry. The study also included a pump price/margin model and provided a general overview of the retail gasoline sub-sector in terms of infrastructure. A review of prices, margins and demand patterns over the past several years was also undertaken to show the relationship between consumer demand patterns and pump price fluctuations. The study presented 22 findings which led to several conclusions and recommendations regarding the competitiveness of Canada's petroleum marketing sector. Two of the key conclusions were that taxation is a significant factor in the price of retail gasoline (about 50 per cent) and that government intervention into petroleum marketing is likely to be a poor alternative to market-based regulation. 18 tabs., 37 figs

  7. Road Safety Data, Collection, Transfer and Analysis DaCoTa. Workpackage 6, Driver Behaviour Monitoring through Naturalistic Driving: Deliverable 6.2: Part B: Sampling techniques and naturalistic driving study design.

    NARCIS (Netherlands)

    Commandeur, J.J.F.

    2015-01-01

    In this document we provide an overview of sampling and estimation methods that can be used to obtain population values of risk exposure data and safety performance indicators based on naturalistic driving study designs. More specifically, we discuss how to determine the optimal sample size required

  8. Psychodramatic psychotherapy combined with pharmacotherapy in major depressive disorder: an open and naturalistic study

    Directory of Open Access Journals (Sweden)

    Costa Elisabeth Maria Sene

    2006-01-01

    Full Text Available OBJETIVE: Recent literature has highlighted the role of psychotherapy in the treatment of major depressive disorder. Combined therapies comprising both psychotherapy and pharmacotherapy have presented the best results. Although several kinds of psychotherapies have been studied in the treatment of depressive disorders, there remains a lack of data on psychodramatic psychotherapy in the treatment of major depressive disorder. The objective of this study was to evaluate the impact of psychodramatic psychotherapy (in a sample of major depressive disorder patients. METHOD: This is an open, naturalistic, controlled, non-randomized study. Twenty major depressive disorder patients (according to the DSM-IV criteria, under pharmacological treatment for depression, with Hamilton Depression Scale total scores between 7 and 20 (mild to moderate depression, were divided into two groups. Patients in the psychotherapeutic group took part in 4 individual and 24 structured psychodramatic group sessions, whilst subjects in the control group did not participate in this psychodramatic psychotherapy. Both groups were evaluated with the Social Adjustment Scale - Self Report and the Hamilton Depression Scale. RESULTS: Psychotherapeutic group patients showed a significant improvement according to the Social Adjustment Scale - Self Report and the Hamilton Depression Scale scores at endpoint, compared to those of the control group. CONCLUSIONS: Results suggest that individual and group psychodramatic psychotherapy, associated to pharmacological treatment, provides good clinical benefits in the treatment of major depressive disorder.

  9. Safety and effectiveness of olanzapine in monotherapy: a multivariate analysis of a naturalistic study.

    Science.gov (United States)

    Ciudad, Antonio; Gutiérrez, Miguel; Cañas, Fernando; Gibert, Juan; Gascón, Josep; Carrasco, José-Luis; Bobes, Julio; Gómez, Juan-Carlos; Alvarez, Enrique

    2005-07-01

    This study investigated safety and effectiveness of olanzapine in monotherapy compared with conventional antipsychotics in treatment of acute inpatients with schizophrenia. This was a prospective, comparative, nonrandomized, open-label, multisite, observational study of Spanish inpatients with an acute episode of schizophrenia. Data included safety assessments with an extrapyramidal symptoms (EPS) questionnaire and the report of spontaneous adverse events, plus clinical assessments with the Brief Psychiatric Rating Scale (BPRS) and the Clinical Global Impressions-Severity of Illness (CGI-S). A multivariate methodology was used to more adequately determine which factors can influence safety and effectiveness of olanzapine in monotherapy. 339 patients treated with olanzapine in monotherapy (OGm) and 385 patients treated with conventional antipsychotics (CG) were included in the analysis. Treatment-emergent EPS were significantly higher in the CG (pOGm (p=0.005). Logistic regression analyses revealed that the only variable significantly correlated with treatment-emergent EPS and clinical response was treatment strategy, with patients in OGm having 1.5 times the probability of obtaining a clinical response and patients in CG having 5 times the risk of developing EPS. In this naturalistic study olanzapine in monotherapy was better-tolerated and at least as effective as conventional antipsychotics.

  10. Moving Perspectives on Patient Competence: A Naturalistic Case Study in Psychiatry.

    Science.gov (United States)

    Ruissen, A M; Abma, T A; Van Balkom, A J L M; Meynen, G; Widdershoven, G A M

    2016-03-01

    Patient competence, defined as the ability to reason, appreciate, understand, and express a choice is rarely discussed in patients with obsessive compulsive disorder (OCD), and coercive measures are seldom used. Nevertheless, a psychiatrist of psychologist may doubt whether OCD patients who refuse treatment understand their disease and the consequences of not being treated, which could result in tension between respecting the patient's autonomy and beneficence. The purpose of this article is to develop a notion of competence that is grounded in clinical practice and corresponds with the experiences of patients with obsessions and/or compulsions. We present a naturalistic case study giving both the patient's and the therapist's perspective based on in-depth interviews and a narrative analysis. The case study shows that competence is not merely an assessment by a therapist, but also a co-constructed reality shaped by the experiences and stories of patient and therapist. The patient, a medical student, initially told her story in a restitution narrative, focusing on cognitive rationality. Reconstructing the history of her disease, her story changed into a quest narrative where there was room for emotions, values and moral learning. This fitted well with the therapist's approach, who used motivational interventions with a view to appealing to the patient's responsibility to deal with her condition. We conclude that in practice both the patient and therapist used a quest narrative, approaching competence as the potential for practical reasoning to incorporate values and emotions.

  11. THE INSTRUCTIONAL DELIVERY OF WRITING COURSE AT ENGLISH DEPARTMENT OF UMS: A NATURALISTIC STUDY

    Directory of Open Access Journals (Sweden)

    Fibrian Anindyawati

    2017-08-01

    Full Text Available The objective of this research is to get a thorough description of the teaching learning process of Writing Course at English Department of Muhammadiyah University of Surakarta, covering the syllabuses, the learning objectives, the instructional materials, the teachers’ roles, the students’ roles, the classroom techniques, the classroom procedures, the teaching media, and the assessment models. The data of this research were collected through observation, interview, and documentation. This research was a naturalistic study. The result shows that the syllabus used in Writing I & II is grammatical syllabus and Writing III & IV task-based syllabus. The learning objectives categorized into two namely, general objectives and specific objectives. The instructional materials were divided into three categories: printed materials, visual materials, and materials from the internet. The teachers’ roles were as organizer, consultant, feedback provider, assessor, and motivator. The students’ roles were as active participant, peer reviewer, and peer editor. The classroom techniques consist of brainstorming, discussion, question and answer, self-correction, assignment. The classroom procedures of Writing I & II were BKOF-MOT-ICOT; Writing III were reviewing, gathering ideas, organizing, build writing activity; and Writing IV were reviewing, explaining the materials, gathering ideas, organizing, build writing activity. The media used were LCD Projector, board, slides, and videos. The assessment model consisted of: multiple choices, weekly assignments, quizzes, mid-test, and final-test.     Keywords: Instruction, writing course, teaching writing

  12. The effects of self-esteem and ego threat on interpersonal appraisals of men and women: a naturalistic study.

    Science.gov (United States)

    Vohs, Kathleen D; Heatherton, Todd F

    2003-11-01

    A naturalistic study examined the effects of self-esteem and threats to the self on interpersonal appraisals. Self-esteem scores, ego threat (operationalized as a substantial decrease in self-esteem across an average of 9 months), and their interaction were used to predict likability and personality perceptions of college men and women. The results revealed a curvilinear function explaining likability: Moderate to low self-esteem men and women were higher in likability when threatened, whereas high self-esteem men were seen as less likable when threatened. Personality ratings indicated that high self-esteem men and women who were threatened were rated highest on Antagonism (i.e., fake, arrogant, unfriendly, rude, and uncooperative). Mediational analyses revealed that differences in Antagonism statistically accounted for differences in likability. These patterns are interpreted with respect to gender and time in interpersonal perceptions as well as naturalistic versus laboratory investigations.

  13. Knowledge Translation and Patient Safety: The Canadian Adverse Events Study

    OpenAIRE

    Baker, G. Ross; Norton, Peter; Flintoft, Virginia

    2006-01-01

    The Canadian Adverse Events Study was the first national study of adverse events in Canadian hospitals. Learning from the controversy surrounding similar studies in other countries, the team engaged in extensive knowledge translation activities throughout the life of the project. Using meetings, Web-based communication and other tools, the team successfully prepared most Canadian stakeholders for the study’s release, allowing them to develop anticipatory patient safety initiatives. However, u...

  14. Investigate moped-car conflicts in China using a naturalistic driving study approach.

    Science.gov (United States)

    Glaser, Yi G; Guo, Feng; Fang, Youjia; Deng, Bing; Hankey, Jonathan

    2017-12-01

    Mopeds are a popular transportation mode in Europe and Asia. Moped-related traffic accidents account for a large proportion of crash fatalities. To develop moped-related crash countermeasures, it is important to understand the characteristics of moped-related conflicts. Naturalistic driving study data were collected in Shanghai, China from 36 car drivers. The data included 2,878h and 78,296km driven from 13,149 trips. Moped-car conflicts were identified and examined from the passenger car driver's perspective using kinematic trigger algorithms and manual video reduction. A total of 119 moped-car conflicts were identified, including 74 high g-force conflicts and 45 low g-force events. These conflicts were classified into 22 on-road configurations where both similarities and differences were found as compared to Western Countries. The majority of the conflicts occurred on secondary main roads and branch roads. Hard braking was the primary response that the car drivers made to these conflicts rather than hard steering. The identified on-road vehicle-moped conflict configurations in Shanghai, China may be attributed to the complicated traffic environment and risky behavior of moped riders. The lower prevalence of hard steering in Shanghai as compared to the United States may be due to the lower speeds at event onsets or less available steering space, e.g., less available shoulder area on Chinese urban roads. The characteristics of moped-car conflicts may impact the design of active safety countermeasures on passenger cars. The pilot data from Shanghai urban areas suggest that countermeasures developed for China may require some modifications to those developed for the United States and European countries, although this recommendation may not be conclusive given the small sample size of the study. Future studies with large samples may help better understand the characteristics of moped-car conflicts. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights

  15. Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder

    Science.gov (United States)

    Young, Allan H; Eberhard, Jonas

    2015-01-01

    Objective This study aimed to evaluate patients with bipolar I disorder (BD-I) who have mania with depressive symptoms and who meet the new “with mixed features” specifier of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). Method This prospective, multinational, naturalistic study surveyed psychiatrists and their patients with BD-I from October 2013 to March 2014. Eligible patients had BD-I, had a (current) manic episode, and had experienced onset of a manic episode within the previous 3 months. Psychiatrists provided patient information on depressive symptoms (DSM-5 criteria); symptoms of anxiety, irritability, and agitation; suicide attempts; and physician satisfaction with treatment response. Data were stratified according to whether patients met the criteria for the BD-I “with mixed features” specifier of DSM-5 (≥3 depressive symptoms) or not, and characteristics were compared between the two subgroups. Patients also self-reported on depressive symptoms using the Mini-International Neuropsychiatric Interview module questionnaire. Results Overall, 34% of 1,035 patients met the criteria for BD-I “with mixed features,” exhibiting ≥3 depressive symptoms during their current manic episode. This correlated with the matched patient self-reports of depressive symptoms. During their current manic episode, BD-I patients “with mixed features” had more severe symptoms of anxiety, irritability, and agitation (average composite severity score of 4.1 vs 3.4), a higher incidence of suicide attempts (38% vs 9%), and more physician dissatisfaction with treatment response (22% vs 14%), compared to patients with 0–2 depressive symptoms (all P<0.05). Conclusion This study found that patients with BD-I “with mixed features” (ie, ≥3 depressive symptoms during a manic episode), suffered, on average, from a greater burden of disease than patients with pure mania. Improved identification of these patients may help to optimize

  16. A naturalistic study of high-dose unilateral ECT among severely depressed inpatients: how does it work in the clinical practice?

    OpenAIRE

    Alves, Lucas P. C.; Freire, Thiago F. V.; Fleck, Marcelo P. A.; Rocha, Neusa S.

    2016-01-01

    Background Naturalistic studies can be useful tools to understand how an intervention works in the real clinical practice. This study aims to investigate the outcomes in a naturalistically treated depressed inpatients cohort, who were referred, or not, to unilateral ECT. Methods Depressed adults according to MINI admitted in a psychiatric unit were divided in unilateral ECT treated and non-ECT treated. Main outcomes were: depression improvement in Hamilton Rating Scale for Depression (HDRS-17...

  17. Adjunctive antipsychotic in the treatment of body dysmorphic disorder - A retrospective naturalistic case note study.

    Science.gov (United States)

    Rashid, Haroon; Khan, Akif A; Fineberg, Naomi A

    2015-06-01

    A retrospective naturalistic case note study to determine the frequency, co-morbidity and treatment-response of body dysmorphic disorder (BDD). Records from 280 patients attending a highly specialised obsessive-compulsive disorder (OCD)/BDD service were analysed. The clinical outcome was measured either through scoring of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) for OCD/BDD, or textual analysis of case notes for evidence of symptomatic improvement, treatment tolerability, and premature disengagement. A total of 32 patients (11.43%) were diagnosed with BDD. Of these, 28 (87.5%) had at least one co-morbidity. All patients were offered cognitive behavioural therapy (CBT) and selective serotonin reuptake inhibitor (SSRI). Adjunctive low-dose antipsychotic was prescribed for 21 (66%) patients. Overall, 18/32 (56%) responded, and 7/32 (22%) disengaged prematurely. Patients offered antipsychotic, SSRI and CBT (n = 21) were compared with those offered SSRI and CBT only (n = 11). The treatment was well-tolerated. Whereas there was no significant inter-group difference in the clinical response rate, premature disengagement occurred less frequently in the antipsychotic-treated patients (9.5% versus 45%; Fisher's Exact Test P = 0.0318). BDD frequently presents with co-morbidity, treatment-resistance and premature disengagement. Adjunctive antipsychotic was associated with significantly better treatment adherence, but responder rates did not differ significantly, possibly related to the small sample-size. A well-powered randomised controlled study is warranted, to determine clinical outcomes with adjunctive antipsychotic in BDD.

  18. Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder.

    Science.gov (United States)

    Young, Allan H; Eberhard, Jonas

    2015-01-01

    This study aimed to evaluate patients with bipolar I disorder (BD-I) who have mania with depressive symptoms and who meet the new "with mixed features" specifier of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). This prospective, multinational, naturalistic study surveyed psychiatrists and their patients with BD-I from October 2013 to March 2014. Eligible patients had BD-I, had a (current) manic episode, and had experienced onset of a manic episode within the previous 3 months. Psychiatrists provided patient information on depressive symptoms (DSM-5 criteria); symptoms of anxiety, irritability, and agitation; suicide attempts; and physician satisfaction with treatment response. Data were stratified according to whether patients met the criteria for the BD-I "with mixed features" specifier of DSM-5 (≥3 depressive symptoms) or not, and characteristics were compared between the two subgroups. Patients also self-reported on depressive symptoms using the Mini-International Neuropsychiatric Interview module questionnaire. Overall, 34% of 1,035 patients met the criteria for BD-I "with mixed features," exhibiting ≥3 depressive symptoms during their current manic episode. This correlated with the matched patient self-reports of depressive symptoms. During their current manic episode, BD-I patients "with mixed features" had more severe symptoms of anxiety, irritability, and agitation (average composite severity score of 4.1 vs 3.4), a higher incidence of suicide attempts (38% vs 9%), and more physician dissatisfaction with treatment response (22% vs 14%), compared to patients with 0-2 depressive symptoms (all Pmixed features" (ie, ≥3 depressive symptoms during a manic episode), suffered, on average, from a greater burden of disease than patients with pure mania. Improved identification of these patients may help to optimize treatment outcomes.

  19. Naturalistic study on the usage of smartphone applications among Finnish drivers.

    Science.gov (United States)

    Kujala, Tuomo; Mäkelä, Jakke

    2018-06-01

    We present results from a naturalistic study that tracked how Finnish drivers use their smartphones while on the move. We monitored 30 heavy in-car smartphone users in Finland during June-September 2016, recording the times that they used their phones, the application used at the time of touch (calls excluded), the location and driving speed. Touches per time unit were used as a proxy for estimating visual-manual distraction due to visual-manual tasks. Our data set allows the determining of whether drivers use their phones differently on varying road types (highway, main road, local rural road, urban road). We found that the road type has an effect on phone use but the effect is contrary to what we expected. Drivers produced more touches per hour on urban roads, yet the use instances tend to be shorter than on the highway or main roads. We also collected statistics on the applications that were used. By far the highest overall rankings in the number of drivers using, number of uses, and duration per use instance was associated with the WhatsApp messaging service. One instance of WhatsApp use had a median of 8 touches, and had a median duration of 35 s. In contrast, navigation application use included a median of 3 touches and lasted for 11 s. The findings suggest that the Finnish smartphone heavy-users do not decrease their phone use when the demands of the traffic conditions increase and that the greatest risk from smartphone use may be currently caused by messaging applications. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. Modeling Driving Performance Using In-Vehicle Speech Data From a Naturalistic Driving Study.

    Science.gov (United States)

    Kuo, Jonny; Charlton, Judith L; Koppel, Sjaan; Rudin-Brown, Christina M; Cross, Suzanne

    2016-09-01

    We aimed to (a) describe the development and application of an automated approach for processing in-vehicle speech data from a naturalistic driving study (NDS), (b) examine the influence of child passenger presence on driving performance, and (c) model this relationship using in-vehicle speech data. Parent drivers frequently engage in child-related secondary behaviors, but the impact on driving performance is unknown. Applying automated speech-processing techniques to NDS audio data would facilitate the analysis of in-vehicle driver-child interactions and their influence on driving performance. Speech activity detection and speaker diarization algorithms were applied to audio data from a Melbourne-based NDS involving 42 families. Multilevel models were developed to evaluate the effect of speech activity and the presence of child passengers on driving performance. Speech activity was significantly associated with velocity and steering angle variability. Child passenger presence alone was not associated with changes in driving performance. However, speech activity in the presence of two child passengers was associated with the most variability in driving performance. The effects of in-vehicle speech on driving performance in the presence of child passengers appear to be heterogeneous, and multiple factors may need to be considered in evaluating their impact. This goal can potentially be achieved within large-scale NDS through the automated processing of observational data, including speech. Speech-processing algorithms enable new perspectives on driving performance to be gained from existing NDS data, and variables that were once labor-intensive to process can be readily utilized in future research. © 2016, Human Factors and Ergonomics Society.

  1. Canadian consumer battery baseline study : final report

    International Nuclear Information System (INIS)

    2007-02-01

    This report provided information about the estimated number of consumer and household batteries sold, re-used, stored, recycled, and disposed each year in Canada. The report discussed the ways in which different batteries posed risks to human health and the environment, and legislative trends were also reviewed. Data used in the report were obtained from a literature review as well as through a series of interviews. The study showed that alkaline batteries are the most common primary batteries used by Canadians, followed by zinc carbon batteries. However, lithium primary batteries are gaining in popularity, and silver oxide and zinc air button cell batteries are also used in applications requiring a flat voltage and high energy. Secondary batteries used in laptop computers, and cell phones are often made of nickel-cadmium, nickel-metal-hydroxide, and lithium ion. Small sealed lead batteries are also commonly used in emergency lighting and alarm systems. Annual consumption statistics for all types of batteries were provided. Results of the study showed that the primary battery market is expected to decline. Total units of secondary batteries are expected to increase to 38.6 million units by 2010. The report also used a spreadsheet model to estimate the flow of consumer batteries through the Canadian waste management system. An estimated 347 million consumer batteries were discarded in 2004. By 2010, it is expected that an estimated 494 million units will be discarded by consumers. The study also considered issues related to lead, cadmium, mercury, and nickel disposal and the potential for groundwater contamination. It was concluded that neither Canada nor its provinces or territories have initiated legislative or producer responsibility programs targeting primary or secondary consumer batteries. 79 refs., 37 tabs., 1 fig

  2. Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder

    Directory of Open Access Journals (Sweden)

    Young AH

    2015-04-01

    Full Text Available Allan H Young,1 Jonas Eberhard1,21Institute of Psychiatry, King’s College London, London, UK; 2Corporate Medical Affairs, H. Lundbeck A/S, Copenhagen, DenmarkObjective: This study aimed to evaluate patients with bipolar I disorder (BD-I who have mania with depressive symptoms and who meet the new “with mixed features” specifier of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5.Method: This prospective, multinational, naturalistic study surveyed psychiatrists and their patients with BD-I from October 2013 to March 2014. Eligible patients had BD-I, had a (current manic episode, and had experienced onset of a manic episode within the previous 3 months. Psychiatrists provided patient information on depressive symptoms (DSM-5 criteria; symptoms of anxiety, irritability, and agitation; suicide attempts; and physician satisfaction with treatment response. Data were stratified according to whether patients met the criteria for the BD-I “with mixed features” specifier of DSM-5 (≥3 depressive symptoms or not, and characteristics were compared between the two subgroups. Patients also self-reported on depressive symptoms using the Mini-International Neuropsychiatric Interview module questionnaire.Results: Overall, 34% of 1,035 patients met the criteria for BD-I “with mixed features,” exhibiting ≥3 depressive symptoms during their current manic episode. This correlated with the matched patient self-reports of depressive symptoms. During their current manic episode, BD-I patients “with mixed features” had more severe symptoms of anxiety, irritability, and agitation (average composite severity score of 4.1 vs 3.4, a higher incidence of suicide attempts (38% vs 9%, and more physician dissatisfaction with treatment response (22% vs 14%, compared to patients with 0–2 depressive symptoms (all P<0.05.Conclusion: This study found that patients with BD-I “with mixed features” (ie, ≥3 depressive symptoms

  3. Three year naturalistic outcome study of panic disorder patients treated with paroxetine.

    Science.gov (United States)

    Dannon, Pinhas N; Iancu, Iulian; Cohen, Ami; Lowengrub, Katherine; Grunhaus, Leon; Kotler, Moshe

    2004-06-11

    This naturalistic open label follow-up study had three objectives: 1) To observe the course of illness in Panic Disorder patients receiving long-term versus intermediate-term paroxetine treatment, 2) To compare the relapse rates and side-effect profile after long-term paroxetine treatment between patients with Panic Disorder and Panic Disorder with Agoraphobia, 3) To observe paroxetine's tolerability over a 24 month period. 143 patients with panic disorder (PD), with or without agoraphobia, successfully finished a short-term (ie 12 week) trial of paroxetine treatment. All patients then continued to receive paroxetine maintenance therapy for a total of 12 months. At the end of this period, 72 of the patients chose to discontinue paroxetine pharmacotherapy and agreed to be monitored throughout a one year discontinuation follow-up phase. The remaining 71 patients continued on paroxetine for an additional 12 months and then were monitored, as in the first group, for another year while medication-free. The primary limitation of our study is that the subgroups of patients receiving 12 versus 24 months of maintenance paroxetine therapy were selected according to individual patient preference and therefore were not assigned in a randomized manner. Only 21 of 143 patients (14%) relapsed during the one year medication discontinuation follow-up phase. There were no significant differences in relapse rates between the patients who received intermediate-term (up to 12 months) paroxetine and those who chose the long-term course (24 month paroxetine treatment). 43 patients (30.1%) reported sexual dysfunction. The patients exhibited an average weight gain of 5.06 kg. All patients who eventually relapsed demonstrated significantly greater weight increase (7.3 kg) during the treatment phase. The extension of paroxetine maintenance treatment from 12 to 24 months did not seem to further decrease the risk of relapse after medication discontinuation. Twenty-four month paroxetine

  4. Three year naturalistic outcome study of panic disorder patients treated with paroxetine

    Directory of Open Access Journals (Sweden)

    Lowengrub Katherine

    2004-06-01

    Full Text Available Abstract Background This naturalistic open label follow-up study had three objectives: 1 To observe the course of illness in Panic Disorder patients receiving long-term versus intermediate-term paroxetine treatment 2 To compare the relapse rates and side-effect profile after long-term paroxetine treatment between patients with Panic Disorder and Panic Disorder with Agoraphobia. 3 To observe paroxetine's tolerability over a 24 month period. Methods 143 patients with panic disorder (PD, with or without agoraphobia, successfully finished a short-term (ie 12 week trial of paroxetine treatment. All patients then continued to receive paroxetine maintenance therapy for a total of 12 months. At the end of this period, 72 of the patients chose to discontinue paroxetine pharmacotherapy and agreed to be monitored throughout a one year discontinuation follow-up phase. The remaining 71 patients continued on paroxetine for an additional 12 months and then were monitored, as in the first group, for another year while medication-free. The primary limitation of our study is that the subgroups of patients receiving 12 versus 24 months of maintenance paroxetine therapy were selected according to individual patient preference and therefore were not assigned in a randomized manner. Results Only 21 of 143 patients (14% relapsed during the one year medication discontinuation follow-up phase. There were no significant differences in relapse rates between the patients who received intermediate-term (up to 12 months paroxetine and those who chose the long-term course (24 month paroxetine treatment. 43 patients (30.1% reported sexual dysfunction. The patients exhibited an average weight gain of 5.06 kg. All patients who eventually relapsed demonstrated significantly greater weight increase (7.3 kg during the treatment phase. Conclusions The extension of paroxetine maintenance treatment from 12 to 24 months did not seem to further decrease the risk of relapse after

  5. The impact of sleep disorders on driving safety-findings from the Second Strategic Highway Research Program naturalistic driving study.

    Science.gov (United States)

    Liu, Shu-Yuan; Perez, Miguel A; Lau, Nathan

    2018-04-01

    This study investigated the association between driving safety and seven sleep disorders amongst 3541 participants of the Second Strategic Highway Research Program (SHRP 2) naturalistic driving study. SHRP 2 collected naturalistic driving data from participants between 16 and 98 years old by instrumenting participants' vehicles. The analyses used logistic regression to determine the likelihood of crash or near-crash involvement, Poisson log-linear regression to assess crash or near-crash rate, and ordinal logistic regression to assess driver maneuver appropriateness and crash or near-crash severity. These analyses did not account for any medical treatments for the sleep disorders. Females with restless legs syndrome/Willis-Ekbom disease (RLS/WED), drivers with insomnia or narcolepsy, are associated with significantly higher risk of crash or near-crash. Drivers with shift work sleep disorder (SWSD) are associated with significantly increased crash or near-crash rate. Females with RLS/WED or sleep apnea and drivers with SWSD are associated with less safe driver maneuver and drivers with periodic limb movement disorder are associated with more severe events. The four analyses provide no evidence of safety decrements associated with migraine. This study is the first examination on the association between seven sleep disorders and different measures of driving risk using large-scale naturalistic driving study data. The results corroborate much of the existing simulator and epidemiological research related to sleep-disorder patients and their driving safety, but add ecological validity to those findings. These results contribute to the empirical basis for medical professionals, policy makers, and employers in making decisions to aid individuals with sleep disorders in balancing safety and personal mobility.

  6. CanWEA Pan-Canadian wind integration study paper

    Energy Technology Data Exchange (ETDEWEB)

    Tremblay, Martin [GL Garrad Hassan Canada Inc, Ottawa, ON (Canada); Gardner, Paul [GL Garrad Hassan and Partners, Glasgow (United Kingdom); Price, Doug; Le, Don [GL Garrad Hassan America, San Diego, CA (United States)

    2010-07-01

    GL Garrad Hassan has been contracted by CanWEA to undertake a scoping study for a future Pan-Canadian Wide-Scale Wind Integration Study. The scoping study provides the methodology and the rationale on which the actual wind integration study and request for proposals will be based on. Major system operators and owners of each Canadian Province along with experts involved in major US wind integration studies have been consulted and contributed to the decisional process. This paper provides a summary of the factors considered in the study and outline the actual methodology that was adopted for the future Pan-Canadian wind integration study. (orig.)

  7. The use of meta-analysis or research synthesis to combine driving simulation or naturalistic study results on driver distraction.

    Science.gov (United States)

    Caird, Jeff K; Johnston, Katherine A; Willness, Chelsea R; Asbridge, Mark

    2014-06-01

    Three important and inter-related topics are addressed in this paper. First, the importance of meta-analysis and research synthesis methods to combine studies on traffic safety, in general, and on driver distraction, in particular, is briefly reviewed. Second, naturalistic, epidemiologic, and driving simulation studies on driver distraction are used to illustrate convergent and divergent results that have accumulated thus far in this domain of research. In particular, mobile phone conversation, passenger presence, and text messaging naturalistic studies use meta-analyses and research syntheses to illustrate important patterns of results that are in need of more in-depth study. Third, a number of driver distraction study limitations such as poorly defined dependent variables, lack of methodological detail, and omission of statistical information prevent the integration of many studies into meta-analyses. In addition, the overall quality of road safety studies suffers from these same limitations and suggestions for improvement are made to guide researchers and reviewers. Practical Applications. The use of research synthesis and meta-analysis provide comprehensive estimates of the impact of distractions on driving performance, which can be used to guide public policy and future research. Copyright © 2014 National Safety Council and Elsevier Ltd. All rights reserved.

  8. Canadian Council for Area Studies Learned Societies - 2007-2008 ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    CCASLS) ... for four area studies associations: the Canadian Association of African Studies (CAAS); the ... IDRC invites applications for the IDRC Doctoral Research Awards ... Canada can learn from Uganda's gender budgeting experience.

  9. A study of Canadian retail gasoline prices

    International Nuclear Information System (INIS)

    Eckert, A.L.

    1999-05-01

    Retail gasoline pricing in Canadian markets was examined to demonstrate why retail prices tend to follow one of two distinct patterns and that neither pattern is observable in the wholesale price. In many cities, retail prices are more rigid than wholesale prices, while in other markets, retail prices follow a cyclic pattern not seen in wholesale prices. This study examined why constant prices are observed in some cities, while other cities have cyclic prices. Theoretical justification was given to the argument that prices will remain constant only in markets in which there are only few gasoline companies with a small number of stations, but a large per-station capacity. It was shown that when one firm operates significantly more stations than its rival, a constant cost equilibrium cannot be maintained. However, a cycle equilibrium can be constructed in this case, and also when the two companies are similarly sized. An initial examination of available price, cost and market structure data shows that there is a positive correlation between price stability and concentration. The response of retail prices to wholesale price movements in the presence of a retail price cycle was also examined through the use of a simple model based on the predictions of the above theory. Data for the city of Windsor, Ontario was used for the modelling approach. A new cycle is created by an increase in price whenever the distance between the previous retail price and the current wholesale prices is very small. Retail prices are more responsive to wholesale prices over the increasing portion of the cycle. It was shown that when the asymmetric error correction model of Borenstein, Cameron and Gilbert is estimated, it indicates a more rapid response to wholesale price increases than to decreases. 72 refs., 22 tabs., 8 figs

  10. Characterizing the motivational orientation of students in higher education: a naturalistic study in three Hong Kong universities.

    Science.gov (United States)

    Kember, David; Hong, Celina; Ho, Amber

    2008-06-01

    Consideration of motivation in higher education has often been drawn upon theories and research that were based upon school or workplace studies. This paper reports an open naturalistic study to better characterize the motivational orientation of students in higher education. Open semi-structured individual interviews were conducted with 36 students from three universities in Hong Kong. The analysis used an exploratory grounded theory approach. Motivation was characterized as a framework with six continua with positive and negative poles. On enrolment, students had positions on the six facets of motivation, which shifted as they progressed through their degree, according to perceptions of their teaching and learning environment. The positive poles of the six continua were given labels: compliance, individual goal setting, interest, career, sense of belonging and university lifestyle. The formulation of motivational orientation is consistent with contemporary social cognitive theories of motivation in that it has been characterized as a multifaceted phenomenon, with students expressing context-dependent multiple motives.

  11. Is the naturalistic course of depression in older people related to received support over time? Results from a longitudinal population-based study

    NARCIS (Netherlands)

    Houtjes, W.; Deeg, D.J.H.; van de Ven, P.M.; van Meijel, B.; van Tilburg, T.G.; Beekman, A.T.F.

    Objectives: To test the interrelation of the naturalistic course of depression in older people with long-term support received. Design: Longitudinal cohort study. Methods: A sample of 277 adults age 55-85years participating in the Longitudinal Aging Study Amsterdam, with clinically relevant

  12. Neuronal encoding of object and distance information: A model simulation study on naturalistic optic flow processing

    Directory of Open Access Journals (Sweden)

    Patrick eHennig

    2012-03-01

    Full Text Available We developed a model of the input circuitry of the FD1 cell, an identified motion-sensitive interneuron in the blowfly’s visual system. The model circuit successfully reproduces the FD1 cell’s most conspicuous property: Its larger responses to objects than to spatially extended patterns. The model circuit also mimics the time-dependent responses of FD1 to dynamically complex naturalistic stimuli, shaped by the blowfly’s saccadic flight and gaze strategy: The FD1 responses are enhanced when, as a consequence of self-motion, a nearby object crosses the receptive field during intersaccadic intervals. Moreover, the model predicts that these object-induced responses are superimposed by pronounced pattern-dependent fluctuations during movements on virtual test flights in a three-dimensional environment with systematic modifications of the environmental patterns. Hence, the FD1 cell is predicted to detect not unambiguously objects defined by the spatial layout of the environment, but to be also sensitive to objects distinguished by textural features. These ambiguous detection abilities suggest an encoding of information about objects - irrespective of the features by which the objects are defined - by a population of cells, with the FD1 cell presumably playing a prominent role in such an ensemble.

  13. Safety-critical event risk associated with cell phone tasks as measured in naturalistic driving studies: A systematic review and meta-analysis.

    Science.gov (United States)

    Simmons, Sarah M; Hicks, Anne; Caird, Jeff K

    2016-02-01

    A systematic review and meta-analysis of naturalistic driving studies involving estimates of safety-critical event risk associated with handheld device use while driving is described. Fifty-seven studies identified from targeted databases, journals and websites were reviewed in depth, and six were ultimately included. These six studies, published between 2006 and 2014, encompass seven sets of naturalistic driver data and describe original research that utilized naturalistic methods to assess the effects of distracting behaviors. Four studies involved non-commercial drivers of light vehicles and two studies involved commercial drivers of trucks and buses. Odds ratios quantifying safety-critical event (SCE) risk associated with talking, dialing, locating or answering, and texting or browsing were extracted. Stratified meta-analysis of pooled odds ratios was used to estimate SCE risk by distraction type; meta-regression was used to test for sources of heterogeneity. The results indicate that tasks that require drivers to take their eyes off the road, such as dialing, locating a phone and texting, increase SCE risk to a greater extent than tasks that do not require eyes off the road such as talking. Although talking on a handheld device did not increase SCE risk, further research is required to determine whether it indirectly influences SCE risk (e.g., by encouraging other cell phone activities). In addition, a number of study biases and quality issues of naturalistic driving studies are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. A naturalistic study of the directional interpretation process of discrete emotions during high-stakes table tennis matches.

    Science.gov (United States)

    Martinent, Guillaume; Ferrand, Claude

    2009-06-01

    The purpose of this study was to explore the directional interpretation process of discrete emotions experienced by table tennis players during competitive matches by adopting a naturalistic qualitative video-assisted approach. Thirty self-confrontation interviews were conducted with 11 national table tennis players (2 or 3 matches per participants). Nine discrete emotions were identified through the inductive analyses of the participants' transcriptions: anger, anxiety, discouragement, disappointment, disgust, joy, serenity, relief, and hope. Inductive analyses revealed the emergence of 4 categories and 13 themes among the 9 discrete emotions: positive direction (increased concentration, increased motivation, increased confidence, positive sensations, and adaptive behaviors), negative direction (decreased concentration, decreased motivation, too confident, decreased confidence, negative sensations, and maladaptive behaviors), neutral direction (take more risk and take less risk), and no perceived influence on own performance. Results are discussed in terms of current research on directional interpretation and emotions in sport.

  15. Mental health concerns among Canadian physicians: results from the 2007-2008 Canadian Physician Health Study.

    Science.gov (United States)

    Compton, Michael T; Frank, Erica

    2011-01-01

    In light of prior reports on the prevalence of stress, depression, and other mental health problems among physicians in training and practice, we examined the mental health concerns of Canadian physicians using data from the 2007-2008 Canadian Physician Health Study. Among 3213 respondents, 5 variables (depressive symptoms during the past year, anhedonia in the past year, mental health concerns making it difficult to handle one's workload in the past month, problems with work-life balance, and poor awareness of resources for mental health problems) were examined in relation to sex, specialty, practice type (solo practice vs group or other practice settings), and practice setting (inner city, urban/suburban, or rural/small town/remote). Nearly one quarter of physicians reported a 2-week period of depressed mood, and depression was more common among female physicians and general practitioners/family physicians. Anhedonia was reported by one fifth; anesthesiologists were most likely to report anhedonia, followed by general practitioners/family physicians. More than one quarter reported mental health concerns making it difficult to handle their workload, which was more common among female physicians and general practitioners/family physicians and psychiatrists. Nearly one quarter reported poor work-life balance. Lack of familiarity with mental health resources was problematic, which was more prominent among female physicians and specialists outside of general practice/family medicine or psychiatry. Mental health concerns are relatively common among Canadian physicians. Training programs and programmatic/policy enhancements should redouble efforts to address depression and other mental health concerns among physicians for the benefit of the workforce and patients served by Canadian physicians. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Naturalistic Cognition: A Research Paradigm for Human-Centered Design

    Directory of Open Access Journals (Sweden)

    Peter Storkerson

    2010-01-01

    Full Text Available Naturalistic thinking and knowing, the tacit, experiential, and intuitive reasoning of everyday interaction, have long been regarded as inferior to formal reason and labeled primitive, fallible, subjective, superstitious, and in some cases ineffable. But, naturalistic thinking is more rational and definable than it appears. It is also relevant to design. Inquiry into the mechanisms of naturalistic thinking and knowledge can bring its resources into focus and enable designers to create better, human-centered designs for use in real-world settings. This article makes a case for the explicit, formal study of implicit, naturalistic thinking within the fields of design. It develops a framework for defining and studying naturalistic thinking and knowledge, for integrating them into design research and practice, and for developing a more integrated, consistent theory of knowledge in design. It will (a outline historical definitions of knowledge, attitudes toward formal and naturalistic thinking, and the difficulties presented by the co-presence of formal and naturalistic thinking in design, (b define and contrast formal and naturalistic thinking as two distinct human cognitive systems, (c demonstrate the importance of naturalistic cognition in formal thinking and real-world judgment, (d demonstrate methods for researching naturalistic thinking that can be of use in design, and (e briefly discuss the impact on design theory of admitting naturalistic thinking as valid, systematic, and knowable.

  17. Naturalistic Inquiry in E-Learning Research

    Directory of Open Access Journals (Sweden)

    Shirley Agostinho

    2005-03-01

    Full Text Available In this article, the author explains how and why one particular qualitative research approach, the naturalistic inquiry paradigm, was implemented in an e-learning research study that investigated the use of the World Wide Web technology in higher education. A framework is presented that situates the research study within the qualitative research literature. The author then justifies how the study was compliant with naturalistic inquiry and concludes by presenting a model for judging the quality of such research. The purpose of this article is to provide an example of how naturalistic inquiry can be implemented in e-learning research that can serve as a guide for researchers undertaking this form of qualitative inquiry. As such, the focus of the article is to illustrate how methodological issues pertaining to naturalistic inquiry were addressed and justified to represent a rigorous research approach rather than presenting the results of the research study.

  18. Age and gender differences in time to collision at braking from the 100-Car Naturalistic Driving Study.

    Science.gov (United States)

    Montgomery, Jade; Kusano, Kristofer D; Gabler, Hampton C

    2014-01-01

    Forward collision warning (FCW) is an active safety system that aims to mitigate the effect of forward collisions by warning the driver of objects in front of the vehicle. Success of FCW relies on how drivers react to the alerts. Drivers who receive too many warnings that they deem as unnecessary-that is, nuisance alarms-may grow to distrust and turn the system off. To reduce the perception of nuisance alarms, FCW systems can be tailored to individual driving styles, but these driving styles must first be characterized. The objective of this study was to characterize differences in braking behavior between age and gender groups in car-following scenarios using data from the 100-Car Naturalistic Driving Study. The data source for this study was the 100-Car Naturalistic Driving Study, which recorded the driving of 108 primary drivers for approximately a year. Braking behavior was characterized in terms of time to collision (TTC) at brake application, a common metric used in the design of warning thresholds of FCW. Because of the large volume of data analyzed, the TTC at which drivers braked during car-following situations was collected via an automated search algorithm. The minimum TTC for each vehicle speed 10 mph increment from 10 mph to 80 mph was recorded for each driver. Mixed model analysis of variance was used to examine the differences between age and gender groups. In total, 527,861 brake applications contained in 11,503 trips were analyzed. Differences in TTC at braking were statistically significant for age and gender (Pbraking of 2.5±0.8 s, and females age 31-50 (n=6) had the highest average minimum TTC at braking of 6.4±0.9 s. On average, women (n=32) braked at a TTC 1.3 s higher than men (n=52). Age was a statistically significant factor for TTC at braking between participants under 30 (n=42) and participants over 30 (n=42), with the latter braking 1.7 s on average before the former. No statistical significance was found between ages 18-20 (n=15) and

  19. Preventing pressure ulcers on the heel: a Canadian cost study.

    Science.gov (United States)

    Torra I Bou, Joan-Enric; Rueda López, Justo; Camañes, Gemma; Herrero Narváez, Elias; Blanco Blanco, Joan; Ballesté Torralba, Jordi; Martinez-Esparza, Elvira Hernández; García, Lorena San Miguel; Soriano, José Verdú

    2009-01-01

    An adaptation of a clinical study of 130 patients at risk of developing a pressure ulcer on the heels was performed using Canadian costs. The aim of the study was to compare the cost effectiveness of a specially shaped hydrocellular dressing (Allevyn Heel) versus that of a protective heel bandage (Soffban and gauze) in pressure ulcer prevention over an 8-week period.

  20. Driver behavior analysis for right-turn drivers at signalized intersections using SHRP 2 naturalistic driving study data.

    Science.gov (United States)

    Wu, Jianqing; Xu, Hao

    2017-12-01

    Understanding driver behavior is important for traffic safety and operation, especially at intersections where different traffic movements conflict. While most driver-behavior studies are based on simulation, this paper documents the analysis of driver-behavior at signalized intersections with the SHRP 2 Naturalistic Driving Study (NDS) data. This study analyzes the different influencing factors on the operation (speed control) and observation of right-turn drivers. A total of 300 NDS trips at six signalized intersections were used, including the NDS time-series sensor data, the forward videos and driver face videos. Different factors of drivers, vehicles, roads and environments were studied for their influence on driver behavior. An influencing index function was developed and the index was calculated for each influencing factor to quantitatively describe its influencing level. The influencing index was applied to prioritize the factors, which facilitates development and selection of safety countermeasures to improve intersection safety. Drivers' speed control was analyzed under different conditions with consideration of the prioritized influencing factors. Vehicle type, traffic signal status, conflicting traffic, conflicting pedestrian and driver age group were identified as the five major influencing factors on driver observation. This research revealed that drivers have high acceleration and low observation frequency under Right-Turn-On-Red (RTOR), which constituted potential danger for other roadway users, especially for pedestrians. As speed has a direct influence on crash rates and severities, the revealed speed patterns of the different situations also benefit selection of safety countermeasures at signalized intersections. Published by Elsevier Ltd.

  1. Long-term outcome of patients with dysthymia and panic disorder: a naturalistic 9-year follow-up study.

    Science.gov (United States)

    Svanborg, Cecilia; Wistedt, Anna Aberg; Svanborg, Pär

    2008-01-01

    The highly prevalent psychiatric disorders dysthymia and panic disorder have often a chronic or recurrent course with superimposed major depression. The prominent comorbidity between these diagnoses constitutes a confounding factor in the study of long-term outcome. We performed a 9-year follow-up of 38 patients with "pure" diagnoses, i.e. without comorbid dysthymia and panic disorder, selected from two 2-year naturalistic treatment studies with psychotherapy and antidepressant medication. The aims of the present study were to investigate 1) the stability of change, and 2) the impact of comorbid personality disorders (PDs) on long-term outcome. Patients were reassessed with SCID-I and SCID-II interviews, SCL-90/BSI and a detailed, modified life-charting interview, investigating course and treatment over time. About 50% of patients showed substantial improvement, of whom about half were in remission. Comorbid PD was a negative prognostic factor independently of Axis I diagnosis. Although patients with panic disorder had a lower frequency of comorbid PD, later onset, shorter duration of illness and better outcome after the original studies, there was no difference in the long-term outcome. The less stable outcome among panic patients suggests that standard treatments are not resulting in enduring remission. In order to achieve remission, it is necessary to 1) address comorbid PDs, 2) perform careful assessments of all comorbid diagnoses, and 3) build routines for the follow-up and augmentation of treatments.

  2. Measuring Holocaust Knowledge and Its Impact: A Canadian Case Study

    Science.gov (United States)

    Jedwab, Jack

    2010-01-01

    This article examines the responses of some 1,500 Canadians to a public opinion survey on knowledge of the Holocaust, awareness of genocide, and attitudes towards discrimination and diversity. Based on one of the most detailed surveys conducted to date on Holocaust knowledge, the study found strong correlations between greater reported Holocaust…

  3. Canadian study of cancer following multiple fluoroscopies

    International Nuclear Information System (INIS)

    Howe, G.R.

    1985-01-01

    Records of patients treated in Canadian Sanatoria during the period 1930-1952 have been linked with the National Death Index maintained by Statistics Canada to provide fact and cause of death information for the years 1950-1980. Of 31,710 women known to be under observation on January 1, 1950, 13,795 were exposed to fluoroscopy for control of collapse therapy, while the remaining 17,915 were unexposed. The unexposed had the similar mortality from breast cancer to that expected from general population rates. Those exposed to fluoroscopy had increasing mortality with increasing radiation dose to the breast, the best fit to the dose-response curve being a quadratic function. Estimates of risk at doses above 300 rads were largely derived from patients treated in Nova Scotia, where fluoroscopy was administered antero-posterior, as distinct from the more usual postero-antero practiced elsewhere. There is evidence of age-related susceptibility to radiation-induced breast cancer. The risk was maximal for those who first received fluoroscopy in their teens or twenties, but it was similar to expectation for those first exposed at age 30 or more. The latent period from onset of exposure to first increase in the death rate from breast cancer was 15 years for those first exposed at ages 10-24 and 10 years for those first exposed at ages 25 or more. However, these periods coincide with years when mortality from breast cancer normally rises and may therefore not be a true latent period effect. Estimates of predicted excess deaths from breast cancer per million women first exposed at ages 10-29 vary depending on the model used to represent the effect and whether or not data from the Nova Scotia Series are included in the computations

  4. Modeling Lane-Changing Behavior in Freeway Off-Ramp Areas from the Shanghai Naturalistic Driving Study

    Directory of Open Access Journals (Sweden)

    Lanfang Zhang

    2018-01-01

    Full Text Available The objective of this study is to investigate lane-changing characteristics in freeway off-ramp areas using Shanghai Naturalistic Driving Study (SH-NDS data, considering a four-lane freeway stretch in various traffic conditions. In SH-NDS, the behavior of drivers is observed unobtrusively in a natural setting for a long period of time. We identified 433 lane-changing events with valid time series data from the whole dataset. Based on the logit model developed to analyze the choice of target lanes, a likelihood analysis of lane-changing behavior was graphed with respect to three traffic conditions: free flow, medium flow, and heavy flow. The results suggested that lane-changing behavior of exiting vehicles is the consequence of the balance between route plan (mandatory incentive and expectation to improve driving condition (discretionary incentive. In higher traffic density, the latter seems to play a significant role. Furthermore, we found that lane-change from the slow lane to the fast lane would lead to higher speed variance value, which indicates a higher crash risk. The findings contribute to a better understanding on drivers’ natural driving behavior in freeway off-ramp areas and can provide important insight into road network design and safety management strategies.

  5. Baseline Face Detection, Head Pose Estimation, and Coarse Direction Detection for Facial Data in the SHRP2 Naturalistic Driving Study

    Energy Technology Data Exchange (ETDEWEB)

    Paone, Jeffrey R [ORNL; Bolme, David S [ORNL; Ferrell, Regina Kay [ORNL; Aykac, Deniz [ORNL; Karnowski, Thomas Paul [ORNL

    2015-01-01

    Keeping a driver focused on the road is one of the most critical steps in insuring the safe operation of a vehicle. The Strategic Highway Research Program 2 (SHRP2) has over 3,100 recorded videos of volunteer drivers during a period of 2 years. This extensive naturalistic driving study (NDS) contains over one million hours of video and associated data that could aid safety researchers in understanding where the driver s attention is focused. Manual analysis of this data is infeasible, therefore efforts are underway to develop automated feature extraction algorithms to process and characterize the data. The real-world nature, volume, and acquisition conditions are unmatched in the transportation community, but there are also challenges because the data has relatively low resolution, high compression rates, and differing illumination conditions. A smaller dataset, the head pose validation study, is available which used the same recording equipment as SHRP2 but is more easily accessible with less privacy constraints. In this work we report initial head pose accuracy using commercial and open source face pose estimation algorithms on the head pose validation data set.

  6. Differences in clinical presentation between bipolar I and II disorders in the early stages of bipolar disorder: A naturalistic study.

    Science.gov (United States)

    Vinberg, Maj; Mikkelsen, Rie Lambaek; Kirkegaard, Thomas; Christensen, Ellen Margrethe; Kessing, Lars Vedel

    2017-01-15

    In a naturalistic clinical study of patients in the early stages of bipolar disorders the aim was to assess differences between patients with bipolar I (BD I) and bipolar II (BD II) disorders on clinical characteristics including affective symptoms, subjective cognitive complaints, functional level, the presence of comorbid personality disorders and coping strategies. Diagnoses were confirmed using the Structured Clinical Interview for DSM-IV Disorders. Clinical symptoms were rated with the Young Mania Rating Scale and the Hamilton Depression Rating Scale, and functional status using the Functional Assessment Short Test. Cognitive complaints were assessed using the Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire, the presence of comorbid personality disorders using the Standardized Assessment of Personality - Abbreviated Scale and coping style using the Coping Inventory for Stressful Situations. In total, 344 patients were included (BD I (n=163) and BD II (n=181). Patients with BD II presented with significantly more depressive symptoms, more cognitive complaints, lower overall functioning, and a higher prevalence of comorbid personality disorders. Finally, they exhibited a trend towards using less adaptive coping styles. It cannot be omitted that some patients may have progressed from BD II to BD I. Most measures were based on patient self report. Overall, BD II was associated with a higher disease burden. Clinically, it is important to differentiate BD II from BD I and research wise, there is a need for tailoring and testing specific interventions towards BD II. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Environmental assessment of plug-in hybrid electric vehicles using naturalistic drive cycles and vehicle travel patterns: A Michigan case study

    International Nuclear Information System (INIS)

    Marshall, Brandon M.; Kelly, Jarod C.; Lee, Tae-Kyung; Keoleian, Gregory A.; Filipi, Zoran

    2013-01-01

    Plug-in hybrid electric vehicles (PHEVs) use grid electricity as well as on-board gasoline for motive force. These multiple energy sources make prediction of PHEV energy consumption challenging and also complicate evaluation of their environmental impacts. This paper introduces a novel PHEV energy consumption modeling approach and compares it to a second approach from the literature, each using actual trip patterns from the 2009 National Household Travel Survey (NHTS). The first approach applies distance-dependent fuel efficiency and on-road electricity consumption rates based on naturalistic or real world, driving information to determine gasoline and electricity consumption. The second uses consumption rates derived in accordance with government certification testing. Both approaches are applied in the context of a location-specific case study that focuses on the state of Michigan. The two PHEV models show agreement in electricity demand due to vehicle charging, gasoline consumption, and life cycle environmental impacts for this case study. The naturalistic drive cycle approach is explored as a means of extending location-specific driving data to supplement existing PHEV impact assessments methods. - Highlights: • Travel patterns from survey data are combined with naturalistic drive cycles. • More realistic PHEV energy modeling using these synthesized real-world drive cycles. • Methodology is demonstrated for PHEVs in Michigan but applicable for other regions. • Energy and emissions findings have major implications for PHEV standards and policy

  8. Tulsa 1000: a naturalistic study protocol for multilevel assessment and outcome prediction in a large psychiatric sample.

    Science.gov (United States)

    Victor, Teresa A; Khalsa, Sahib S; Simmons, W Kyle; Feinstein, Justin S; Savitz, Jonathan; Aupperle, Robin L; Yeh, Hung-Wen; Bodurka, Jerzy; Paulus, Martin P

    2018-01-24

    Although neuroscience has made tremendous progress towards understanding the basic neural circuitry underlying important processes such as attention, memory and emotion, little progress has been made in applying these insights to psychiatric populations to make clinically meaningful treatment predictions. The overall aim of the Tulsa 1000 (T-1000) study is to use the NIMH Research Domain Criteria framework in order to establish a robust and reliable dimensional set of variables that quantifies the positive and negative valence, cognition and arousal domains, including interoception, to generate clinically useful treatment predictions. The T-1000 is a naturalistic study that will recruit, assess and longitudinally follow 1000 participants, including healthy controls and treatment-seeking individuals with mood, anxiety, substance use and eating disorders. Each participant will undergo interview, behavioural, biomarker and neuroimaging assessments over the course of 1 year. The study goal is to determine how disorders of affect, substance use and eating behaviour organise across different levels of analysis (molecules, genes, cells, neural circuits, physiology, behaviour and self-report) to predict symptom severity, treatment outcome and long-term prognosis. The data will be used to generate computational models based on Bayesian statistics. The final end point of this multilevel latent variable analysis will be standardised assessments that can be developed into clinical tools to help clinicians predict outcomes and select the best intervention for each individual, thereby reducing the burden of mental disorders, and taking psychiatry a step closer towards personalised medicine. Ethical approval was obtained from Western Institutional Review Board screening protocol #20101611. The dissemination plan includes informing health professionals of results for clinical practice, submitting results to journals for peer-reviewed publication, presenting results at national

  9. Driving context influences drivers' decision to engage in visual-manual phone tasks: Evidence from a naturalistic driving study.

    Science.gov (United States)

    Tivesten, Emma; Dozza, Marco

    2015-06-01

    Visual-manual (VM) phone tasks (i.e., texting, dialing, reading) are associated with an increased crash/near-crash risk. This study investigated how the driving context influences drivers' decisions to engage in VM phone tasks in naturalistic driving. Video-recordings of 1,432 car trips were viewed to identify VM phone tasks and passenger presence. Video, vehicle signals, and map data were used to classify driving context (i.e., curvature, other vehicles) before and during the VM phone tasks (N=374). Vehicle signals (i.e., speed, yaw rate, forward radar) were available for all driving. VM phone tasks were more likely to be initiated while standing still, and less likely while driving at high speeds, or when a passenger was present. Lead vehicle presence did not influence how likely it was that a VM phone task was initiated, but the drivers adjusted their task timing to situations when the lead vehicle was increasing speed, resulting in increasing time headway. The drivers adjusted task timing until after making sharp turns and lane change maneuvers. In contrast to previous driving simulator studies, there was no evidence of drivers reducing speed as a consequence of VM phone task engagement. The results show that experienced drivers use information about current and upcoming driving context to decide when to engage in VM phone tasks. However, drivers may fail to sufficiently increase safety margins to allow time to respond to possible unpredictable events (e.g., lead vehicle braking). Advanced driver assistance systems should facilitate and possibly boost drivers' self-regulating behavior. For instance, they might recognize when appropriate adaptive behavior is missing and advise or alert accordingly. The results from this study could also inspire training programs for novice drivers, or locally classify roads in terms of the risk associated with secondary task engagement while driving. Copyright © 2015. Published by Elsevier Ltd.

  10. Analysis of clinical characteristics and antipsychotic medication prescribing practices of first-episode schizophrenia in Israel: a naturalistic prospective study.

    Science.gov (United States)

    Strous, Rael D; Bar, Faina; Keret, Noa; Lapidus, Raya; Kosov, Nikolai; Chelben, Joseph; Kotler, Moshe

    2006-01-01

    Investigation of the clinical presentation and treatment of first-episode psychosis is important in order to exclude effects of age, chronic illness, long-term treatment and institutionalization. The aim of this descriptive study was to investigate the management practices of first-episode schizophrenia in a cohort of patients in Israel and to document use of the various "typical" or "atypical" antipsychotic agents. Fifty-one consecutive patients (26 M, 25 F) with first-episode psychosis were recruited for study participation and were administered either typical or atypical antipsychotic medications in a naturalistic manner. While an approximately equal number of subjects received typical and atypical medications at illness onset, a prominent shift to atypical antipsychotic treatment occurred over the study course; 18 subjects had medication class shifts: 17 from typical to atypical, and one from atypical to typical. Negative symptoms did not affect length of hospitalization, but were associated with aggression. Higher depression rates were noted in patients with long hospitalizations who received typical antipsychotic medications. Immigrants were admitted at an age approximately four years older than native-born Israelis. The prominent shift from "typical" to "atypical" antipsychotic medications may indicate sensitivity of first-episode psychotic patients to side-effects of "typical" medications and prominence of use of atypical medications in this patient subpopulation be it due to improved efficacy over time or successful marketing. Unique cultural and population characteristics may contribute to the manifestation of first-episode psychosis and suggest the importance of more effective outreach to the immigrant population in order to manage an apparent treatment delay.

  11. Analysis of near crashes among teen, young adult, and experienced adult drivers using the SHRP2 naturalistic driving study.

    Science.gov (United States)

    Seacrist, Thomas; Douglas, Ethan C; Huang, Elaine; Megariotis, James; Prabahar, Abhiti; Kashem, Abyaad; Elzarka, Ayya; Haber, Leora; MacKinney, Taryn; Loeb, Helen

    2018-02-28

    Motor vehicle crashes are the leading cause of death among young drivers. Though previous research has focused on crash events, near crashes offer additional data to help identify driver errors that could potentially lead to crashes as well as evasive maneuvers used to avoid them. The Strategic Highway Research Program 2 (SHRP2) Naturalistic Driving Study (NDS) contains extensive data on real-world driving and offers a reliable methodology to quantify and study near crashes. This article presents findings on near crashes and how they compare to crash events among teen, young adult, and experienced adult drivers. A subset from the SHRP2 database consisting of 1,653 near crashes for teen (16-19 years, n = 550), young adult (20-24 years, n = 748), and experienced adult (35-54 years, n = 591) drivers was used. Onboard instrumentation including scene cameras, accelerometers, and Global Positioning System logged time series data at 10 Hz. Scene videos were reviewed for all events to classify near crashes based on 7 types: rear-end, road departure, intersection, head-on, side-swipe, pedestrian/cyclist, and animal. Near crash rates, incident type, secondary tasks, and evasive maneuvers were compared across age groups and between crashes and near crashes. For rear-end near crashes, vehicle dynamic variables including near crash severity, headway distance, time headway, and time to collision at the time of braking were compared across age groups. Crashes and near crashes were combined to compare the frequency of critical events across age. Teen drivers exhibited a significantly higher (P systems based on the most common driving errors for vulnerable road users.

  12. Prospective and concurrent correlates of emotion perception in psychotic disorders: a naturalistic, longitudinal study of neurocognition, affective blunting and avolition.

    Science.gov (United States)

    Vaskinn, Anja; Johnsen, Erik; Jørgensen, Hugo A; Kroken, Rune A; Løberg, Else-Marie

    2013-06-01

    This naturalistic study investigated longitudinal and cross-sectional symptomatic and neurocognitive correlates of social cognition indexed by emotion perception. Participants were 31 persons admitted to a psychiatric emergency ward due to acute psychosis. Positive and negative (i.e., affective blunting and avolition) symptoms were assessed at baseline and 12-month follow-up using the Positive and Negative Syndrome Scale. Participants completed neuropsychological assessments with alternative versions of the Repeatable Battery for the Assessment of Neuropsychological Status at baseline and at 12-month follow-up. Emotion perception was measured using the Face/Voice Emotion Test at 12-month follow-up. Correlational analyses (Spearman's rho) revealed strong and statistically significant associations between neurocognition and emotion perception (baseline r = 0.58, follow-up r = 0.43). Associations between positive symptoms and emotion perception were weak or non-existent (baseline r = 0.13, follow-up r  =  -0.01). Emotion perception was moderately, but not significantly, associated with affective blunting at follow-up (r = 0.33), but not at baseline (r = 0.21). The association with avolition was non-existent (baseline r  =  -0.05, follow-up r = 0.01). This study supports the notion that emotion perception has neurocognitive correlates. The cross-sectional trend level association with affective blunting suggests that the ability to perceive emotions might be related to, but dissociable from the ability to express emotions. © 2013 The Authors. Scandinavian Journal of Psychology © 2013 The Scandinavian Psychological Associations.

  13. Implications of comorbid ADHD in ASD interventions and outcome: Results from a naturalistic follow up study from south India.

    Science.gov (United States)

    Manohar, Harshini; Kuppili, Pooja Patnaik; Kandasamy, Preeti; Chandrasekaran, Venkatesh; Rajkumar, Ravi Philip

    2018-03-01

    Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder commonly associated with Attention Deficit Hyperactivity Disorder (ADHD), the prevalence ranging from 14-70%. The current study attempted to assess the impact of comorbid ADHD in children with ASD, in terms of challenges in diagnosis, treatment, intervention outcomes and parental stress and coping through a naturalistic design. Fifty children aged 2-6 years with ASD were recruited, assessed and followed up for six months. Twenty children were found to have comorbid ADHD. Severity of ASD and ADHD was assessed by Childhood Autism rating scale and Connor's abbreviated rating scale respectively. Parental stress and coping was assessed by Family Interview for stress and coping. The diagnosis of ASD was apparently obscured by ADHD symptoms in about 22% of cases, as only diagnosis of ADHD was made at the time of referral to our centre. ADHD was the most common comorbidity followed by intellectual disability and seizure disorder. About 66% of children received combination of pharmacological and behavioral interventions. Clonidine was the most common medication to be used and was well tolerated. The improvement in ADHD symptomatology showed positive correlation with improvement with ASD-specific interventions as reflected by change in severity scores. Severity of ADHD significantly also predicted parental stress and coping, and thereby engagement in ASD-specific interventions. The current study highlights the need for screening and early diagnosis of comorbid ADHD in children with ASD and vice versa considering the management challenges. In case of multiple comorbid neurodevelopmental disorders, early interventions for one disorder can improve the outcome of the other. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Ten-year prospective follow-up study of the naturalistic course of dysthymic disorder and double depression.

    Science.gov (United States)

    Klein, Daniel N; Shankman, Stewart A; Rose, Suzanne

    2006-05-01

    The purpose of this study was to describe the 10-year course and outcome of dysthymic disorder. The authors conducted a naturalistic, prospective, longitudinal follow-up of 97 adults with early-onset dysthymic disorder and 45 adults with nonchronic major depressive disorder selected from consecutive admissions to several outpatient facilities. Follow-up data were obtained for 90% of the cohort. Assessments were conducted at baseline, 30, 60, 90, and 120 months. Measures included the Longitudinal Interval Follow-Up Evaluation and the Hamilton Depression Rating Scale. The Kaplan-Meier estimated recovery rate from dysthymic disorder was 73.9%, with a median time to recovery of 52 months. Among patients who recovered, the estimated risk of relapse into another period of chronic depression was 71.4%. Chronic depressive relapses took a variety of forms and were not limited to dysthymia. Nonetheless, the distinction between chronic and nonchronic forms of depression was relatively stable over the follow-up period. Mixed-effects models indicated that patients with dysthymic disorder experienced a significantly slower rate of improvement in symptoms over time and exhibited significantly greater depression at the 10-year point, compared to patients with nonchronic major depression. Dysthymic disorder has a protracted course and is associated with a high risk of relapse. The nature of chronic depressive episodes varies over time within individuals, indicating that the various manifestations of chronic depression in DSM-IV do not represent distinct disorders. However, the distinction between chronic and nonchronic forms of depression is relatively stable and may provide a useful basis for subtyping in genetic and neurobiological research.

  15. Breast cancer incidence and mortality in the Canadian fluoroscopy study

    International Nuclear Information System (INIS)

    Howe, G.R.

    1993-03-01

    This report describes the formation of the National Cancer Incidence Reporting System in a data base format suitable for computerized record linkage, and the linkage of the data from the Canadian study of cancer following multiple fluoroscopies to that database and to the Canadian National Mortality Data Base between 1940 and 1987. A comprehensive statistical analysis of the breast cancer mortality data occurring among female members of the cohort between 1950 and 1987 with respect to exposure to low-LET radiation is reported, together with a parallel analysis of the breast cancer incidence data between 1975 and 1983. The Canadian fluoroscopy study is a cohort study of tuberculosis patients first treated in Canadian institutions between 1930 and 1952. The present mortality analysis relates to the breast cancer mortality experience between 1950 and 1987. A total of 677 deaths from breast cancer was observed in this period. The most appropriate dose-response relationship appears to be a simple linear one. There is a strong modifying influence of age at first exposure; women first exposed past the age of 30 have little excess risk due to radiation exposure. The breast cancer incidence analysis is based upon 628 cases observed between 1975 and 1983. Again a simple linear model appears to provide an adequate fit to the data. There is a suggestion of time dependency under the additive model, but this is not statistically significant. The results from this latest analysis continue to be reassuring in terms of radiation risk from mammography. (L.L.) 15 refs., figs., tabs

  16. A Naturalistic Investigation of Media Multitasking While Studying and the Effects on Exam Performance

    Science.gov (United States)

    Patterson, Michael C.

    2017-01-01

    The present study investigated the use of multiple digital media technologies, including social networking platforms, by students while preparing for an examination (media multitasking) and the subsequent effects on exam performance. The level of media multitasking (number of simultaneous media technologies) and duration of study were used as…

  17. Canadian Consumer Food Safety Practices and Knowledge: Foodbook Study.

    Science.gov (United States)

    Murray, Regan; Glass-Kaastra, Shiona; Gardhouse, Christine; Marshall, Barbara; Ciampa, Nadia; Franklin, Kristyn; Hurst, Matt; Thomas, M Kate; Nesbitt, Andrea

    2017-10-01

    Understanding consumers' food safety practices and knowledge supports food safety education for the prevention of foodborne illness. The objective of this study was to describe Canadian consumer food safety practices and knowledge. This study identifies demographic groups for targeted food safety education messaging and establishes a baseline measurement to assess the effectiveness of food safety interventions over time. Questions regarding consumer food safety practices and knowledge were included in a population-based telephone survey, Foodbook, conducted from November 2014 to March 2015. The results were analyzed nationally by age group and by gender. The results showed that approximately 90% of Canadians reported taking the recommended cleaning and separating precautions when handling raw meat to prevent foodborne illness. Only 29% of respondents reported using a food thermometer when cooking any meat, and even fewer (12%) reported using a food thermometer for small cuts of meat such as chicken pieces. The majority (>80%) of Canadians were aware of the foodborne illness risks related to chicken and hamburger, but fewer (poultry.

  18. Some issues concerning applications of naturalistic paradigm to the study of religion

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    Kinga Kowalczyk-Purol

    2014-01-01

    Full Text Available Viewing religion as a product of evolution already has yielded a new and interesting hypotheses, which could help to integrate entire heritage of scientific study of religion. Nonetheless, there are some objections toward this program. First, despite the fact that evolutionary theories of religion are inherently interdisciplinary, its integration with sociological, anthropological and historical studies should be improve in the future. Second, phenomenological descriptions (that is individual religious experiences are neglected by Darwinians. This fact could negatively affects explanatory potential of this approach. Finally, opponents of analyzed paradigm state that evolutionary hypotheses have still low level of confirmation. It stems from a small number of conducted empirical investigations on evolutionary roots of religion. Nevertheless, application of Darwinian tools to the study of religion remains a very promising scientific venture.

  19. Outcomes for depression and anxiety in primary care and details of treatment : a naturalistic longitudinal study

    NARCIS (Netherlands)

    Prins, Marijn A.; Verhaak, Peter F. M.; Hilbink-Smolders, Mirrian; Spreeuwenberg, Peter; Laurant, Miranda G. H.; van der Meer, Klaas; van Marwijk, Harm W. J.; Penninx, Brenda W. J. H.; Bensing, Jozien M.

    2011-01-01

    Background: There is little evidence as to whether or not guideline concordant care in general practice results in better clinical outcomes for people with anxiety and depression. This study aims to determine possible associations between guideline concordant care and clinical outcomes in general

  20. Outcomes for depression and anxiety in primary care and details of treatment: a naturalistic longitudinal study

    NARCIS (Netherlands)

    Prins, M.A.; Verhaak, P.F.; Hilbink-Smolders, M.; Spreeuwenberg, P.; Laurant, M.G.; van der Meer, K.; van Marwijk, H.W.J.; Penninx, B.W.J.H.; Bensing, J.M.

    2011-01-01

    Background: There is little evidence as to whether or not guideline concordant care in general practice results in better clinical outcomes for people with anxiety and depression. This study aims to determine possible associations between guideline concordant care and clinical outcomes in general

  1. Outcomes for depression and anxiety in primary care and details of treatment: a naturalistic longitudinal study.

    NARCIS (Netherlands)

    Prins, M.A.; Verhaak, P.F.M.; Hilbink-Smolders, M.; Spreeuwenberg, P.; Laurant, M.G.H.; Meer, K. van der; Marwijk, H.W.J. van; Penninx, B.W.J.H.; Bensing, J.M.

    2011-01-01

    Background: There is little evidence as to whether or not guideline concordant care in general practice results in better clinical outcomes for people with anxiety and depression. This study aims to determine possible associations between guideline concordant care and clinical outcomes in general

  2. Inpatient Treatment for Early Sexually Abused Adults: A Naturalistic 12-Month Follow-Up Study

    NARCIS (Netherlands)

    Jepsen, E.K.K.; Langeland, W.; Sexton, H.; Heir, T.

    2014-01-01

    To date, most of the inpatient outcome studies among early traumatized individuals lack data on dissociative disorders. More research is needed to evaluate whether severely dissociative patients can improve following specialized inpatient treatment for chronic childhood abuse. The objectives of this

  3. Metabolic syndrome in a cohort of affectively ill patients, a naturalistic study

    DEFF Research Database (Denmark)

    Vinberg, Maj; Madsen, Maiken; Breum, Leif

    2012-01-01

    at a Mood Disorder Clinic. Methods: Patients were evaluated for the presence of metabolic syndrome (MeS) according to modified NCEP ATP III criteria. Results: Of the 143 patients eligible for participation, 100 patients participated in the study (32% male, mean age 43.6 ± 14.2); the prevalence of MeS was 26...

  4. Cultural Characteristics of a Nursing Education Center of Excellence: A Naturalistic Inquiry Case Study

    Science.gov (United States)

    Leiker, Tona L.

    2011-01-01

    Nursing education is at a crossroad today. Stressors in nursing programs include expanding enrollments to meet growing workforce demands for more registered nurses, demanding workloads with low average nursing faculty salaries compared to practice peers, and growing numbers of faculty retirements. The purpose of this study was to identify the…

  5. Subthreshold Psychosis in 22q11.2 Deletion Syndrome: Multisite Naturalistic Study.

    Science.gov (United States)

    Weisman, Omri; Guri, Yael; Gur, Raquel E; McDonald-McGinn, Donna M; Calkins, Monica E; Tang, Sunny X; Emanuel, Beverly; Zackai, Elaine H; Eliez, Stephan; Schneider, Maude; Schaer, Marie; Kates, Wendy R; Antshel, Kevin M; Fremont, Wanda; Shashi, Vandana; Hooper, Stephen R; Armando, Marco; Vicari, Stefano; Pontillo, Maria; Kushan, Leila; Jalbrzikowski, Maria; Bearden, Carrie E; Cubells, Joseph F; Ousley, Opal Y; Walker, Elaine F; Simon, Tony J; Stoddard, Joel; Niendam, Tara A; van den Bree, Marianne B M; Gothelf, Doron

    2017-09-01

    Nearly one-third of individuals with 22q11.2 deletion syndrome (22q11.2DS) develop a psychotic disorder during life, most of them by early adulthood. Importantly, a full-blown psychotic episode is usually preceded by subthreshold symptoms. In the current study, 760 participants (aged 6-55 years) with a confirmed hemizygous 22q11.2 microdeletion have been recruited through 10 medical sites worldwide, as part of an international research consortium. Of them, 692 were nonpsychotic and with complete measurement data. Subthreshold psychotic symptoms were assessed using the Structured Interview for Prodromal Syndromes (SIPS). Nearly one-third of participants met criteria for positive subthreshold psychotic symptoms (32.8%), less than 1% qualified for acute positive subthreshold symptoms, and almost a quarter met criteria for negative/disorganized subthreshold symptoms (21.7%). Adolescents and young adults (13-25 years) showed the highest rates of subthreshold psychotic symptoms. Additionally, higher rates of anxiety disorders and attention deficit/hyperactivity disorder (ADHD) were found among the study participants with subthreshold psychotic symptoms compared to those without. Full-scale IQ, verbal IQ, and global functioning (GAF) scores were negatively associated with participants' subthreshold psychotic symptoms. This study represents the most comprehensive analysis reported to date on subthreshold psychosis in 22q11.2DS. Novel findings include age-related changes in subthreshold psychotic symptoms and evidence that cognitive deficits are associated with subthreshold psychosis in this population. Future studies should longitudinally follow these symptoms to detect whether and how early identification and treatment of these manifestations can improve long-term outcomes in those that eventually develop a psychotic disorder. © The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For

  6. Outcomes for depression and anxiety in primary care and details of treatment: a naturalistic longitudinal study

    Directory of Open Access Journals (Sweden)

    Prins Marijn A

    2011-11-01

    Full Text Available Abstract Background There is little evidence as to whether or not guideline concordant care in general practice results in better clinical outcomes for people with anxiety and depression. This study aims to determine possible associations between guideline concordant care and clinical outcomes in general practice patients with depression and anxiety, and identify patient and treatment characteristics associated with clinical improvement. Methods This study forms part of the Netherlands Study of Depression and Anxiety (NESDA. Adult patients, recruited in general practice (67 GPs, were interviewed to assess DSM-IV diagnoses during baseline assessment of NESDA, and also completed questionnaires measuring symptom severity, received care, socio-demographic variables and social support both at baseline and 12 months later. The definition of guideline adherence was based on an algorithm on care received. Information on guideline adherence was obtained from GP medical records. Results 721 patients with a current (6-month recency anxiety or depressive disorder participated. While patients who received guideline concordant care (N = 281 suffered from more severe symptoms than patients who received non-guideline concordant care (N = 440, both groups showed equal improvement in their depressive or anxiety symptoms after 12 months. Patients who (still had moderate or severe symptoms at follow-up, were more often unemployed, had smaller personal networks and more severe depressive symptoms at baseline than patients with mild symptoms at follow-up. The particular type of treatment followed made no difference to clinical outcomes. Conclusion The added value of guideline concordant care could not be demonstrated in this study. Symptom severity, employment status, social support and comorbidity of anxiety and depression all play a role in poor clinical outcomes.

  7. The relationships between exercise and affective states: a naturalistic, longitudinal study of recreational runners

    Directory of Open Access Journals (Sweden)

    Tim Bonham

    2018-01-01

    Full Text Available Background Although people generally feel more positive and more energetic in the aftermath of exercise than before, longitudinal research on how exercise relates to within-person fluctuations in affect over the course of everyday life is still relatively limited. One constraint on doing such research is the need to provide participants with accelerometers to objectively record their exercise, and pagers to capture affective reports. Aims We aimed to develop a methodology for studying affect and exercise using only technology that participants already possess, namely GPS running watches and smartphones. Using this methodology, we aimed to characterize within-individual fluctuations in affective valence and arousal in relation to bouts of exercise, and explore possible moderators of these fluctuations. Methods We recruited a sample of 38 recreational runners. Participants provided daily affective reports for six weeks using their smartphones. Information on their runs was harvested from their own GPS devices via an online platform for athletes. Results Average valence and arousal were higher on days when the person had run than on the next day, and higher the day after a run than on the days after that. Over the course of the day of a run, valence and arousal declined significantly as the time since the run increased. Physically fitter participants had more positive valence overall, and this was particularly true when they had not run recently. There was some evidence of higher-dose (i.e., longer and faster runs being associated with lower arousal on the next and subsequent days. Gender did not moderate associations between running and valence or arousal. Discussion Our study demonstrated the potential for studying the associations between affect and exercise in a way that is precise, undemanding for participants, and convenient for researchers, using technologies that participants already own and use.

  8. Characteristics of autism spectrum disorder in anorexia nervosa: A naturalistic study in an inpatient treatment programme.

    Science.gov (United States)

    Tchanturia, Kate; Adamson, James; Leppanen, Jenni; Westwood, Heather

    2017-11-01

    Previous research has demonstrated links between anorexia nervosa and autism spectrum disorder however, few studies have examined the possible impact of symptoms of autism spectrum disorder on clinical outcomes in anorexia nervosa. The aim of this study was to examine the association between symptoms of autism spectrum disorder and eating disorders, and other psychopathology during the course of inpatient treatment in individuals with anorexia nervosa. Participants with anorexia nervosa (n = 171) completed questionnaires exploring eating disorder psychopathology, symptoms of depression and anxiety, and everyday functioning at both admission and discharge. Characteristics associated with autism spectrum disorder were assessed using the Autism Spectrum Quotient, short version. Autism spectrum disorder symptoms were significantly positively correlated with eating disorder psychopathology, work and social functioning, and symptoms of depression and anxiety, but not with body mass index. Autism Spectrum Quotient, short version scores remained relatively stable from admission to discharge but there was a small, significant reduction in scores. There was no interaction between time and Autism Spectrum Quotient, short version scores on clinical symptom change. In anorexia nervosa, autism spectrum disorder symptoms appear to be associated with a more severe clinical presentation on admission to inpatient care. Autism spectrum disorder symptoms as assessed by self-report measures may be exacerbated by other mental health psychopathology, which warrants further investigation.

  9. Achieving symptomatic remission in out-patients with schizophrenia--a naturalistic study with quetiapine.

    Science.gov (United States)

    Wobrock, T; Köhler, J; Klein, P; Falkai, P

    2009-08-01

    Symptomatic remission was defined as a score of mild or less on each of eight key schizophrenia symptoms on the Positive and Negative Syndrome Scale (PANSS-8). To evaluate the symptomatic remission criterion in clinical practice and to determine predictors for achieving symptomatic remission, a 12-week non-interventional study (NIS) with quetiapine was conducted in Germany. For the comparison of patients with and without symptomatic remission, sociodemographic and clinical variables of 693 patients were analyzed by logistic regression for their predictive value to achieve remission. Four hundred and four patients (58.3%) achieved symptomatic remission after 12 weeks' treatment with quetiapine. Remission was significantly predicted by a low degree of PANSS-8 total score, PANSS single items blunted affect (N1), social withdrawal (N4), lack of spontaneity (N6), mannerism and posturing (G5), and low disease severity (CGI-S) at baseline. Predictors of non-remission were older age, diagnosis of schizophrenic residuum, multiple previous episodes, longer duration of current episode, presence of concomitant diseases, and alcohol abuse. This study demonstrated that the majority of schizophrenia out-patients achieved symptomatic remission after 12 weeks treatment and confirms the importance of managing negative symptoms in order to achieve disease remission.

  10. Adherence predicts symptomatic and psychosocial remission in schizophrenia: Naturalistic study of patient integration in the community.

    Science.gov (United States)

    Bernardo, Miguel; Cañas, Fernando; Herrera, Berta; García Dorado, Marta

    Psychosocial functioning in patients with schizophrenia attended in daily practice is an understudied aspect. The aim of this study was to assess the relationship between symptomatic and psychosocial remission and adherence to treatment in schizophrenia. This cross-sectional, non-interventional, and multicenter study assessed symptomatic and psychosocial remission and community integration of 1,787 outpatients with schizophrenia attended in Spanish mental health services. Adherence to antipsychotic medication in the previous year was categorized as≥80% vs.<80%. Symptomatic remission was achieved in 28.5% of patients, and psychosocial remission in 26.1%. A total of 60.5% of patients were classified as adherent to antipsychotic treatment and 41% as adherent to non-pharmacological treatment. During the index visit, treatment was changed in 28.4% of patients, in 31.1% of them because of low adherence (8.8% of the total population). Adherent patients showed higher percentages of symptomatic and psychosocial remission than non-adherent patients (30.5 vs. 25.4%, P<.05; and 32 vs. 17%, P<.001, respectively). Only 3.5% of the patients showed an adequate level of community integration, which was also higher among adherent patients (73.0 vs. 60.1%, P<.05). Adherence to antipsychotic medication was associated with symptomatic and psychosocial remission as well as with community integration. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Communal proactive coping strategies among Tamil refugees in Norway: A case study in a naturalistic setting

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    Guribye Eugene

    2011-04-01

    Full Text Available Abstract Background An exclusive focus on individual or family coping strategies may be inadequate for people whose major point of concern may be collective healing on a more communal level. Methods To our knowledge, the current study is the first to make use of ethnographic fieldwork methods to investigate this type of coping as a process in a natural setting over time. Participant observation was employed within a Tamil NGO in Norway between August 2006 and December 2008. Results Tamil refugees in Norway co-operated to appraise their shared life situation and accumulate resources communally to improve it in culturally meaningful ways. Long term aspirations were related to both the situation in the homeland and in exile. However, unforeseen social events created considerable challenges and forced them to modify and adapt their coping strategies. Conclusions We describe a form of coping previously not described in the scientific literature: Communal proactive coping strategies, defined as the process by which group members feel collectively responsible for their future well-being and co-operate to promote desired outcomes and prevent undesired changes. The study shows that proactive coping efforts occur in a dynamic social setting which may force people to use their accumulated proactive coping resources in reactive coping efforts. Theoretical and clinical implications are explored.

  12. Emerging Adults' Text Message Use and Sleep Characteristics: A Multimethod, Naturalistic Study.

    Science.gov (United States)

    Murdock, Karla Klein; Horissian, Mikael; Crichlow-Ball, Caroline

    2017-01-01

    Emerging adults use text messaging as a principal form of social communication, day and night, and this may compromise their sleep. In this study, a hypothetical model was tested linking daytime and nighttime text message use with multiple sleep characteristics. Subjective and objective measures of texting and sleep were utilized to assess 83 college students over a seven-day period during an academic term. Greater number of daily texts, awareness of nighttime cell phone notifications, and compulsion to check nighttime notifications were significantly associated with poorer subjective sleep quality. Awareness of nighttime notifications was significantly associated with higher self-reported global sleep problems and more sleep disruptions. Results suggest potential benefits of targeting nighttime texting habits in health promotion efforts for emerging adults.

  13. A prospective naturalistic study of antidepressant-induced jitteriness/anxiety syndrome

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    Harada T

    2014-11-01

    Full Text Available Tsuyoto Harada, Ken Inada, Kazuo Yamada, Kaoru Sakamoto, Jun Ishigooka Department of Psychiatry, Tokyo Women’s Medical University School of Medicine, Tokyo, Japan Objective: Patients often develop neuropsychiatric symptoms such as anxiety and agitation after they have started taking an antidepressant, and this is thought to be associated with a potentially increased risk of suicide. However, the incidence of antidepressant-induced jitteriness/anxiety syndrome has not been fully investigated, and little has been reported on its predictors. The aim of this study was to survey the incidence of antidepressant-induced jitteriness/anxiety syndrome and clarify its predictors in a natural clinical setting.Materials and methods: Between January 2009 and July 2012, we prospectively surveyed 301 patients who had not taken any antidepressants for 1 month before presentation, and who were prescribed antidepressants for 1 month after their initial visit. Patients were classified as developing antidepressant-induced jitteriness/anxiety syndrome if they experienced any symptoms of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, or mania during the first month.Results: Among the 301 patients, 21 (7.0% developed antidepressant-induced jitteriness/anxiety syndrome. Major depressive disorder and a diagnosis of mood disorder in first-degree relatives of patients were significantly associated with induction of antidepressant-induced jitteriness/anxiety syndrome (odds ratio 10.2, P=0.001; odds ratio 4.65, P=0.02; respectively. However, there was no such relationship for sex, age, class of antidepressant, combined use of benzodiazepines, or diagnosis of anxiety disorder.Conclusion: The findings of this study suggest that major depressive disorder and a diagnosis of mood disorder in first-degree relatives may be clinical predictors of antidepressant-induced jitteriness/anxiety syndrome

  14. Effects of ecstasy on cooperative behaviour and perception of trustworthiness: a naturalistic study.

    Science.gov (United States)

    Stewart, L H; Ferguson, B; Morgan, C J A; Swaboda, N; Jones, L; Fenton, R; Wall, M B; Curran, H V

    2014-11-01

    Acute recreational use of 3,4-methylenedioxymethamphetamine (MDMA; 'ecstasy') can promote pro-social effects which may alter interpersonal perceptions. To explore such effects, this study investigated whether acute recreational use of ecstasy was associated with changes in individual perception of trustworthiness of people's faces and co-operative behaviours. An independent group, repeated measures design was used in which 17 ecstasy users were tested on the night of drug use (day 0) and again three days later (day 3); 22 controls were tested on parallel days. On each day, participants rated the trustworthiness of 66 faces, carried out three co-operative behaviour tasks (public good; dictator; ultimatum game) and completed mood self-ratings. Acute ecstasy use was associated with increased face trustworthiness ratings and increased cooperative behaviour on the dictator and ultimatum games; on day 3 there were no group differences on any task. Self-ratings showed the standard acute ecstasy effects (euphoria, energy, jaw clenching) with negative effects (less empathy, compassion, more distrust, hostility) emerging on day 3. Our findings of increased perceived trustworthiness and co-operative behaviours following use of ecstasy suggest that a single dose of the drug enhances aspects of empathy. This may in turn contribute to its popularity as a recreational drug and potentially to its enhancement of the therapeutic alliance in psychotherapy. © The Author(s) 2014.

  15. Academic computer science and gender: A naturalistic study investigating the causes of attrition

    Science.gov (United States)

    Declue, Timothy Hall

    Far fewer women than men take computer science classes in high school, enroll in computer science programs in college, or complete advanced degrees in computer science. The computer science pipeline begins to shrink for women even before entering college, but it is at the college level that the "brain drain" is the most evident numerically, especially in the first class taken by most computer science majors called "Computer Science 1" or CS-I. The result, for both academia and industry, is a pronounced technological gender disparity in academic and industrial computer science. The study revealed the existence of several factors influencing success in CS-I. First, and most clearly, the effect of attribution processes seemed to be quite strong. These processes tend to work against success for females and in favor of success for males. Likewise, evidence was discovered which strengthens theories related to prior experience and the perception that computer science has a culture which is hostile to females. Two unanticipated themes related to the motivation and persistence of successful computer science majors. The findings did not support the belief that females have greater logistical problems in computer science than males, or that females tend to have a different programming style than males which adversely affects the females' ability to succeed in CS-I.

  16. Canadian National Dairy Study: Herd-level milk quality.

    Science.gov (United States)

    Bauman, C A; Barkema, H W; Dubuc, J; Keefe, G P; Kelton, D F

    2018-03-01

    The objective of this study was to estimate Canadian national milk quality parameters and estimate the bulk tank milk (BTM) prevalence of 4 mastitis pathogens, Staphylococcus aureus, Streptococcus agalactiae, Mycoplasma bovis, and Prototheca spp., on Canadian dairy farms. A questionnaire was sent to all Canadian dairy producers. Of the 1,062 producers who completed the questionnaire, 374 producers from across the country were visited and milking hygiene was assessed. Farm-level milk quality data for all Canadian dairy producers was collected from the provincial marketing boards and combined with the questionnaire and farm visit data. In addition, a BTM sample was collected either during the farm visit or by the marketing board in November of 2015 and was tested for 4 major mastitis pathogens using the PathoProof Mastitis Major 4 PCR Assay (Thermo Fisher Scientific Inc., Waltham, MA). Apparent herd-level prevalence was 46% for S. aureus, 6% for Prototheca spp., 0% for M. bovis, and 0% for Strep. agalactiae. Due to the low prevalence of M. bovis and Strep. agalactiae and a lack of significant factors associated with farms testing positive for Prototheca spp., an association analysis could only be carried out for Staph. aureus-positive farms. Factors associated with Staph. aureus-positive farms were not fore-stripping cows before milking (odds ratio = 1.87), milking with a pipeline system (odds ratio = 2.21), and stall bases made of a rubberized surface (mats and mattresses), whereas protective factors were using blanket dry cow therapy (odds ratio = 0.49) and applying a tag or visible mark on cows known to have chronic mastitis infections (odds ratio = 0.45). The Canadian national production-weighted geometric mean somatic cell count was determined to be 208,000 cells/mL. This is the first national dairy study conducted in Canada. Participating farms had higher milk yield; were more likely to have a loose housing system, parlor, or automated milking system; and had

  17. Children's books and the nature of science: A multisite naturalistic case study of three elementary teachers in the rural southeast

    Science.gov (United States)

    Bricker, Patricia Lynn

    This naturalistic case study describes the efforts of three elementary teachers in a rural southeastern school to use children's books in support of inquiry-based science and specifically addresses issues related to the nature of science. Data were collected through 26 classroom and meeting observations, 16 semi-structured and informal interviews, 35 documents and 76 children's books used by the teachers. Three themes were identified related to the nature of science and the selection and use of children's books in the teachers' second, fourth, and fifth grade classrooms. (1) Science was portrayed as a human endeavor that connects to the lives of people and that involves fascination, passion, and interest; imagination and creativity; values; and diverse views. The collection of books was analyzed to look specifically at race, culture, and gender issues. While women, people of color, and different cultures were represented in the book collection, they were not represented well when considering the collection as a whole. (2) Books and the teachers' use of them supported firsthand investigation of the natural world and the idea that empirical evidence underlies scientific understanding. This theme involved observation and journaling, identification of questions to investigate and procedures to use, reasonable interpretations of results, and inferential thinking. (3) Books helped teach about the durable body of scientific knowledge we have discovered over time. They were used to broaden background knowledge and as references after firsthand investigations. The complexity of science education is revealed in these cases. The teachers were able to artfully balance multiple aspects of the nature of science in their book selection and presentation. Particularly promising aspects include their work to use fiction and poetry to promote connections between imagination, creativity and science and their innovative use of books to help students interpret data and infer. Important

  18. Suicidality and symptoms of anxiety, irritability, and agitation in patients experiencing manic episodes with depressive symptoms: a naturalistic study

    Directory of Open Access Journals (Sweden)

    Eberhard J

    2016-08-01

    Full Text Available Jonas Eberhard,1 Emmanuelle Weiller2 1Department of Clinical Sciences, Lund University, Lund, Sweden; 2H. Lundbeck A/S, Copenhagen, Denmark Purpose: Patients with a bipolar I disorder (BD-I manic episode meeting the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5, criteria for “with mixed features” have a high incidence of suicide attempts and of anxiety, irritability, and agitation (AIA symptoms. The aim of this analysis was to explore the relationship between suicidality and AIA symptoms in patients with BD-I experiencing mania with depressive symptoms, using data from a previous naturalistic study.Patients and methods: Psychiatrists completed an online questionnaire about their adult patients who had a current BD-I manic episode. Questions covered the DSM-5 “with mixed features” specifier, the severity of AIA symptoms, the frequency and controllability of suicidal ideation, and the number of suicide attempts.Results: Of 1,035 patients with BD-I mania who were included in the analyses, 348 (33.6% met the criteria for the DSM-5 “with mixed features” specifier (three or more depressive symptoms. These patients were further stratified according to the severity of their AIA symptoms: “mild AIA” (zero or one AIA symptom above a severity threshold; 105 patients or “severe AIA” (all three AIA symptoms above a severity threshold; 167 patients. A greater incidence of suicidal ideation was observed in the severe AIA group (71.9% than in the mild AIA group (47.6%. Twice as many patients had easily controlled suicidal ideation than difficult-to-control suicidal ideation in both subgroups. The mean number of suicide attempts was higher in the severe AIA group than in the mild AIA group, during the current episode (0.84 vs 0.34 attempts, respectively; P<0.05 and over the patient’s lifetime (1.56 vs 1.04 attempts, respectively.Conclusion: The high risk of suicide among BD-I mania patients with depressive

  19. The Alabama VIP older driver study rationale and design: examining the relationship between vision impairment and driving using naturalistic driving techniques.

    Science.gov (United States)

    Owsley, Cynthia; McGwin, Gerald; Antin, Jonathan F; Wood, Joanne M; Elgin, Jennifer

    2018-02-07

    Older drivers aged ≥70 years old have among the highest rates of motor vehicle collisions (MVC) compared to other age groups. Driving is a highly visual task, and older adults have a high prevalence of vision impairment compared to other ages. Most studies addressing visual risk factors for MVCs by older drivers utilize vehicle accident reports as the primary outcome, an approach with several methodological limitations. Naturalistic driving research methods overcome these challenges and involve installing a high-tech, unobtrusive data acquisition system (DAS) in an older driver's own vehicle. The DAS continuously records multi-channel video of driver and roadway, sensor-based kinematics, GPS location, and presence of nearby objects in front of the vehicle, providing an objective measure of driving exposure. In this naturalistic driving study, the purpose is to examine the relationship between vision and crashes and near-crashes, lane-keeping, turning at intersections, driving performance during secondary tasks demands, and the role of front-seat passengers. An additional aim is to compare results of the on-road driving evaluation by a certified driving rehabilitation specialist to objective indicators of driving performance derived from the naturalistic data. Drivers ≥70 years old are recruited from ophthalmology clinics and a previous population-based study of older drivers, with the goal of recruiting persons with wide ranging visual function. Target samples size is 195 drivers. At a baseline visit, the DAS is installed in the participant's vehicle and a battery of health and functional assessments are administered to the driver including visual-sensory and visual-cognitive tests. The DAS remains installed in the vehicle for six months while the participant goes about his/her normal driving with no imposed study restrictions. After six months, the driver returns for DAS de-installation, repeat vision testing, and an on-road driving evaluation by a certified

  20. A naturalistic long-term comparison study of selective serotonin reuptake inhibitors in the treatment of panic disorder.

    Science.gov (United States)

    Dannon, Pinhas N; Iancu, Iulian; Lowengrub, Katherine; Gonopolsky, Yehudit; Musin, Ernest; Grunhaus, Leon; Kotler, Moshe

    2007-01-01

    Selective serotonin reuptake inhibitors (SSRIs) are currently considered as the first drug of choice in the treatment of panic disorder (PD). The aim of this long-term, naturalistic comparison study was to compare 4 SSRIs with respect to tolerability and treatment outcome of PD. Outcome measures included relapse rates and adverse effects. Two hundred patients with PD were enrolled in our study. All subjects met DSM-IV criteria for PD or PD with agoraphobia (PDA). All patients were assigned to receive SSRI monotherapy for 12 months with either citalopram (n = 50), fluoxetine (n = 50), fluvoxamine (n = 50), or paroxetine (n = 50) in a randomized, nonblinded fashion. Both the treating psychiatrist and the patients were not blind to the assigned treatment, but the clinician raters were blind to the study medication. The study design allowed for assignment of a particular SSRI as indicated according to the clinical judgment of the study psychiatrists. The Panic Self-Questionnaire, which is a self-report scale, was administered at baseline and then once per month during the duration of the 12-month study. The visual analog scale and the Clinical Global Impression Scale were administered at baseline and then once per month during the period of the study. Reports of sexual dysfunction were assessed using a nonstructured clinical interview at monthly visits. The body weight of study subjects was measured at baseline, and then at the 12th month visit end point. Of 200 patients who entered the study, 127 patients (63.5%) completed the full 12-month protocol. Retention rates were highest for paroxetine (76% [38/50]), intermediate for citalopram (68% [34/50]) and fluvoxamine (60% [30/50]), and lowest for fluoxetine (50% [25/50]). Patients who completed the 12-month protocol responded favorably to the study treatment. The paroxetine and the citalopram groups had significantly lower rates of panic symptoms as measured at visits on weeks 4 and 8. At visits on months 3, 6, 9, and

  1. The parasitic model of L2 and L3 vocabulary acquisition: evidence from naturalistic and experimental studies

    Directory of Open Access Journals (Sweden)

    Peter Ecke

    2014-09-01

    Full Text Available This paper reviews evidence for the Parasitic Model of Vocabulary Acquisition for second and third language learners/developing multilinguals. It first describes the model’s predictions about default processes based on the detection and use of similarity at the three stages involved in the development of individual lexical items: (1 the establishing of a form representation, (2 the building of connections to syntactic frame and concept representations, and (3 the strengthening and automatization of representations and access routes. The paper then summarizes both naturalistic and experimental evidence for processes involved at these three stages. Finally it discusses open issues and potential areas for future investigation.

  2. Talking on a Wireless Cellular Device While Driving: Improving the Validity of Crash Odds Ratio Estimates in the SHRP 2 Naturalistic Driving Study

    Directory of Open Access Journals (Sweden)

    Richard A. Young

    2017-12-01

    Full Text Available Dingus and colleagues (Proc. Nat. Acad. Sci. U.S.A. 2016, 113, 2636–2641 reported a crash odds ratio (OR estimate of 2.2 with a 95% confidence interval (CI from 1.6 to 3.1 for hand-held cell phone conversation (hereafter, “Talk” in the SHRP 2 naturalistic driving database. This estimate is substantially higher than the effect sizes near one in prior real-world and naturalistic driving studies of conversation on wireless cellular devices (whether hand-held, hands-free portable, or hands-free integrated. Two upward biases were discovered in the Dingus study. First, it selected many Talk-exposed drivers who simultaneously performed additional secondary tasks besides Talk but selected Talk-unexposed drivers with no secondary tasks. This “selection bias” was removed by: (1 filtering out records with additional tasks from the Talk-exposed group; or (2 adding records with other tasks to the Talk-unexposed group. Second, it included records with driver behavior errors, a confounding bias that was also removed by filtering out such records. After removing both biases, the Talk OR point estimates declined to below 1, now consistent with prior studies. Pooling the adjusted SHRP 2 Talk OR estimates with prior study effect size estimates to improve precision, the population effect size for wireless cellular conversation while driving is estimated as 0.72 (CI 0.60–0.88.

  3. Rationale, design, and methods for Canadian alliance for healthy hearts and minds cohort study (CAHHM) - a Pan Canadian cohort study.

    Science.gov (United States)

    Anand, Sonia S; Tu, Jack V; Awadalla, Philip; Black, Sandra; Boileau, Catherine; Busseuil, David; Desai, Dipika; Després, Jean-Pierre; de Souza, Russell J; Dummer, Trevor; Jacquemont, Sébastien; Knoppers, Bartha; Larose, Eric; Lear, Scott A; Marcotte, Francois; Moody, Alan R; Parker, Louise; Poirier, Paul; Robson, Paula J; Smith, Eric E; Spinelli, John J; Tardif, Jean-Claude; Teo, Koon K; Tusevljak, Natasa; Friedrich, Matthias G

    2016-07-27

    The Canadian Alliance for Healthy Hearts and Minds (CAHHM) is a pan-Canadian, prospective, multi-ethnic cohort study being conducted in Canada. The overarching objective of the CAHHM is to understand the association of socio-environmental and contextual factors (such as societal structure, activity, nutrition, social and tobacco environments, and access to health services) with cardiovascular risk factors, subclinical vascular disease, and cardiovascular and other chronic disease outcomes. Participants between 35 and 69 years of age are being recruited from existing cohorts and a new First Nations Cohort to undergo a detailed assessment of health behaviours (including diet and physical activity), cognitive function, assessment of their local home and workplace environments, and their health services access and utilization. Physical measures including weight, height, waist/hip circumference, body fat percentage, and blood pressure are collected. In addition, eligible participants undergo magnetic resonance imaging (MRI) of the brain, heart, carotid artery and abdomen to detect early subclinical vascular disease and ectopic fat deposition. CAHHM is a prospective cohort study designed to investigate the impact of community level factors, individual health behaviours, and access to health services, on cognitive function, subclinical vascular disease, fat distribution, and the development of chronic diseases among adults living in Canada.

  4. Injuries at a Canadian National Taekwondo Championships: a prospective study

    Directory of Open Access Journals (Sweden)

    Pieter Willy

    2004-07-01

    Full Text Available Abstract Background The purpose of this prospective study was to assess the injury rates in male and female adult Canadian Taekwondo athletes relative to total number of injuries, type and body part injured. Methods Subjects (219 males, 99 females participated in the 1997 Canadian National Taekwondo Championships in Toronto, Canada. Injuries were recorded on an injury form to documents any injury seen and treatment provided by the health care team. These data were later used for this study. The injury form describes the athlete and nature, site, severity and mechanism of the injury. Results The overall rate of injuries was 62.9/1,000 athlete-exposures (A-E. The males (79.9/1,000 A-E sustained significantly more injuries than the females (25.3/1,000 A-E. The lower extremities were the most commonly injured body region in the men (32.0 /1,000 A-E, followed by the head and neck (18.3/1,000 A-E. Injuries to the spine (neck, upper back, low back and coccyx were the third most often injured body region in males (13.8/1,000 A-E. All injuries to the women were sustained to the lower extremities. The most common type of injury in women was the contusion (15.2/1,000 A-E. However, men's most common type of injury was the sprain (22.8/1,000 A-E followed by joint dysfunction (13.7/1,000A-E. Concussions were only reported in males (6.9/1,000 A-E. Compared to international counterparts, the Canadian men and women recorded lower total injury rates. However, the males incurred more cerebral concussions than their American colleagues (4.7/1,000 A-E. Conclusions Similar to what was found in previous studies, the current investigation seems to suggest that areas of particular concern for preventive measures involve the head and neck as well as the lower extremities. This is the first paper to identify spinal joint dysfunction.

  5. Naturalistic acquisition in an early language classroom.

    Science.gov (United States)

    Dahl, Anne; Vulchanova, Mila D

    2014-01-01

    This study investigated whether it is possible to provide naturalistic second language acquisition (SLA) of vocabulary for young learners in a classroom situation without resorting to a classical immersion approach. Participants were 60 first-grade pupils in two Norwegian elementary schools in their first year. The control group followed regular instruction as prescribed by the school curriculum, while the experimental group received increased naturalistic target language input. This entailed extensive use of English by the teacher during English classes, and also during morning meetings and for simple instructions and classroom management throughout the day. Our hypothesis was that it is possible to facilitate naturalistic acquisition through better quality target language exposure within a normal curriculum. The students' English vocabulary knowledge was measured using the Peabody Picture Vocabulary Test, version 4 (PPVT-IV, Dunn and Dunn, 2007a), at the beginning and the end of the first year of school. Findings are that (1) early-start second-language (L2) programs in school do not in themselves guarantee vocabulary development in the first year, (2) a focus on increased exposure to the L2 can lead to a significant increase in receptive vocabulary comprehension in the course of only 8 months, and (3) even with relatively modest input, learners in such an early-start L2 program can display vocabulary acquisition comparable in some respects to that of younger native children matched on vocabulary size. The overall conclusion is that naturalistic vocabulary acquisition is in fact possible in a classroom setting.

  6. Canadian Forces Experience with Turbofan HCF - Case Study

    National Research Council Canada - National Science Library

    Kinart, Corey; Theriault, Pierre

    2005-01-01

    High Cycle Fatigue (HCF) cracking of a Canadian Forces (CF) turbofan engine fuel tube resulted in a six year, multinational effort to identify the root cause and to ultimately develop and implement a solution...

  7. Better together? a naturalistic qualitative study of inter-professional working in collaborative care for co-morbid depression and physical health problems.

    Science.gov (United States)

    Knowles, Sarah E; Chew-Graham, Carolyn; Coupe, Nia; Adeyemi, Isabel; Keyworth, Chris; Thampy, Harish; Coventry, Peter A

    2013-09-20

    Mental-physical multi-morbidities pose challenges for primary care services that traditionally focus on single diseases. Collaborative care models encourage inter-professional working to deliver better care for patients with multiple chronic conditions, such as depression and long-term physical health problems. Successive trials from the United States have shown that collaborative care effectively improves depression outcomes, even in people with long-term conditions (LTCs), but little is known about how to implement collaborative care in the United Kingdom. The aim of the study was to explore the extent to which collaborative care was implemented in a naturalistic National Health Service setting. A naturalistic pilot study of collaborative care was undertaken in North West England. Primary care mental health professionals from IAPT (Increasing Access to Psychological Therapies) services and general practice nurses were trained to collaboratively identify and manage patients with co-morbid depression and long-term conditions. Qualitative interviews were performed with health professionals at the beginning and end of the pilot phase. Normalization Process Theory guided analysis. Health professionals adopted limited elements of the collaborative care model in practice. Although benefits of co-location in primary care practices were reported, including reduced stigma of accessing mental health treatment and greater ease of disposal for identified patients, existing norms around the division of mental and physical health work in primary care were maintained, limiting integration of the mental health practitioners into the practice setting. Neither the mental health practitioners nor the practice nurses perceived benefits to joint management of patients. Established divisions between mental and physical health may pose particular challenges for multi-morbidity service delivery models such as collaborative care. Future work should explore patient perspectives about

  8. Individual differences in compliance and agreement for sleep logs and wrist actigraphy: A longitudinal study of naturalistic sleep in healthy adults.

    Directory of Open Access Journals (Sweden)

    Steven M Thurman

    Full Text Available There is extensive laboratory research studying the effects of acute sleep deprivation on biological and cognitive functions, yet much less is known about naturalistic patterns of sleep loss and the potential impact on daily or weekly functioning of an individual. Longitudinal studies are needed to advance our understanding of relationships between naturalistic sleep and fluctuations in human health and performance, but it is first necessary to understand the efficacy of current tools for long-term sleep monitoring. The present study used wrist actigraphy and sleep log diaries to obtain daily measurements of sleep from 30 healthy adults for up to 16 consecutive weeks. We used non-parametric Bland-Altman analysis and correlation coefficients to calculate agreement between subjectively and objectively measured variables including sleep onset time, sleep offset time, sleep onset latency, number of awakenings, the amount of wake time after sleep onset, and total sleep time. We also examined compliance data on the submission of daily sleep logs according to the experimental protocol. Overall, we found strong agreement for sleep onset and sleep offset times, but relatively poor agreement for variables related to wakefulness including sleep onset latency, awakenings, and wake after sleep onset. Compliance tended to decrease significantly over time according to a linear function, but there were substantial individual differences in overall compliance rates. There were also individual differences in agreement that could be explained, in part, by differences in compliance. Individuals who were consistently more compliant over time also tended to show the best agreement and lower scores on behavioral avoidance scale (BIS. Our results provide evidence for convergent validity in measuring sleep onset and sleep offset with wrist actigraphy and sleep logs, and we conclude by proposing an analysis method to mitigate the impact of non-compliance and measurement

  9. Areas of interest of potential users for naturalistic observation studies. PROmoting real Life Observations for Gaining Understanding of road user behaviour in Europe PROLOGUE, Deliverable D1.2.

    NARCIS (Netherlands)

    Schagen, I.N.L.G. van Craen, S. de Nes, N. van & Eenink, R.

    2010-01-01

    Identification of the interests of potential users is crucial for setting up a useful and broadly supported large-scale naturalistic driving (ND) study. This report describes the results of a survey amongst 72 road transport professionals in Europe from different organisation types that aimed at

  10. Pre-adult versus adult onset major depressive disorder in a naturalistic patient sample: the Leiden Routine Outcome Monitoring Study.

    Science.gov (United States)

    van Noorden, M S; Minkenberg, S E; Giltay, E J; den Hollander-Gijsman, M E; van Rood, Y R; van der Wee, N J; Zitman, F G

    2011-07-01

    Pre-adult onset of major depressive disorder (MDD) may predict a more severe phenotype of depression. As data from naturalistic psychiatric specialty care settings are scarce, we examined phenotypic differences between pre-adult and adult onset MDD in a large sample of consecutive out-patients. Altogether, 1552 out-patients, mean age 39.2 ± 11.6 years, were diagnosed with current MDD on the Mini-International Neuropsychiatric Interview Plus diagnostic interview as part of the usual diagnostic procedure. A total of 1105 patients (71.2%) had complete data on all variables of interest. Pre-adult onset of MDD was defined as having experienced the signs and symptoms of a first major depressive episode before the age of 18 years. Patients were stratified according to the age at interview (20-40/40-65 years). Correlates of pre-adult onset were analysed using logistic regression models adjusted for age, age squared and gender. Univariate analyses showed that pre-adult onset of MDD had a distinct set of demographic (e.g. less frequently living alone) and clinical correlates (more co-morbid DSM-IV - Text Revision diagnoses, more social phobia, more suicidality). In the multivariate model, we found an independent association only for a history of suicide attempts [odds ratio (OR) 3.15, 95% confidence intervals (CI) 1.97-5.05] and current suicidal thoughts (OR 1.81, 95% CI 1.26-2.60) in patients with pre-adult versus adult onset MDD. Pre-adult onset of MDD is associated with more suicidality than adult onset MDD. Age of onset of depression is an easy to ascertain characteristic that may help clinicians in weighing suicide risk.

  11. Impact of depression on treatment effectiveness and gains maintenance in social phobia: a naturalistic study of cognitive behavior group therapy.

    Science.gov (United States)

    Marom, Sofi; Gilboa-Schechtman, Eva; Aderka, Idan M; Weizman, Abraham; Hermesh, Haggai

    2009-01-01

    The impact of depression on cognitive behavioral group therapy (CBGT) for social phobia (SP) in a naturalistic outpatient setting was examined after treatment termination and at 1-year follow-up. Consecutive SP outpatients (N=219) were diagnosed using a structured interview. CBGT was provided in 18 1.5-hr weekly sessions. At pretreatment and posttreatment questionnaires and clinician ratings were administered. Self-report measures were obtained at 1-year follow-up. The main outcome measure was the Liebowitz Social Anxiety Scale. CBGT was found to be effective in reducing both social anxiety (effect size=1.23) as well as depression (effect size=0.94). Individuals with generalized social phobia (GSP) and individuals with specific social phobia (SSP) differed in their presenting psychopathology and in their response to CBGT. Among treatment completers, 44% GSPs and 37% SSPs achieved at least 50% improvement, and 44% GSPs and 87% SSPs reported distress and functioning within the normal range at the end of treatment. Among SPs diagnosed with major depressive disorder (MDD) at the onset of treatment, SP symptoms aggravated during the follow-up period, whereas SPs not diagnosed with MDD experienced a further alleviation of SP symptoms during follow-up. CBGT provided in a public clinic to non-selected, mostly unmedicated and comorbid patients, is an effective treatment for the majority of SP sufferers. MDD at the onset of CBGT was not associated with poorer treatment response, but predicted exacerbation of SP symptoms following treatment termination. Depressed SPs may need additional intervention to maintain CBGT gains. SSPs may benefit from less intensive CBGT than GSPs. (c) 2009 Wiley-Liss, Inc.

  12. Heart Disease and Occupational Risk Factors in the Canadian Population: An Exploratory Study Using the Canadian Community Health Survey

    Directory of Open Access Journals (Sweden)

    Behdin Nowrouzi-Kia

    2018-06-01

    Full Text Available Background: The objective of this study is to find temporal trends in the associations between cardiovascular disease and occupational risk factors in the context of the Canadian population. Methods: Population data were analyzed from the Canadian Community Health Survey (CCHS collected between 2001 and 2014 for trends over time between heart disease and various occupational risk factors: hours worked, physical exertion at work, and occupation type (management/arts/education, business/finance, sales/services, trades/transportations, and primary industry/processing. Results: We found no significant difference in the average number of hours worked/wk between individuals who report having heart disease in all years of data except in 2011 (F1,96 = 7.02, p = 0.009 and 2012 (F1,96 = 8.86, p = 0.004. We also found a significant difference in the degree of physical exertion at work in 2001 (F1,79 = 7.45, p = 0.008. There were statistically significant results of occupation type on self-reported heart disease from 2003 to 2014. Conclusion: Canadian data from the CCHS do not exhibit a trend toward an association between heart disease and the number of hours worked/wk. There is an association between heart disease and physical exertion at work, but the trend is inconsistent. The data indicate a trend toward an association between heart disease and occupation type, but further analysis is required to determine which occupation type may be associated with heart disease. Keywords: occupational health, occupation type, physical exertion, self-reported cardiovascular disease

  13. Wuskwatim generation project : Canadian Environmental Assessment Act comprehensive study report

    International Nuclear Information System (INIS)

    2005-10-01

    This study report described the plan by Manitoba Hydro and the Nisichawayasihk Cree Nation (NCN) to construct a new 200- megawatt (MW) generating station at Taskinigup Falls on the Burntwood River, near the outlet of Wuskwatim Lake. This hydroelectric power project will allow Manitoba Hydro to meet its projected energy needs within the next two decades as identified in its 2002/03 Power Resource Plan. It will also allow Manitoba Hydro and NCN to obtain additional export revenues and profits by advancing the in-service date of the Project from 2020 to 2009. A formal environmental assessment is required under the Canadian Environmental Assessment Act (CEAA) because Fisheries and Oceans Canada (DFO) has determined that the Project would cause fish habitat losses requiring an authorization under the Fisheries Act. Many of the structures to be built in navigable waters would also require formal approval under the Navigable Waters Protection Act (NWPA), which has prompted this application of the CEAA. This environmental assessment report has been prepared by DFO in consultation with Transport Canada and other federal authorities concerned. It provides a summary of the Wuskwatim Generation Project and the environment in which it will be built and operated. In addition, the results of public consultations are discussed. It presents an assessment of the Project's influence on fish and fish habitat, birds, species at risk, human health (local air quality, quality of drinking water and consumption of fishery products), navigation, use of renewable resources, and current use of lands and resources for traditional purposes by Aboriginal persons (hunting, trapping, gathering, subsistence fishing and heritage sites). It was concluded that the proposed Project, as defined by the scope of the study, is not likely to cause significant adverse environmental effects. 45 refs., 5 tabs., 13 figs., 3 appendices

  14. Prospective, naturalistic study of open-label OROS methylphenidate treatment in Chinese school-aged children with attention-deficit/hyperactivity disorder

    Institute of Scientific and Technical Information of China (English)

    ZHENG Yi; GONG Mei-en; YIN Qing-yun; MAI Jian-ning; JING Jin; LUO Xiang-yang; MA Hong-wei; LI Hai-bo; XIE Ling; LI Yan; Kuang Gui-fang; WANG Yu-feng; YI Ming-ji; WANG Feng; ZHU Xiao-hua; YAO Yah-bin; QIN Jiong; WANG Li-wen; ZOU Li-ping; JIN Xing-ming; XU Tong; WANG Yi; QI Yuan-li

    2011-01-01

    Background Attention deficit hyperactivity disorder (ADHD) is one of the most common mental disorders during childhood,characterized by the core symptoms of hyperactivity,impulsivity and inattention and puts great burden on children themselves,their families and the society.Osmotic release oral system methylphenidate (OROS-MPH) is a once-daily controlled-release formulation developed to overcome some of the limitations associated with immediate-release methylphenidate (IR-MPH).It has been marketed in China since 2005 but still lacks data from large-sample clinical trials on efficacy and safety profiles.The aim of this study was to evaluate the effectiveness and safety of OROS-MPH in children aged 6 to 16 years with ADHD under naturalistic clinical setting.Methods This 6-week,multi-center,prospective,open-label study enrolled 1447 ADHD children to once-daily OROS-MPH (18 mg,36 mg or 54 mg) treatment.The effectiveness measures were parent-rated Inattention and Overactivity With Aggression (IOWA) Conners I/O and O/D subscales,physician-rated CGI-I and parent-rated global efficacy assessment scale.Blood pressure,pulse rate measurement,adverse events (AEs) and concomitant medications and treatment review were conducted by the investigator and were served as safety measures.Results A total of 1447 children with ADHD (mean age (9.52±2.36) years) were enrolled in this trial.Totally 96.8%children received an OROS-MPH modal dose of 18 mg,3.1% with 36 mg and 0.1% with 54 mg at the endpoint of study.The parent IOWA Conners I/O score at the end of week 2 showed statistically significant (P <0.001) improvement with OROS-MPH (mean:6.95±2.71) versus the score at baseline (10.45±2.72).The change in the parent IOWA Conners O/D subscale,CGI-I and parent-rated global efficacy assessment scale also supported the superior efficacy for OROS-MPH treatment.Fewer than half of 1447 patients (511 (35.3%)) reported AEs,and the majority of the events reported were mild (68.2

  15. Are obsessive-compulsive personality traits associated with a poor outcome in anorexia nervosa? A systematic review of randomized controlled trials and naturalistic outcome studies.

    Science.gov (United States)

    Crane, Anna M; Roberts, Marion E; Treasure, Janet

    2007-11-01

    Obsessive-compulsive personality disorder (OCPD) traits are commonly associated with anorexia nervosa (AN). The aim of this review was to systematically search the literature to examine whether OCPD traits have an impact on the outcome of AN. A systematic electronic search of the literature (using Medline, PsycINFO, and the Cochrane Central Register of Controlled Trials) was undertaken to identify relevant publications (randomized controlled trials (RCT's) and naturalistic studies), until February 2006. Eleven prospective longitudinal studies and 12 RCT's met criteria for inclusion. A meta-analysis was not feasible as the studies were too heterogeneous. Just over half of published longitudinal studies found that OCPD traits were associated with a negative outcome in AN. Additionally, results from three RCTs suggested that these traits may moderate outcome. OCPD traits were reduced after treatment in five RCTs. There is tentative support to suggest that individuals with AN and concomitant OCPD traits have a poorer prognosis, and that these traits moderate outcome. A reduction in these traits may mediate this change. An individualized case formulation with treatment tailored to OCPD traits may improve the outcome of AN. (c) 2007 by Wiley Periodicals, Inc.

  16. Canadian Pharmacy Practice Residents’ Projects: Publication Rates and Study Characteristics

    Science.gov (United States)

    Hung, Michelle; Duffett, Mark

    2013-01-01

    Background: Research projects are a key component of pharmacy residents’ education. Projects represent both a large investment of effort for each resident (up to 10 weeks over the residency year) and a large body of research (given that there are currently over 150 residency positions in Canada annually). Publication of results is a vital part of the dissemination of information gleaned from these projects. Objectives: To determine the publication rate for research projects performed under the auspices of accredited English-language hospital pharmacy residency programs in Canada and to describe the study characteristics of residency projects performed in Ontario from 1999/2000 to 2008/2009. Methods: Lists of residents and project titles for the period of interest were obtained from residency coordinators. PubMed, CINAHL, the Canadian Journal of Hospital Pharmacy, and Google were searched for evidence of publication of each project identified, as an abstract or presentation at a meeting, a letter to the editor, or a full-text manuscript. The library holdings of the University of Toronto were reviewed to determine study characteristics of the Ontario residency projects. Results: For the objective of this study relating to publication rate, 518 projects were included. The overall publication rate was 32.2% (60 [35.9%] as abstracts and 107 [64.1%] as full-text manuscripts). Publication in pharmacy-specific journals (66 [61.7%] of 107 full-text manuscripts) was more frequent than publication in non-pharmacy-specific journals. The publication rate of projects as full-text manuscripts remained stable over time. Of the 202 Ontario residency projects archived in the University of Toronto’s library, most were cohort studies (83 [41.1%]), and the most common topic was efficacy and/or safety of a medication (46 [22.8%]). Conclusions: Most hospital pharmacy residents’ projects were unpublished, and the publication rate of projects as full-text manuscripts has not

  17. Canadian pharmacy practice residents' projects: publication rates and study characteristics.

    Science.gov (United States)

    Hung, Michelle; Duffett, Mark

    2013-03-01

    Research projects are a key component of pharmacy residents' education. Projects represent both a large investment of effort for each resident (up to 10 weeks over the residency year) and a large body of research (given that there are currently over 150 residency positions in Canada annually). Publication of results is a vital part of the dissemination of information gleaned from these projects. To determine the publication rate for research projects performed under the auspices of accredited English-language hospital pharmacy residency programs in Canada and to describe the study characteristics of residency projects performed in Ontario from 1999/2000 to 2008/2009. Lists of residents and project titles for the period of interest were obtained from residency coordinators. PubMed, CINAHL, the Canadian Journal of Hospital Pharmacy, and Google were searched for evidence of publication of each project identified, as an abstract or presentation at a meeting, a letter to the editor, or a full-text manuscript. The library holdings of the University of Toronto were reviewed to determine study characteristics of the Ontario residency projects. For the objective of this study relating to publication rate, 518 projects were included. The overall publication rate was 32.2% (60 [35.9%] as abstracts and 107 [64.1%] as full-text manuscripts). Publication in pharmacy-specific journals (66 [61.7%] of 107 full-text manuscripts) was more frequent than publication in non-pharmacy-specific journals. The publication rate of projects as full-text manuscripts remained stable over time. Of the 202 Ontario residency projects archived in the University of Toronto's library, most were cohort studies (83 [41.1%]), and the most common topic was efficacy and/or safety of a medication (46 [22.8%]). Most hospital pharmacy residents' projects were unpublished, and the publication rate of projects as full-text manuscripts has not increased over time. Most projects were observational studies

  18. Social networks and substance use among at-risk emerging adults living in disadvantaged urban areas in the southern United States: a cross-sectional naturalistic study.

    Science.gov (United States)

    Tucker, Jalie A; Cheong, JeeWon; Chandler, Susan D; Crawford, Scott M; Simpson, Cathy A

    2015-09-01

    Substance use and risk-taking are common during emerging adulthood, a transitional period when peer influences often increase and family influences decrease. Investigating relationships between social network features and substance use can inform community-based prevention programs. This study investigated whether substance use among emerging adults living in disadvantaged urban areas was influenced by peer and family social network messages that variously encouraged and discouraged substance use. Cross-sectional, naturalistic field study. Lower-income neighborhoods in Birmingham, Alabama, USA with 344 participants (110 males, 234 females, ages 15-25 years; mean = 18.86 years), recruited via respondent-driven sampling. During structured interviews conducted in community locations, the Alcohol, Smoking and Substance Involvement Screening Test assessed substance use and related problems. Predictor variables were network characteristics, including presence of substance-using peers, messages from friends and family members about substance use and network sources for health information. Higher substance involvement was associated with friend and family encouragement of use and having close peer network members who used substances (Ps Social networks appear to be important in both promoting and preventing substance use in disadvantaged young adults in the United States. © 2015 Society for the Study of Addiction.

  19. The Canadian petroleum industry: An activity study. 1987 Annual report

    International Nuclear Information System (INIS)

    1988-01-01

    This report provides financial aspects of activity in the Canadian petroleum and natural gas industry. Data are given in graphic and tabular form on revenues, sources and destinations of funds (including financing, incentives, dividend payments, capital and operational expenditures); on comparisons with other industries; on how revenues are shared between the industry and various levels of government; and on principal trends observed. Data are broken down by various industry sectors where applicable. 10 figs., 15 tabs

  20. Added value of 18F-florbetaben amyloid PET in the diagnostic workup of most complex patients with dementia in France: A naturalistic study.

    Science.gov (United States)

    Ceccaldi, Mathieu; Jonveaux, Thérèse; Verger, Antoine; Krolak-Salmon, Pierre; Houzard, Claire; Godefroy, Olivier; Shields, Trevor; Perrotin, Audrey; Gismondi, Rossella; Bullich, Santiago; Jovalekic, Aleksandar; Raffa, Nicola; Pasquier, Florence; Semah, Franck; Dubois, Bruno; Habert, Marie-Odile; Wallon, David; Chastan, Mathieu; Payoux, Pierre; Stephens, Andrew; Guedj, Eric

    2018-03-01

    Although some studies have previously addressed the clinical impact of amyloid positron emission tomography (PET), none has specifically addressed its selective and hierarchical implementation in relation to cerebrospinal fluid analysis in a naturalistic setting. This multicenter study was performed at French tertiary memory clinics in patients presenting with most complex clinical situations (i.e., early-onset, atypical clinical profiles, suspected mixed etiological conditions, unexpected rate of progression), for whom cerebrospinal fluid analysis was indicated but either not feasible or considered as noncontributory (ClinicalTrials.gov: NCT02681172). Two hundred five patients were enrolled with evaluable florbetaben PET scans; 64.4% of scans were amyloid positive. PET results led to changed diagnosis and improved confidence in 66.8% and 81.5% of patients, respectively, and altered management in 80.0% of cases. High-level improvement of diagnostic certainty and management is provided by selective and hierarchical implementation of florbetaben PET into current standard practices for the most complex dementia cases. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  1. Psychiatric and physical comorbidities and their impact on the course of bipolar disorder: A prospective, naturalistic 4-year follow-up study.

    Science.gov (United States)

    Amann, Benedikt L; Radua, Joaquim; Wunsch, Christian; König, Barbara; Simhandl, Christian

    2017-05-01

    The aim of the present study was to increase the available evidence on how physical and psychiatric comorbidities influence the long-term outcome in bipolar I and II disorder. We examined the prevalence of comorbid physical (metabolic, cardiovascular, thyroid, and neurological) diseases and psychiatric (neurotic, stress-related, somatoform, and personality) disorders and their impact on the risk of relapse in bipolar disorder. A total of 284 consecutively admitted patients with ICD-10 bipolar I (n=161) and II (n=123) disorder were followed up naturalistically over a period of 4 years. Globally, 22.0% patients had metabolic, 18.8% cardiovascular, 18.8% thyroid, and 7.6% neurological diseases; 15.5% had neurotic, stress-related, and somatoform disorders; 12.0% had personality disorders; and 52.9% had nicotine dependence. We did not find any effect of comorbid metabolic, cardiovascular or neurological diseases or psychiatric disorders on the relapse risk. However, the presence of thyroid diseases, and especially hypothyroidism, was associated with an increased risk of manic relapse in bipolar disorder I (thyroid disease: hazard ratio [HR]=2.7; P=.003; hypothyroidism: HR=3.7;, Pbipolar disorder with more manic episodes, and the importance of its detection and treatment. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Correlation between the Efficacy of Lamotrigine and the Serum Lamotrigine Level during the Remission Phase of Acute Bipolar II Depression: A Naturalistic and Unblinded Prospective Pilot Study.

    Science.gov (United States)

    Kikkawa, Akiyoshi; Kitamura, Yoshihisa; Aiba, Tetsuya; Hiraki, Koichi; Sendo, Toshiaki

    2017-01-01

    Lamotrigine has acute antidepressant effects in patients with bipolar disorder. However, there is little information regarding appropriate serum levels of lamotrigine and the time until remission after the start of lamotrigine therapy in patients with bipolar II depression. This was a naturalistic and unblinded prospective pilot study. Twelve patients' depressive symptoms were evaluated using the Montgomery-Åsberg Depression Rating Scale (MADRS) at the start of treatment and at the time of remission, and blood samples were obtained at the time of remission. Mahalanobis distance was used to analyze the relationship between the MADRS improvement rate and the serum lamotrigine level. Furthermore, we calculated the Spearman's rank correlation coefficient for the relationship between the MADRS improvement rate and the serum lamotrigine level, and produced box plots of the serum lamotrigine level at remission and the time until remission. The Mahalanobis distance for the patient that was co-administered lamotrigine and valproic acid differed significantly from those of the other patients (p<0.001). There was no linear relationship between the serum lamotrigine level and the MADRS improvement rate among the patients that did not receive valproic acid. The median time from the start of lamotrigine therapy until remission was 6 weeks. The serum lamotrigine level does not have an important impact on the acute therapeutic effects of lamotrigine on bipolar II depression. In addition, we consider that different treatment options should be considered for non-responders who do not exhibit any improvement after the administration of lamotrigine for approximately 6 weeks.

  3. Occupation and risk of prostate cancer in Canadian men: A case-control study across eight Canadian provinces.

    Science.gov (United States)

    Sritharan, Jeavana; Demers, Paul A; Harris, Shelley A; Cole, Donald C; Peters, Cheryl E; Villeneuve, Paul J

    2017-06-01

    The etiology of prostate cancer continues to be poorly understood, including the role of occupation. Past Canadian studies have not been able to thoroughly examine prostate cancer by occupation with detailed information on individual level factors. Occupation, industry and prostate cancer were examined using data from the National Enhanced Cancer Surveillance System, a large population-based case-control study conducted across eight Canadian provinces from 1994 to 1997. This analysis included 1737 incident cases and 1803 controls aged 50 to 79 years. Lifetime occupational histories were used to group individuals by occupation and industry employment. Odds ratios and 95% confidence intervals were calculated and adjustments were made for known and possible risk factors. By occupation, elevated risks were observed in farming and farm management (OR=1.37, 95% CI 1.02-1.84), armed forces (OR=1.33, 95% CI 1.06-1.65) and legal work (OR=2.58, 95% CI 1.05-6.35). Elevated risks were also observed in office work (OR=1.20, 95% CI 1.00-1.43) and plumbing (OR=1.77, 95% CI 1.07-2.93) and with ≥10 years duration of employment. Decreased risks were observed in senior management (OR=0.65, 95% CI 0.46-0.91), construction management (OR=0.69, 95% CI 0.50-0.94) and travel work (OR=0.37, 95% CI 0.16-0.88). Industry results were similar to occupation results, except for an elevated risk in forestry/logging (OR=1.54, 95% CI 1.06-2.25) and a decreased risk in primary metal products (OR=0.70, 95% CI 0.51-0.96). This study presents associations between occupation, industry and prostate cancer, while accounting for individual level factors. Further research is needed on potential job-specific exposures and screening behaviours. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Risk Factors for Progression of Alzheimer Disease in a Canadian Population: The Canadian Outcomes Study in Dementia (COSID).

    Science.gov (United States)

    Herrmann, Nathan; Harimoto, Tetsuhiro; Balshaw, Robert; Lanctôt, Krista L

    2015-04-01

    To determine risk factors for clinically significant progression during 12 months in patients with mild-to-moderate Alzheimer disease. Community-dwelling patients with mild-to-moderate Alzheimer disease were enrolled in a 3-year prospective study, the Canadian Outcomes Study in Dementia (commonly referred to as COSID), at 32 Canadian sites. Assessments included the Global Deterioration Scale (GDS) for disease severity, the Mini-Mental State Examination (MMSE) for cognition, the Functional Autonomy Measurement System (SMAF) for daily functioning, and the NeuroPsychiatric Inventory (NPI) for behaviour, measured at baseline and at 12 months. Logistic regression identified factors associated with GDS decline, and subsequent stepwise regression identified key independent predictors. Area under the curve (AUC) was then calculated for the model. Among 488 patients (mean age 76.5 years [SD 6.4], MMSE 22.1 [SD4.6], 44.1% male), 225 (46%) showed GDS decline. After adjusting for age, baseline risk factors for deterioration included the following: poorer cognition (lower MMSE score, OR 0.55; 95% CI 0.4 to 0.72 per 5 points, P ≤ 0.001), greater dependence (lower SMAF, OR 0.72; 95% CI 0.63 to 0.83 per 5 points, P ≤ 0.001), and more neuropsychiatric symptoms (higher NPI, OR 1.11; 95% CI 1.02 to 1.2 per 5 points, P = 0.02), with a protective effect of male sex (OR 0.59; 95% CI 0.39 to 0.9, P = 0.02), and higher (worse) GDS score (very mild, compared with mild OR 0.25; 95% CI 0.09 to 0.70, P ≤ 0.01; compared with moderate, OR 0.08; 95% CI 0.03 to 0.23, P Alzheimer disease in Canada can be predicted using readily available clinical information.

  5. Aging and Autism Spectrum Disorder: A Naturalistic, Longitudinal Study of the Comorbidities and Behavioral and Neuropsychiatric Symptoms in Adults with ASD

    Science.gov (United States)

    Wise, Elizabeth A.; Smith, Marcia D.; Rabins, Peter V.

    2017-01-01

    Little is known about Autism Spectrum Disorder (ASD) in persons over age 50. In a retrospective, naturalistic review of 74 individuals aged 30 and older meeting DSM-5 criteria for ASD, the point prevalence of behavioral and neuropsychiatric symptoms (BNPS) declined significantly for 12 of 13 BNPS over a mean of 25 years while many other features…

  6. "Naturalist Inquiry" and Grounded Theory

    Directory of Open Access Journals (Sweden)

    Barney G. Glaser

    2004-01-01

    Full Text Available The world of Qualitative Data Analysis (QDA methodology became quite taken with LINCOLN and GUBA's book "Naturalist Inquiry" (1985. I have no issue with it with respect to its application to QDA; it helped clarify and advance so many QDA issues. However, its application to Grounded Theory (GT has been a major block on GT, as originated, by its cooptation and corruption hence remodeling of GT by default. LINCOLN and GUBA have simply assumed GT is just another QDA method, which it is not. In "The Grounded Theory Perspective II" (GLASER 2002a, Chapter 9 on credibility, I have discussed "Naturalist In­quiry" (NI thought regarding how LINCOLN and GUBA's notion of "trustworthy" data (or worrisome data orientation and how their view of constant comparison can and has remodeled and eroded GT. In this paper I will consider other aspects of NI that remodel GT. URN: urn:nbn:de:0114-fqs040170

  7. Cost as a barrier to accessing dental care: findings from a Canadian population-based study.

    Science.gov (United States)

    Thompson, Brandy; Cooney, Peter; Lawrence, Herenia; Ravaghi, Vahid; Quiñonez, Carlos

    2014-01-01

    The aim of this study is to determine the demographic and socioeconomic characteristics of Canadians who report cost barriers to dental care. An analysis of data collected from the 2007/09 Canadian Health Measures Survey was undertaken from a sample of 5,586 Canadian participants aged 6-79. Cost barriers to dental care were operationalized through two questions: "In the past 12 months, have you avoided going to a dental professional because of the cost of dental care?" and "In the past 12 months, have you avoided having all the dental treatment that was recommended because of the cost?" Logistic regressions were conducted to identify relationships between covariates and positive responses to these questions. Approximately 17.3 percent of respondents had avoided a dental professional because of cost within the previous year, and 16.5 percent had declined recommended dental treatment because of cost. Adjusted estimates demonstrate that respondents with lower incomes and without dental insurance were over four times more likely to avoid a dental professional because of cost and approximately two and a half times more likely to decline recommended dental treatment because of cost. Nearly one out of five Canadians surveyed reported cost barriers to dental care. This study provides valuable baseline information for future studies to assess whether financial barriers to dental care are getting better or worse for Canadians. © 2014 American Association of Public Health Dentistry.

  8. Implication of Integrative Treatment Strategies for Real-Life Geriatric Patients with Multiple, Chronic Illnesses: A 60-Month Follow-Up of a Naturalistic Study

    Directory of Open Access Journals (Sweden)

    Gjumrakch Aliev

    2015-03-01

    Full Text Available Neurodegeneration [Stroke and Alzheimer disease (AD] is fastly becoming one of the leading causes of age-associated disability, dementia, and death. In addition, the Centers for Disease Control and Prevention (CDC and the National Center for Health Statistics recently reported that AD has surpassed diabetes as a leading cause of death and is now considered the sixth-leading cause of death in the United States. Unfortunately, currently no effective treatments are available against this devastating disease. In the past we have shown the preservation and improvement of cognitive tasks in depressed and demented patients after 24 and 36 months of combined pharmacological and non- pharmacological treatment. Here we present the results of our ongoing, naturalistic study, in the same outpatient setting, at the 60 month follow up. The study group consisted of 156 medically ill, physically-disabled patients with mild to moderate dementia and depression. Patients were treated with antidepressants, cholinesterase inhibitors, and NMDA antagonists, along with their regular medication regimen. Non-pharmacological intervention was centered on a home-based program of physical and cognitive exercises as well as with vitamins and supplements (multivitamins, vitamin E, L-methylfolate, alpha-lipoic acid, acetyl-l-carnitine, omega-3, and coenzyme Q-10 and diet modification. Cognitive assessments were performed yearly. After 60 months of treatment, performance of all tasks remained at or above baseline. The MMSE, Cognistat–Attention, Cognistat–Judgment, and RFFT - Total Unique Designs demonstrated significant improvement. Our results, for the first time, demonstrate arrest in cognitive decline in demented/depressed patients with multiple medical co-morbidities for 60 months. Future investigations addressing the application of a combined, integrative treatment models in clinical practices are warranted.

  9. Canadian retail petroleum markets study : a review of competitiveness in the Canadian refined petroleum marketing industry

    International Nuclear Information System (INIS)

    Ervin, M.J.

    1997-01-01

    A retail petroleum market study was conducted to provide a comprehensive overview of the competitiveness of the downstream petroleum industry in Canada, as well as to provide a foundation for effective policy development. A model which illustrates the interrelationships between the many stakeholders who receive revenue from the sale of gasoline was presented. It was shown that although there has been an upward trend in world crude prices since 1991, both refiners and marketers have experienced a decline in margins due to price competition at the rack and at the retail pump. Government intervention into petroleum marketing was considered to be of questionable value and a poor alternative to market-based regulation. In this study, 19 markets representing a broad range of conditions, were chosen for a detailed review of outlet economics. Market-by-market and regional comparisons of key competitiveness indicators were reviewed and discussed. Improving public understanding and awareness of competition in the petroleum marketing sector and developing cooperative industry research into marketing sector competitive issues were recommended. 7 refs., 15 tabs., 37 figs

  10. Mobile Phone-Based Measures of Activity, Step Count, and Gait Speed: Results From a Study of Older Ambulatory Adults in a Naturalistic Setting.

    Science.gov (United States)

    Rye Hanton, Cassia; Kwon, Yong-Jun; Aung, Thawda; Whittington, Jackie; High, Robin R; Goulding, Evan H; Schenk, A Katrin; Bonasera, Stephen J

    2017-10-03

    Cellular mobile telephone technology shows much promise for delivering and evaluating healthcare interventions in cost-effective manners with minimal barriers to access. There is little data demonstrating that these devices can accurately measure clinically important aspects of individual functional status in naturalistic environments outside of the laboratory. The objective of this study was to demonstrate that data derived from ubiquitous mobile phone technology, using algorithms developed and previously validated by our lab in a controlled setting, can be employed to continuously and noninvasively measure aspects of participant (subject) health status including step counts, gait speed, and activity level, in a naturalistic community setting. A second objective was to compare our mobile phone-based data against current standard survey-based gait instruments and clinical physical performance measures in order to determine whether they measured similar or independent constructs. A total of 43 ambulatory, independently dwelling older adults were recruited from Nebraska Medicine, including 25 (58%, 25/43) healthy control individuals from our Engage Wellness Center and 18 (42%, 18/43) functionally impaired, cognitively intact individuals (who met at least 3 of 5 criteria for frailty) from our ambulatory Geriatrics Clinic. The following previously-validated surveys were obtained on study day 1: (1) Late Life Function and Disability Instrument (LLFDI); (2) Survey of Activities and Fear of Falling in the Elderly (SAFFE); (3) Patient Reported Outcomes Measurement Information System (PROMIS), short form version 1.0 Physical Function 10a (PROMIS-PF); and (4) PROMIS Global Health, short form version 1.1 (PROMIS-GH). In addition, clinical physical performance measurements of frailty (10 foot Get up and Go, 4 Meter walk, and Figure-of-8 Walk [F8W]) were also obtained. These metrics were compared to our mobile phone-based metrics collected from the participants in the community

  11. Canadian solar export market study. Export policy recommendations

    Energy Technology Data Exchange (ETDEWEB)

    1983-11-01

    This report outlines policies and recommendations on the export of Canadian solar equipment and technology, with a view toward stimulating the domestic solar industry. The current picture is of an industry which is relatively small, operates in a competitive domestic market with low profit margins, and needs assistance in order to break into the world market. A number of recommendations are therefore made on the main thrust of industry and government solar export development activities. An export development program is described which includes a strategy of concentrating on a limited number of product lines, namely: low-temperature solar heating systems for recreational applications, integrated residential water heating systems, prepackaged commercial water heating systems, and industrial pre-heat systems. It is also recommended that this strategy be directed only at a limited number of target countries where the market justifies such activity. Market research, international cooperation agreements, promotional services, and proper export organization are also needed.

  12. Naturalistic Driving: A Framework and Advances in Using Big Data

    Directory of Open Access Journals (Sweden)

    Frank Knoefel

    2018-03-01

    Full Text Available Driving is an activity that facilitates physical, cognitive, and social stimulation in older adults, ultimately leading to better physical and cognitive health. However, aging is associated with declines in vision, physical health, and cognitive health, all of which can affect driving ability. One way of assessing driving ability is with the use of sensors in the older adult’s own vehicle. This paper provides a framework for driving assessment and addresses how naturalistic driving studies can assist in such assessments. The framework includes driving characteristics (how much driving, speed, position, type of road, actions and reactions (lane changes, intersections, passing, merging, traffic lights, pedestrians, other vehicles, destinations (variety and distance, sequencing and route planning, and driving conditions (time of day and season. Data from a subset of Ottawa drivers from the Candrive study is used to illustrate the use of naturalistic driving data. Challenges in using naturalistic driving big data and the changing technology in vehicles are discussed.

  13. Illness Management & Recovery (IMR) in the Netherlands : A naturalistic pilot study to explore the feasibility of a randomized controlled trial

    NARCIS (Netherlands)

    Roosenschoon, B.J.; Van Weeghel, J.; Bogaards, M.; Deen, M.L.; Mulder, C.L.

    2016-01-01

    Background Illness Management & Recovery (IMR) is a curriculum-based program for people with severe and persistent mental illness. To date, four randomized controlled trials (RCTs) have been published on it. As these produced mixed results, we conducted a pilot study to test the feasibility of

  14. Illness Management & Recovery (IMR) in the Netherlands; a naturalistic pilot study to explore the feasibility of a randomized controlled trial

    NARCIS (Netherlands)

    B.J. Roosenschoon (Bert); J. van Weeghel (Jaap); Bogaards, M. (Moniek); M. Deen (Mathijs); C.L. Mulder (Niels)

    2016-01-01

    textabstractBackground: Illness Management & Recovery (IMR) is a curriculum-based program for people with severe and persistent mental illness. To date, four randomized controlled trials (RCTs) have been published on it. As these produced mixed results, we conducted a pilot study to test the

  15. Short- and long-term neurocognitive functioning after electroconvulsive therapy in depressed elderly: a prospective naturalistic study

    NARCIS (Netherlands)

    Verwijk, E.; Comijs, H.C.; Kok, R.M.; Spaans, H.P.; Tielkes, C.E.M.; Scherder, E.J.A.; Stek, M.L.

    2014-01-01

    Background: It is generally assumed that the elderly patients are more vulnerable to cognitive side effects after electroconvulsive therapy (ECT) than younger depressed patients. The current study aims to evaluate the nature and extent of changes across multiple domains of neurocognitive functioning

  16. Predicting Dropout from Intensive Outpatient Cognitive Behavioural Therapy for Binge Eating Disorder Using Pre-treatment Characteristics: A Naturalistic Study.

    Science.gov (United States)

    Vroling, Maartje S; Wiersma, Femke E; Lammers, Mirjam W; Noorthoorn, Eric O

    2016-11-01

    Dropout rates in binge eating disorder (BED) treatment are high (17-30%), and predictors of dropout are unknown. Participants were 376 patients following an intensive outpatient cognitive behavioural therapy programme for BED, 82 of whom (21.8%) dropped out of treatment. An exploratory logistic regression was performed using eating disorder variables, general psychopathology, personality and demographics to identify predictors of dropout. Binge eating pathology, preoccupations with eating, shape and weight, social adjustment, agreeableness, and social embedding appeared to be significant predictors of dropout. Also, education showed an association to dropout. This is one of the first studies investigating pre-treatment predictors for dropout in BED treatment. The total explained variance of the prediction model was low, yet the model correctly classified 80.6% of cases, which is comparable to other dropout studies in eating disorders. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

  17. Comparative Analysis of Institutional Policy Definitions of Plagiarism: A Pan-Canadian University Study

    Science.gov (United States)

    Eaton, Sarah Elaine

    2017-01-01

    This article shares the findings of a study investigating institutional policy definitions of plagiarism at twenty English-speaking Canadian universities. The types of primary sources consulted for this study included: (1) university academic calendars for 2016-2017, (2) institutional policies on academic misconduct, and (3) student academic codes…

  18. Child Maltreatment among Children with Intellectual Disability in the Canadian Incidence Study

    Science.gov (United States)

    Dion, Jacinthe; Paquette, Geneviève; Tremblay, Karine-N.; Collin-Vézina, Delphine; Chabot, Martin

    2018-01-01

    This study aims to compare, among a representative sample of substantiated child maltreatment cases, the characteristics of those with intellectual disability (ID) from those without ID. Using the 2008 Canadian Incidence Study of Reported Child Abuse and Neglect, 5,797 cases of substantiated maltreatment that involved children aged between 0 and…

  19. Clinical effectiveness of aripiprazole in short-term treatment of tic disorder in children and adolescents: a naturalistic study.

    Science.gov (United States)

    Ho, Che-Sheng; Chiu, Nan-Chang; Tseng, Chih-Fan; Huang, Yuan-Ling

    2014-02-01

    The purpose of this study was to evaluate the effectiveness and tolerability of aripiprazole in short-term treatment of children and adolescents with tic disorder (TD). This was a 14-week, prospective, open-label flexible dose trial of aripiprazole. We enrolled patients with TD aged between 4 years and 18 years. They received aripiprazole (dose: 2.5 mg/day) initially, which was then adjusted according to clinical response. The severity was assessed by the Yale Global Tic Severity Score (YGTSS) at 0, 2, 6, 10, and 14 weeks. The linear mixed models were used for evaluation of the YGTSSs at each follow-up, which were compared with baseline scores. Eighty-one patients were enrolled in this study. Nine patients withdrew from the study with complaints of adverse side effects. Of the remaining 72 patients, 15 patients discontinued medications prematurely due to being free of symptoms for over 2 weeks. Two patients discontinued medications due to no significant improvement. The mean scores had significantly decreased since the 2nd week (p tic scores, 67.1% in the vocal tic scores, and 70.0% in the total YGTSSs. The common adverse effects were sedation (32.1%) and increased appetite (22.2%). A slight increase in average body weight was noted, from 32.7 to 33.7 kg (+1.0 kg, p tics, in children and adolescents with mild adverse effects. However, further double-blind trials against placebo or other medications are needed to verify the efficacy of aripiprazole in the pharmacotherapy of TD. Copyright © 2013. Published by Elsevier B.V.

  20. The association between mood state and chronobiological characteristics in bipolar I disorder: a naturalistic, variable cluster analysis-based study.

    Science.gov (United States)

    Gonzalez, Robert; Suppes, Trisha; Zeitzer, Jamie; McClung, Colleen; Tamminga, Carol; Tohen, Mauricio; Forero, Angelica; Dwivedi, Alok; Alvarado, Andres

    2018-02-19

    Multiple types of chronobiological disturbances have been reported in bipolar disorder, including characteristics associated with general activity levels, sleep, and rhythmicity. Previous studies have focused on examining the individual relationships between affective state and chronobiological characteristics. The aim of this study was to conduct a variable cluster analysis in order to ascertain how mood states are associated with chronobiological traits in bipolar I disorder (BDI). We hypothesized that manic symptomatology would be associated with disturbances of rhythm. Variable cluster analysis identified five chronobiological clusters in 105 BDI subjects. Cluster 1, comprising subjective sleep quality was associated with both mania and depression. Cluster 2, which comprised variables describing the degree of rhythmicity, was associated with mania. Significant associations between mood state and cluster analysis-identified chronobiological variables were noted. Disturbances of mood were associated with subjectively assessed sleep disturbances as opposed to objectively determined, actigraphy-based sleep variables. No associations with general activity variables were noted. Relationships between gender and medication classes in use and cluster analysis-identified chronobiological characteristics were noted. Exploratory analyses noted that medication class had a larger impact on these relationships than the number of psychiatric medications in use. In a BDI sample, variable cluster analysis was able to group related chronobiological variables. The results support our primary hypothesis that mood state, particularly mania, is associated with chronobiological disturbances. Further research is required in order to define these relationships and to determine the directionality of the associations between mood state and chronobiological characteristics.

  1. Stress: a naturalistic proposal

    Directory of Open Access Journals (Sweden)

    María de Lourdes Rodríguez Campuzano

    2013-08-01

    Full Text Available Some of the stress related topics, especially from the conceptual framework of Lazarus and Folkman are reviewed on this work. It is sustained that this approach is dualistic and that the research made from this view is made on the basis of morphological criteria that don’t allow studying important elements of this kind of behavior. From an interbehavioral approach three functional criteria are proposed to study this phenomenon: the functional nature of situations, aptitude levels of behavior, and its three dimensions. Emphasis is made on the singular and individual nature of stress reactions. Finally it is suggested to take into account these functional criteria to develop a generic situational taxonomy to study these reactions as parts of complex behavioral patterns.

  2. Predictors of antipsychotic monotherapy with olanzapine during a 1-year naturalistic study of schizophrenia patients in Japan

    Directory of Open Access Journals (Sweden)

    Ye W

    2012-01-01

    Full Text Available Wenyu Ye1, Haya Ascher-Svanum2, Jennifer A Flynn3, Yuka Tanji3, Michihiro Takahashi3,41Lilly Suzhou Pharmaceutical Co, Shanghai, People's Republic of China; 2Eli Lilly and Company, Indianapolis, IN, USA; 3Lilly Research Laboratories Japan, Eli Lilly Japan K.K., Kobe, 4Terauchi-Takahashi Psychiatric Clinic, Ashiya, JapanPurpose: Although expert guidelines for the treatment of schizophrenia recommend antipsychotic monotherapy, the use of antipsychotic polypharmacy is common. This study identified characteristics that differentiate patients with schizophrenia who are treated with olanzapine monotherapy versus polypharmacy in usual care in Japan.Patients and methods: In a large (N = 1850 prospective, observational study, Japanese patients with schizophrenia who initiated treatment with olanzapine were followed for 1 year. Consistent with past research, antipsychotic polypharmacy was defined as the concurrent use of olanzapine and another antipsychotic for at least 60 days. Switching was defined as discontinuing a prior antipsychotic therapy rather than augmenting the medication regimen. Predictors of antipsychotic monotherapy were based on information available at the time of olanzapine initiation. Baseline characteristics were compared using t-tests and Χ2 tests. Stepwise logistic regression was used to identify independent predictors of monotherapy.Results: Patients treated with olanzapine monotherapy (43.2% differed from those treated with antipsychotic polypharmacy (56.8% on demographics, treatment history, baseline symptom levels, functional levels, and treatment-emergent adverse events. Stepwise logistic regression identified multiple variables that significantly predicted monotherapy: older age, shorter duration of schizophrenia, outpatient status, comorbid medical conditions, lower body mass index, no prior anticholinergic use, no prior mood stabilizer use, and switching from a previous antipsychotic (typical or atypical

  3. Asymmetric Drug-Induced Parkinsonism and Psychopathology: A Prospective Naturalistic Study in Long-Stay Psychiatric Patients

    Directory of Open Access Journals (Sweden)

    Lydia E. Pieters

    2018-02-01

    Full Text Available BackgroundDrug-induced parkinsonism (DIP is the most common movement disorder induced by antipsychotics. Although DIP is mostly symmetric, asymmetric DIP is reported in a substantial part of the patients. We investigated the frequency of motor asymmetry in DIP and its relationship to the severity of psychopathology in long-stay psychiatric patients.MethodsWe obtained data from a cohort study of 207 long-stay psychiatric patients on the frequency and risk factors of tardive dyskinesia, akathisia, tardive dystonia, and DIP. From July 2003 to May 2007 (mean follow-up, 1.1 year drug-induced movement disorders were assessed at least two times in each patient, with a frequency of persistent DIP of 56.2%. All patients who had at least one time parkinsonism in the upper/lower limb(s were included for analyses (190 patients, 79 women; mean age, 48.0 ± 12.9 years. The Unified Parkinson Disease Rating Scale motor scale was used to calculate the frequency of asymmetric parkinsonism. Multilevel mixed models were built to explore the relationship between asymmetry in parkinsonism and the severity of psychopathology, measured on the Clinical Global Impression-Schizophrenia scale severity index (CGI-SCH SI.ResultsThe frequency of asymmetric parkinsonism was 20.8%. Asymmetry in parkinsonism was associated with symptom severity on all CGI-SCH SI scales (β range, 0.37–3.74 and significantly associated with the positive symptom scale (β, 3.74; 95% CI, 0.35–7.31.ConclusionDIP is asymmetric in a substantial part of patients. Asymmetric presentation of DIP is of clinical relevance as it is related to the severity of psychopathology and may alert the clinician of more severe psychopathology. Future research is recommended to provide insight into the neuropsychopathology and clinical value of asymmetric parkinsonism for psychiatric patients.

  4. Noninvasive brain stimulation by radioelectric asymmetric conveyor in the treatment of agoraphobia: open-label, naturalistic study

    Directory of Open Access Journals (Sweden)

    Mannu P

    2011-11-01

    Full Text Available Piero Mannu, Salvatore Rinaldi, Vania Fontani, Alessandro Castagna, Matteo Lotti MargottiDepartment of Neuro Psycho Physio Pathology, Rinaldi Fontani Institute, Florence, ItalyBackground: Agoraphobia is considered to be the most serious complication of panic disorder. It involves progressive development of debilitating anxiety symptoms related to being in situations where one would be extremely embarrassed and could not be rescued in the case of a panic attack. This study aimed to investigate the efficacy of noninvasive brain stimulation using a radioelectric asymmetric conveyor (REAC for agoraphobia.Patients and methods: Twenty-three patients (3 males and 20 females suffering from agoraphobia and without a history of panic disorder were evaluated by a psychiatrist using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, and the Agoraphobia Scale (AS. The patients were subjected to two 18-session cycles of noninvasive brain stimulation with the REAC, according to an established therapeutic protocol called neuro-psycho-physical optimization.Results: Analyzing the anxiety and avoidance parameters of the AS after the first and second cycles of REAC treatment revealed variation in levels of response to treatment, including weak (AS item 7, moderate (AS items 10 and 13, and good responses (AS items 1–6, 8, 9, 11, 12, and 14–20.Conclusion: These results highlight the potential of the REAC to treat complex clinical situations such as agoraphobia, which is typically resistant to pharmacologic treatments. Furthermore, these data show the advantages of REAC treatment, even compared with modern cognitive behavioral therapy, including a relatively rapid and “stable” clinical response (just over 6 months and economic cost.Keywords: anxiety, avoidance, fear, REAC

  5. A solid majority remit following evidence-based OCD treatments: a 3-year naturalistic outcome study in pediatric OCD.

    Science.gov (United States)

    Melin, Karin; Skarphedinsson, Gudmundur; Skärsäter, Ingela; Haugland, Bente Storm Mowatt; Ivarsson, Tord

    2018-03-03

    This study reports follow-up 2 and 3 years after the initial assessment of a sample of youth with a primary diagnosis of OCD. Participants were 109 children and adolescents, aged 5-17 years, recruited from a specialized, outpatient OCD clinic in Sweden. Patients were treated with cognitive behavioral therapy (CBT), augmented when indicated by selective serotonin reuptake inhibitor (SSRI). In cases where SSRIs were insufficient, augmentation with a second-generation antipsychotic (SGA) was applied. Participants were assessed with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), Children's OCD Impact Scale (COIS), and Children's Depressive Inventory (CDI) at follow-ups 2 and 3 years after baseline assessment. Treatment response was defined as CY-BOCS total score ≤ 15, and remission was defined as CY-BOCS total score ≤ 10. Analyzing the outcomes with linear mixed-effects models (LME) showed a decrease in OCD symptom load from 23 to 6.9 at the 3-year follow-up. Moreover, two of three (66.1%) participants were in remission, and another 19.2% had responded to treatment at the 3-year follow-up. Thus, 85.3% of participants responded to treatment. Moreover, during the follow-up period, participants' psychosocial functioning had significantly improved, and depressive symptoms had significantly decreased. The results suggest that evidence-based treatment for pediatric OCD, following expert consensus guidelines, has long-term positive effects for most children and adolescents diagnosed with OCD. The results also indicate that improvements are maintained over a 3-year period, at least, and that improvement is also found with regard to psychosocial functioning and depressive symptoms.

  6. Naturalistic Bicycling Behavior Pilot Study.

    Science.gov (United States)

    2017-11-01

    Bicyclists experience disproportionate rates of injuries and fatalities compared to other road users. The safety for bicyclists is of particular concern in Florida, where bicyclist fatality rates were nearly triple the national average in 2015. This ...

  7. Do Children Who Bully Their Peers Also Play Violent Video Games? A Canadian National Study

    Science.gov (United States)

    Dittrick, Crystal J.; Beran, Tanya N.; Mishna, Faye; Hetherington, Ross; Shariff, Shaheen

    2013-01-01

    The study examined whether children who bully others are likely to prefer playing video games that are rated high in maturity and violence. A stratified random sample of Canadian children ages 10 to 17 years from the provinces of Canada was obtained. Parents (n = 397) and their children (n = 492) completed an online survey of children's bullying…

  8. A Call for More Religious Education in the Secondary Social Studies Curriculum of Western Canadian Provinces

    Science.gov (United States)

    Patrick, Margaretta L.

    2015-01-01

    The inclusion of religion in public education remains contentious in many countries, including Canada. As multiple religions fill the public sphere, some religious education is necessary if Canadians are to understand each other. Social studies is seen as an appropriate subject to include such education given its foci on diversity and citizenship.…

  9. Academic Integrity, Remix Culture, Globalization: A Canadian Case Study of Student and Faculty Perceptions of Plagiarism

    Science.gov (United States)

    Evans-Tokaryk, Tyler

    2014-01-01

    This article presents the results of a case study at a Canadian university that used a combination of surveys and focus groups to explore faculty members' and students' perceptions of plagiarism. The research suggests that the globalization of education and remix culture have contributed to competing and contradictory understandings of plagiarism…

  10. The Influence of Cultural Background on Parental Perceptions of Adolescent Gambling Behaviour: A Canadian Study

    Science.gov (United States)

    Campbell, Colin A.; Derevensky, Jeffrey L.; Meerkamper, Eric; Cutajar, Jo

    2012-01-01

    Considerable research has begun to address youth gambling issues from a bio-psycho-social perspective. The current Canadian national study adds to this body of knowledge by examining the cultural influences impacting parent's attitudes, behaviors and perceptions of youth gambling. A total of 3,279 parents with a child between the ages of 13 and 18…

  11. A Non-Interventional Naturalistic Study of the Prescription Patterns of Antipsychotics in Patients with Schizophrenia from the Spanish Province of Tarragona.

    Directory of Open Access Journals (Sweden)

    Ana M Gaviria

    Full Text Available The analysis of prescribing patterns in entire catchment areas contributes to global mapping of the use of antipsychotics and may improve treatment outcomes.To determine the pattern of long-term antipsychotic prescription in outpatients with schizophrenia in the province of Tarragona (Catalonia-Spain.A naturalistic, observational, retrospective, non-interventional study based on the analysis of registries of computerized medical records from an anonymized database of 1,765 patients with schizophrenia treated between 2011 and 2013.The most used antipsychotic was risperidone, identified in 463 (26.3% patients, followed by olanzapine in 249 (14.1%, paliperidone in 225 (12.7%, zuclopenthixol in 201 (11.4%, quetiapine in 141 (8%, aripiprazole in 100 (5.7%, and clozapine in 100 (5.7%. Almost 8 out of 10 patients (79.3% were treated with atypical or second-generation antipsychotics. Long-acting injectable (LAI formulations were used in 44.8% of patients. Antipsychotics were generally prescribed in their recommended doses, with clozapine, ziprasidone, LAI paliperidone, and LAI risperidone being prescribed at the higher end of their therapeutic ranges. Almost 7 out of 10 patients (69.6% were on antipsychotic polypharmacy, and 81.4% were on psychiatric medications aside from antipsychotics. Being prescribed quetiapine (OR 14.24, 95% CI 4.94-40.97, LAI (OR 9.99, 95% CI 6.45-15.45, psychiatric co-medications (OR 4.25, 95% CI 2.72-6.64, and paliperidone (OR 3.13, 95% CI 1.23-7.92 were all associated with an increased likelihood of polypharmacy. Being prescribed risperidone (OR 0.54, 95% CI 0.35-0.83 and older age (OR 0.98, 95% CI 0.97-0.99 were related to a low polypharmacy probability.Polypharmacy is the most common pattern of antipsychotic use in this region of Spain. Use of atypical antipsychotics is extensive. Most patients receive psychiatric co-medications such as anxiolytics or antidepressants. Polypharmacy is associated with the use of quetiapine or

  12. A naturalistic inquiry into the social world of whitewater kayakers

    Science.gov (United States)

    Jason W. Whiting; Katharine A. Pawelko

    2012-01-01

    This exploratory research focused on kayakers at whitewater kayaking parks; the social and recreational characteristics of this specific user group had not previously been studied from a managerial and theoretical standpoint. Twelve kayakers were interviewed at whitewater kayaking parks in Colorado and Utah. The interviewers utilized naturalistic methodology with a...

  13. A Brief Coaching Intervention for Teaching Naturalistic Strategies to Parents

    Science.gov (United States)

    Lane, Justin D.; Ledford, Jennifer R.; Shepley, Collin; Mataras, Theologia K.; Ayres, Kevin M.; Davis, Alicia B.

    2016-01-01

    Coaching parents to implement evidence-based strategies is one method for increasing the number of hours young children with autism spectrum disorder (ASD) access intervention services. The purpose of this study was to teach parents of young children with ASD to implement naturalistic strategies during play in a clinic setting. Results indicate a…

  14. Teen drivers' awareness of vehicle instrumentation in naturalistic research.

    Science.gov (United States)

    Ehsani, J P; Haynie, D; Ouimet, M C; Zhu, C; Guillaume, C; Klauer, S G; Dingus, T; Simons-Morton, B G

    2017-12-01

    Naturalistic driving methods require the installation of instruments and cameras in vehicles to record driving behavior. A critical, yet unexamined issue in naturalistic driving research is the extent to which the vehicle instruments and cameras used for naturalistic methods change human behavior. We sought to describe the degree to which teenage participants' self-reported awareness of vehicle instrumentation changes over time, and whether that awareness was associated with driving behaviors. Forty-two newly-licensed teenage drivers participated in an 18-month naturalistic driving study. Data on driving behaviors including crash/near-crashes and elevated gravitational force (g-force) events rates were collected over the study period. At the end of the study, participants were asked to rate the extent to which they were aware of instruments in the vehicle at four time points. They were also asked to describe their own and their passengers' perceptions of the instrumentation in the vehicle during an in-depth interview. The number of critical event button presses was used as a secondary measure of camera awareness. The association between self-reported awareness of the instrumentation and objectively measured driving behaviors was tested using correlations and linear mixed models. Most participants' reported that their awareness of vehicle instrumentation declined across the duration of the 18-month study. Their awareness increased in response to their passengers' concerns about the cameras or if they were involved in a crash. The number of the critical event button presses was initially high and declined rapidly. There was no correlation between driver's awareness of instrumentation and their crash and near-crash rate or elevated g-force events rate. Awareness was not associated with crash and near-crash rates or elevated g-force event rates, consistent with having no effect on this measure of driving performance. Naturalistic driving studies are likely to yield

  15. An inventory of Canadian pregnancy and birth cohort studies: research in progress

    Directory of Open Access Journals (Sweden)

    Joly Marie-Pier

    2012-10-01

    Full Text Available Abstract Background A web-based inventory was developed as a voluntary registry of Canadian pregnancy and birth cohort studies, with the objective to foster collaboration and sharing of research tools among cohort study groups as a means to enrich research in maternal and child health across Canada. Description Information on existing birth cohort studies conducted in Canada exclusively or as part of broader international initiatives was accessed by searching the literature in PubMed and PsychInfo databases. Additional studies were identified by enquiring about the research activities of researchers at Canadian universities or working in affiliated hospitals or research centres or institutes. Of the fifty-eight birth cohort studies initially identified, forty-six were incorporated into the inventory if they were of a retrospective and/or prospective longitudinal design and with a minimum of two phases of data collection, with the first period having occurred before, during, or shortly after pregnancy and had an initial study sample size of a minimum of 200 participants. Information collected from each study was organized into four main categories: basic information, data source and period of collection, exposures, and outcome measures and was coded and entered into an Excel spreadsheet. The information incorporated into the Excel spreadsheet was double checked, completed when necessary, and verified for completeness and accuracy by contacting the principal investigator or research coordinator. All data collected were then uploaded onto the website of the Institute of Human Development Child and Youth Health of the Canadian Institutes of Health Research. Subsequently, the database was updated and developed as an online searchable inventory on the website of the Maternal, Infant, Child and Youth Research Network. Conclusions This inventory is unique, as it represents detailed information assembled for the first time on a large number of Canadian

  16. Qualitative Insights from a Canadian Multiinstitutional Research Study: In Search of Meaningful E-learning

    OpenAIRE

    Lorraine M. Carter; Vince Salyers; Sue Myers; Carol Hipfner; Caroline Hoffart; Christa MacLean; Kathy White; Theresa Matus; Vivian Forssman; Penelope Barrett

    2014-01-01

    This paper reports the qualitative findings of a mixed methods research study conducted at three Canadian post-secondary institutions. Called the Meaningful E-learning or MEL project, the study was an exploration of the teaching and learning experiences of faculty and students as well as their perceptions of the benefits and challenges of e-learning. Importantly, e-learning was conceptualized as the integration of pedagogy, instructional technology, and the Internet into teaching ...

  17. Job satisfaction, workplace stress, unhealthy lifestyle choices, and productivity among Canadian nurses: an empirical study

    OpenAIRE

    Karen J. Buhr

    2012-01-01

    BACKGROUND: Nurses’ occupational stress and job satisfaction can have an affect on lifestyle choices and productivity. OBJECTIVES: The objective of this study is to provide a detailed examination of the relationship between job satisfaction, job stress, unhealthy lifestyle choices, and productivity among Canadian nurses. METHODS: This study uses data from the confidential master data files of the 2005 National Survey of the Work and Health of Nurses (NSWHN). Ordinary least squares regressions...

  18. Rationale, design, and methods for Canadian alliance for healthy hearts and minds cohort study (CAHHM – a Pan Canadian cohort study

    Directory of Open Access Journals (Sweden)

    Sonia S. Anand

    2016-07-01

    Full Text Available Abstract Background The Canadian Alliance for Healthy Hearts and Minds (CAHHM is a pan-Canadian, prospective, multi-ethnic cohort study being conducted in Canada. The overarching objective of the CAHHM is to understand the association of socio-environmental and contextual factors (such as societal structure, activity, nutrition, social and tobacco environments, and access to health services with cardiovascular risk factors, subclinical vascular disease, and cardiovascular and other chronic disease outcomes. Methods/Design Participants between 35 and 69 years of age are being recruited from existing cohorts and a new First Nations Cohort to undergo a detailed assessment of health behaviours (including diet and physical activity, cognitive function, assessment of their local home and workplace environments, and their health services access and utilization. Physical measures including weight, height, waist/hip circumference, body fat percentage, and blood pressure are collected. In addition, eligible participants undergo magnetic resonance imaging (MRI of the brain, heart, carotid artery and abdomen to detect early subclinical vascular disease and ectopic fat deposition. Discussion CAHHM is a prospective cohort study designed to investigate the impact of community level factors, individual health behaviours, and access to health services, on cognitive function, subclinical vascular disease, fat distribution, and the development of chronic diseases among adults living in Canada.

  19. A card game for the treatment of delusional ideas: A naturalistic pilot trial

    Directory of Open Access Journals (Sweden)

    Benzakin Laetitia

    2006-10-01

    Full Text Available Abstract Background "Michael's game" is a card game which aims at familiarizing healthcare professionals and patients with cognitive behavioral therapy of psychotic symptoms. This naturalistic study tests the feasibility and the impact of the intervention in various naturalistic settings. Method Fifty five patients were recruited in seven centers. They were assessed in pre and post-test with the Peters Delusion Inventory – 21 items (PDI-21. Results Forty five patients completed the intervention significantly reducing their conviction and preoccupation scores on the PDI-21. Conclusion This pilot study supports the feasibility and effectiveness of "Michael's game" in naturalistic setting. Additional studies could validate the game in a controlled fashion.

  20. Using Mobile Technology to Enhance Undergraduate Student Digital Information Literacy Skills: A Canadian Case Study

    OpenAIRE

    Alice Schmidt Hanbidge; Nicole Sanderson; Tony Tin

    2015-01-01

    Learning essential information literacy skills through the use of mobile phones is an innovative mlearning pilot project that was collaboratively undertaken in a Canadian university college over the course of two academic terms by faculty and the library staff. The research pilot project involved ninety one undergraduate students in five different classes majoring in psychology, social work, education or social development studies in an attempt to determine the effectiveness of us...

  1. Cost of allogeneic and autologous blood transfusion in Canada. Canadian Cost of Transfusion Study Group.

    OpenAIRE

    Tretiak, R; Laupacis, A; Rivière, M; McKerracher, K; Souêtre, E

    1996-01-01

    OBJECTIVE: To determine the cost, from a societal perspective, of blood transfusion in Canada. STUDY DESIGN: Cost-structure analysis. SETTING: Data were collected from eight hospitals and from six blood centres operated by the Canadian Red Cross Society in four provinces. OUTCOME MEASURES: Costs associated with four stages of transfusion-- collection, production, distribution and delivery--in 1933 were assessed. Costs were divided into the following categories; personnel, purchases, external ...

  2. Prevalence and characteristics of Postpartum Depression symptomatology among Canadian women: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Kuk Jennifer L

    2011-05-01

    Full Text Available Abstract Background This study aims to look at the prevalence and characteristics of postpartum depression symptomatology (PPDS among Canadian women. Studies have found that in developed countries, 10-15% of new mothers were affected by major postpartum depression. Mothers who suffer from postpartum depression may endure difficulties regarding their ability to cope with life events, as well as negative clinical implications for maternal-infant attachment. Methods An analysis based on 6,421 Canadian women, who had a live birth between 2005 and 2006 and were part of the Maternity Experience Survey (MES, was performed. PPDS was measured based on the Edinburgh Postnatal Depression Scale. Various factors that assessed socio-economic status, demographic factors, and maternal characteristics were considered for the multinomial regression model. Results The national prevalence of minor/major and major PPDS was found to be 8.46% and 8.69% respectively. A mother's stress level during pregnancy, the availability of support after pregnancy, and a prior diagnosis of depression were the characteristics that had the strongest significant association with the development of PPDS. Conclusions A significant number of Canadian women experience symptoms of postpartum depression. Findings from this study may be useful to increase both the attainment of treatment and the rate at which it can be obtained among new mothers. Interventions should target those with the greatest risk of experiencing PPDS, specifically immigrant and adolescent mothers.

  3. A Large Eddy Simulation Study of Heat Entrainment under Sea Ice in the Canadian Arctic Basin

    Science.gov (United States)

    Ramudu, E.; Yang, D.; Gelderloos, R.; Meneveau, C. V.; Gnanadesikan, A.

    2016-12-01

    Sea ice cover in the Arctic has declined rapidly in recent decades. The much faster than projected retreat suggests that climate models may be missing some key processes, or that these processes are not accurately represented. The entrainment of heat from the mixed layer by small-scale turbulence is one such process. In the Canadian Basin of the Arctic Ocean, relatively warm Pacific Summer Water (PSW) resides at the base of the mixed layer. With an increasing influx of PSW, the upper ocean in the Canadian Basin has been getting warmer and fresher since the early 2000s. While studies show a correlation between sea ice reduction and an increase in PSW temperature, others argue that PSW intrusions in the Canadian Basin cannot affect sea ice thickness because the strongly-stratified halocline prevents heat from the PSW layer from being entrained into the mixed layer and up to the basal ice surface. In this study, we try to resolve this conundrum by simulating the turbulent entrainment of heat from the PSW layer to a moving basal ice surface using large eddy simulation (LES). The LES model is based on a high-fidelity spectral approach on horizontal planes, and includes a Lagrangian dynamic subgrid model that reduces the need for empirical inputs for subgrid-scale viscosities and diffusivities. This LES tool allows us to investigate physical processes in the mixed layer at a very fine scale. We focus our study on summer conditions, when ice is melting, and show for a range of ice-drift velocities, halocline temperatures, and halocline salinity gradients characteristic of the Canadian Basin how much heat can be entrained from the PSW layer to the sea ice. Our results can be used to improve parameterizations of vertical heat flux under sea ice in coarse-grid ocean and climate models.

  4. Inequalities in the spiritual health of young Canadians: a national, cross-sectional study.

    Science.gov (United States)

    Michaelson, Valerie; Freeman, John; King, Nathan; Ascough, Hannah; Davison, Colleen; Trothen, Tracy; Phillips, Sian; Pickett, William

    2016-11-28

    Spiritual health, along with physical, emotional, and social aspects, is one of four domains of health. Assessment in this field of research is challenging methodologically. No contemporary population-based studies have profiled the spiritual health of adolescent Canadians with a focus on health inequalities. In a 2014 nationally representative sample of Canadians aged 11-15 years we therefore: (1) psychometrically evaluated a series of items used to assess the perceived importance of spiritual health and its four potential sub-domains (connections with: self, others, nature and the natural environment, and the transcendent) to adolescents; (2) described potential inequalities in spiritual health within adolescent populations, overall and by spiritual health sub-domain, by key socio-demographic factors. Cross-sectional analysis of survey reports from the 2014 (Cycle 7) of the Canadian Health Behaviour in School-aged Children study (weighted n = 25,036). Principal components analysis followed by confirmatory factor analysis were used to explore the psychometric properties of the spiritual health items and the associated composite scale describing perceived importance of spiritual health. Associations among this composite scale, its individual sub-domains, and key socio-demographic factors were then explored. The principal components analysis best supported a four-factor structure where the eight scale items loaded highly according to the original four domains. This was also supported in confirmatory factor analyses. We then combined the eight items into composite spiritual health score as supported by theory, principal components analysis findings, and acceptable tests of reliability. Further confirmatory factor analysis suggested the need for additional refinements to this scale. Based upon exploratory cross-sectional analyses, strong socio-demographic inequalities were observed in the spiritual health measures by age, gender, relative material wealth

  5. Aging and Autism Spectrum Disorder: A Naturalistic, Longitudinal Study of the Comorbidities and Behavioral and Neuropsychiatric Symptoms in Adults with ASD.

    Science.gov (United States)

    Wise, Elizabeth A; Smith, Marcia D; Rabins, Peter V

    2017-06-01

    Little is known about Autism Spectrum Disorder (ASD) in persons over age 50. In a retrospective, naturalistic review of 74 individuals aged 30 and older meeting DSM-5 criteria for ASD, the point prevalence of behavioral and neuropsychiatric symptoms (BNPS) declined significantly for 12 of 13 BNPS over a mean of 25 years while many other features of ASD remained stable. GI disorders (68.9%) and seizure disorders (23%) were common, and 25.7% of the sample had a BMI >30. Females were more likely to engage in screaming (p < 0.05) and oppositional behavior (p < 0.05). Current age did not have a significant effect on BNPS prevalence.

  6. Bird interactions with wind turbines : a Canadian case study

    Energy Technology Data Exchange (ETDEWEB)

    Brown, K.; Hamilton, B. [TAEM Ltd., Calgary, AB (Canada)

    2004-07-01

    An environmental study has been conducted on a wind farm adjacent to Castle River, in the foothills of the Rocky Mountains in Alberta. The objective was to determine the impact of the many wind turbines on birds. The study involved observations of different bird species including raptors, waterfowl and passerines. The observations looked at bird numbers, location relative to turbines, and changes in flight pattern. The study found that raptors flew around or over the turbine blades, while passerines remained below, and waterfowl flew up and over the blades. Very few dead birds were found over the monitoring period, suggesting that wind turbines do not have a major impact on birds. figs.

  7. Highlight: Canadian, African researchers collaborate on study of ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-04-13

    Apr 13, 2016 ... English · Français ... The project aims to study women's livelihood strategies in artisanal mining of gold, tin, ... Using a mixed-methods approach, including surveys and life histories, ... Making labour markets work for youth.

  8. Biomedical and health studies with the new Canadian SLOWPOKE reactor

    International Nuclear Information System (INIS)

    Jervis, R.E.; Hancock, R.G.V.; Isles, K.; Hill, D.E.

    1977-01-01

    Results are reported from studies on clinical patients who had malnutrition, cystic fibrosis and other related electrolyte disorders. A stable activable tracer technique has been developed to determine the extracellular fluid volume (ECV) of infants. A regulated dose of sodium bromide is injected into the patient and, following short-term equilibration and dilution of this sample, a small blood sample is taken, yielding 50 μl of plasma. The plasma bromide concentration is determined by 80 Br (T=18 m) activation. Some samples were cross-checked by a microdiffusion method. The technique has been applied to 230 patients and controls, and has proved to be simple, rapid, accurate and sensitive for determining ECV to +-6%. Patients with cystic fibrosis (C.F.) were studied with respect to their growth and their sodium and electrolyte balance. In related clinical studies, hair and nail clippings from 50 C.F. patients and control children of the same age groups were activated at SLOWPOKE and Cu, Ca, Br, Cl, K, Na and I determined for use in differentiating C.F., along with a number of other elements including Zn, Mn, Al, Ti and Ni which showed little difference. A fairly good correlation of hair and nail concentrations was found for a number of the elements determined, suggesting that either tissue may be used in future studies. (T.G.)

  9. A study of algal biomass potential in selected Canadian regions.

    Energy Technology Data Exchange (ETDEWEB)

    Passell, Howard David; Roach, Jesse Dillon; Klise, Geoffrey T.

    2011-11-01

    A dynamic assessment model has been developed for evaluating the potential algal biomass and extracted biocrude productivity and costs, using nutrient and water resources available from waste streams in four regions of Canada (western British Columbia, Alberta oil fields, southern Ontario, and Nova Scotia). The purpose of this model is to help identify optimal locations in Canada for algae cultivation and biofuel production. The model uses spatially referenced data across the four regions for nitrogen and phosphorous loads in municipal wastewaters, and CO{sub 2} in exhaust streams from a variety of large industrial sources. Other data inputs include land cover, and solar insolation. Model users can develop estimates of resource potential by manipulating model assumptions in a graphic user interface, and updated results are viewed in real time. Resource potential by location can be viewed in terms of biomass production potential, potential CO{sub 2} fixed, biocrude production potential, and area required. The cost of producing algal biomass can be estimated using an approximation of the distance to move CO{sub 2} and water to the desired land parcel and an estimation of capital and operating costs for a theoretical open pond facility. Preliminary results suggest that in most cases, the CO{sub 2} resource is plentiful compared to other necessary nutrients (especially nitrogen), and that siting and prospects for successful large-scale algae cultivation efforts in Canada will be driven by availability of those other nutrients and the efficiency with which they can be used and re-used. Cost curves based on optimal possible siting of an open pond system are shown. The cost of energy for maintaining optimal growth temperatures is not considered in this effort, and additional research in this area, which has not been well studied at these latitudes, will be important in refining the costs of algal biomass production. The model will be used by NRC-IMB Canada to identify

  10. Canadian prediction equations of spirometric lung function for Caucasian adults 20 to 90 years of age: Results from the Canadian Obstructive Lung Disease (COLD) study and the Lung Health Canadian Environment (LHCE) study

    DEFF Research Database (Denmark)

    Tan, Wan C; Bourbeau, J; Hernandez, P

    2011-01-01

    BACKGROUND: Currently, no reference or normative values for spirometry based on a randomly selected Canadian population exist. OBJECTIVE: The aim of the present analysis was to construct spirometric reference values for Canadian adults 20 to 90 years of age by combining data collected from health...

  11. Naturalistic decision-making in expert badminton players.

    Science.gov (United States)

    Macquet, A C; Fleurance, P

    2007-09-01

    This paper reports on a study of naturalistic decision-making in expert badminton players. These decisions are frequently taken under time-pressured conditions, yet normally lead to successful performance. Two male badminton teams participated in this study. Self-confrontation interviews were used to collect data. Inductive data analysis revealed three types of intentions during a rally: to maintain the rally; to take the advantage; and to finish the point. It also revealed eight types of decision taken in this situation: to ensure an action; to observe the opponent's response to an action; to realize a limited choice; to influence the opponent's decision; to put pressure on an opponent; to surprise the opponent; to reproduce an efficient action; and to play wide. A frequent decision was to put pressure on the opponent. Different information and knowledge was linked to specific decisions. The results are discussed in relation to research that has considered naturalistic decision-making.

  12. Naturalistic Assessment of Novice Teenage Crash Experience

    Science.gov (United States)

    Lee, Suzanne E.; Simons-Morton, Bruce G.; Klauer, Sheila E.; Ouimet, Marie Claude; Dingus, Thomas A.

    2011-01-01

    Background Crash risk is highest during the first months after licensure. Current knowledge about teenagers’ driving exposure and the factors increasing their crash risk is based on self-reported data and crash database analyses. While these research tools are useful, new developments in naturalistic technologies have allowed researchers to examine newly-licensed teenagers’ exposure and crash risk factors in greater detail. The Naturalistic Teenage Driving Study (NTDS) described in this paper is the first study to follow a group of newly-licensed teenagers continuously for 18 months after licensure. The goals of this paper are to compare the crash and near-crash experience of drivers in the NTDS to national trends, to describe the methods and lessons learned in the NTDS, and to provide initial data on driving exposure for these drivers. Methods A data acquisition system was installed in the vehicles of 42 newly-licensed teenage drivers 16 years of age during their first 18 months of independent driving. It consisted of cameras, sensors (accelerometers, GPS, yaw, front radar, lane position, and various sensors obtained via the vehicle network), and a computer with removable hard drive. Data on the driving of participating parents was also collected when they drove the instrumented vehicle. Findings The primary findings after 18 months included the following: (1) crash and near-crash rates among teenage participants were significantly higher during the first six months of the study than the final 12 months, mirroring the national trends; (2) crash and near-crash rates were significantly higher for teenage than adult (parent) participants, also reflecting national trends; (3) teenaged driving exposure averaged between 507-710 kilometers (315-441 miles) per month over the study period, but varied substantially between participants with standard errors representing 8-14 percent of the mean; and (4) crash and near-crash types were very similar for male and female

  13. Mental health service use by patients with dysthymic disorder: treatment use and dropout in a 7 1/2-year naturalistic follow-up study.

    Science.gov (United States)

    McFarland, Brian R; Klein, Daniel N

    2005-01-01

    Little is known about long-term treatment use among patients with dysthymia. This paper describes patterns of treatment use by 85 outpatients with dysthymic disorder and a comparison group of 36 outpatients with nonchronic (episodic) major depression in a naturalistic follow-up. Patients with dysthymia had higher rates of treatment use across 7 1/2 years compared with patients with episodic major depression. Baseline variables that predicted which patients with dysthymia dropped out of treatment before recovering from dysthymic disorder included age, ethnicity, Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition Axis II pathology as obtained from informant reports, higher self-reported autonomy, and receiving psychotherapy alone as compared to receiving a combination of psychotherapy and medication. Dysthymic disorder places a significant burden on the mental health services system, yet many outpatients with dysthymia may be receiving inadequate treatment. Younger patients, ethnic minority patients, and patients with personality disorders may be at increased risk of dropping out from treatment for depression. Combination treatments may increase treatment retention.

  14. Teen Driving Risk and Prevention: Naturalistic Driving Research Contributions and Challenges

    OpenAIRE

    Simons-Morton, Bruce G.; Ehsani, Johnathon P.; Gershon, Pnina; Klauer, Sheila G.; Dingus, Thomas A.

    2017-01-01

    Naturalistic driving (ND) methods may be particularly useful for research on young driver crash risk. Novices are not safe drivers initially, but tend to improve rapidly, although the pace of learning is highly variable. However, knowledge is lacking about how best to reduce the learning curve and the variability in the development of safe driving judgment. A great deal has been learned from recent naturalistic driving (ND) studies that have included young drivers, providing objective informa...

  15. Internet Exposure Associated With Canadian Parents' Perception of Risk on Childhood Immunization: Cross-Sectional Study.

    Science.gov (United States)

    Tustin, Jordan Lee; Crowcroft, Natasha Sarah; Gesink, Dionne; Johnson, Ian; Keelan, Jennifer

    2018-01-19

    There is a large presence of provaccination and antivaccination content on the Internet. The Internet has been identified as an important source for parents to seek and share vaccine information. There are concerns that parental fears or hesitancy on childhood immunizations are increasing due to the popularity of social media and exposure to online antivaccination sentiment. No other studies have investigated the association between seeking vaccine information online and Canadian parents' perception of risk on childhood immunization. We aimed to investigate the potential association between seeking vaccine information on the Internet and Canadian parents' perception of risk on childhood immunization in order to quantify the perceived association and increase our understanding on the impact of the Internet to help guide public health interventions. We analyzed this association in two population samples: a self-selecting Web-based sample of Canadian parents recruited through Facebook (n=966) and a population-based sample of parents recruited by random digit dialing (RDD; n=951). The outcome was parental perception of vaccine safety on a seven-point ordinal scale from "not safe" to "extremely safe." An ordinal regression model was used to investigate if Internet information seeking on childhood vaccination predicted parental perception of vaccine safety. After adjusting for income level, Internet reliability, age of parent, and region, the odds of perceiving vaccines as less safe rather than more safe were 1.6 times higher (95% CI 1.3-2.1) for parents who used the Internet to search for vaccination information compared to parents who did not search the Internet in the Web-based sample, and 2.0 times higher (95% CI 1.6-2.5) in the population-based RDD sample. The results suggest the Internet is significantly associated with Canadian parents' negative perception of vaccine risk. Governmental and scientific sectors should consider the development and implementation of

  16. Naturalistic drive cycle synthesis for pickup trucks.

    Science.gov (United States)

    Liu, Zifan; Ivanco, Andrej; Filipi, Zoran

    2015-09-01

    Future pick-up trucks are meeting much stricter fuel economy and exhaust emission standards. Design tradeoffs will have to be carefully evaluated to satisfy consumer expectations within the regulatory and cost constraints. Boundary conditions will obviously be critical for decision making: thus, the understanding of how customers are driving in naturalistic settings is indispensable. Federal driving schedules, while critical for certification, do not capture the richness of naturalistic cycles, particularly the aggressive maneuvers that often shape consumer perception of performance. While there are databases with large number of drive cycles, applying all of them directly in the design process is impractical. Therefore, representative drive cycles that capture the essence of the naturalistic driving should be synthesized from naturalistic driving data. Naturalistic drive cycles are firstly categorized by investigating their micro-trip components, defined as driving activities between successive stops. Micro-trips are expected to characterize underlying local traffic conditions, and separate different driving patterns. Next, the transitions from one vehicle state to another vehicle state in each cycle category are captured with Transition Probability Matrix (TPM). Candidate drive cycles can subsequently be synthesized using Markov Chain based on TPMs for each category. Finally, representative synthetic drive cycles are selected through assessment of significant cycle metrics to identify the ones with smallest errors. This paper provides a framework for synthesis of representative drive cycles from naturalistic driving data, which can subsequently be used for efficient optimization of design or control of pick-up truck powertrains. Manufacturers will benefit from representative drive cycles in several aspects, including quick assessments of vehicle performance and energy consumption in simulations, component sizing and design, optimization of control strategies, and

  17. Using naturalistic driving films as a design tool for investigating driver requirements in HMI design for ADAS.

    Science.gov (United States)

    Wang, Minjuan; Sun, Dong; Chen, Fang

    2012-01-01

    In recent years, there are many naturalistic driving projects have been conducted, such as the 100-Car Project (Naturalistic Driving study in United State), EuroFOT(European Large-Scale Field Operational Tests on Vehicle Systems), SeMi- FOT(Sweden Michigan Naturalistic Field Operational Test and etc. However, those valuable naturalistic driving data hasn't been applied into Human-machine Interaction (HMI) design for Advanced Driver Assistance Systems (ADAS), a good HMI design for ADAS requires a deep understanding of drive environment and the interactions between the driving car and other road users in different situations. The results demonstrated the benefits of using naturalistic driving films as a mean for enhancing focus group discussion for better understanding driver's needs and traffic environment constraints. It provided an efficient tool for designers to have inside knowledge about drive and the needs for information presentation; The recommendations for how to apply this method is discussed in the paper.

  18. Factors associated with the grief after stillbirth: a comparative study between Brazilian and Canadian women

    Directory of Open Access Journals (Sweden)

    Gisele Ferreira Paris

    Full Text Available Abstract OBJECTIVE To verify the association between complicated grief and sociodemographic, reproductive, mental, marital satisfaction, and professional support characteristics in women after stillbirth. METHOD Cross-sectional study with 26 women who had stillbirth in 2013, living in the city of Maringá, Brazil, and eight women who attended the Centre d'Études et de Rechercheen Intervention Familiale at the University of Quebec en Outaouais, in Canada. The instrument was administered as an interview to a small number of mothers of infants up to three months (n=50, who did not participate in the validation study. RESULTS By applying the short version of the Perinatal Grief Scale, the prevalence of complicated grief in Brazilian women was found to be higher (35% in relation to Canadian women (12%.Characteristics of the Brazilian women associated with the grief period included the presence of previous pregnancy with live birth, absence of previous perinatal loss, postpartum depression, and lack of marital satisfaction. For the Canadians it was observed that 80% of the women presenting no grief made use of the professional support group. In both populations the occurrence of complicated grief presented a higher prevalence in women with duration of pregnancy higher than 28 weeks. CONCLUSION The women that must be further investigated during the grief period are those living in Brazil, making no use of a professional support group, presenting little to no marital satisfaction, having no religion, and of a low educational level.

  19. A national study of the provision of oncology sperm banking services among Canadian fertility clinics.

    Science.gov (United States)

    Yee, S; Buckett, W; Campbell, S; Yanofsky, R A; Barr, R D

    2013-07-01

    The purpose of this study was to survey the current state of oncology sperm banking services provided by fertility clinics across Canada. A total of 78 Canadian fertility facilities were invited to complete a questionnaire related to the availability, accessibility, affordability and utilisation of sperm banking services for cancer patients. The total response rate was 59%, with 20 (69%) in vitro fertilisation clinics and 26 (53%) other fertility centres returning the survey. A total of 24 responding facilities accepted oncology sperm banking referrals. The time frame to book the first banking appointment for 19 (79%) facilities was within 2 days. Inconsistent practice was found regarding the consent process for cancer patients who are of minority age. Eight (33%) facilities did not provide any subsidy and charged a standard banking fee regardless of patients' financial situations. Overall, the utilisation of oncology sperm banking services was low despite its availability and established efficacy, suggesting that Canadian cancer patients are notably underserved. The study has highlighted some important issues for further consideration in improving access to sperm banking services for cancer patients, especially for adolescents. Better collaboration between oncology and reproductive medicine to target healthcare providers would help to improve sperm banking rates. © 2013 John Wiley & Sons Ltd.

  20. Developing a Canadian Curriculum for Simulation-Based Education in Obstetrics and Gynaecology: A Delphi Study.

    Science.gov (United States)

    Craig, Catherine; Posner, Glenn D

    2017-09-01

    As obstetrics and gynaecology (Ob/Gyn) residency training programs move towards a competence-based approach to training and assessment, the development of a national standardized simulation curriculum is essential. The primary goal of this study was to define the fundamental content for the Canadian Obstetrics and Gynecology Simulation curriculum. A modified Delphi technique was used to achieve consensus in three rounds by surveying residency program directors or their local simulation educator delegates in 16 accredited Canadian Ob/Gyn residency programs. A consensus rate of 80% was agreed upon. Survey results were collected over 11 months in 2016. Response rates for the Delphi were 50% for the first round, 81% for the second round, and 94% for the third round. The first survey resulted in 84 suggested topics. These were organized into four categories: obstetrics high acuity low frequency events, obstetrics common events, gynaecology high acuity low frequency events, and gynaecology common events. Using the modified Delphi method, consensus was reached on 6 scenarios. This study identified the content for a national simulation-based curriculum for Ob/Gyn residency training programs and is the first step in the development of this curriculum. Copyright © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

  1. Needed for Teacher Education: Naturalistic Research that Is Culturally Responsive.

    Science.gov (United States)

    Tabachnick, B. Robert

    1989-01-01

    This article examines some of the advantages and problems in using qualitative (naturalistic) research methods to understand teaching, learning, and schooling. An example of naturalistic research involving first year teachers is included. (IAH)

  2. Neighborhood Walkability and Body Mass Index Trajectories: Longitudinal Study of Canadians.

    Science.gov (United States)

    Wasfi, Rania A; Dasgupta, Kaberi; Orpana, Heather; Ross, Nancy A

    2016-05-01

    To assess the impact of neighborhood walkability on body mass index (BMI) trajectories of urban Canadians. Data are from Canada's National Population Health Survey (n = 2935; biannual assessments 1994-2006). We measured walkability with the Walk Score. We modeled body mass index (BMI, defined as weight in kilograms divided by the square of height in meters [kg/m(2)]) trajectories as a function of Walk Score and sociodemographic and behavioral covariates with growth curve models and fixed-effects regression models. In men, BMI increased annually by an average of 0.13 kg/m(2) (95% confidence interval [CI] = 0.11, 0.14) over the 12 years of follow-up. Moving to a high-walkable neighborhood (2 or more Walk Score quartiles higher) decreased BMI trajectories for men by approximately 1 kg/m(2) (95% CI = -1.16, -0.17). Moving to a low-walkable neighborhood increased BMI for men by approximately 0.45 kg/m(2) (95% CI = 0.01, 0.89). There was no detectable influence of neighborhood walkability on body weight for women. Our study of a large sample of urban Canadians followed for 12 years confirms that neighborhood walkability influences BMI trajectories for men, and may be influential in curtailing male age-related weight gain.

  3. Characteristics of martial art injuries in a defined Canadian population: a descriptive epidemiological study

    Directory of Open Access Journals (Sweden)

    Pickett William

    2010-12-01

    Full Text Available Abstract Background The martial arts have emerged as common activities in the Canadian population, yet few studies have investigated the occurrence of associated injuries on a population basis. Methods We performed such an investigation and suggest potential opportunities for prevention. The data source was 14 years (1993 to 2006 of records from the Kingston sites of the Canadian Hospital Injury Reporting and Prevention Program (CHIRPP. Results 920 cases were identified. Incidence rates were initially estimated using census data as denominators. We then imputed annual injury rates per 10000 using a range of published estimates of martial arts participation available from a national survey. Rates of injury in males and females were 2300 and 1033 per 10000 (0.3% participation and 575 and 258 per 10000 (1.2% participation. Injuries were most frequently reported in karate (33% and taekwondo (14%. The most common mechanisms of injury were falls, throws and jumps (33%. Fractures (20% were the most frequently reported type of injury and the lower limb was the most common site of injury (41%. Conclusions Results provide a foundation for potential interventions with a focus on falls, the use of weapons, participation in tournaments, as well as head and neck trauma.

  4. Characteristics of martial art injuries in a defined Canadian population: a descriptive epidemiological study.

    Science.gov (United States)

    McPherson, Mark; Pickett, William

    2010-12-30

    The martial arts have emerged as common activities in the Canadian population, yet few studies have investigated the occurrence of associated injuries on a population basis. We performed such an investigation and suggest potential opportunities for prevention. The data source was 14 years (1993 to 2006) of records from the Kingston sites of the Canadian Hospital Injury Reporting and Prevention Program (CHIRPP). 920 cases were identified. Incidence rates were initially estimated using census data as denominators. We then imputed annual injury rates per 10000 using a range of published estimates of martial arts participation available from a national survey. Rates of injury in males and females were 2300 and 1033 per 10000 (0.3% participation) and 575 and 258 per 10000 (1.2% participation). Injuries were most frequently reported in karate (33%) and taekwondo (14%). The most common mechanisms of injury were falls, throws and jumps (33%). Fractures (20%) were the most frequently reported type of injury and the lower limb was the most common site of injury (41%). Results provide a foundation for potential interventions with a focus on falls, the use of weapons, participation in tournaments, as well as head and neck trauma.

  5. The potential for energy efficiency gains in the Canadian commercial building sector: A stochastic frontier study

    International Nuclear Information System (INIS)

    Buck, J.; Young, D.

    2007-01-01

    The achievement of energy efficiency in commercial buildings is a function of the activities undertaken, the technology in place, and the extent to which those technologies are used efficiently. We study the factors that affect efficient energy use in the Canadian commercial sector by applying a stochastic frontier approach to a cross-section of Canadian commercial buildings included in the Commercial and Institutional Building Energy Use Survey (CIBEUS). Structural and climate-control features of the buildings as well as climatic conditions are assumed to determine the location of the frontier, while management-related variables including such factors as ownership type and activities govern whether or not the maximally attainable efficiency along the frontier is achieved. Our results indicate that although, on average, buildings appear to be fairly efficient, certain types of operations are more likely than others to exhibit energy efficiencies that are significantly worse than average. These results, along with those related to the effects of physical characteristics on the stochastic efficiency frontier, suggest that there is scope for focused policy initiatives to increase energy efficiency in this sector

  6. Western University (No. 10 Canadian Stationary Hospital and No. 14 Canadian General Hospital): a study of medical volunteerism in the First World War.

    Science.gov (United States)

    Istl, Alexandra C; McAlister, Vivian C

    2016-12-01

    The Canadian government depended on chaotic civilian volunteerism to staff a huge medical commitment during the First World War. Offers from Canadian universities to raise, staff and equip hospitals for deployment, initially rejected, were incrementally accepted as casualties mounted. When its offer was accepted in 1916, Western University Hospital quickly adopted military decorum and equipped itself using Canadian Red Cross Commission guidelines. Staff of the No. 10 Canadian Stationary Hospital and the No. 14 Canadian General Hospital retained excellent morale throughout the war despite heavy medical demand, poor conditions, aerial bombardment and external medical politics. The overwhelming majority of volunteers were Canadian-born and educated. The story of the hospital's commanding officer, Edwin Seaborn, is examined to understand the background upon which the urge to volunteer in the First World War was based. Although many Western volunteers came from British stock, they promoted Canadian independence. A classical education and a broad range of interests outside of medicine, including biology, history and native Canadian culture, were features that Seaborn shared with other leaders in Canadian medicine, such as William Osler, who also volunteered quickly in the First World War.

  7. Study of the economic and environmental impacts of the research and development program of the Canadian Carbonization Research Association (CCRA)

    International Nuclear Information System (INIS)

    2001-06-01

    A partnership between the Canada Centre for Mineral and Energy Technology (CANMET) Energy Technology Centre (CETC) of Natural Resources Canada (NRCan), and the Canadian coal and steel industries, the Canadian Carbonization Research Association (CCRA) which conducts research and development activities with its partners. This document summarizes the economic and environmental impacts of the research and development program administered by the CCRA. More than 25 research programs have been undertaken by the CCRA since it was established in 1964. The activities dealt with specific technical challenges which the Canadian coal industry faced with regard to the production and marketing of metallurgical coal, as well as the uses of coal and alternative fuels such as natural gas to make coke used in blast furnaces. The report detailed the scope of CETC's energy for high temperature processes, then addressed program resources and study methodology. Three categories of impacts were discussed: general-level impacts, economic and environmental impacts, and quantitative estimates of economic impacts. The attribution of impacts was examined and future directions were examined in the last section of the report. It was determined that CETC participation in the research program is still required, due to the fact that it is Canada's only technical support available to the Canadian coking coal industry. The survival of Canadian coal producers owes something to the economic impacts derived from the CCRA under the current decreasing metallurgical coal prices conditions. 2 tabs

  8. Comparative study of radon exposure in Canadian homes and uranium mines - a discussion on the importance of national radon program

    International Nuclear Information System (INIS)

    Chen, Jing

    2017-01-01

    The history of lung cancer in uranium miners is well known for over hundreds of years when the disease was referred to as 'miner's disease' or 'mountain sickness'. Radon levels in uranium mines have decreased significantly over the past 30 years as a result of effective radiation protection measures at workplaces. For the most recent 10-year period, the average radon concentrations to underground and surface workers in Canadian uranium mines were 111 and 11 Bq m -3 , respectively. Based on the recent radon survey carried out in roughly 14 000 homes in 121 health regions across Canada and the more recent radon and thoron survey in 33 Canadian cities and 4000 homes, the average radon concentration in Canadian homes is 77 Bq m -3 . This study demonstrates that, nowadays, workers are exposed to radon in underground mines at a comparable radon level to what Canadians are exposed to at home. Since exposure to indoor radon is the main source of natural radiation exposure to the population, it is important for the National Radon Program to further increase radon awareness, and to encourage more Canadians to take appropriate actions to reduce radon exposure. (authors)

  9. Naturalistic and Supernaturalistic Disclosures: The Possibility of ...

    African Journals Online (AJOL)

    Naturalistic and Supernaturalistic Disclosures: The Possibility of Relational Miracles. Amy Fisher Smith. Abstract. This paper explores naturalism and supernaturalism as modes of disclosure that reveal and conceal different aspects of relationality. Naturalism is presented as a worldview or set of philosophical assumptions ...

  10. Da Costa on ontology: a naturalistic interpretation

    Directory of Open Access Journals (Sweden)

    Antonio Mariano Nogueira Coelho

    2011-06-01

    Full Text Available Da Costa's conception of being modifies that of Quine to incorporate relativization to non-classical logics. A naturalistic view of this conception is discussed. This view tries to extend to logic some ideas of Maddy's naturalism concerning mathematics.

  11. Approaches for building community participation: A qualitative case study of Canadian food security programs.

    Science.gov (United States)

    Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

    2017-10-01

    There is increasing opportunity and support for occupational therapists to expand their scope of practice in community settings. However, evidence is needed to increase occupational therapists' knowledge, confidence, and capacity with building community participation and adopting community-centered practice roles. The purpose of this study is to improve occupational therapists' understanding of an approach to building community participation, through case study of a network of Canadian food security programs. Qualitative case study was utilized. Data were semistructured interviews, field observations, documents, and online social media. Thematic analysis was used to identify and describe four themes that relate to processes used to build community participation. The four themes were use of multiple methods, good leaders are fundamental, growing participation via social media, and leveraging outcomes. Occupational therapists can utilize an approach for building community participation that incorporates resource mobilization. Challenges of sustainability and social exclusion must be addressed.

  12. Medical end-of-life practices among Canadian physicians: a pilot study.

    Science.gov (United States)

    Marcoux, Isabelle; Boivin, Antoine; Mesana, Laura; Graham, Ian D; Hébert, Paul

    2016-01-01

    Medical end-of-life practices are hotly debated in Canada, and data from other countries are used to support arguments. The objective of this pilot study was twofold: to adapt and validate a questionnaire designed to measure the prevalence of these practices in Canada and the underlying decision-making process, and to assess the feasibility of a nationally representative study. In phase 1, questionnaires from previous studies were adapted to the Canadian context through consultations with a multidisciplinary committee and based on a scoping review. The modified questionnaire was validated through cognitive interviews with 14 physicians from medical specialties associated with a higher probability of being involved with dying patients recruited by means of snowball sampling. In phase 2, we selected a stratified random sample of 300 Canadian physicians in active practice from a national medical directory and used the modified tailored method design for mail and Web surveys. There were 4 criteria for success: modified questions are clearly understood; response patterns for sensitive questions are similar to those for other questions; respondents are comparable to the overall sampling frame; and mean questionnaire completion time is less than 20 minutes. Phase 1: main modifications to the questionnaire were related to documentation of all other medical practices (including practices intended to prolong life) and a question on the proportionality of drugs used. The final questionnaire contained 45 questions in a booklet style. Phase 2: of the 280 physicians with valid addresses, 87 (31.1%) returned the questionnaire; 11 of the 87 declined to participate, for a response rate of 27.1% (n = 76). Most respondents (64 [84%]) completed the mail questionnaire. All the criteria for success were met. It is feasible to study medical end-of-life practices, even for practices that are currently illegal, including the intentional use of lethal drugs. Results from this pilot study

  13. The Canadian Healthy Infant Longitudinal Development (CHILD) Study: examining developmental origins of allergy and asthma.

    Science.gov (United States)

    Subbarao, Padmaja; Anand, Sonia S; Becker, Allan B; Befus, A Dean; Brauer, Michael; Brook, Jeffrey R; Denburg, Judah A; HayGlass, Kent T; Kobor, Michael S; Kollmann, Tobias R; Kozyrskyj, Anita L; Lou, W Y Wendy; Mandhane, Piushkumar J; Miller, Gregory E; Moraes, Theo J; Pare, Peter D; Scott, James A; Takaro, Tim K; Turvey, Stuart E; Duncan, Joanne M; Lefebvre, Diana L; Sears, Malcolm R

    2015-10-01

    The Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort study recruited 3624 pregnant women, most partners and 3542 eligible offspring. We hypothesise that early life physical and psychosocial environments, immunological, physiological, nutritional, hormonal and metabolic influences interact with genetics influencing allergic diseases, including asthma. Environmental and biological sampling, innate and adaptive immune responses, gene expression, DNA methylation, gut microbiome and nutrition studies complement repeated environmental and clinical assessments to age 5. This rich data set, linking prenatal and postnatal environments, diverse biological samples and rigorous phenotyping, will inform early developmental pathways to allergy, asthma and other chronic inflammatory diseases. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Qualitative Insights from a Canadian Multi-Institutional Research Study: In Search of Meaningful E-Learning

    Science.gov (United States)

    Carter, Lorraine M.; Salyers, Vince; Myers, Sue; Hipfner, Carol; Hoffart, Caroline; MacLean, Christa; White, Kathy; Matus, Theresa; Forssman, Vivian; Barrett, Penelope

    2014-01-01

    This paper reports the qualitative findings of a mixed methods research study conducted at three Canadian post-secondary institutions. Called the Meaningful E-learning or MEL project, the study was an exploration of the teaching and learning experiences of faculty and students as well as their perceptions of the benefits and challenges of…

  15. Increase in Utilization of Afterhours Medical Imaging: A Study of Three Canadian Academic Centers.

    Science.gov (United States)

    Chaudhry, Shivani; Dhalla, Irfan; Lebovic, Gerald; Rogalla, Patrik; Dowdell, Timothy

    2015-11-01

    The objectives of our study were to assess trends in afterhours medical imaging utilization for emergency department (ED) and inpatient (IP) patient populations from 2006-2013, including analysis by modality and specialty and with adjustment for patient volume. For this retrospective study, we reviewed the number of CT, MRI, and ultrasound studies performed for the ED and IP patients during the afterhours time period (5pm - 8am on weekdays and 24 hours on weekends and statutory holidays) from 2006-2013 at three different Canadian academic hospitals. We used the Jonckheere-Terpstra (JT) test to determine statistical significance of imaging and patient volume trends. A regression model was used to examine whether there was an increasing trend over time in the volume of imaging tests per 1000 patients. For all three sites from 2006-2013 during the afterhours time period: There was a statistically significant increasing trend in total medical imaging volume, which also held true when the volumes were assessed by modality and by specialty. There was a statistically significant increasing trend in ED and IP patient volume. When medical imaging volumes were adjusted for patient volumes, there was a statistically significant increasing trend in imaging being performed per patient. Afterhours medical imaging volumes demonstrated a statistically significant increasing trend at all three sites from 2006-2013 when assessed by total volume, modality, and specialty. During the same time period and at all three sites, the ED and IP patient volumes also demonstrated a statistically significant increasing trend with more medical imaging, however, being performed per patient. Copyright © 2015 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  16. A study of Canadian hospice palliative care volunteers' attitudes toward physician-assisted suicide.

    Science.gov (United States)

    Claxton-Oldfield, Stephen; Miller, Kathryn

    2015-05-01

    The purpose of this study was to examine the attitudes of hospice palliative care (HPC) volunteers who provide in-home support (n = 47) and members of the community (n = 58) toward the issue of physician-assisted suicide (PAS). On the first part of the survey, participants responded to 15 items designed to assess their attitudes toward PAS. An examination of individual items revealed differences in opinions among members of both the groups. Responses to additional questions revealed that the majority of volunteers and community members (1) support legalizing PAS; (2) would choose HPC over PAS for themselves if they were terminally ill; and (3) think Canadians should place more priority on developing HPC rather than on legalizing PAS. The implications of these findings are discussed. © The Author(s) 2014.

  17. Cross-sectional study of Hepatitis B Awareness among Chinese and Southeast Asian Canadians in the Vancouver-Richmond community

    Directory of Open Access Journals (Sweden)

    Justin Cheung

    2005-01-01

    Full Text Available BACKGROUND: Hepatitis B (HBV is endemic and a leading cause of morbidity and mortality in Asia. British Columbia has the highest proportion of Chinese and Southeast Asians among all Canadian provinces. The present study was designed to evaluate the degree of concern for and knowledge of HBV in this high-risk community.

  18. Ready or Not...: Perspectives on Literacy and Essential Skills in this Economic Downturn--A Canadian Baseline Study

    Science.gov (United States)

    Murray, Janet; Yerichuk, Deanna; Murray-Smith, Nick

    2009-01-01

    In March 2009, Movement for Canadian Literacy (MCL) commissioned "Resources for Results", a private research and evaluation firm, to conduct a baseline study to explore the effects of the recent economic downturn on literacy and essential skills programs across Canada. The "Resources for Results" research team interviewed 35…

  19. Critical challenges in ERP implementation: A qualitative case study in the Canadian oil and gas industry

    Science.gov (United States)

    Menon, Sreekumar A.

    This exploratory qualitative single-case study examines critical challenges encountered during ERP implementation based on individual perspectives in four project roles: senior leaders, project managers, project team members, and business users, all specifically in Canadian oil and gas industry. Data was collected by interviewing participants belonging to these categories, and by analyzing project documentation about ERP implementation. The organization for the case study was a leading multinational oil and gas company having a substantial presence in the energy sector in Canada. The study results were aligned with the six management questions regarding critical challenges in ERP: (a) circumstances to implement ERP, (b) benefits and process improvements achieved, (c) best practices implemented, (d) critical challenges encountered, (e) strategies and mitigating actions used, and (f) recommendations to improve future ERP implementations. The study results highlight six key findings. First, the study provided valid circumstances for implementing ERP systems. Second, the study underscored the importance of benefits and process improvements in ERP implementation. Third, the study highlighted that adoption of best practices is crucial for ERP Implementation. Fourth, the study found that critical challenges are encountered in ERP Implementation and are significant during ERP implementation. Fifth, the study found that strategies and mitigating actions can overcome challenges in ERP implementation. Finally, the study provided ten major recommendations on how to improve future ERP implementations.

  20. Intuitions in Epistemology: Towards a Naturalistic Alternative

    DEFF Research Database (Denmark)

    Ahlström, Kristoffer

    2009-01-01

    The present paper revisits the main methodological problems with conceptual analysis and considers two attempts to rectify them in terms of prototypes and reflective equilibria, respectively. Finding both wanting for the purposes of epistemological analysis, a naturalistic alternative is then ske......The present paper revisits the main methodological problems with conceptual analysis and considers two attempts to rectify them in terms of prototypes and reflective equilibria, respectively. Finding both wanting for the purposes of epistemological analysis, a naturalistic alternative...... is then sketched that explores the positive implications of aforementioned problems for the demarcation of the respective roles of intuitions and empirical investigation within three epistemological domains, viz., the evaluation of epistemological hypotheses, the amelioration of epistemic practices...

  1. Who's Afraid of the Naturalistic Fallacy?

    Directory of Open Access Journals (Sweden)

    Oliver Curry

    2006-01-01

    Full Text Available David Hume argued that values are the projections of natural human desires, and that moral values are the projections of desires that aim at the common good of society. Recent developments in game theory, evolutionary biology, animal behaviour and neuroscience explain why humans have such desires, and hence provide support for a Humean approach to moral psychology and moral philosophy. However, few philosophers have been willing to pursue this naturalistic approach to ethics for fear that it commits something called ‘the naturalistic fallacy’. This paper reviews several versions of the fallacy, and demonstrates that none of them present an obstacle to this updated, evolutionary version of Humean ethical naturalism.

  2. Bridging naturalistic and laboratory assessment of memory: the Baycrest mask fit test.

    Science.gov (United States)

    Armson, Michael J; Abdi, Hervé; Levine, Brian

    2017-09-01

    Autobiographical memory tests provide a naturalistic counterpoint to the artificiality of laboratory research methods, yet autobiographical events are uncontrolled and, in most cases, unverifiable. In this study, we capitalised on a scripted, complex naturalistic event - the mask fit test (MFT), a standardised procedure required of hospital employees - to bridge the gap between naturalistic and laboratory memory assessment. We created a test of recognition memory for the MFT and administered it to 135 hospital employees who had undertaken the MFT at various points over the past five years. Multivariate analysis revealed two dimensions defined by accuracy and response bias. Accuracy scores showed the expected relationship to encoding-test delay, supporting the validity of this measure. Relative to younger adults, older adults' memory for this naturalistic event was better than would be predicted from the cognitive ageing literature, a result consistent with the notion that older adults' memory performance is enhanced when stimuli are naturalistic and personally relevant. These results demonstrate that testing recognition memory for a scripted event is a viable method of studying autobiographical memory.

  3. No Medication for My Child! A Naturalistic Study on the Treatment Preferences for and Effects of Cogmed Working Memory Training Versus Psychostimulant Medication in Clinically Referred Youth with ADHD.

    Science.gov (United States)

    Muris, Peter; Roodenrijs, Dorien; Kelgtermans, Lut; Sliwinski, Sonja; Berlage, Ulrike; Baillieux, Hanna; Deckers, Anne; Gunther, Marieke; Paanakker, Bertien; Holterman, Ida

    2018-05-16

    In this naturalistic clinical study, we explored the applicability and clinical effectiveness of Cogmed WMT, pharmacotherapy, and their combination for clinically referred children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Ninety youth with ADHD (ages 6-16 years) and their parents were offered the possibility to choose one of the three interventions. The motives for choosing various interventions were quite different. Medication was chosen because this treatment was expected to be most effective, but also because the Cogmed WMT program was regarded as too taxing. The choice for Cogmed WMT was mainly negatively motivated: participants tended to be strongly against the use of medication, found it a too rigorous step, or feared side effects and addiction problems. The choice for the combination treatment was strongly positively motivated: parents and youth indicated that they wanted to receive the best possible intervention and part of them also had high expectations of Cogmed WMT. In terms of clinical effectiveness, pharmacotherapy with stimulant medication and the combination treatment produced larger reductions in ADHD symptomatology than Cogmed WMT. Further, results indicated that Cogmed WMT selectively enhanced working memory performance. Finally, after conducting Cogmed WMT, youths and parents were more 'open' to accept pharmacotherapy as intervention, probably because the training increased greater insight in and awareness of the problematic features of ADHD.

  4. Adherence to Canadian C-Spine Rule in a regional hospital: a retrospective study of 406 cases.

    Science.gov (United States)

    Paxton, Mark; Heal, Clare F; Drobetz, Herwig

    2012-10-01

    Cervical spine radiography may be over-utilised in an emergency department setting. The Canadian C-Spine Rule has been developed to reduce unnecessary radiography. Our aim was to retrospectively determine the proportion of cervical spine radiographs requested through the emergency department for trauma patients that were clinically indicated, according to the Canadian C-Spine Rule. This was a cross-sectional survey conducted at a regional centre in Northern Queensland, Australia. All cervical spine radiographs for trauma, performed at the Mackay Base Hospital from 1 January 2009 to the 31 December 2009, were reviewed. The relevant patient charts were audited for evidence of indications for radiography. Of 406 patients in the study, 155 patients (38%) (95% confidence interval 33.3%, 42.7%) had cervical spine imaging performed that was not indicated according to the Canadian C-Spine Rule. None of these patients had a significant cervical spine injury on radiography. Applying the Canadian C-Spine Rule would have safely reduced the incidence of cervical spine radiography by 38%. This would also reduce costs, patient morbidity and radiation exposure. © 2012 The Authors. Journal of Medical Imaging and Radiation Oncology © 2012 The Royal Australian and New Zealand College of Radiologists.

  5. A study of supply-chain capabilities in the Canadian wind power industry

    International Nuclear Information System (INIS)

    Wittholz, H.; Pan, D.

    2004-11-01

    In recent years, Canadian wind energy has developed to a total installed capacity of 439 MW. It is possible that by 2012, the cumulative installed wind power capacity may reach 5,600 MW, representing an investment of $8.4 billion. This analysis of the supply-chain structure in the life cycle of a wind farm identified many potential areas where Canadian companies can offer services. Opportunities for both manufacturers and service providers were presented. It was emphasized that although wind energy is a growth industry, Canada has not participated in the development and commercialization of large wind turbine technology. The technical barriers facing Canadian suppliers regarding wind turbine generator (WTG) assembly and component manufacturing were presented. Currently, Canada imports all large WTGs and components. In order to maximize benefits to the Canadian economy, it was recommended that Canadian companies acquire European technology through licences, joint ventures or foreign investment. Technology transfer funding, training and technical assistance funding, tax incentives for capital equipment and support to universities and colleges were also recommended. It was suggested that Canadian companies should focus on manufacturing rotor blades, towers, base frames, nacelle covers and spinners, flexible drive shafts, disk brakes, vibration mounts, inverters, control cabinets, and generators. tabs., figs

  6. Power in methods: language to infants in structured and naturalistic contexts.

    Science.gov (United States)

    Tamis-LeMonda, Catherine S; Kuchirko, Yana; Luo, Rufan; Escobar, Kelly; Bornstein, Marc H

    2017-11-01

    Methods can powerfully affect conclusions about infant experiences and learning. Data from naturalistic observations may paint a very different picture of learning and development from those based on structured tasks, as illustrated in studies of infant walking, object permanence, intention understanding, and so forth. Using language as a model system, we compared the speech of 40 mothers to their 13-month-old infants during structured play and naturalistic home routines. The contrasting methods yielded unique portrayals of infant language experiences, while simultaneously underscoring cross-situational correspondence at an individual level. Infants experienced substantially more total words and different words per minute during structured play than they did during naturalistic routines. Language input during structured play was consistently dense from minute to minute, whereas language during naturalistic routines showed striking fluctuations interspersed with silence. Despite these differences, infants' language experiences during structured play mirrored the peak language interactions infants experienced during naturalistic routines, and correlations between language inputs in the two conditions were strong. The implications of developmental methods for documenting the nature of experiences and individual differences are discussed. © 2017 John Wiley & Sons Ltd.

  7. Recording and automated analysis of naturalistic bioptic driving.

    Science.gov (United States)

    Luo, Gang; Peli, Eli

    2011-05-01

    People with moderate central vision loss are legally permitted to drive with a bioptic telescope in 39 US states and the Netherlands, but the safety of bioptic driving remains highly controversial. There is no scientific evidence about bioptic use and its impact on safety. We propose searching for evidence by recording naturalistic driving activities in patients' cars. In a pilot study we used an analogue video system to record two bioptic drivers' daily driving activities for 10 and 5 days, respectively. In this technical report, we also describe our novel digital system that collects vehicle manoeuvre information and enables recording over more extended periods, and discuss our approach to analyzing the vast amount of data. Our observations of telescope use by the pilot subjects were quite different from their reports in a previous survey. One subject used the telescope only seven times in nearly 6 h of driving. For the other subject, the average interval between telescope use was about 2 min, and Mobile (cell) phone use in one trip extended the interval to almost 5 min. We demonstrate that computerized analysis of lengthy recordings based on video, GPS, acceleration, and black box data can be used to select informative segments for efficient off-line review of naturalistic driving behaviours. The inconsistency between self reports and objective data as well as infrequent telescope use underscores the importance of recording bioptic driving behaviours in naturalistic conditions over extended periods. We argue that the new recording system is important for understanding bioptic use behaviours and bioptic driving safety. © 2011 The College of Optometrists.

  8. The potential benefits of naturalistic driving for road safety research : theoretical and empirical considerations and challenges for the future.

    NARCIS (Netherlands)

    Schagen, I.N.L.G. van & Sagberg, F.

    2012-01-01

    Naturalistic driving (ND) is a research method that provides insight in everyday driver behaviour. Typically, in an ND study vehicles are equipped with several small cameras and sensors, which continuously and inconspicuously register vehicle manoeuvres, driver behaviour, and external conditions.

  9. Naturalistic Extremes in Al Aswaany’s The Yacoubian Building

    Directory of Open Access Journals (Sweden)

    Hussein H. Zeidanin

    2016-01-01

    Full Text Available Emile Zola and other naturalistic novelists such as Stephen Crane, Jack London, Edith Wharton, Frank Norris, John Steinbeck and Richard Wright perceive naturalism as an anti-romantic philosophy dispensing with emotions, sentiments and imagination and parodying the romantic paradigm for idealizing the past and avoiding realities. They view literature as experimental and investigational as science and the novelist as scientist who objectively and methodologically observes and tests the actions and reactions of representative fictional characters under controlled conditions.  On the contrary, the writings of the opponents of naturalism like those of A. Plantinga (2010, H. Putnam (2000, J. Kim (2008, J. Spencer (2010, R. Bush (2003, and R. Gerhardt (2010 criticize naturalistic literature for focusing on the negative side instead of the bright side of life, attaching violence and threatening behaviors to the low class people, and representing a pessimistic view of life and human progress. Our paper seeks to recapitulate the epistemological premises of naturalism and the views of its proponents and opponents who debate over the materialism, atheism and sensationism of naturalism. The paper further analyzes the predominant correlation between environment and man, fate and man and biology and man from the perspective of naturalists. The study finds out that the actions and reactions of the fictional characters of Busayna el Sayed and Zaki el Dessouki in Al Aswany’s The Yacoubian Building (2003 are not self-determined; rather, they are predetermined by the triad of environment, fate and biology. In addition, the study observes that the absence of hope pervading the characters’ lives gives rise to their pessimistic worldviews and stoic behaviors. The study’s analysis and findings are based on Al Aswany’s text because it, on one hand, epitomizes the naturalistic poetics of classism, fatalism and predeterminism in the Egyptian society. On the other

  10. Investigating gaze of children with ASD in naturalistic settings.

    Directory of Open Access Journals (Sweden)

    Basilio Noris

    Full Text Available BACKGROUND: Visual behavior is known to be atypical in Autism Spectrum Disorders (ASD. Monitor-based eye-tracking studies have measured several of these atypicalities in individuals with Autism. While atypical behaviors are known to be accentuated during natural interactions, few studies have been made on gaze behavior in natural interactions. In this study we focused on i whether the findings done in laboratory settings are also visible in a naturalistic interaction; ii whether new atypical elements appear when studying visual behavior across the whole field of view. METHODOLOGY/PRINCIPAL FINDINGS: Ten children with ASD and ten typically developing children participated in a dyadic interaction with an experimenter administering items from the Early Social Communication Scale (ESCS. The children wore a novel head-mounted eye-tracker, measuring gaze direction and presence of faces across the child's field of view. The analysis of gaze episodes to faces revealed that children with ASD looked significantly less and for shorter lapses of time at the experimenter. The analysis of gaze patterns across the child's field of view revealed that children with ASD looked downwards and made more extensive use of their lateral field of view when exploring the environment. CONCLUSIONS/SIGNIFICANCE: The data gathered in naturalistic settings confirm findings previously obtained only in monitor-based studies. Moreover, the study allowed to observe a generalized strategy of lateral gaze in children with ASD when they were looking at the objects in their environment.

  11. Comparison of Climate Preferences for Domestic and International Beach Holidays: A Case Study of Canadian Travelers

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    Michelle Rutty

    2016-02-01

    Full Text Available Coastal tourism is the largest segment of global leisure tourism and it is firmly linked to the destination’s natural resources—with climatic resources chief among them. Through observations and survey responses of beach users, studies have evaluated climatic resources for coastal tourism by quantifying optimal and unacceptable conditions. However, these studies have not taken into consideration that different forms of holidays (e.g., daytrips, short trips, main annual holiday, “once-in-a-lifetime” trip may have varying degrees of resilience to climatic conditions. This is the first study to explore whether ideal and unacceptable climatic conditions vary between domestic and international tourists. Using an in situ survey, Canadian beach users traveling domestically (n = 359 and internationally (n = 120 were examined. Key findings include statistically significant differences (p ≤ 0.05 between the two sample groups for every climate variable, with the international sample more resilient to a broader range of weather conditions, including a greater acceptance for warm temperatures, longer rainfall durations, higher wind speeds, and greater cloud cover. This study adds further insight into the complexities of evaluating climate for tourism, with implications for the demand response of tourists to climate change.

  12. Developing Canadian oncology education goals and objectives for medical students: a national modified Delphi study.

    Science.gov (United States)

    Tam, Vincent C; Ingledew, Paris-Ann; Berry, Scott; Verma, Sunil; Giuliani, Meredith E

    2016-01-01

    Studies have shown that there is a deficiency in focused oncology teaching during medical school in Canada. This study aimed to develop oncology education goals and objectives for medical students through consensus of oncology educators from across Canada. In 2014 we created a comprehensive list of oncology education objectives using existing resources. Experts in oncology education and undergraduate medical education from all 17 Canadian medical schools were invited to participate in a 3-round modified Delphi process. In round 1, the participants scored the objectives on a 9-point Likert scale according to the degree to which they agreed an objective should be taught to medical students. Objectives with a mean score of 7.0 or greater were retained, those with a mean score of 1.0-3.9 were excluded, and those with a mean score of 4.0-6.9 were discussed at a round 2 Web meeting. In round 3, the participants voted on inclusion and exclusion of the round 2 objectives. Thirty-four (92%) of the 37 invited oncology educators, representing 14 medical schools, participated in the study. They included oncologists, family physicians, members of undergraduate medical education curriculum committees and a psychologist. Of the 214 objectives reviewed in round 1, 146 received a mean score of 7.0 or greater, and 68 were scored 4.0-6.9; no objective received a mean score below 4.0. Nine new objectives were suggested. The main themes of participants' comments were to minimize the number of objectives and to aim objectives at the knowledge level required for family physicians. In round 2, the participants were able to combine 28 of the objectives with other existing objectives. In round 3, 7 of the 49 objectives received consensus of at least 75% for inclusion. The final Canadian Oncology Goals and Objectives for Medical Students contained 10 goals and 153 objectives. Through a systematic process, we created a comprehensive, consensus-based set of oncology goals and objectives to

  13. Older driver fitness-to-drive evaluation using naturalistic driving data.

    Science.gov (United States)

    Guo, Feng; Fang, Youjia; Antin, Jonathan F

    2015-09-01

    As our driving population continues to age, it is becoming increasingly important to find a small set of easily administered fitness metrics that can meaningfully and reliably identify at-risk seniors requiring more in-depth evaluation of their driving skills and weaknesses. Sixty driver assessment metrics related to fitness-to-drive were examined for 20 seniors who were followed for a year using the naturalistic driving paradigm. Principal component analysis and negative binomial regression modeling approaches were used to develop parsimonious models relating the most highly predictive of the driver assessment metrics to the safety-related outcomes observed in the naturalistic driving data. This study provides important confirmation using naturalistic driving methods of the relationship between contrast sensitivity and crash-related events. The results of this study provide crucial information on the continuing journey to identify metrics and protocols that could be applied to determine seniors' fitness to drive. Published by Elsevier Ltd.

  14. The Canadian approach to microbial studies in nuclear waste management and disposal

    International Nuclear Information System (INIS)

    Stroes-Gascoyne, S.; Sargent, F.P.

    1998-01-01

    Many countries considering radioactive waste disposal have, or are considering programs to study and quantify microbial effects in terms of their particular disposal concept. Although there is an abundance of qualitative information, there is a need for quantitative data. Quantitative research should cover topics such as the kinetics of microbial activity in geological media, microbial effects on radionuclide migration in host rock (including effects of biofilms), tolerance to extreme conditions of radiation, heat and desiccation, microbially-influenced corrosion of waste containers and microbial gas production. The research should be performed in relevant disposal environments with the ultimate objective to quantify those effects that need to be included in models for predictive and safety assessment purposes. The Canadian approach to dealing with microbial effects involves a combination of pertinent, quantitative measurements from carefully designed laboratory studies and from large scale engineering experiments in AECL's Underground Research Laboratory (URL). The validity of these quantitative data is measured against observations from natural environments and analogues. An example is the viability of microbes in clay-based scaling materials. Laboratory studies have shown that the clay content of these barriers strongly affects microbial activity and movement. This is supported by natural environment and analogue observations that show clay deposits to contain very old tree segments and dense clay lenses in sediments to contain much smaller, less diverse and less active microbial populations than more porous sediments. This approach has allowed for focused, quantitative research on microbial effects in Canada. (author)

  15. Job satisfaction, workplace stress, unhealthy lifestyle choices, and productivity among Canadian nurses: an empirical study

    Directory of Open Access Journals (Sweden)

    Karen J. Buhr

    2012-12-01

    Full Text Available BACKGROUND: Nurses’ occupational stress and job satisfaction can have an affect on lifestyle choices and productivity. OBJECTIVES: The objective of this study is to provide a detailed examination of the relationship between job satisfaction, job stress, unhealthy lifestyle choices, and productivity among Canadian nurses. METHODS: This study uses data from the confidential master data files of the 2005 National Survey of the Work and Health of Nurses (NSWHN. Ordinary least squares regressions and binary probit regression models were used to estimate the relationships between job satisfaction and job stress on productivity and unhealthy lifestyle choices. RESULTS: Workplace stress variables have a small effect on lifestyle choices. Job satisfaction has an effect on the probability of smoking, but not on drinking. Workplace stress and job satisfaction do not have statistically significant effects on productivity. DISCUSSION: The study found weak relationships among the work related stress variables and productivity. These findings can allow policy makers to consider efforts to reduce workplace stress which can be beneficial to productivity.

  16. Determinants of internal medicine residents' choice in the canadian R4 Fellowship Match: A qualitative study

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    Kassam Narmin

    2011-06-01

    Full Text Available Abstract Background There is currently a discrepancy between Internal Medicine residents' decisions in the Canadian subspecialty fellowship match (known as the R4 match and societal need. Some studies have been published examining factors that influence career choices. However, these were either demographic factors or factors pre-determined by the authors' opinion as possibly being important to incorporate into a survey. Methods A qualitative study was undertaken to identify factors that determine the residents choice in the subspecialty (R4 fellowship match using focus group discussions involving third and fourth year internal medicine residents Results Based on content analysis of the discussion data, we identified five themes: 1 Practice environment including acuity of practice, ability to do procedures, lifestyle, job prospects and income 2 Exposure in rotations and to role models 3 Interest in subspecialty's patient population and common diseases 4 Prestige and respect of subspecialty 5 Fellowship training environment including fellowship program resources and length of training Conclusions There are a variety of factors that contribute to Internal Medicine residents' fellowship choice in Canada, many of which have been identified in previous survey studies. However, we found additional factors such as the resources available in a fellowship program, the prestige and respect of a subspecialty/career, and the recent trend towards a two-year General Internal Medicine fellowship in our country.

  17. A study of Iranian immigrants’ experiences of accessing Canadian health care services: a grounded theory

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    Dastjerdi Mahdieh

    2012-09-01

    Full Text Available Abstract Background Immigration is not a new phenomenon but, rather, has deep roots in human history. Documents from every era detail individuals who left their homelands and struggled to reestablish their lives in other countries. The aim of this study was to explore and understand the experience of Iranian immigrants who accessed Canadian health care services. Research with immigrants is useful for learning about strategies that newcomers develop to access health care services. Methods The research question guiding this study was, “What are the processes by which Iranian immigrants learn to access health care services in Canada?” To answer the question, a constructivist grounded theory approach was applied. Initially, unstructured interviews were conducted with 17 participants (11 women and six men who were adults (at least 18 years old and had immigrated to Canada within the past 15 years. Eight participants took part in a second interview, and four participants took part in a third interview. Results Using a constructivist grounded theory approach, “tackling the stumbling blocks of access” emerged as the core category. The basic social process (BSP, becoming self-sufficient, was a transitional process and had five stages: becoming a stranger; feeling helpless; navigating/seeking information; employing strategies; and becoming integrated and self-sufficient. We found that “tackling the stumbling blocks of access” was the main struggle throughout this journey. Some of the immigrants were able to overcome these challenges and became proficient in accessing health care services, but others were unable to make the necessary changes and thus stayed in earlier stages/phases of transition, and sometimes returned to their country of origin. Conclusion During the course of this journey a substantive grounded theory was developed that revealed the challenges and issues confronted by this particular group of immigrants. This process explains

  18. Epidemiology of electrical and lightning-related injuries among Canadian children and youth, 1997-2010: A Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) study.

    Science.gov (United States)

    Böhrer, Madeleine; Stewart, Samuel A; Hurley, Katrina F

    2017-06-27

    Introduction Although death due to electrical injury and lightning are rare in children, these injuries are often preventable. Twenty years ago, most injuries occurred at home, precipitated by oral contact with electrical cords, contact with wall sockets and faulty electrical equipment. We sought to assess the epidemiology of electrical injuries in children presenting to Emergency Departments (EDs) that participate in the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP). This study is a retrospective review of electrical and lightning injury data from CHIRPP. The study population included children and youth aged 0-19 presenting to participating CHIRPP EDs from 1997-2010. Age, sex, year, setting, circumstance and disposition were extracted. Variables were tested using Fisher's exact test and simple linear regression. The dataset included 1183 electrical injuries, with 84 (7%) resulting in hospitalization. Most events occurred at home in the 2-5 year age group and affected the hands. Since 1997 there has been a gradual decrease in the number of electrical injuries per year (plightning were rare (n=19). No deaths were recorded in the database. Despite the decrease in the number of electrical injuries per year, a large portion of injuries still appear to be preventable. Further research should focus on effective injury prevention strategies.

  19. Diagnostic budget study of the internal variability in ensemble simulations of the Canadian RCM

    Energy Technology Data Exchange (ETDEWEB)

    Nikiema, Oumarou; Laprise, Rene [UQAM, Canadian Network for Regional Climate Modelling and Diagnostics, Centre ESCER, Departement des Sciences de la Terre et de l' Atmosphere, B.P. 8888, Montreal, QC (Canada)

    2011-06-15

    Due to the chaotic and nonlinear nature of the atmospheric dynamics, it is known that small differences in the initial conditions (IC) of models can grow and affect the simulation evolution. In this study, we perform a quantitative diagnostic budget calculation of the various diabatic and dynamical contributions to the time evolution and spatial distribution of internal variability (IV) in simulations with the nested Canadian Regional Climate Model. We establish prognostic budget equations of the IV for the potential temperature and the relative vorticity fields. For both of these variables, the IV equations present similar terms, notably terms relating to the transport of IV by ensemble-mean flow and to the covariance of fluctuations acting on the gradient of the ensemble-mean state. We show the skill of these equations to diagnose the IV that took place in an ensemble of 20 3-month (summer season) simulations that differed only in their IC. Our study suggests that the dominant terms responsible for the large increase of IV are either the covariance term involving the potential temperature fluctuations and diabatic heating fluctuations, or the covariance of inter-member fluctuations acting upon ensemble-mean gradients. Our results also show that, on average, the third-order terms are negligible, but they can become important when the IV is large. (orig.)

  20. A Qualitative Study on Unassisted Smoking Cessation Among Chinese Canadian Immigrants.

    Science.gov (United States)

    Mao, Aimei; Bottorff, Joan L

    2017-11-01

    It is well-known that majority of smokers worldwide quit smoking without any assistance. This is even more evident among Chinese smokers. The aim of this qualitative study was to explore how Chinese Canadian immigrant men who smoked cigarettes perceived smoking cessation aids and services and how they used any form of the smoking cessation assistance to help them quit smoking. The study was conducted in British Columbia, Canada. Twenty-two Chinese immigrants were recruited by internet advertisement and through connections with local Chinese communities. Ten of the 22 participants were current smokers and the other 12 had quit smoking in the past 5 years. Data were collected using semistructured interviews. Although all participants, including both the ex-smokers and current smokers, had made more than one quit attempt, they rarely used cessation aids or services even after they had immigrated to Canada. The barriers to seeking the cessation assistance were grouped into two categories: practical barriers and cultural barriers. The practical barriers included "Lack of available information on smoking cessation assistance" and "Difficulty in accessing smoking cessation assistance," while cultural barriers included "Denial of physiological addiction to nicotine," "Mistrust in the effectiveness of smoking cessation assistance," "Tendency of self-reliance in solving problems," and "Concern of privacy revelation related to utilization of smoking cessation assistance." The findings revealed Chinese immigrants' unwillingness to use smoking cessation assistance as the result of vulnerability as immigrants and culturally cultivated masculinities of self-control and self-reliance.

  1. Servant leadership: a case study of a Canadian health care innovator

    Directory of Open Access Journals (Sweden)

    Vanderpyl TH

    2012-02-01

    Full Text Available Tim H VanderpylSchool of Global Leadership, Regent University, Virginia Beach, VA, USAAbstract: Both servant leadership and innovation are easier to theorize than to actually implement in practice. This article presents a case study of a Canadian health care executive who led a remarkable turnaround of St Michael's Health Centre, a floundering and almost bankrupt nursing home. In less than 7 years, Kevin Cowan turned around the finances and changed numerous broken relationships into strategic alliances. Under his leadership, St Michael's Health Centre went from being one of the most underperforming health care organizations in Canada, to one of the most innovative. This article describes some of Cowan's strategies and argues that a servant leadership approach has a direct impact on an organization's ability to innovate. As far as the author is aware, this is the first published article on this specific change effort, which presents a unique perspective on the topics of servant leadership and innovation.Keywords: servant leadership, innovation, Canada, health care, case study

  2. HIV Testing and Care in Canadian Aboriginal Youth: A community based mixed methods study

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    Myers Ted

    2008-10-01

    Full Text Available Abstract Background HIV infection is a serious concern in the Canadian Aboriginal population, particularly among youth; however, there is limited attention to this issue in research literature. The purpose of this national study was to explore HIV testing and care decisions of Canadian Aboriginal youth. Methods A community-based mixed-method design incorporating the Aboriginal research principles of Ownership, Control, Access and Possession (OCAP was used. Data were collected through surveys (n = 413 and qualitative interviews (n = 28. Eleven community-based organizations including urban Aboriginal AIDS service organizations and health and friendship centres in seven provinces and one territory assisted with the recruitment of youth (15 to 30 years. Results Average age of survey participants was 21.5 years (median = 21.0 years and qualitative interview participants was 24.4 years (median = 24.0. Fifty-one percent of the survey respondents (210 of 413 youth and 25 of 28 interview participants had been tested for HIV. The most common reason to seek testing was having sex without a condom (43.6% or pregnancy (35.4% while common reasons for not testing were the perception of being low HIV risk (45.3% or not having had sex with an infected person (34.5%. Among interviewees, a contributing reason for not testing was feeling invulnerable. Most surveyed youth tested in the community in which they lived (86.5% and 34.1% visited a physician for the test. The majority of surveyed youth (60.0% had tested once or twice in the previous 2 years, however, about one-quarter had tested more than twice. Among the 26 surveyed youth who reported that they were HIV-positive, 6 (23.1% had AIDS at the time of diagnosis. Delays in care-seeking after diagnosis varied from a few months to seven years from time of test. Conclusion It is encouraging that many youth who had tested for HIV did so based on a realistic self-assessment of HIV risk behaviours; however, for others

  3. Naturalistic rapid deceleration data: Drivers aged 75 years and older

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    Anna Chevalier

    2016-12-01

    Full Text Available The data presented in this article are related to the research manuscript “Predictors of older drivers’ involvement in rapid deceleration events”, which investigates potential predictors of older drivers’ involvement in rapid deceleration events including measures of vision, cognitive function and driving confidence (A. Chevalier et al., 2016 [1]. In naturalistic driving studies such as this, when sample size is not large enough to allow crashes to be used to investigate driver safety, rapid deceleration events may be used as a surrogate safety measure. Naturalistic driving data were collected for up to 52 weeks from 182 volunteer drivers aged 75–94 years (median 80 years, 52% male living in the suburban outskirts of Sydney. Driving data were collected using an in-vehicle monitoring device. Accelerometer data were recorded 32 times per second and Global Positioning System (GPS data each second. To measure rapid deceleration behavior, rapid deceleration events (RDEs were defined as having at least one data point at or above the deceleration threshold of 750 milli-g (7.35 m/s2. All events were constrained to a maximum 5 s duration. The dataset provided with this article contains 473 events, with a row per RDE. This article also contains information about data processing, treatment and quality control. The methods and data presented here may assist with planning and analysis of future studies into rapid deceleration behaviour using in-vehicle monitoring.

  4. Using Mobile Technology to Enhance Undergraduate Student Digital Information Literacy Skills: A Canadian Case Study

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    Alice Schmidt Hanbidge

    2015-08-01

    Full Text Available Learning essential information literacy skills through the use of mobile phones is an innovative mlearning pilot project that was collaboratively undertaken in a Canadian university college over the course of two academic terms by faculty and the library staff. The research pilot project involved ninety one undergraduate students in five different classes majoring in psychology, social work, education or social development studies in an attempt to determine the effectiveness of using mobile technology to enhance students’ information literacy skills and learning experiences. Pre and post-test measures, and survey questionnaires generated quantitative and qualitative data that was analyzed to determine the degree of changes in frequency of mobile device information literacy access and fluency in digital literacy skills. The article highlights the Mobile Information Literacy innovation and includes the development and design of the mobile lessons, interactive exercises, and its applications. The study’s main results and conclusions are also discussed. Additionally, the successes and challenges of the pilot to support anytime, anywhere student mobile information literacy eLearning training that engages mobile learners and enhances their learning experience are identified and critically reflected upon to improve the innovation for stage two of the project.

  5. Studying illicit drug trafficking on Darknet markets: Structure and organisation from a Canadian perspective.

    Science.gov (United States)

    Broséus, J; Rhumorbarbe, D; Mireault, C; Ouellette, V; Crispino, F; Décary-Hétu, D

    2016-07-01

    Cryptomarkets are online marketplaces that are part of the Dark Web and mainly devoted to the sale of illicit drugs. They combine tools to ensure anonymity of participants with the delivery of products by mail to enable the development of illicit drug trafficking. Using data collected on eight cryptomarkets, this study provides an overview of the Canadian illicit drug market. It seeks to inform about the most prevalent illicit drugs vendors offer for sale and preferred destination countries. Moreover, the research gives an insight into the structure and organisation of distribution networks existing online. In particular, we provide information about how vendors are diversifying and replicating across marketplaces. We inform on the number of listings each vendor manages, the number of cryptomarkets they are active on and the products they offer. This research demonstrates the importance of online marketplaces in the context of illicit drug trafficking. It shows how the analysis of data available online may elicit knowledge on criminal activities. Such knowledge is mandatory to design efficient policy for monitoring or repressive purposes against anonymous marketplaces. Nevertheless, trafficking on Dark Net markets is difficult to analyse based only on digital data. A more holistic approach for investigating this crime problem should be developed. This should rely on a combined use and interpretation of digital and physical data within a single collaborative intelligence model. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Cost study on waste management at three model Canadian uranium mines

    International Nuclear Information System (INIS)

    1984-03-01

    A waste management cost study was initiated to determine the capital and operating costs of three different uranium waste management systems which incorporate current technologies being used in Canadian uranium mining operations. Cost estimates were to be done to a thirty percent level of accuracy and were to include all waste management related costs of a uranium ore processing facility. Each model is based on an annual uranium production of 1,923,000 kg U (5,000,000 lbs U 3 O 8 ) with a total operating life of 20 years for the facility. The three models, A, B, and C, are based on three different uranium ore grades, 0.10 percent U 3 O 8 , 0.475 percent U 3 O 8 and 1.5 percent U 3 O 8 respectively. Yellowcake production is assumed to start in January 1984. Model A is based on a conceptual 7,180 tonne per day uranium ore processing facility and waste management system typical of uranium operations in the Elliot Lake area of northern Ontario with an established infrastructure. Model B is a 1.512 tonne per day operation based on a remote uranium operation typical of the Athabasca Basin properties in northern Saskatchewan. Model C is a 466 tonne per day operation processing a high-grade uranium ore containing arsenic and heavy metal concentrations typical of some northern Saskatchewan deposits

  7. Canadian Alliance for Healthy Hearts and Minds: First Nations Cohort Study Rationale and Design.

    Science.gov (United States)

    Anand, Sonia S; Abonyi, Sylvia; Arbour, Laura; Brook, Jeff; Bruce, Sharon; Castleden, Heather; Desai, Dipika; de Souza, Russell J; Harris, Stewart; Irvine, James; Lai, Christopher; Lewis, Diana; Oster, Richard T; Poirier, Paul; Toth, Ellen L; Bannon, Karen; Chrisjohn, Vicky; Davis, Albertha D; L'Hommecourt, Jean; Littlechild, Randy; McMullin, Kathleen; McIntosh, Sarah; Morrison, Julie; Picard, Manon; Landing First Nation, Pictou; M Thomas, Melissa; Tusevljak, Natasa; Friedrich, Matthias G; Tu, Jack V

    2018-01-01

    This is the first national indigenous cohort study in which a common, in-depth protocol with a common set of objectives has been adopted by several indigenous communities across Canada. The overarching objective of the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort is to investigate how the community-level environment is associated with individual health behaviors and the presence and progression of chronic disease risk factors and chronic diseases such as cardiovascular disease (CVD) and cancer. CAHHM aims to recruit approximately 2,000 First Nations indigenous individuals from up to nine communities across Canada and have participants complete questionnaires, blood collection, physical measurements, cognitive assessments, and magnetic resonance imaging (MRI). Through individual- and community-level data collection, we will develop an understanding of the specific role of the socioenvironmental, biological, and contextual factors have on the development of chronic disease risk factors and chronic diseases. Information collected in the indigenous cohort will be used to assist communities to develop local management strategies for chronic disease, and can be used collectively to understand the contextual, environmental, socioeconomic, and biological determinants of differences in health status in harmony with First Nations beliefs and reality.

  8. Comparison of the antidepressant effects of venlafaxine and dosulepin in a naturalistic setting

    DEFF Research Database (Denmark)

    Bukh, Jens Drachmann; Jørgensen, Martin Balslev; Dam, Henrik

    2009-01-01

    practice. This study sought to evaluate in a naturalistic setting the treatment outcomes of dosulepin and venlafaxine for patients with depressive episodes. At the university hospital in Copenhagen, Denmark, between 1998 and early 2001, the first-line treatment for psychiatric inpatients with depression...... was dosulepin; after that time, venlafaxine was the first-line medication. We compared the treatment outcomes among inpatients during the respective periods. There was no significant difference in the primary outcome parameters between the two groups. A tendency in favour of dosulepin confirmed by a post...... because of an underpowered design) after replacing dosulepin with venlafaxine as first-line drug for depression in a naturalistic inpatient setting....

  9. The effects of outdoor air pollution on the respiratory health of Canadian children: A systematic review of epidemiological studies.

    Science.gov (United States)

    Rodriguez-Villamizar, Laura Andrea; Magico, Adam; Osornio-Vargas, Alvaro; Rowe, Brian H

    2015-01-01

    Outdoor air pollution is a global problem with serious effects on human health, and children are considered to be highly susceptible to the effects of air pollution. To conduct a comprehensive and updated systematic review of the literature reporting the effects of outdoor air pollution on the respiratory health of children in Canada. Searches of four electronic databases between January 2004 and November 2014 were conducted to identify epidemiological studies evaluating the effect of exposure to outdoor air pollutants on respiratory symptoms, lung function measurements and the use of health services due to respiratory conditions in Canadian children. The selection process and quality assessment, using the Newcastle-Ottawa Scale, were conducted independently by two reviewers. Twenty-seven studies that were heterogeneous with regard to study design, population, respiratory outcome and air pollution exposure were identified. Overall, the included studies reported adverse effects of outdoor air pollution at concentrations that were below Canadian and United States standards. Heterogeneous effects of air pollutants were reported according to city, sex, socioeconomic status and seasonality. The present review also describes trends in research related to the effect of air pollution on Canadian children over the past 25 years. The present study reconfirms the adverse effects of outdoor air pollution on the respiratory health of children in Canada. It will help researchers, clinicians and environmental health authorities identify the available evidence of the adverse effect of outdoor air pollution, research gaps and the limitations for further research.

  10. Dominant Cultural Narratives, Racism, and Resistance in the Workplace: A Study of the Experiences of Young Black Canadians.

    Science.gov (United States)

    Hasford, Julian

    2016-03-01

    Although many studies have examined lived experiences of racism and resistance in various contexts, relatively little research has examined such experiences among Black youth within the workplace-particularly in the Canadian context. In this study I use qualitative analyses of narrative interviews with 24 Black Canadian youth and young adults (aged 16-35) to examine the impact of dominant cultural narratives on lived experiences of workplace racism and resistance. Findings are presented using theatrical games as a central conceptual metaphor, suggesting that: (a) dominant cultural narratives have a major impact on relational dynamics of oppression in the workplace; (b) identity performance is a critical strategy for negotiating dominant cultural narratives in the workplace; and (c) panopticism (the internalized gaze) is a significant aspect of internalized oppression. Implications for future research and action are discussed. © Society for Community Research and Action 2016.

  11. Intuitions in Epistemology: Towards a Naturalistic Alternative

    Directory of Open Access Journals (Sweden)

    Kristoffer Ahlstrom

    2009-12-01

    Full Text Available The present paper revisits the main methodological problems with conceptual analysis and considers two attempts to rectify them in terms of prototypes and reflective equilibria, respectively. Finding both wanting for the purposes of epistemological analysis, a naturalistic alternative is then sketched that explores the positive implications of aforementioned problems for the demarcation of the respective roles of intuitions and empirical investigation within three epistemological domains, viz., the evaluation of epistemological hypotheses, the amelioration of epistemic practices, and the construction of a theory of epistemic value.

  12. Philosophy of biology: naturalistic or transcendental?

    Science.gov (United States)

    Kolen, Filip; Van de Vijver, Gertrudis

    2007-01-01

    The aim of this article is to clarify the meaning of a naturalistic position within philosophy of biology, against the background of an alternative view, founded on the basic insights of transcendental philosophy. It is argued that the apparently minimal and neutral constraints naturalism imposes on philosophy of science turn out to involve a quite heavily constraining metaphysics, due to the naturalism's fundamental neglect of its own perspective. Because of its intrinsic sensitivity to perspectivity and historicity, transcendental philosophy can avoid this type of hidden metaphysics.

  13. ASSESSMENT OF RADARSAT-2 HR STEREO DATA OVER CANADIAN NORTHERN AND ARCTIC STUDY SITES

    Directory of Open Access Journals (Sweden)

    T. Toutin

    2013-04-01

    Full Text Available Digital surface models (DSMs extracted from high-resolution Radarsat-2 (R2 stereo images using a new hybrid radargrammetric modeling developed at the Canada Centre for Remote Sensing are evaluated over two Canadian northern and arctic study sites. Because the new hybrid model uses the full metadata of R2, it does not require any ground control point. The first study site in the north of Quebec is used for the scientific validation where accurate checked data (dGPS, lidas is available. The second study site in the Arctic (steep relief and glaciated surfaces is challenging for the operational evaluation of topographic mapping capabilities of R2. For the first study site, the bias and elevation linear errors with 68 percent confidence level (LE68 of R2 stero-extracted DSM compared to lidar data were computed over bare surfaces: LE90 of 3.9 m and no bias were achieved. For the second study site the comparison was performed between the R2 DEM and ICESat data. A negative 18-m bias was computed and certainly results suggests a bias in the stereo-model of R2 and thus in the metadata used in the model computation because there is few temporal variation in the data acquisition (R2 and ICESat/ LE68 of 28 m was obtained. However, the differential melting and thinning depending of the glaciers elevations and planimetric surging of glacier tongues with less accumulation of debris and moraines, a lower LE68 of around 20 m could be expected. In addition to evaluate the potential of R2 over ice bodies, which generally have low slope relief and because the errors are strongly correlated with slopes, other statistical results of elevation differences were also computed: LE68 of 15 m was obtained over ice fields with 0–5° slopes while a little more than 20-m over less than 30° slopes was achieved.

  14. Assessing availability of scientific journals, databases, and health library services in Canadian health ministries: a cross-sectional study.

    Science.gov (United States)

    Léon, Grégory; Ouimet, Mathieu; Lavis, John N; Grimshaw, Jeremy; Gagnon, Marie-Pierre

    2013-03-21

    Evidence-informed health policymaking logically depends on timely access to research evidence. To our knowledge, despite the substantial political and societal pressure to enhance the use of the best available research evidence in public health policy and program decision making, there is no study addressing availability of peer-reviewed research in Canadian health ministries. To assess availability of (1) a purposive sample of high-ranking scientific journals, (2) bibliographic databases, and (3) health library services in the fourteen Canadian health ministries. From May to October 2011, we conducted a cross-sectional survey among librarians employed by Canadian health ministries to collect information relative to availability of scientific journals, bibliographic databases, and health library services. Availability of scientific journals in each ministry was determined using a sample of 48 journals selected from the 2009 Journal Citation Reports (Sciences and Social Sciences Editions). Selection criteria were: relevance for health policy based on scope note information about subject categories and journal popularity based on impact factors. We found that the majority of Canadian health ministries did not have subscription access to key journals and relied heavily on interlibrary loans. Overall, based on a sample of high-ranking scientific journals, availability of journals through interlibrary loans, online and print-only subscriptions was estimated at 63%, 28% and 3%, respectively. Health Canada had a 2.3-fold higher number of journal subscriptions than that of the provincial ministries' average. Most of the organisations provided access to numerous discipline-specific and multidisciplinary databases. Many organisations provided access to the library resources described through library partnerships or consortia. No professionally led health library environment was found in four out of fourteen Canadian health ministries (i.e. Manitoba Health, Northwest

  15. Research Awards: Canadian Partnerships Program Deadline: 12 ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Jean-Claude Dumais

    2012-09-12

    Sep 12, 2012 ... IDRC's Canadian Partnerships (CP) Program offers a Research ... For this, they may consider quantitative and qualitative methods, case studies, ... What types of processes do Canadian organizations use to learn about their ...

  16. Prevalence and determinants of visual impairment in Canada: cross-sectional data from the Canadian Longitudinal Study on Aging.

    Science.gov (United States)

    Aljied, Rumaisa; Aubin, Marie-Josée; Buhrmann, Ralf; Sabeti, Saama; Freeman, Ellen E

    2018-06-01

    To determine the prevalence and determinants of visual impairment in Canada. Cross-sectional population-based study. 30,097 people in the Comprehensive Cohort of the Canadian Longitudinal Study on Aging METHODS: Inclusion criteria included being between the ages of 45 and 85 years old, community-dwelling, and living near one of the 11 data collection sites across 7 Canadian provinces. People were excluded if they were in an institution, living on a First Nations reserve, were a full-time member of the Canadian Armed Forces, did not speak French or English, or had cognitive impairment. Visual acuity was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart while participants wore their usual prescription for distance, if any. Visual impairment was defined as presenting binocular acuity worse than 20/40. Of Canadian adults, 5.7% (95% CI 5.4-6.0) had visual impairment. A wide variation in the provincial prevalence of visual impairment was observed ranging from a low of 2.4% (95% CI 2.0-3.0) in Manitoba to a high of 10.9% (95% CI 9.6-12.2) in Newfoundland and Labrador. Factors associated with a higher odds of visual impairment included older age (odds ratio [OR] = 1.07, 95% CI 1.06-1.08), lower income (OR = 2.07 for those earning less than $20 000 per year, 95% CI 1.65-2.59), current smoking (OR = 1.52, 95% CI 1.25-1.85), type 2 diabetes (OR = 1.20, 95% CI 1.03-1.41), and memory problems (OR = 1.44, 95% CI 1.04-2.01). Refractive error was the leading cause of visual impairment. Older age, lower income, province, smoking, diabetes, and memory problems were associated with visual impairment. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  17. Multicenter study of environmental contamination with cyclophosphamide, ifosfamide, and methotrexate in 66 Canadian hospitals: A 2016 follow-up study.

    Science.gov (United States)

    Roland, C; Caron, N; Bussières, J F

    2017-08-01

    Oncology workers are occupationally exposed to antineoplastic drugs. This exposure can induce adverse health effects. To reduce their exposure, contamination on surfaces should be kept as low as possible. The main objective of this study was to monitor environmental contamination with cyclophosphamide, ifosfamide, and methotrexate in oncology pharmacy and patient care areas in Canadian centers. The secondary objective was to describe the impact of some factors that may limit contamination. This is a descriptive study. Twelve standardized sites were sampled in each participating center (six in the pharmacy and six in patient care areas). Samples were analyzed for the presence of cyclophosphamide, ifosfamide, and methotrexate by ultra-performance liquid chromatography-tandem mass spectrometry technology. Descriptive statistical analyses were done and results were compared with a Kolmogorov-Smirnov test for independent samples. In 2016, 66 centers participated in this study (66/202, 32.7%). Overall, 43.4% (326/752) of the samples were positive for cyclophosphamide, 13.2% (99/752) for ifosfamide and 6.9% (52/752) for methotrexate. The 75th percentile value of cyclophosphamide surface concentration was 6.8 pg/cm 2 and lower than the limit of detection for ifosfamide and methotrexate. Centers who prepared more antineoplastic drugs per year (p contamination to cyclophosphamide. Environmental surveillance is one part of a comprehensive approach for minimizing hazardous exposures in healthcare. This study highlights a low level of contamination of three hazardous drugs amongst 66 Canadian centers. Regular environmental monitoring is a good practice to maintain contamination as low as reasonably achievable.

  18. Multicenter study of environmental contamination with cyclophosphamide, ifosfamide, and methotrexate in 48 Canadian hospitals.

    Science.gov (United States)

    Poupeau, Céline; Tanguay, Cynthia; Caron, Nicolas J; Bussières, Jean-François

    2018-01-01

    Context Oncology workers are occupationally exposed to antineoplastic drugs. This exposure can induce adverse health effects. In order to reduce their exposure, contamination on surfaces should be kept as low as possible. Objectives To monitor environmental contamination with cyclophosphamide, ifosfamide, and methotrexate in oncology pharmacy and patient care areas in Canadian hospitals. To describe the impact of some factors that may limit contamination. Methods This is a descriptive study. Twelve standardized sites were sampled in each participating center (six in the pharmacy and six in patient care areas). Samples were analyzed for the presence of cyclophosphamide, ifosfamide, and methotrexate by ultra-performance liquid chromatography tandem mass spectrometry technology. Descriptive statistical analyses were done and results were compared with a Kolmogorov-Smirnov test for independent samples. Results In 2015, 48 hospitals participated in this study (48/202, 24%). Overall, 34% (181/525) of the samples were positive for cyclophosphamide, 8% (41/525) for ifosfamide, and 6% (31/525) for methotrexate. The 75th percentile value of cyclophosphamide surface concentration was 6.9 pg/cm 2 . For ifosfamide and methotrexate, they were lower than the limit of detection. Centers who prepared more antineoplastic drugs per year and centers who used more cyclophosphamide per year showed significantly higher surface contamination ( p contamination. Conclusion In comparison with other multicenter studies that were conducted in Canada, the concentration of antineoplastic drugs measured on surfaces is decreasing. Regular environmental monitoring is a good practice in order to maintain contamination as low as reasonably achievable.

  19. Qualitative Insights from a Canadian Multiinstitutional Research Study: In Search of Meaningful E-learning

    Directory of Open Access Journals (Sweden)

    Lorraine M. Carter

    2014-11-01

    Full Text Available This paper reports the qualitative findings of a mixed methods research study conducted at three Canadian post-secondary institutions. Called the Meaningful E-learning or MEL project, the study was an exploration of the teaching and learning experiences of faculty and students as well as their perceptions of the benefits and challenges of e-learning. Importantly, e-learning was conceptualized as the integration of pedagogy, instructional technology, and the Internet into teaching and learning environments. Based on this definition, participants reflected on e-learning in relation to one or more of the following contexts: face-to-face (f2f classrooms in which instructional technologies (e.g. learning management systems, video and webconferencing, mobile devices, etc. are used; blended or web-enhanced learning environments; and fully online learning environments. Data collected for the study included survey data (n=1377 for students, n=187 for faculty; narrative comments (n=269 for students, n=74 for faculty; and focus groups (n=16 for students, n=33 for faculty. The latter two sets of data comprise the basis of this paper. Four major themes emerged based on the responses of students and faculty. Represented by the acronym HIDI, the themes include human connection (H, IT support (I, design (D, and institutional infrastructure (I. These themes and sub-themes are presented in the paper as well as recommendations for educators and administrators who aspire to make e-learning a pedagogically meaningful experience for both learners and their teachers.

  20. Associations between sensory loss and social networks, participation, support, and loneliness: Analysis of the Canadian Longitudinal Study on Aging.

    Science.gov (United States)

    Mick, Paul; Parfyonov, Maksim; Wittich, Walter; Phillips, Natalie; Kathleen Pichora-Fuller, M

    2018-01-01

    To determine if hearing loss, vision loss, and dual sensory loss were associated with social network diversity, social participation, availability of social support, and loneliness, respectively, in a population-based sample of older Canadians and to determine whether age or sex modified the associations. Cross-sectional population-based study. Canada. The sample included 21 241 participants in the Canadian Longitudinal Study on Aging tracking cohort. The sample was nationally representative of English- and French-speaking, non-institutionalized 45- to 89-year-old Canadians who did not live on First Nations reserves and who had normal cognition. Participants with missing data for any of the variables in the multivariable regression models were excluded from analysis. Hearing and vision loss were determined by self-report. Dual sensory loss was defined as reporting both hearing and vision loss. Univariate analyses were performed to assess cross-sectional associations between hearing, vision, and dual sensory loss, and social, demographic, and medical variables. Multivariable regression models were used to analyze cross-sectional associations between each type of sensory loss and social network diversity, social participation, availability of social support, and loneliness. Vision loss (in men) and dual sensory loss (in 65- to 85-year-olds) were independently associated with reduced social network diversity. Vision loss and dual sensory loss (in 65- to 85-year-olds) were each independently associated with reduced social participation. All forms of sensory loss were associated with both low availability of social support and loneliness. Sensory impairment is associated with reduced social function in older Canadians. Interventions and research that address the social needs of older individuals with sensory loss are needed. Copyright© the College of Family Physicians of Canada.

  1. Prevalence, risk factors and awareness of albuminuria on a Canadian First Nation: A community-based screening study

    Directory of Open Access Journals (Sweden)

    Zacharias James

    2012-04-01

    Full Text Available Abstract Background Both diabetic and non-diabetic end stage renal disease (ESRD are more common among Canadian First Nations people than among the general Canadian population. The purpose of this research was to determine the prevalence of and risk factors for albuminuria in a Canadian First Nation population at high risk for ESRD and dialysis. Methods Data from a community-based screening study of 483 residents of a Plains Ojibway First Nation in Manitoba was used. Participants provided random urine samples. Proteinuria was defined as any dipstick positive for protein (≥1 g/L or those with ACR in the macroalbuminuric range (≥30 mg/mmol on at least one sample. Microalbuminuria was defined as ACR ≥2 mg/mmol for males and ≥2.8 mg/mmol for females. Other measures included fasting glucose, haemoglobin A1c, triglycerides, cholesterol, blood pressure, height, weight and waist and hip circumferences. Results Twenty percent of study participants had albuminuria, (5% proteinuria and 15% microalbuminuria. Of participants with diabetes, 42% (56/132 had albuminuria compared to 26% (7/27 among those with impaired fasting glucose and 10% (30/303 among those with normal glucose tolerance. Only 5.3% of those with albuminuria were aware of any degree of renal disease. In a multivariate logistic regression, independent associations with albuminuria were male gender [p = 0.002], increasing fasting glucose [p Conclusions The independent association between BMI and albuminuria has not been previously reported among indigenous populations. There is a high prevalence of albuminuria in this Canadian First Nation population; the high proportion of patients with diabetes and undiagnosed kidney disease demonstrates the need for screening, education and intervention to halt the progression and development of albuminuria and ultimately ESRD and CVD.

  2. Criminal Profiling Belief and Use : A Study of Canadian Police Officer Opinion

    NARCIS (Netherlands)

    Snook, Brent; Haines, Amanda; Taylor, Paul J.; Bennell, Craig

    2007-01-01

    Fifty-one Canadian police officers, working in major crime divisions, were interviewed about their experiences with criminal profiling (CP), and their beliefs about its utility and validity. The majority of officers agreed that CP helps solve cases, is a valuable investigative tool, and advances

  3. A Road Map to Canadian Chemical Recovery Handbook for Inhabited Areas: Scoping Study

    Science.gov (United States)

    2014-05-01

    A Road Map to Canadian Chemical Recovery Handbook for I © Her Majesty the Queen in Right of Canada, as represented by the Minister of National...Australia (EMA) Office of Attorney General, Canberra. b) Australian Emergency Management Institute Mount Macedon, Victoria

  4. Quality in Family Child Care: A Focus Group Study with Canadian Providers

    Science.gov (United States)

    Doherty, Gillian

    2015-01-01

    A substantial proportion of American, Canadian and English preschoolers regularly participate in family child care making its quality of vital importance for the children concerned, their parents, the school system and the society in which they live. This article discusses the seven key caregiver behaviors and physical space characteristics…

  5. Talent Management Programmes at British, American and Canadian Universities: Comparative Study

    Science.gov (United States)

    Boichenko, Maryna

    2015-01-01

    The article deals with the peculiarities of talent management programmes implementation at the top British, American and Canadian universities. The essence of the main concepts of research--talent and talent management--has been revealed. Talent management is referred to as the systematic attraction, identification, development, engagement,…

  6. Temporal integration windows for naturalistic visual sequences.

    Directory of Open Access Journals (Sweden)

    Scott L Fairhall

    Full Text Available There is increasing evidence that the brain possesses mechanisms to integrate incoming sensory information as it unfolds over time-periods of 2-3 seconds. The ubiquity of this mechanism across modalities, tasks, perception and production has led to the proposal that it may underlie our experience of the subjective present. A critical test of this claim is that this phenomenon should be apparent in naturalistic visual experiences. We tested this using movie-clips as a surrogate for our day-to-day experience, temporally scrambling them to require (re- integration within and beyond the hypothesized 2-3 second interval. Two independent experiments demonstrate a step-wise increase in the difficulty to follow stimuli at the hypothesized 2-3 second scrambling condition. Moreover, only this difference could not be accounted for by low-level visual properties. This provides the first evidence that this 2-3 second integration window extends to complex, naturalistic visual sequences more consistent with our experience of the subjective present.

  7. Mortality and morbidity hazards associated with cognitive status in seniors: a Canadian population prospective cohort study.

    Science.gov (United States)

    Meng, Xiangfei; D'Arcy, Carl

    2013-09-01

    Although cognitive impairment is widely accepted as a leading indicator of dementia, influences of cognitive status on incident dementia and mortality remain unclear. The present study investigated the morbidity hazard associated with cognitive impairment and the mortality hazard associated with dementia in comparison to cognitively intact seniors. A population-based sample of 2914 seniors with clinically diagnosed cognitive status at Wave I (1991-1992) of the Canadian Study of Health and Aging (CSHA) were followed-up 5 years later (1996-1997). At Wave I, there were 921 cognitively intact, 861 cognitively impaired but not demented (CIND), and 1132 seniors with dementia, respectively. The primary outcome measures 5 years later were being cognitively intact, CIND, dementia and death. Kaplan-Meier estimates, log-rank tests, and Cox's proportional models were used in the analyses. Respondents with CIND at Wave I were 2.191 times (95%CI 1.706-2.814) more likely to have dementia 5 years later than cognitively intact seniors. After adjusting for confounding socio-demographic and health status factors, the odds ratio was reduced to 2.147 times (95%CI 1.662-2.774), but remained significant. Respondents with CIND had a mortality rate 1.869 times (95%CI 1.602-2.179) and seniors with dementia 3.362 times greater (95%CI 2.929-3.860) than that of seniors who were cognitively intact. After controlling the confounders, the odds remained significant at 1.576 (95%CI 1.348-1.843) for CIND respondents and 2.415 (95%CI 2.083-2.800) for seniors with dementia. CIND increases both the risk of dementia and mortality. Early intervention with CIND is warranted to reduce both dementia incidence and mortality. Copyright © 2012 Wiley Publishing Asia Pty Ltd.

  8. Predictors of homelessness among vulnerably housed adults in 3 Canadian cities: a prospective cohort study.

    Science.gov (United States)

    To, Matthew J; Palepu, Anita; Aubry, Tim; Nisenbaum, Rosane; Gogosis, Evie; Gadermann, Anne; Cherner, Rebecca; Farrell, Susan; Misir, Vachan; Hwang, Stephen W

    2016-10-03

    Homelessness is a major concern in many urban communities across North America. Since vulnerably housed individuals are at risk of experiencing homelessness, it is important to identify predictive factors linked to subsequent homelessness in this population. The objectives of this study were to determine the probability of experiencing homelessness among vulnerably housed adults over three years and factors associated with higher risk of homelessness. Vulnerably housed adults were recruited in three Canadian cities. Data on demographic characteristics, chronic health conditions, and drug use problems were collected through structured interviews. Housing history was obtained at baseline and annual follow-up interviews. Generalized estimating equations were used to characterize associations between candidate predictors and subsequent experiences of homelessness during each follow-up year. Among 561 participants, the prevalence of homelessness was 29.2 % over three years. Male gender (AOR = 1.59, 95 % CI: 1.14-2.21) and severe drug use problems (AOR = 1.98, 95 % CI: 1.22-3.20) were independently associated with experiencing homelessness during the follow-up period. Having ≥3 chronic conditions (AOR = 0.55, 95 % CI: 0.33-0.94) and reporting higher housing quality (AOR = 0.99, 95 % CI: 0.97-1.00) were protective against homelessness. Vulnerably housed individuals are at high risk for experiencing homelessness. The study has public health implications, highlighting the need for enhanced access to addiction treatment and improved housing quality for this population.

  9. Dental students' perceptions of and attitudes about poverty: a Canadian participatory case study.

    Science.gov (United States)

    Reis, Clarice M R; Rodriguez, Charo; Macaulay, Ann C; Bedos, Christophe

    2014-12-01

    This qualitative case study was conducted in a Canadian dental school using a participatory approach and was based on Paulo Freire's theoretical concept of conscientização, a form of critical consciousness that involves awareness of social reality and fosters action towards social justice. The aim of the study was to understand dental students' perceptions of and attitudes about poverty and dental care provided to people living in poverty. It also examined how these perceptions shape students' plans for their professional careers, as well as their opinions on educational strategies to prepare them to work with poor patients. The sources of data generation were semistructured interviews, participant observations, and document analysis. A deductive-inductive thematic strategy was used to analyze the data. Out of a class of thirty-five senior dental students, the authors interviewed a convenience sample of twelve: five male and seven female. The findings suggest that the students had incipient conscientização about poverty-related themes. They perceived poverty as a distant issue and as the responsibility of the government or of the poor individuals themselves. The students did not have plans to work with patients living in poverty in the future and struggled to envision ways to address these patients' needs other than volunteer work. This research supports the need for academic dental institutions to adopt strategies to increase students' critical consciousness about oral health inequities. Reducing oral health inequities is a matter of social justice, and dental care providers are key actors in this endeavor.

  10. Do new and traditional models of primary care differ with regard to access?: Canadian QUALICOPC study.

    Science.gov (United States)

    Miedema, Baukje; Easley, Julie; Thompson, Ashley E; Boivin, Antoine; Aubrey-Bassler, Kris; Katz, Alan; Hogg, William E; Breton, Mylaine; Francoeur, Danièle; Wong, Sabrina T; Wodchis, Walter P

    2016-01-01

    To examine access to primary care in new and traditional models using 2 dimensions of the concept of patient-centred access. An international survey examining the quality and costs of primary health care (the QUALICOPC study) was conducted in 2013 in Canada. This study adopted a descriptive cross-sectional survey method using data from practices across Canada. Each participating practice filled out the Family Physician Survey and the Practice Survey, and patients in each participating practice were asked to complete the Patient Experiences Survey. All 10 Canadian provinces. A total of 759 practices and 7172 patients. Independent t tests were conducted to examine differences between new and traditional models of care in terms of availability and accommodation, and affordability of care. Of the 759 practices, 407 were identified as having new models of care and 352 were identified as traditional. New models of care were distinct with respect to payment structure, opening hours, and having an interdisciplinary work force. Most participating practices were from large cities or suburban areas. There were few differences between new and traditional models of care regarding accessibility and accommodation in primary care. Patients under new models of care reported easier access to other physicians in the same practice, while patients from traditional models reported seeing their regular family physicians more frequently. There was no difference between the new and traditional models of care with regard to affordability of primary care. Patients attending clinics with new models of care reported that their physicians were more involved with them as a whole person than patients attending clinics based on traditional models did. Primary care access issues do not differ strongly between traditional and new models of care; however, patients in the new models of care believed that their physicians were more involved with them as people.

  11. Predictors of homelessness among vulnerably housed adults in 3 Canadian cities: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Matthew J. To

    2016-10-01

    Full Text Available Abstract Background Homelessness is a major concern in many urban communities across North America. Since vulnerably housed individuals are at risk of experiencing homelessness, it is important to identify predictive factors linked to subsequent homelessness in this population. The objectives of this study were to determine the probability of experiencing homelessness among vulnerably housed adults over three years and factors associated with higher risk of homelessness. Methods Vulnerably housed adults were recruited in three Canadian cities. Data on demographic characteristics, chronic health conditions, and drug use problems were collected through structured interviews. Housing history was obtained at baseline and annual follow-up interviews. Generalized estimating equations were used to characterize associations between candidate predictors and subsequent experiences of homelessness during each follow-up year. Results Among 561 participants, the prevalence of homelessness was 29.2 % over three years. Male gender (AOR = 1.59, 95 % CI: 1.14–2.21 and severe drug use problems (AOR = 1.98, 95 % CI: 1.22–3.20 were independently associated with experiencing homelessness during the follow-up period. Having ≥3 chronic conditions (AOR = 0.55, 95 % CI: 0.33–0.94 and reporting higher housing quality (AOR = 0.99, 95 % CI: 0.97–1.00 were protective against homelessness. Conclusions Vulnerably housed individuals are at high risk for experiencing homelessness. The study has public health implications, highlighting the need for enhanced access to addiction treatment and improved housing quality for this population.

  12. Facebook Recruitment of Vaccine-Hesitant Canadian Parents: Cross-Sectional Study.

    Science.gov (United States)

    Tustin, Jordan Lee; Crowcroft, Natasha Sarah; Gesink, Dionne; Johnson, Ian; Keelan, Jennifer; Lachapelle, Barbara

    2017-07-24

    There is concern over the increase in the number of "vaccine-hesitant" parents, which contributes to under-vaccinated populations and reduced herd immunity. Traditional studies investigating parental immunization beliefs and practices have relied on random digit dialing (RDD); however, this method presents increasing limitations. Facebook is the most used social media platform in Canada and presents an opportunity to recruit vaccine-hesitant parents in a novel manner. The study aimed to explore the use of Facebook as a tool to reach vaccine-hesitant parents, as compared with RDD methods. We recruited Canadian parents over 4 weeks in 2013-14 via targeted Facebook advertisements linked to a Web-based survey. We compared methodological parameters, key parental demographics, and three vaccine hesitancy indicators to an RDD sample of Canadian parents. Two raters categorized respondent reasons for difficulties in deciding to vaccinate, according to the model of determinants of vaccine hesitancy developed by the World Health Organization's Strategic Advisory Group of Experts on Immunization. The Facebook campaign received a total of 4792 clicks from unique users, of whom 1696 started the Web-based survey. The total response rate of fully completed unique Web-based surveys was 22.89% (1097/4792) and the survey completion rate was 64.68% (1097/1696). The total cost including incentives was reasonable (Can $4861.19). The Web-based sample yielded younger parents, with 85.69% (940/1097) under the age of 40 years as compared with 23.38% (408/1745) in the RDD sample; 91.43% (1003/1097) of the Facebook respondents were female as compared with 59.26% (1034/1745) in the RDD sample. Facebook respondents had a lower median age of their youngest child (1 year vs 8 years for RDD). When compared with the RDD sample, the Web-based sample yielded a significantly higher proportion of respondents reporting vaccines as moderately safe to not safe (26.62% [292/1097] vs 18.57% [324

  13. Facebook Recruitment of Vaccine-Hesitant Canadian Parents: Cross-Sectional Study

    Science.gov (United States)

    2017-01-01

    Background There is concern over the increase in the number of “vaccine-hesitant” parents, which contributes to under-vaccinated populations and reduced herd immunity. Traditional studies investigating parental immunization beliefs and practices have relied on random digit dialing (RDD); however, this method presents increasing limitations. Facebook is the most used social media platform in Canada and presents an opportunity to recruit vaccine-hesitant parents in a novel manner. Objective The study aimed to explore the use of Facebook as a tool to reach vaccine-hesitant parents, as compared with RDD methods. Methods We recruited Canadian parents over 4 weeks in 2013-14 via targeted Facebook advertisements linked to a Web-based survey. We compared methodological parameters, key parental demographics, and three vaccine hesitancy indicators to an RDD sample of Canadian parents. Two raters categorized respondent reasons for difficulties in deciding to vaccinate, according to the model of determinants of vaccine hesitancy developed by the World Health Organization’s Strategic Advisory Group of Experts on Immunization. Results The Facebook campaign received a total of 4792 clicks from unique users, of whom 1696 started the Web-based survey. The total response rate of fully completed unique Web-based surveys was 22.89% (1097/4792) and the survey completion rate was 64.68% (1097/1696). The total cost including incentives was reasonable (Can $4861.19). The Web-based sample yielded younger parents, with 85.69% (940/1097) under the age of 40 years as compared with 23.38% (408/1745) in the RDD sample; 91.43% (1003/1097) of the Facebook respondents were female as compared with 59.26% (1034/1745) in the RDD sample. Facebook respondents had a lower median age of their youngest child (1 year vs 8 years for RDD). When compared with the RDD sample, the Web-based sample yielded a significantly higher proportion of respondents reporting vaccines as moderately safe to not safe

  14. "Canadianizing" an American Communication Textbook.

    Science.gov (United States)

    Maclennan, Jennifer M.

    2000-01-01

    Presents a study on the process involved in the "Canadianization" of U.S. textbooks for the domestic market. Explores whether disciplinary values have been shaped by the United States in the field of communication. Focuses on the experience of developing the Canadian edition of the book "Public Speaking: Strategies for Success"…

  15. The Effectiveness of Enhanced Cognitive Behavioural Therapy (CBT-E): A Naturalistic Study within an Out-Patient Eating Disorder Service.

    Science.gov (United States)

    Signorini, Rachel; Sheffield, Jeanie; Rhodes, Natalie; Fleming, Carmel; Ward, Warren

    2018-01-01

    The effectiveness of enhanced cognitive behavioural Therapy (CBT-E) for adults with a range of eating disorder presentations within routine clinical settings has been examined in only two known published studies, neither of which included a follow-up assessment period. The current study aimed to evaluate the effectiveness of CBT-E within an out-patient eating disorder service in Brisbane, Queensland, Australia, and incorporated a follow-up assessment period of approximately 20 weeks post-treatment. The study involved 114 adult females with a diagnosed eating disorder, who attended an average of 20-40 individual CBT-E sessions with a psychologist or a psychiatry registrar between 2009 and 2013. Of those who began treatment, 50% did not complete treatment, and the presence of psychosocial and environmental problems predicted drop-out. Amongst treatment completers, statistically and clinically significant improvements in eating disorder and general psychopathology were observed at post-treatment, which were generally maintained at the 20-week follow-up. Statistically significant improvements in eating disorder and general psychopathology were observed amongst the total sample. The findings, which were comparable to the previous Australian effectiveness study of CBT-E, indicate that CBT-E is an effective treatment for adults with all eating disorders within out-patient settings. Given the high attrition rate, however, minimizing drop-out appears to be an important consideration when implementing CBT-E within clinical settings.

  16. Stereotypic information about drinkers and students' observed alcohol intake: an experimental study on prototype-behavior relations in males and females in a naturalistic drinking context

    NARCIS (Netherlands)

    Teunissen, H.A.; Spijkerman, R.; Larsen, H.; Kremer, K.A.; Kuntsche, E.; Gibbons, F.X.; Scholte, R.H.J.; Engels, R.C.M.E.

    2012-01-01

    Background: Cross-sectional and longitudinal research has shown that favorable drinker prototypes (i.e., perceptions about the typical drinker) are related to higher levels of alcohol consumption in adolescents and college students. So far, few studies have experimentally tested the causality of

  17. Association between lithium serum level, mood state, and patient-reported adverse drug reactions during long-term lithium treatment : a naturalistic follow-up study

    NARCIS (Netherlands)

    Wilting, Ingeborg; Heerdink, Eibert R.; Mersch, Peter-Paul A.; den Boer, Johannes A.; Egberts, Antoine C. G.; Nolen, Willem A.

    To assess the association between mood state and the prevalence and the severity of lithium adverse drug reactions (ADRs). A 26-year follow-up study was conducted among patients >= 18 years treated at the outpatient lithium clinic of the University Medical Center Groningen, The Netherlands, between

  18. Coaching Parents to Use Naturalistic Language and Communication Strategies

    Science.gov (United States)

    Akamoglu, Yusuf; Dinnebeil, Laurie

    2017-01-01

    Naturalistic language and communication strategies (i.e., naturalistic teaching strategies) refer to practices that are used to promote the child's language and communication skills either through verbal (e.g., spoken words) or nonverbal (e.g., gestures, signs) interactions between an adult (e.g., parent, teacher) and a child. Use of naturalistic…

  19. Naturalistic Cognition: A Research Paradigm for Human-Centered Design

    Science.gov (United States)

    Storkerson, Peter

    2010-01-01

    Naturalistic thinking and knowing, the tacit, experiential, and intuitive reasoning of everyday interaction, have long been regarded as inferior to formal reason and labeled primitive, fallible, subjective, superstitious, and in some cases ineffable. But, naturalistic thinking is more rational and definable than it appears. It is also relevant to…

  20. Using naturalistic driving study data to investigate the impact of driver distraction on driver's brake reaction time in freeway rear-end events in car-following situation.

    Science.gov (United States)

    Gao, Jingru; Davis, Gary A

    2017-12-01

    The rear-end crash is one of the most common freeway crash types, and driver distraction is often cited as a leading cause of rear-end crashes. Previous research indicates that driver distraction could have negative effects on driving performance, but the specific association between driver distraction and crash risk is still not fully revealed. This study sought to understand the mechanism by which driver distraction, defined as secondary task distraction, could influence crash risk, as indicated by a driver's reaction time, in freeway car-following situations. A statistical analysis, exploring the causal model structure regarding drivers' distraction impacts on reaction times, was conducted. Distraction duration, distraction scenario, and secondary task type were chosen as distraction-related factors. Besides, exogenous factors including weather, visual obstruction, lighting condition, traffic density, and intersection presence and endogenous factors including driver age and gender were considered. There was an association between driver distraction and reaction time in the sample freeway rear-end events from SHRP 2 NDS database. Distraction duration, the distracted status when a leader braked, and secondary task type were related to reaction time, while all other factors showed no significant effect on reaction time. The analysis showed that driver distraction duration is the primary direct cause of the increase in reaction time, with other factors having indirect effects mediated by distraction duration. Longer distraction duration, the distracted status when a leader braked, and engaging in auditory-visual-manual secondary task tended to result in longer reaction times. Given drivers will be distracted occasionally, countermeasures which shorten distraction duration or avoid distraction presence while a leader vehicle brakes are worth considering. This study helps better understand the mechanism of freeway rear-end events in car-following situations, and

  1. Efficacy of a family intervention program for prevention of hospitalization in patients with schizophrenia. A naturalistic multicenter controlled and randomized study in Spain.

    Science.gov (United States)

    Mayoral, Fermín; Berrozpe, Adela; de la Higuera, Jesús; Martinez-Jambrina, Juan José; de Dios Luna, Juan; Torres-Gonzalez, Francisco

    2015-01-01

    According to most relevant guidelines, family psycho-educational interventions are considered to be one the most effective psychosocial treatments for people with schizophrenia. The main outcome measure in controlled and randomized studies has been prevention of relapses and admissions, and encouragement of compliance, although some questions remain about its applicability and results in clinical practice. The aim of study was to evaluate the efficacy and implementation of a single family psychoeducational intervention in 'real' conditions for people diagnosed with schizophrenia. A total of 88 families were randomized in two groups. The family intervention group received a 12 months psychoeducational treatment, and the other group followed normal standard treatment. Assessments were made at baseline, at 12 and at 18 months. The main outcome measure was hospitalization, and secondary outcome measures were clinical condition (BPRS-E) and social disability (DAS-II). A total of 71 patients finished the study (34 family intervention group and 37 control group). Patients who received family intervention reduced the risk of hospitalization by 40% (P = .4018; 95%CI: 0.1833-0.6204). Symptomatology improved significantly at 12 months (P = .4018; 95%CI: 0.1833-0.6204), but not at 18 months (P = .4018; 95%CI: 0.1833-0.6204). Social disability was significantly reduced in the family intervention group at 12 months and 18 months. Family psychoeducational intervention reduces hospitalization risk and improves clinical condition and social functioning of people with schizophrenia. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

  2. No influence of one right-sided prefrontal HF-rTMS session on alcohol craving in recently detoxified alcohol-dependent patients: results of a naturalistic study.

    Science.gov (United States)

    Herremans, S C; Baeken, C; Vanderbruggen, N; Vanderhasselt, M A; Zeeuws, D; Santermans, L; De Raedt, R

    2012-01-01

    Prior research in substance dependence has suggested potential anti-craving effects of repetitive transcranial magnetic stimulation (rTMS) when applied to the dorsolateral prefrontal cortex (DLPFC). However, no single sham-controlled session studies applied to the right DLPFC have been carried-out in recently detoxified alcohol-dependent patients. Furthermore, no studies examined the effect of a single HF-rTMS session on craving in these patients' natural habitat. To further investigate the effect of high-frequency (HF)-rTMS of the right DLPFC on alcohol craving, we performed a prospective, single-blind, sham-controlled study involving 36 hospitalized patients with alcohol dependence syndrome. After successful detoxification, patients were allocated receiving one active or one sham HF-rTMS session. The obsessive-compulsive drinking scale (OCDS) was administered to evaluate the extent of craving just before and after the HF-rTMS session (on Friday), on Saturday and Sunday during the weekend at home, and on Monday when the patient returned to the hospital. One single blind sham-controlled HF-rTMS session applied to the right DLPFC did not result in changes in craving (neither immediately after the stimulation session, nor in patients' natural environment during the weekend). One HF-rTMS stimulation session applied to the right DLPFC had no significant effects on alcohol craving in alcohol dependent patients. One such session could have been too short to alter alcohol craving in a sample of alcohol dependent patients. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  3. Active transportation and bullying in Canadian schoolchildren: a cross-sectional study.

    Science.gov (United States)

    Cozma, Ioana; Kukaswadia, Atif; Janssen, Ian; Craig, Wendy; Pickett, William

    2015-02-07

    Bullying is a recognized social problem within child populations. Engagement in childhood bullying often occurs in settings that are away from adult supervision, such as en route to and from school. Bullying episodes may also have a negative impact on school childrens' decisions to engage in active transportation. Using a cross-sectional design, we analyzed reports from the 2009/10 cycle of the Canadian Health Behaviour in School-Aged Children (HBSC) study. Records from this general health survey were obtained for 3,997 urban students in grades 6-10 who lived in close proximity of their school and were hence ineligible for school bussing. Students who indicated walking or bicycling to school were classified as engaged in active transportation. Victims and perpetrators of bullying were defined using standard measures and a frequency cut-off of at least 2-3 times per month. Analyses focused on relations between bullying and active transportation, as well as barriers to active transportation as perceived by young people. 27% of young people indicated being victimized, and 12% indicated that they engaged in bullying. Girls were more likely to be victimized than boys, and younger students were more likely to be victimized than older students. Engagement in active transportation was reported by 63% of respondents, of these, 68% indicated that worrying about bullying on the way to school was an impediment to such transportation methods. Victimization by bullying (adjusted OR = 1.26, 95% CI: 1.00 - 1.59) was reported more frequently by children who used active transportation. Health promotion efforts to promote engagement in active transportation of students to school have obvious value. The potential for modest increases in exposure to bullying should be considered in the planning of such initiatives.

  4. Exploring Canadian Physicians' Experiences Providing Medical Assistance in Dying: A Qualitative Study.

    Science.gov (United States)

    Khoshnood, Narges; Hopwood, Marie-Clare; Lokuge, Bhadra; Kurahashi, Allison; Tobin, Anastasia; Isenberg, Sarina; Husain, Amna

    2018-05-15

    MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. To explore the professional challenges faced by Canadian physicians who provide MAiD. Sixteen physicians from across Canada who provide MAiD completed in-depth, semi-structured telephone interviews. An inductive thematic analysis approach guided data collection and the iterative, interpretive analysis of interview transcripts. Three members of the research team systematically co-coded interview transcripts and the emerging themes were developed with the broader research team. NVivo was used to manage the coded data. Participants described three challenges associated with providing MAiD: 1) their relationships with other MAiD providers were enhanced and relationships with objecting colleagues were sometimes strained, 2) they received inadequate financial compensation for time, and, 3) they experienced increased workload, resulting in sacrifices to personal time. Although these providers did not intend to stop providing MAiD at the time of the interview, they indicated their concerns about whether they would be able to sustain this service over time. Physicians described relationship, financial, and workload challenges to providing MAiD. We provide several recommendations to address these challenges and help ensure the sustainability of MAiD in countries that provide this service. Copyright © 2018. Published by Elsevier Inc.

  5. Evaluation of the cost-effectiveness of evolocumab in the FOURIER study: a Canadian analysis.

    Science.gov (United States)

    Lee, Todd C; Kaouache, Mohammed; Grover, Steven A

    2018-04-03

    Evolocumab, a proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitor, has been shown to reduce low-density lipoprotein levels by up to 60%. Despite the absence of a reduction in overall or cardiovascular mortality in the Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk (FOURIER) trial, some believe that, with longer treatment, such a benefit might eventually be realized. Our aim was to estimate the potential mortality benefit over a patient's lifetime and the cost per year of life saved (YOLS) for an average Canadian with established coronary artery disease. We also sought to estimate the price threshold at which evolocumab might be considered cost-effective for secondary prevention in Canada. We calibrated the Cardio-metabolic Model, a well-validated tool for predicting cardiovascular events and life expectancy, to the reduction in nonfatal events seen in the FOURIER trial. Assuming that long-term treatment will eventually result in mortality benefits, we estimated YOLSs and cost per YOLS with evolocumab treatment plus a statin compared to a statin alone. We then estimated the annual drug costs that would provide a 50% chance of being cost-effective at willingness-to-pay values of $50 000 and $100 000. In secondary prevention in patients similar to those in the FOURIER study, evolocumab treatment would save an average of 0.34 (95% confidence interval [CI] 0.27-0.41) life-years at a cost of $101 899 (95% CI $97 325-$106 473), yielding a cost per YOLS of $299 482. We estimate that to have a 50% probability of achieving a cost per YOLS below $50 000 and $100 000 would require annual drug costs below $1200 and $2300, respectively. At current pricing, the use of evolocumab for secondary prevention is unlikely to be cost-effective in Canada. Copyright 2018, Joule Inc. or its licensors.

  6. Basic Laparoscopic Skills Assessment Study: Validation and Standard Setting among Canadian Urology Trainees.

    Science.gov (United States)

    Lee, Jason Y; Andonian, Sero; Pace, Kenneth T; Grober, Ethan

    2017-06-01

    As urology training programs move to a competency based medical education model, iterative assessments with objective standards will be required. To develop a valid set of technical skills standards we initiated a national skills assessment study focusing initially on laparoscopic skills. Between February 2014 and March 2016 the basic laparoscopic skill of Canadian urology trainees and attending urologists was assessed using 4 standardized tasks from the AUA (American Urological Association) BLUS (Basic Laparoscopic Urological Surgery) curriculum, including peg transfer, pattern cutting, suturing and knot tying, and vascular clip applying. All performances were video recorded and assessed using 3 methods, including time and error based scoring, expert global rating scores and C-SATS (Crowd-Sourced Assessments of Technical Skill Global Rating Scale), a novel, crowd sourced assessment platform. Different methods of standard setting were used to develop pass-fail cut points. Six attending urologists and 99 trainees completed testing. Reported laparoscopic experience and training level correlated with performance (p standard setting methods to define pass-fail cut points for all 4 AUA BLUS tasks. The 4 AUA BLUS tasks demonstrated good construct validity evidence for use in assessing basic laparoscopic skill. Performance scores using the novel C-SATS platform correlated well with traditional time-consuming methods of assessment. Various standard setting methods were used to develop pass-fail cut points for educators to use when making formative and summative assessments of basic laparoscopic skill. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  7. Exploring patients’ perceptions for insulin therapy in type 2 diabetes: a Brazilian and Canadian qualitative study

    Directory of Open Access Journals (Sweden)

    Camila Guimarães

    2010-06-01

    Full Text Available Camila Guimarães2, Carlo A Marra1, Sabrina Gill1, Graydon Meneilly1, Scot Simpson3, Ana LPC Godoy2, Maria Cristina Foss de Freitas2, Regina HC Queiroz2, Larry Lynd11The University of British Columbia, Canada; 2University of São Paulo, Brazil; 3The University of Alberta, CanadaObjective: To explore which attributes of insulin therapy drive patients’ preferences for management in Canada and Brazil.Methods: A qualitative design was implemented in which a total of 32 patients with type 2 diabetes from Canada and Brazil, were interviewed in one of the 4 focus groups, or 16 individual interviews. Eighteen participants (56% were women and fourteen participants (44% were men (15 insulin nonusers and 17 insulin users. Two focus groups of 4 participants each and 9 individual interviews were conducted in Brazil. In Canada, 2 focus groups of 4 participants each and 7 individual interviews were conducted. A framework analysis was used to analyse all data.Results: Brazilian participants, when considering two insulin treatments, would prefer the one that had fewer side-effects (specially hypoglycemia events, was noninjectable, had the lowest cost and was most effective. Meanwhile, Canadian participants would prefer a treatment that had fewer side-effects (specially weight gain, was less invasive, was more convenient and was most effective.Conclusions: Finding the insulin-delivery system and the attributes of insulin therapy that best meet patients’ preferences may lead to improved control, through improved compliance, which may ultimately reduce the financial burden of the disease and improve quality of life.Keywords: type 2 diabetes, insulin administration, glycemic control, weight gain, hypoglycemia, qualitative study, patients’ preferences

  8. The duty to care in an influenza pandemic: a qualitative study of Canadian public perspectives.

    Science.gov (United States)

    Bensimon, Cécile M; Smith, Maxwell J; Pisartchik, Dmitri; Sahni, Sachin; Upshur, Ross E G

    2012-12-01

    Ever since the emergence of SARS, when we were reminded that the nature of health care practitioners' duty to care is greatly contested, it has remained a polarizing issue. Discussions on the nature and limits of health care practitioners' duty to care during disasters and public health emergencies abounds the literature, ripe with arguments seeking to ground its foundations. However, to date there has been little public engagement on this issue. This study involved three Townhall meetings held between February 2008 and May 2010 in three urban settings in Canada in order to probe lay citizens' views about ethical issues related to pandemic influenza, including issues surrounding the duty to care. Participants included Canadian residents aged 18 and over who were fluent in English. Data were collected through day-long facilitated group discussions using case scenarios and focus group guides. Participant's views were organized according to several themes, including the following main themes (and respective sub-themes): 1. Legitimate limits; a) competing obligations; and b) appeal to personal choice; and 2. Legitimate expectations; a) reciprocity; and b) enforcement and planning. Our findings show that participants moved away from categorical notions of the duty to care towards more equivocal and often normative views throughout deliberations. Our analysis contributes a better understanding of the constitutive nature of the duty to care, defined in part by taking account of public views. This broadened understanding can further inform the articulation of acceptable norms of duty to care and policy development efforts. What is more, it illustrates the urgent need for policy-makers and regulators to get clarity on obligations, responsibilities, and accountability in the execution of HCPs' duty to care during times of universal vulnerability. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Stress-related psycho-physiological disorders: randomized single blind placebo controlled naturalistic study of psychometric evaluation using a radio electric asymmetric treatment

    Science.gov (United States)

    2011-01-01

    Background The aim of this study is to investigate the effects of a radio electric asymmetric treatment on psycho-physiological disorders (PPD). PPD are often stress related and are under the unconscious control of the patient and cannot be traced back to any serious physical disease. The brain stimulation treatment protocol used is called Neuro Psycho Physical Optimization (NPPO) with a Radio Electric Asymmetric Conveyer (REAC) device. Methods Psychological stress and PPD were measured for a group of 888 subjects using the Psychological Stress Measure (PSM) test, a self-administered questionnaire. Data were collected immediately before and after the 4-weeks of REAC treatment cycle. Results This study showed a significant reduction in scores measuring subjective perceptions of stress for subjects treated with a cycle of NPPO REAC treatment. At the end-point the number of subjects reporting symptoms of stress-related PPD on the PSM test was significantly reduced, whereas in the placebo group the difference was not significant. Conclusion A cycle of NPPO treatment with REAC was shown to reduce subjective perceptions of stress measured by the PSM test and in particular on PPD. Trial Registration This trial has been registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) with the number: ACTRN12607000463471. PMID:21771304

  10. Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of quality of life outcome measures in clinical practice.

    Science.gov (United States)

    Janicak, Philip G; Dunner, David L; Aaronson, Scott T; Carpenter, Linda L; Boyadjis, Terrence A; Brock, David G; Cook, Ian A; Lanocha, Karl; Solvason, Hugh B; Bonneh-Barkay, Dafna; Demitrack, Mark A

    2013-12-01

    Transcranial magnetic stimulation (TMS) is an effective and safe therapy for major depressive disorder (MDD). This study assessed quality of life (QOL) and functional status outcomes for depressed patients after an acute course of TMS. Forty-two, U.S.-based, clinical TMS practice sites treated 307 outpatients with a primary diagnosis of MDD and persistent symptoms despite prior adequate antidepressant pharmacotherapy. Treatment parameters were based on individual clinical considerations and followed the labeled procedures for use of the approved TMS device. Patient self-reported QOL outcomes included change in the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the EuroQol 5-Dimensions (EQ-5D) ratings from baseline to end of the acute treatment phase. Statistically significant improvement in functional status on a broad range of mental health and physical health domains was observed on the SF-36 following acute TMS treatment. Similarly, statistically significant improvement in patient-reported QOL was observed on all domains of the EQ-5D and on the General Health Perception and Health Index scores. Improvement on these measures was observed across the entire range of baseline depression symptom severity. These data confirm that TMS is effective in the acute treatment of MDD in routine clinical practice settings. This symptom benefit is accompanied by statistically and clinically meaningful improvements in patient-reported QOL and functional status outcomes.

  11. A naturalistic study on the relationship among resilient factors, psychiatric symptoms, and psychosocial functioning in a sample of residential patients with psychosis.

    Science.gov (United States)

    Poloni, Nicola; Zizolfi, Daniele; Ielmini, Marta; Pagani, Roberto; Caselli, Ivano; Diurni, Marcello; Milano, Anna; Callegari, Camilla

    2018-01-01

    Resilience is a multidimensional process of adaptation aimed to overcome stressful or traumatic life experiences; only in the last few years it has been considered as a personal resource in psychosis and schizophrenia. This study aimed to assess the relationship between intrapersonal and interpersonal resilience factors and schizophrenia, particularly whether and how resilience can improve the course of psychotic illness. In this observational study, all patients recruited had to fulfill the following inclusion criteria: diagnosis of schizophrenia spectrum disorder ( Diagnostic and Statistical Manual of Mental Disorders-5 ); aged between 18 and 65 years; provided written informed consent; to be clinically stable (Clinical Global Impression Scale SPSS. Partial correlations were evaluated to assess the relationship between RSA total scores and subscores and BPRS-A, SANS, SAPS, and LSP total scores, removing the common variance among variables. Then, a series of hierarchical multiple linear regression models were used to examine the association between resilience, psychopathology, and psychosocial functioning. A statistically significant negative correlation among intrapersonal resilience factors and BPRS-A total score emerged, predicting psychiatric symptoms severity and explaining approximately 31% of the BPRS-A variance; otherwise, only the interpersonal resilience factors associated with social support were statistically and positively correlated with LSP total score, predicting psychosocial functioning and explaining the 11% of LSP variance. The specific contribution that resilience factors may have in predicting the severity of symptoms and the extent of psychosocial functioning emphasizes the importance of personalizing treatment for patients affected by schizophrenia, promoting personal resources, and translating them into better outcomes.

  12. Clinical outcomes and costs for people with complex psychosis; a naturalistic prospective cohort study of mental health rehabilitation service users in England.

    Science.gov (United States)

    Killaspy, Helen; Marston, Louise; Green, Nicholas; Harrison, Isobel; Lean, Melanie; Holloway, Frank; Craig, Tom; Leavey, Gerard; Arbuthnott, Maurice; Koeser, Leonardo; McCrone, Paul; Omar, Rumana Z; King, Michael

    2016-04-07

    Mental health rehabilitation services in England focus on people with complex psychosis. This group tend to have lengthy hospital admissions due to the severity of their problems and, despite representing only 10-20 % of all those with psychosis, they absorb 25-50 % of the total mental health budget. Few studies have investigated the effectiveness of these services and there is little evidence available to guide clinicians working in this area. As part of a programme of research into inpatient mental health rehabilitation services, we carried out a prospective study to investigate longitudinal outcomes and costs for patients of these services and the predictors of better outcome. Inpatient mental health rehabilitation services across England that scored above average (median) on a standardised quality assessment tool used in a previous national survey were eligible for the study. Unit quality was reassessed and costs of care and patient characteristics rated using standardised tools at recruitment. Multivariable regression modelling was used to investigate the relationship between service quality, patient characteristics and the following clinical outcomes at 12 month follow-up: social function; length of admission in the rehabiliation unit; successful community discharge (without readmission or community placement breakdown) and costs of care. Across England, 50 units participated and 329 patients were followed over 12 months (94 % of those recruited). Service quality was not associated with patients' social function or length of admission (median 16 months) at 12 months but most patients were successfully discharged (56 %) or ready for discharge (14 %), with associated reductions in the costs of care. Factors associated with successful discharge were the recovery orientation of the service (OR 1.04, 95 % CI 1.00-1.08), and patients' activity (OR 1.03, 95 % CI 1.01-1.05) and social skills (OR 1.13, 95 % CI 1.04-1.24) at recruitment. Inpatient mental health

  13. Cordance derived from REM sleep EEG as a biomarker for treatment response in depression--a naturalistic study after antidepressant medication.

    Science.gov (United States)

    Adamczyk, Marek; Gazea, Mary; Wollweber, Bastian; Holsboer, Florian; Dresler, Martin; Steiger, Axel; Pawlowski, Marcel

    2015-04-01

    To evaluate whether prefrontal cordance in theta frequency band derived from REM sleep EEG after the first week of antidepressant medication could characterize the treatment response after 4 weeks of therapy in depressed patients. 20 in-patients (15 females, 5 males) with a depressive episode and 20 healthy matched controls were recruited into 4-week, open label, case-control study. Patients were treated with various antidepressants. No significant differences in age (responders (mean ± SD): 45 ± 22) years; non-responders: 49 ± 12 years), medication or Hamilton Depression Rating Scale (HAM-D) score (responders: 23.8 ± 4.5; non-responders 24.5 ± 7.6) at inclusion into the study were found between responders and non-responders. Response to treatment was defined as a ≥50% reduction of HAM-D score at the end of four weeks of active medication. Sleep EEG of patients was recorded after the first and the fourth week of medication. Cordance was computed for prefrontal EEG channels in theta frequency band during tonic REM sleep. The group of 8 responders had significantly higher prefrontal theta cordance in relation to the group of 12 non-responders after the first week of antidepressant medication. This finding was significant also when controlling for age, gender and number of previous depressive episodes (F1,15 = 6.025, P = .027). Furthermore, prefrontal cordance of all patients showed significant positive correlation (r = 0.52; P = .019) with the improvement of HAM-D score between the inclusion week and fourth week of medication. The results suggest that prefrontal cordance derived from REM sleep EEG could provide a biomarker for the response to antidepressant treatment in depressed patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Outlook for Canadian refining

    International Nuclear Information System (INIS)

    Boje, G.

    1998-01-01

    The petroleum supply and demand balance was discussed and a comparison between Canadian and U.S. refineries was provided. The impact of changing product specifications on the petroleum industry was also discussed. The major changes include sulphur reductions in gasoline, benzene and MMT additives. These changes have been made in an effort to satisfy environmental needs. Geographic margin variations in refineries between east and west were reviewed. An overview of findings from the Solomon Refining Study of Canadian and American refineries, which has been very complimentary of the Canadian refining industry, was provided. From this writer's point of view refinery utilization has improved but there is a threat from increasing efficiency of US competitors. Environmental issues will continue to impact upon the industry and while the chances for making economic returns on investment are good for the years ahead, it will be a challenge to maintain profitability

  15. The Differential Effect of Three Naturalistic Language Interventions on Language Use in Children with Autism

    Science.gov (United States)

    Ingersoll, Brooke

    2011-01-01

    Naturalistic interventions show promise for improving language in children with autism. Specific interventions differ in direct elicitation of child language and indirect language stimulation, and thus may produce different language outcomes. This study compared the effects of responsive interaction, milieu teaching, and a combined intervention on…

  16. An Analysis of Naturalistic Interventions for Increasing Spontaneous Expressive Language in Children with Autism Spectrum Disorder

    Science.gov (United States)

    Lane, Justin D.; Lieberman-Betz, Rebecca; Gast, David L.

    2016-01-01

    The purpose of this review was to identify naturalistic language interventions for increasing spontaneous expressive language (defined in this review as absence of verbal prompt or other verbalization from adults or peers) in young children with autism spectrum disorder. Also, the methodological rigor and effectiveness of each study were evaluated…

  17. Motivational Climate and Fundamental Motor Skill Performance in a Naturalistic Physical Education Setting

    Science.gov (United States)

    Martin, Ellen H.; Rudisill, Mary E.; Hastie, Peter A.

    2009-01-01

    Background: The literature on motivation suggests that student learning and performance is influenced by the motivational climate, and that positive benefits can be derived from exposure to a mastery motivational climate. Nonetheless, to date, only a few studies have attempted to investigate a mastery motivational climate in a naturalistic setting…

  18. The Effects of Prospective Naturalistic Contact on the Stigma of Mental Illness

    Science.gov (United States)

    Couture, Shannon M.; Penn, David L.

    2006-01-01

    The primary aim of this study was to determine whether naturalistic, interpersonal contact with persons with a severe mental illness (SMI) could reduce stigma. Participants from the agency Compeer (which pairs volunteers with people with SMI) were compared to volunteers from a control agency and to nonvolunteer participants from the community on…

  19. A naturalistic study on the relationship among resilient factors, psychiatric symptoms, and psychosocial functioning in a sample of residential patients with psychosis

    Directory of Open Access Journals (Sweden)

    Poloni N

    2018-04-01

    Full Text Available  Nicola Poloni, Daniele Zizolfi, Marta Ielmini, Roberto Pagani, Ivano Caselli, Marcello Diurni, Anna Milano, Camilla Callegari Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Varese, Italy Objective: Resilience is a multidimensional process of adaptation aimed to overcome stressful or traumatic life experiences; only in the last few years it has been considered as a personal resource in psychosis and schizophrenia. This study aimed to assess the relationship between intrapersonal and interpersonal resilience factors and schizophrenia, particularly whether and how resilience can improve the course of psychotic illness. Patients and methods: In this observational study, all patients recruited had to fulfill the following inclusion criteria: diagnosis of schizophrenia spectrum disorder (Diagnostic and Statistical Manual of Mental Disorders-5; aged between 18 and 65 years; provided written informed consent; to be clinically stable (Clinical Global Impression Scale <3; history of illness ≥5 years; to be compliant with antipsychotic therapy over the last year; and regular submission to periodic monthly psychiatric visits. Patients were evaluated through the following scales: Resilience Scale for Adults (RSA for resilience; Brief Psychiatric Rating Scale-Anchored version (BPRS-A, Scale for the Assessment of Negative Symptoms (SANS, and Scale for the Assessment of Positive Symptoms (SAPS for psychotic symptomatology; and Life Skills Profile (LSP for psychosocial functioning. ­Statistical analysis was performed by SPSS. Partial correlations were evaluated to assess the relationship between RSA total scores and subscores and BPRS-A, SANS, SAPS, and LSP total scores, removing the common variance among variables. Then, a series of hierarchical multiple linear regression models were used to examine the association between resilience, psychopathology, and psychosocial functioning. Results: A statistically significant

  20. A naturalistic study of the acceptability and effectiveness of internet-delivered cognitive behavioural therapy for psychiatric disorders in older australians.

    Directory of Open Access Journals (Sweden)

    Louise Mewton

    Full Text Available The current study investigates the acceptability, effectiveness and uptake of internet-delivered cognitive behavioural therapy (iCBT amongst older individuals (>60 years seeking psychiatric treatment in general practice.The sample consisted of 2413 (mean age 39.5; range 18-83 years patients prescribed iCBT through This Way Up clinic by their primary care clinician. The intervention consisted of six fully automated, unassisted online lessons specific to four disorders major depression, generalised anxiety disorder, panic disorder or social phobia. Patients were categorised into five age groups (18-29 years, 30-39 years, 40-49 years, 50-59 years, 60 years and above. 225 (9.3% patients were aged over 60 years. Analyses were conducted across the four disorders to ensure sufficient sample sizes in the 60 years and older age group. Age differences in adherence to the six lesson courses were assessed to demonstrate acceptability. Age-based reductions in psychological distress (Kessler Psychological Distress Scale; K10 and disability (the World Health Organisation Disability Assessment Schedule; WHODAS-II were compared to demonstrate effectiveness. To evaluate the uptake of iCBT, the age distribution of those commencing iCBT was compared with the prevalence of these disorders in the 2007 Australian National Survey of Mental Health and Well-Being.Older adults were more likely to complete all six lessons when compared with their younger counterparts. Marginal model analyses indicated that there were significant reductions in the K10 and WHODAS-II from baseline to post-intervention, regardless of age (p<0.001. The measurement occasion by age interactions were not significant, indicating that individuals showed similar reductions in the K10 and WHODAS-II regardless of age. In general, the age distribution of individuals commencing the iCBT courses matched the age distribution of the four diagnoses in the Australian general population, indicating that i

  1. Intentional forgetting: note-taking as a naturalistic example.

    Science.gov (United States)

    Eskritt, Michelle; Ma, Sierra

    2014-02-01

    In the present study, we examined whether note-taking as a memory aid may provide a naturalistic example of intentional forgetting. In the first experiment, participants played Concentration, a memory card game in which the identity and location of pairs of cards need to be remembered. Before the game started, half of the participants were allowed to study the cards, and the other half made notes that were then unexpectedly taken away. No significant differences emerged between the two groups for remembering identity information, but the study group remembered significantly more location information than did the note-taking group. In a second experiment, we examined whether note-takers would show signs of proactive interference while playing Concentration repeatedly. The results indicated that they did not. The findings suggest that participants adopted an intentional-forgetting strategy when using notes to store certain types of information.

  2. Pan-Canadian assessment of pandemic immunization data collection: study methodology

    Directory of Open Access Journals (Sweden)

    Sikora Christopher A

    2010-06-01

    Full Text Available Abstract Background The collection of individual-level pandemic (H1N1 2009 influenza immunization data was considered important to facilitate optimal vaccine delivery and accurate assessment of vaccine coverage. These data are also critical for research aimed at evaluating the new vaccine's safety and effectiveness. Systems used to collect immunization data include manual approaches in which data are collected and retained on paper, electronic systems in which data are captured on computer at the point of vaccination and hybrid systems which are comprised of both computerized and manual data collection components. This study's objective was to compare the efficiencies and perceptions of data collection methods employed during Canada's pandemic (H1N1 2009 influenza vaccination campaign. Methods/Design A pan-Canadian observational study was conducted in a convenience sample of public health clinics and healthcare institutions during the H1N1 vaccination campaign in the fall of 2009. The study design consisted of three stages: Stage 1 involved passive observation of the site's layout, processes and client flow; Stage 2 entailed timing site staff on 20 clients through five core immunization tasks: i client registration, ii medical history collection, iii medical history review, iv vaccine administration record keeping and v preparation of proof of vaccine administration for the client; in Stage 3, site staff completed a questionnaire regarding perceived usability of the site's data collection approach. Before the national study began, a pilot study was conducted in three seasonal influenza vaccination sites in Ontario, to both test that the proposed methodology was logistically feasible and to determine inter-rater reliability in the measurements of the research staff. Comparative analyses will be conducted across the range of data collection methods with respect to time required to collect immunization data, number and type of individual-level data

  3. The U.S./Canadian GEO Bilateral Drought Indices and Definitions Study: Implications for the Canadian Drought Monitor and a Global Drought Early Warning System

    Science.gov (United States)

    Hadwen, T.; Heim, R. R.; Howard, A.

    2011-12-01

    Drought is a difficult phenomenon to define; the way in which it is monitored, measured, assessed and even the very definition of drought vary from location to location based on the regional climate and the potential impacts. Drought is not an absolute condition but an evolving state brought on by relatively dry weather, growing more severe over time. There are many factors that define a drought and many more that define its impacts. Many definitions and indices are based solely on meteorological characteristics. Although this approach has merit, it is often necessary to go further to define those meteorological conditions in a way that is relevant to the land and water use in a region. A Drought Indices and Definitions Study was initiated in 2010 as part of a GEO Bilateral effort to examine drought across the U.S. and Canada. The Study's deliverables will include a survey of the drought indices used to monitor drought, and a bibliography of research addressing the nature of drought, across the diverse climates of the continent. With an increasing pressure to utilize drought monitoring as a primary indicator of need for disaster assistance, the reliability of drought indices must be validated and utilized in appropriate in various regions. In 2009, following over five years of participation in the North American Drought Monitor (NA-DM), the National Agroclimate Information Service of Agriculture and Agri-Food Canada initiated a project to develop a Canadian Drought Monitor (Can-DM), based on primary principles used in the NA-DM and the US Drought Monitor (US-DM). The process of developing an operational monitoring tool and using drought indices in a vast and environmentally diverse country has been challenging. in Canada, many of the commonly used indices are not appropriate in certain regions or data densities do not allow for proper use. This paper will discuss the experiences that the Can-DM team has had dealing with these challenges, how these experiences

  4. A national surveillance project on chronic kidney disease management in Canadian primary care: a study protocol.

    Science.gov (United States)

    Bello, Aminu K; Ronksley, Paul E; Tangri, Navdeep; Singer, Alexander; Grill, Allan; Nitsch, Dorothea; Queenan, John A; Lindeman, Cliff; Soos, Boglarka; Freiheit, Elizabeth; Tuot, Delphine; Mangin, Dee; Drummond, Neil

    2017-08-04

    Effective chronic disease care is dependent on well-organised quality improvement (QI) strategies that monitor processes of care and outcomes for optimal care delivery. Although healthcare is provincially/territorially structured in Canada, there are national networks such as the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) as important facilitators for national QI-based studies to improve chronic disease care. The goal of our study is to improve the understanding of how patients with chronic kidney disease (CKD) are managed in primary care and the variation across practices and provinces and territories to drive improvements in care delivery. The CPCSSN database contains anonymised health information from the electronic medical records for patients of participating primary care practices (PCPs) across Canada (n=1200). The dataset includes information on patient sociodemographics, medications, laboratory results and comorbidities. Leveraging validated algorithms, case definitions and guidelines will help define CKD and the related processes of care, and these enable us to: (1) determine prevalent CKD burden; (2) ascertain the current practice pattern on risk identification and management of CKD and (3) study variation in care indicators (eg, achievement of blood pressure and proteinuria targets) and referral pattern for specialist kidney care. The process of care outcomes will be stratified across patients' demographics as well as provider and regional (provincial/territorial) characteristics. The prevalence of CKD stages 3-5 will be presented as age-sex standardised prevalence estimates stratified by province and as weighted averages for population rates with 95% CIs using census data. For each PCP, age-sex standardised prevalence will be calculated and compared with expected standardised prevalence estimates. The process-based outcomes will be defined using established methods. The CPCSSN is committed to high ethical standards when dealing with

  5. Linkage of the Canadian Study of Health and Aging to provincial administrative health care databases in Nova Scotia.

    Science.gov (United States)

    Yip, A M; Kephart, G; Rockwood, K

    2001-01-01

    The Canadian Study of Health and Aging (CSHA) was a cohort study that included 528 Nova Scotian community-dwelling participants. Linkage of CSHA and provincial Medical Services Insurance (MSI) data enabled examination of health care utilization in this subsample. This article discusses methodological and ethical issues of database linkage and explores variation in the use of health services by demographic variables and health status. Utilization over 24 months following baseline was extracted from MSI's physician claims, hospital discharge abstracts, and Pharmacare claims databases. Twenty-nine subjects refused consent for access to their MSI file; health card numbers for three others could not be retrieved. A significant difference in healthcare use by age and self-rated health was revealed. Linkage of population-based data with provincial administrative health care databases has the potential to guide health care planning and resource allocation. This process must include steps to ensure protection of confidentiality. Standard practices for linkage consent and routine follow-up should be adopted. The Canadian Study of Health and Aging (CSHA) began in 1991-92 to explore dementia, frailty, and adverse health outcomes (Canadian Study of Health and Aging Working Group, 1994). The original CSHA proposal included linkage to provincial administrative health care databases by the individual CSHA study centers to enhance information on health care utilization and outcomes of study participants. In Nova Scotia, the Medical Services Insurance (MSI) administration, which drew the sampling frame for the original CSHA, did not retain the list of corresponding health card numbers. Furthermore, consent for this access was not asked of participants at the time of the first interview. The objectives of this study reported here were to examine the feasibility and ethical considerations of linking data from the CSHA to MSI utilization data, and to explore variation in health

  6. Development of the Canadian Marginalization Index: a new tool for the study of inequality.

    Science.gov (United States)

    Matheson, Flora I; Dunn, James R; Smith, Katherine L W; Moineddin, Rahim; Glazier, Richard H

    2012-04-30

    Area-based measures of socio-economic status are increasingly used in population health research. Based on previous research and theory, the Canadian Marginalization Index (CAN-Marg) was created to reflect four dimensions of marginalization: residential instability, material deprivation, dependency and ethnic concentration. The objective of this paper was threefold: to describe CAN-Marg; to illustrate its stability across geographic area and time; and to describe its association with health and behavioural problems. CAN-Marg was created at the dissemination area (DA) and census tract level for census years 2001 and 2006, using factor analysis. Descriptions of 18 health and behavioural problems were selected using individual-level data from the Canadian Community Health Survey (CCHS) 3.1 and 2007/08. CAN-Marg quintiles created at the DA level (2006) were assigned to individual CCHS records. Multilevel logistic regression modeling was conducted to examine associations between marginalization and CCHS health and behavioural problems. The index demonstrated marked stability across time and geographic area. Each of the four dimensions showed strong and significant associations with the selected health and behavioural problems, and these associations differed depending on which of the dimensions of marginalization was examined. CAN-Marg is a census-based, empirically derived and theoretically informed tool designed to reflect a broader conceptualization of Canadian marginalization.

  7. Mental health and functional impairment outcomes following a 6-week intensive treatment programme for UK military veterans with post-traumatic stress disorder (PTSD): a naturalistic study to explore dropout and health outcomes at follow-up.

    Science.gov (United States)

    Murphy, Dominic; Hodgman, Georgina; Carson, Carron; Spencer-Harper, Lucy; Hinton, Mark; Wessely, Simon; Busuttil, Walter

    2015-03-20

    Combat Stress, a UK national charity for veterans with mental health problems, has been funded by the National Health Service (NHS) to provide a national specialist service to deliver treatment for post-traumatic stress disorder (PTSD). This paper reports the efficacy of a PTSD treatment programme for UK veterans at 6 months follow-up. A within subject design. UK veterans with a diagnosis of PTSD who accessed Combat Stress. 246 veterans who received treatment between late 2012 and early 2014. An intensive 6-week residential treatment programme, consisting of a mixture of individual and group sessions. Participants were offered a minimum of 15 individual trauma-focused cognitive behavioural therapy sessions. In addition, participants were offered 55 group sessions focusing on psychoeducational material and emotional regulation. Clinicians completed measures of PTSD and functional impairment and participants completed measures of PTSD, depression, anger and functional impairment. We observed significant reductions in PTSD scores following treatment on both clinician completed measures (PSS-I: -13.0, 95% CI -14.5 to -11.5) and self-reported measures (Revised Impact of Events Scale (IES-R): -16.5, 95% CI -19.0 to -14.0). Significant improvements in functional impairment were also observed (eg, Health of the Nation Outcome Scales (HONOS): -6.85, 95% CI -7.98 to -5.72). There were no differences in baseline outcomes between those who completed and those who did not complete the programme, or post-treatment outcomes between those we were able to follow-up at 6 months and those lost to follow-up. In a naturalistic study we observed a significant reduction in PTSD scores and functional impairment following treatment. These improvements were maintained at 6 month follow-up. Our findings suggest it may be helpful to take a closer look at combining individual trauma-focused cognitive behaviour therapy and group sessions when treating veterans with PTSD. This is the first

  8. Sparse coding reveals greater functional connectivity in female brains during naturalistic emotional experience.

    Directory of Open Access Journals (Sweden)

    Yudan Ren

    Full Text Available Functional neuroimaging is widely used to examine changes in brain function associated with age, gender or neuropsychiatric conditions. FMRI (functional magnetic resonance imaging studies employ either laboratory-designed tasks that engage the brain with abstracted and repeated stimuli, or resting state paradigms with little behavioral constraint. Recently, novel neuroimaging paradigms using naturalistic stimuli are gaining increasing attraction, as they offer an ecologically-valid condition to approximate brain function in real life. Wider application of naturalistic paradigms in exploring individual differences in brain function, however, awaits further advances in statistical methods for modeling dynamic and complex dataset. Here, we developed a novel data-driven strategy that employs group sparse representation to assess gender differences in brain responses during naturalistic emotional experience. Comparing to independent component analysis (ICA, sparse coding algorithm considers the intrinsic sparsity of neural coding and thus could be more suitable in modeling dynamic whole-brain fMRI signals. An online dictionary learning and sparse coding algorithm was applied to the aggregated fMRI signals from both groups, which was subsequently factorized into a common time series signal dictionary matrix and the associated weight coefficient matrix. Our results demonstrate that group sparse representation can effectively identify gender differences in functional brain network during natural viewing, with improved sensitivity and reliability over ICA-based method. Group sparse representation hence offers a superior data-driven strategy for examining brain function during naturalistic conditions, with great potential for clinical application in neuropsychiatric disorders.

  9. fMRI-activation during drawing a naturalistic or sketchy portrait.

    Science.gov (United States)

    Schaer, K; Jahn, G; Lotze, M

    2012-07-15

    Neural processes for naturalistic drawing might be discerned into object recognition and analysis, attention processes guiding eye hand interaction, encoding of visual features in an allocentric reference frame, a transfer into the motor command and precise motor guidance with tight sensorimotor feedback. Cerebral representations in a real life paradigm during naturalistic drawing have sparsely been investigated. Using a functional Magnetic Resonance Imaging (fMRI) paradigm we measured 20 naive subjects during drawing a portrait from a frontal face presented as a photograph. Participants were asked to draw the portrait in either a naturalistic or a sketchy characteristic way. Tracing the contours of the face with a pencil or passive viewing of the face served as control conditions. Compared to passive viewing, naturalistic and sketchy drawing recruited predominantly the dorsal visual pathway, somatosensory and motor areas and bilateral BA 44. The right occipital lobe, middle temporal (MT) and the fusiform face area were increasingly active during drawing compared to passive viewing as well. Compared to tracing with a pencil, both drawing tasks increasingly involved the bilateral precuneus together with the cuneus and right inferior temporal lobe. Overall, our study identified cerebral areas characteristic for previously proposed aspects of drawing: face perception and analysis (fusiform gyrus and higher visual areas), encoding and retrieval of locations in an allocentric reference frame (precuneus), and continuous feedback processes during motor output (parietal sulcus, cerebellar hemisphere). Copyright © 2012 Elsevier B.V. All rights reserved.

  10. Naturalistic assessment of demand for cigarettes, snus, and nicotine gum.

    Science.gov (United States)

    Stein, Jeffrey S; Wilson, A George; Koffarnus, Mikhail N; Judd, Michael C; Bickel, Warren K

    2017-01-01

    Behavioral economic measures of demand provide estimates of tobacco product abuse liability and may predict effects of policy-related price regulation on consumption of existing and emerging tobacco products. In the present study, we examined demand for snus, a smokeless tobacco product, in comparison to both cigarettes and medicinal nicotine. We used both a naturalistic method in which participants purchased these products for use outside the laboratory, as well as laboratory-based self-administration procedures. Cigarette smokers (N = 42) used an experimental income to purchase their usual brand of cigarettes and either snus or gum (only one product available per session) across a range of prices, while receiving all products they purchased from one randomly selected price. In a separate portion of the study, participants self-administered these products during laboratory-based, progressive ratio sessions. Demand elasticity (sensitivity of purchasing to price) was significantly greater for snus than cigarettes. Elasticity for gum was intermediate between snus and cigarettes but was not significantly different than either. Demand intensity (purchasing unconstrained by price) was significantly lower for gum compared to cigarettes, with no significant difference observed between snus and cigarettes. Results of the laboratory-based, progressive ratio sessions were generally discordant with measures of demand elasticity, with significantly higher "breakpoints" for cigarettes compared to gum and no significant differences between other study products. Moreover, breakpoints and product purchasing were generally uncorrelated across tasks. Under naturalistic conditions, snus appears more sensitive to price manipulation than either cigarettes or nicotine gum in existing smokers.

  11. Berkson error adjustment and other exposure surrogates in occupational case-control studies, with application to the Canadian INTEROCC study.

    Science.gov (United States)

    Oraby, Tamer; Sivaganesan, Siva; Bowman, Joseph D; Kincl, Laurel; Richardson, Lesley; McBride, Mary; Siemiatycki, Jack; Cardis, Elisabeth; Krewski, Daniel

    2018-05-01

    Many epidemiological studies assessing the relationship between exposure and disease are carried out without data on individual exposures. When this barrier is encountered in occupational studies, the subject exposures are often evaluated with a job-exposure matrix (JEM), which consists of mean exposure for occupational categories measured on a comparable group of workers. One of the objectives of the seven-country case-control study of occupational exposure and brain cancer risk, INTEROCC, was to investigate the relationship of occupational exposure to electromagnetic fields (EMF) in different frequency ranges and brain cancer risk. In this paper, we use the Canadian data from INTEROCC to estimate the odds of developing brain tumours due to occupational exposure to EMF. The first step was to find the best EMF exposure surrogate among the arithmetic mean, the geometric mean, and the mean of log-normal exposure distribution for each occupation in the JEM, in comparison to Berkson error adjustments via numerical approximation of the likelihood function. Contrary to previous studies of Berkson errors in JEMs, we found that the geometric mean was the best exposure surrogate. This analysis provided no evidence that cumulative lifetime exposure to extremely low frequency magnetic fields increases brain cancer risk, a finding consistent with other recent epidemiological studies.

  12. International cross-cultural validation study of the Canadian haemophilia outcomes: kids' life assessment tool.

    Science.gov (United States)

    McCusker, P J; Fischer, K; Holzhauer, S; Meunier, S; Altisent, C; Grainger, J D; Blanchette, V S; Burke, T A; Wakefield, C; Young, N L

    2015-05-01

    Health-related quality of life (HRQoL) assessment is recognized as an important outcome in the evaluation of different therapeutic regimens for persons with haemophilia. The Canadian Haemophilia Outcomes-Kids' Life Assessment Tool (CHO-KLAT) is a disease-specific measure of HRQoL for 4 to 18-year-old boys with haemophilia. The purpose of this study was to extend this disease-specific, child-centric, outcome measure for use in international clinical trials. We adapted the North American English CHO-KLAT version for use in five countries: France, Germany, the Netherlands, Spain and the United Kingdom (UK). The process included four stages: (i) translation; (ii) cognitive debriefing; (iii) validity assessment relative to the PedsQL (generic) and the Haemo-QoL (disease-specific) and (iv) assessment of inter and intra-rater reliability. Cognitive debriefing was performed in 57 boys (mean age 11.4 years), validation was performed in 144 boys (mean age 11.0 years) and reliability was assessed for a subgroup of 64 boys (mean age 12.0 years). Parents also participated. The mean scores reported by the boys were high: CHO-KLAT 77.0 (SD = 11.2); PedsQL 83.8 (SD = 11.9) and Haemo-QoL 79.6 (SD = 11.5). Correlations between the CHO-KLAT and PedsQL ranged from 0.63 in Germany to 0.39 in the Netherlands and Spain. Test-retest reliability (concordance) for child self-report was 0.67. Child-parent concordance was slightly lower at 0.57. The CHO-KLAT has been fully culturally adapted and validated for use in five different languages and cultures (in England, the Netherlands, France, Germany and Spain) where treatment is readily available either on demand or as prophylaxis. © 2014 John Wiley & Sons Ltd.

  13. Canadian attitudes to nuclear power

    International Nuclear Information System (INIS)

    Davies, J.E.O.

    1977-01-01

    In the past ten years, public interest in nuclear power and its relationship to the environment has grown. Although most Canadians have accepted nuclear power as a means of generating electricity, there is significant opposition to its use. This opposition has effectively forced the Canadian nuclear industry to modify its behaviour to the public in the face of growing concern over the safety of nuclear power and related matters. The paper reviews Canadian experience concerning public acceptance of nuclear power, with special reference to the public information activities of the Canadian nuclear industry. Experience has shown the need for scientific social data that will permit the nuclear industry to involve the public in a rational examination of its concern about nuclear power. The Canadian Nuclear Association sponsored such studies in 1976 and the findings are discussed. They consisted of a national assessment of public attitudes, two regional studies and a study of Canadian policy-makers' views on nuclear energy. The social data obtained were of a base-line nature describing Canadian perceptions of and attitudes to nuclear power at that time. This research established that Canadian levels of knowledge about nuclear power are very low and that there are marked regional differences. Only 56% of the population have the minimum knowledge required to indicate that they know that nuclear power can be used to generate electricity. Nevertheless, 21% of informed Canadians oppose nuclear power primarily on the grounds that it is not safe. Radiation and waste management are seen to be major disadvantages. In perspective, Canadians are more concerned with inflation than with the energy supply. About half of all Canadians see the question of energy supplies as a future problem (within five years), not a present one. A more important aspect of energy is seen by the majority of Canadians to be some form of energy independence. The use of data from these studies is no easy

  14. Study in Grey and White: Measuring the Impact of the 8Rs Canadian Library Human Resources Study

    Directory of Open Access Journals (Sweden)

    Allison Sivak

    2009-06-01

    Full Text Available Objective – To use the 8Rs Canadian Library Human Resources Study (the 8Rs Study as a test case to develop a model for assessing research impact in LIS. Methods – Three different methods of citation analysis which take into account the changing environment of scholarly communications. These include a ‚manual‛ method of locating citations to the 8Rs Study through a major LIS database, an enhanced-citation tool Google Scholar, and a general Google search to locate Study references in non-scholarly documents Results – The majority of references (82% were found using Google or Google Scholar; the remainder were located via LISA. Each method had strengths and limitations.Conclusion - In-depth citation analysis provides a promising method of understanding the reach of published research. This investigation’s findings suggest the need for improvements in LIS citation tools, as well as digital archiving practices to improve the accessibility of references for measuring research impact. The findings also suggest the merit of researchers and practitioners defining levels of research impact, which will assist researchers in the dissemination of their work.

  15. Canadian gas resource

    International Nuclear Information System (INIS)

    Anon.

    1989-01-01

    Canadian exports of gas to the United States are a critical component of EMF-9 (North American Gas Supplies). However, it has been noted that there are differences between US expectations for imports and Canadian forecasts of export supply capacity. Recent studies by the National Petroleum Council (NPC) and the US Department of Energy (DOE) indicate that 1.8 to 2.4 Tcf of imports may be required in the mid to late 1990's; A recent study by Canada's National Energy Board (NEB) indicates that the conventional resource base may not be able to provide continued gas exports to the US after the mid 1990's and that frontier sources would need to be developed to meet US expectations. The discrepancies between US expectations and Canadian estimates of capacity are of great concern to US policymakers because they call into question the availability of secure supplies of natural gas and suggest that the cost of imports (if available) will be high. By implication, if shortages are to be averted, massive investment may be required to bring these higher cost sources to market. Since the long-term supply picture will be determined by the underlying resource base, EMF-9 participants have been asked to provide estimates of critical components of the Canadian resource base. This paper provides a summary of ICF-Lewin's recent investigation of both the Conventional and Tight Gas resource in Canada's Western Sedimentary Basin, which includes both quantitative estimates and a brief sketch of the analysis methodology

  16. Depressive symptoms among immigrant and Canadian born mothers of preterm infants at neonatal intensive care discharge: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Ballantyne Marilyn

    2013-01-01

    Full Text Available Abstract Background Mothers of preterm infants are considered at higher risk for depressive symptoms, higher than for mothers of healthy term infants. Predictors of depressive symptoms in mothers of preterm infants are not yet well established. Immigrant mothers of term infants have higher prevalence of depressive symptoms than Canadian born mothers but the relative prevalence for immigrant mothers of preterm infants is unknown. This study had two aims: (i to investigate the prevalence of depressive symptoms in immigrant as compared to Canadian born mothers of preterm infants, and (ii to determine what factors are associated with depressive symptoms in mothers of preterm infants. Methods This is a multi-site, cross sectional study of mothers whose preterm infants required hospitalization in neonatal intensive care unit (NICU. Consecutive eligible mothers (N = 291 were recruited during the week prior to their infant’s NICU discharge. Mothers completed a self-administered questionnaire booklet of validated psychosocial/cultural measures including the Center for Epidemiological Studies Depression Scale (CES-D, Parental Stressor Scale:NICU, General Functioning Subscale of the McMaster Family Assessment Device, Social Support Index, and Vancouver Index of Acculturation; and demographic characteristics questions. Infant characteristics included gestational age, birth weight, sex, singleton/multiple birth, and Score for Neonatal Acute Physiology-II. Results Immigrant mothers (N = 107, when compared to Canadian born mothers (N = 184, reported more depressive symptoms, poorer family functioning, less social support, and less mainstream acculturation. Hierarchical regression for a subsample of 271 mothers indicated that single parent status, high stress, poorer family functioning, and less social support were associated with increased depressive symptoms and accounted for 39% of the variance on the CES-D. Immigrant status did not contribute

  17. Depressive symptoms among immigrant and Canadian born mothers of preterm infants at neonatal intensive care discharge: a cross sectional study

    Science.gov (United States)

    2013-01-01

    Background Mothers of preterm infants are considered at higher risk for depressive symptoms, higher than for mothers of healthy term infants. Predictors of depressive symptoms in mothers of preterm infants are not yet well established. Immigrant mothers of term infants have higher prevalence of depressive symptoms than Canadian born mothers but the relative prevalence for immigrant mothers of preterm infants is unknown. This study had two aims: (i) to investigate the prevalence of depressive symptoms in immigrant as compared to Canadian born mothers of preterm infants, and (ii) to determine what factors are associated with depressive symptoms in mothers of preterm infants. Methods This is a multi-site, cross sectional study of mothers whose preterm infants required hospitalization in neonatal intensive care unit (NICU). Consecutive eligible mothers (N = 291) were recruited during the week prior to their infant’s NICU discharge. Mothers completed a self-administered questionnaire booklet of validated psychosocial/cultural measures including the Center for Epidemiological Studies Depression Scale (CES-D), Parental Stressor Scale:NICU, General Functioning Subscale of the McMaster Family Assessment Device, Social Support Index, and Vancouver Index of Acculturation; and demographic characteristics questions. Infant characteristics included gestational age, birth weight, sex, singleton/multiple birth, and Score for Neonatal Acute Physiology-II. Results Immigrant mothers (N = 107), when compared to Canadian born mothers (N = 184), reported more depressive symptoms, poorer family functioning, less social support, and less mainstream acculturation. Hierarchical regression for a subsample of 271 mothers indicated that single parent status, high stress, poorer family functioning, and less social support were associated with increased depressive symptoms and accounted for 39% of the variance on the CES-D. Immigrant status did not contribute significantly to the final

  18. Lithofacies control in detrital zircon provenance studies: Insights from the Cretaceous Methow basin, southern Canadian Cordillera

    Science.gov (United States)

    DeGraaff-Surpless, K.; Mahoney, J.B.; Wooden, J.L.; McWilliams, M.O.

    2003-01-01

    High-frequency sampling for detrital zircon analysis can provide a detailed record of fine-scale basin evolution by revealing the temporal and spatial variability of detrital zircon ages within clastic sedimentary successions. This investigation employed detailed sampling of two sedimentary successions in the Methow/Methow-Tyaughton basin of the southern Canadian Cordillera to characterize the heterogeneity of detrital zircon signatures within single lithofacies and assess the applicability of detrital zircon analysis in distinguishing fine-scale provenance changes not apparent in lithologic analysis of the strata. The Methow/Methow-Tyaughton basin contains two distinct stratigraphic sequences of middle Albian to Santonian clastic sedimentary rocks: submarine-fan deposits of the Harts Pass Formation/Jackass Mountain Group and fluvial deposits of the Winthrop Formation. Although both stratigraphic sequences displayed consistent ranges in detrital zircon ages on a broad scale, detailed sampling within each succession revealed heterogeneity in the detrital zircon age distributions that was systematic and predictable in the turbidite succession but unpredictable in the fluvial succession. These results suggest that a high-density sampling approach permits interpretation of finescale changes within a lithologically uniform turbiditic sedimentary succession, but heterogeneity within fluvial systems may be too large and unpredictable to permit accurate fine-scale characterization of the evolution of source regions. The robust composite detrital zircon age signature developed for these two successions permits comparison of the Methow/Methow-Tyaughton basin age signature with known plutonic source-rock ages from major plutonic belts throughout the Cretaceous North American margin. The Methow/Methow-Tyaughton basin detrital zircon age signature matches best with source regions in the southern Canadian Cordillera, requiring that the basin developed in close proximity to the

  19. Canadian petroleum industry

    Energy Technology Data Exchange (ETDEWEB)

    Dagher, J.H.

    1969-12-01

    This study covers the following Canadian petroleum industry categories: (1) a brief history; (2) the demand for Alberta crude; (3) U.S. oil policies; (4) overseas exploration; (5) the national oil policy; (6) the Montreal pipeline and its targets; (7) a continental oil policy; and (8) the impact of Arctic reserves. It is noted that large potential benefits will improve from the Manhattan navigating the Northwest Passage. Without prejudging the analysis now applied to the information gathered on this voyage, the Manhattan has greatly contributed to the solution of the problem of access to the Arctic islands. The picture for natural gas is less fraught with uncertainties. Unlike oil, where domestic and international considerations may weigh in U.S. policy decision, Canadian natural gas is likely to be allowed to enjoy its full economic potential in bridging the foreseeable U.S. supply gap and, inasmuch as this potential is ultimately tied with that for crude oil markets, the anticipated U.S. needs for Canadian natural gas may be expected to enhance U.S. interest in the overall well-being of the Canadian petroleum industry.

  20. Modeling Canadian Quality Control Test Program for Steroid Hormone Receptors in Breast Cancer: Diagnostic Accuracy Study.

    Science.gov (United States)

    Pérez, Teresa; Makrestsov, Nikita; Garatt, John; Torlakovic, Emina; Gilks, C Blake; Mallett, Susan

    The Canadian Immunohistochemistry Quality Control program monitors clinical laboratory performance for estrogen receptor and progesterone receptor tests used in breast cancer treatment management in Canada. Current methods assess sensitivity and specificity at each time point, compared with a reference standard. We investigate alternative performance analysis methods to enhance the quality assessment. We used 3 methods of analysis: meta-analysis of sensitivity and specificity of each laboratory across all time points; sensitivity and specificity at each time point for each laboratory; and fitting models for repeated measurements to examine differences between laboratories adjusted by test and time point. Results show 88 laboratories participated in quality control at up to 13 time points using typically 37 to 54 histology samples. In meta-analysis across all time points no laboratories have sensitivity or specificity below 80%. Current methods, presenting sensitivity and specificity separately for each run, result in wide 95% confidence intervals, typically spanning 15% to 30%. Models of a single diagnostic outcome demonstrated that 82% to 100% of laboratories had no difference to reference standard for estrogen receptor and 75% to 100% for progesterone receptor, with the exception of 1 progesterone receptor run. Laboratories with significant differences to reference standard identified with Generalized Estimating Equation modeling also have reduced performance by meta-analysis across all time points. The Canadian Immunohistochemistry Quality Control program has a good design, and with this modeling approach has sufficient precision to measure performance at each time point and allow laboratories with a significantly lower performance to be targeted for advice.

  1. Physical and Leisure Activity in Older Community-Dwelling Canadians Who Use Wheelchairs: A Population Study

    Directory of Open Access Journals (Sweden)

    Krista L. Best

    2011-01-01

    Full Text Available Background. Physical and leisure activities are proven health promotion modalities and have not been examined in older wheelchair users. Main Objectives. Examine physical and leisure activity in older wheelchair users and explore associations between wheelchair use and participation in physical and leisure activity, and wheelchair use, physical and leisure activity, and perceived health. Methods. 8301 Canadians ≥60 years of age were selected from the Canadian Community Health Survey. Sociodemographic, health-related, mobility-related, and physical and leisure activity variables were analysed using logistic regression to determine, the likelihood of participation in physical and leisure activity, and whether participation in physical and leisure activities mediates the relationship between wheelchair use and perceived health. Results. 8.3% and 41.3% older wheelchair users were physically and leisurely active. Wheelchair use was a risk factor for reduced participation in physical (OR=44.71 and leisure activity (OR=10.83. Wheelchair use was a risk factor for poor perceived health (OR=10.56 and physical and leisure activity negatively mediated the relationship between wheelchair user and perceived health. Conclusion. There is a need for the development of suitable physical and leisure activity interventions for older wheelchair users. Participation in such interventions may have associations with health benefits.

  2. A survey study of evidence-based medicine training in US and Canadian medical schools.

    Science.gov (United States)

    Blanco, Maria A; Capello, Carol F; Dorsch, Josephine L; Perry, Gerald; Zanetti, Mary L

    2014-07-01

    The authors conducted a survey examining (1) the current state of evidence-based medicine (EBM) curricula in US and Canadian medical schools and corresponding learning objectives, (2) medical educators' and librarians' participation in EBM training, and (3) barriers to EBM training. A survey instrument with thirty-four closed and open-ended questions was sent to curricular deans at US and Canadian medical schools. The survey sought information on enrollment and class size; EBM learning objectives, curricular activities, and assessment approaches by year of training; EBM faculty; EBM tools; barriers to implementing EBM curricula and possible ways to overcome them; and innovative approaches to EBM education. Both qualitative and quantitative methods were used for data analysis. Measurable learning objectives were categorized using Bloom's taxonomy. One hundred fifteen medical schools (77.2%) responded. Over half (53%) of the 900 reported learning objectives were measurable. Knowledge application was the predominant category from Bloom's categories. Most schools integrated EBM into other curricular activities; activities and formal assessment decreased significantly with advanced training. EBM faculty consisted primarily of clinicians, followed by basic scientists and librarians. Various EBM tools were used, with PubMed and the Cochrane database most frequently cited. Lack of time in curricula was rated the most significant barrier. National agreement on required EBM competencies was an extremely helpful factor. Few schools shared innovative approaches. Schools need help in overcoming barriers related to EBM curriculum development, implementation, and assessment. Findings can provide a starting point for discussion to develop a standardized competency framework.

  3. Are Military and Medical Ethics Necessarily Incompatible? A Canadian Case Study.

    Science.gov (United States)

    Rochon, Christiane; Williams-Jones, Bryn

    2016-12-01

    Military physicians are often perceived to be in a position of 'dual loyalty' because they have responsibilities towards their patients but also towards their employer, the military institution. Further, they have to ascribe to and are bound by two distinct codes of ethics (i.e., medical and military), each with its own set of values and duties, that could at first glance be considered to be very different or even incompatible. How, then, can military physicians reconcile these two codes of ethics and their distinct professional/institutional values, and assume their responsibilities towards both their patients and the military institution? To clarify this situation, and to show how such a reconciliation might be possible, we compared the history and content of two national professional codes of ethics: the Defence Ethics of the Canadian Armed Forces and the Code of Ethics of the Canadian Medical Association. Interestingly, even if the medical code is more focused on duties and responsibility while the military code is more focused on core values and is supported by a comprehensive ethical training program, they also have many elements in common. Further, both are based on the same core values of loyalty and integrity, and they are broad in scope but are relatively flexible in application. While there are still important sources of tension between and limits within these two codes of ethics, there are fewer differences than may appear at first glance because the core values and principles of military and medical ethics are not so different.

  4. Physical and leisure activity in older community-dwelling canadians who use wheelchairs: a population study.

    Science.gov (United States)

    Best, Krista L; Miller, William C

    2011-04-13

    Background. Physical and leisure activities are proven health promotion modalities and have not been examined in older wheelchair users. Main Objectives. Examine physical and leisure activity in older wheelchair users and explore associations between wheelchair use and participation in physical and leisure activity, and wheelchair use, physical and leisure activity, and perceived health. Methods. 8301 Canadians ≥60 years of age were selected from the Canadian Community Health Survey. Sociodemographic, health-related, mobility-related, and physical and leisure activity variables were analysed using logistic regression to determine, the likelihood of participation in physical and leisure activity, and whether participation in physical and leisure activities mediates the relationship between wheelchair use and perceived health. Results. 8.3% and 41.3% older wheelchair users were physically and leisurely active. Wheelchair use was a risk factor for reduced participation in physical (OR = 44.71) and leisure activity (OR = 10.83). Wheelchair use was a risk factor for poor perceived health (OR = 10.56) and physical and leisure activity negatively mediated the relationship between wheelchair user and perceived health. Conclusion. There is a need for the development of suitable physical and leisure activity interventions for older wheelchair users. Participation in such interventions may have associations with health benefits.

  5. Focus: the peculiar persistence of the naturalistic fallacy. Introduction.

    Science.gov (United States)

    Milam, Erika Lorraine

    2014-09-01

    Although "naturalistic fallacy" is a term coined in the twentieth century, scholars have long voiced myriad anxieties over the mechanisms by which their contemporaries have derived moral, social, and political lessons from natural phenomena--often as gambits for advancing their own alternative explanations. The essays in this Focus section explore five episodes in the history of such concerns with naturalistic reasoning in order to shed new light on the persistence of naturalism itself.

  6. Naturalist Intelligence Among the Other Multiple Intelligences [In Bulgarian

    Directory of Open Access Journals (Sweden)

    R. Genkov

    2007-09-01

    Full Text Available The theory of multiple intelligences was presented by Gardner in 1983. The theory was revised later (1999 and among the other intelligences a naturalist intelligence was added. The criteria for distinguishing of the different types of intelligences are considered. While Gardner restricted the analysis of the naturalist intelligence with examples from the living nature only, the present paper considered this problem on wider background including objects and persons of the natural sciences.

  7. Naturalistically observed conflict and youth asthma symptoms.

    Science.gov (United States)

    Tobin, Erin T; Kane, Heidi S; Saleh, Daniel J; Naar-King, Sylvie; Poowuttikul, Pavadee; Secord, Elizabeth; Pierantoni, Wayne; Simon, Valerie A; Slatcher, Richard B

    2015-06-01

    To investigate the links between naturalistically observed conflict, self-reported caregiver-youth conflict, and youth asthma symptoms. Fifty-four youth with asthma (age range: 10-17 years) wore the Electronically Activated Recorder (EAR) for a 4-day period to assess interpersonal conflict and caregiver-youth conflict as they occur in daily life. Conflict also was assessed with baseline self-report questionnaires and daily diaries completed by youth participants and their caregivers. Asthma symptoms were assessed using daily diaries, baseline self-reports, and wheezing, as coded from the EAR. EAR-observed measures of conflict were strongly associated with self-reported asthma symptoms (both baseline and daily diaries) and wheezing coded from the EAR. Further, when entered together in regression analyses, youth daily reports of negative caregiver-youth interactions and EAR-observed conflict uniquely predicted asthma symptoms; only EAR-observed conflict was associated with EAR-observed wheezing. These findings demonstrate the potential impact of daily conflict on youth asthma symptoms and the importance of assessing conflict as it occurs in everyday life. More broadly, they point to the importance of formulating a clear picture of family interactions outside of the lab, which is essential for understanding how family relationships "get under the skin" to affect youth health. (c) 2015 APA, all rights reserved).

  8. Cardiovascular Reactivity During Marital Conflict in Laboratory and Naturalistic Settings: Differential Associations with Relationship and Individual Functioning Across Contexts.

    Science.gov (United States)

    Baucom, Brian R W; Baucom, Katherine J W; Hogan, Jasara N; Crenshaw, Alexander O; Bourne, Stacia V; Crowell, Sheila E; Georgiou, Panayiotis; Goodwin, Matthew S

    2018-03-25

    Cardiovascular reactivity during spousal conflict is considered to be one of the main pathways for relationship distress to impact physical, mental, and relationship health. However, the magnitude of association between cardiovascular reactivity during laboratory marital conflict and relationship functioning is small and inconsistent given the scope of its importance in theoretical models of intimate relationships. This study tests the possibility that cardiovascular data collected in laboratory settings downwardly bias the magnitude of these associations when compared to measures obtained in naturalistic settings. Ambulatory cardiovascular reactivity data were collected from 20 couples during two relationship conflicts in a research laboratory, two planned relationship conflicts at couples' homes, and two spontaneous relationship conflicts during couples' daily lives. Associations between self-report measures of relationship functioning, individual functioning, and cardiovascular reactivity across settings are tested using multilevel models. Cardiovascular reactivity was significantly larger during planned and spontaneous relationship conflicts in naturalistic settings than during planned relationship conflicts in the laboratory. Similarly, associations with relationship and individual functioning variables were statistically significantly larger for cardiovascular data collected in naturalistic settings than the same data collected in the laboratory. Our findings suggest that cardiovascular reactivity during spousal conflict in naturalistic settings is statistically significantly different from that elicited in laboratory settings both in magnitude and in the pattern of associations with a wide range of inter- and intrapersonal variables. These differences in findings across laboratory and naturalistic physiological responses highlight the value of testing physiological phenomena across interaction contexts in romantic relationships. © 2018 Family Process

  9. Migraine and Despair: Factors Associated with Depression and Suicidal Ideation among Canadian Migraineurs in a Population-Based Study

    Directory of Open Access Journals (Sweden)

    Esme Fuller-Thomson

    2013-01-01

    Full Text Available This study sought to (1 investigate the association between migraine and both depression and suicidal ideation and (2 to identify the factors independently associated with each of these mental health problems among Canadian men and women with migraine. Data were analyzed from the 2005 Canadian Community Health Survey (CCHS. Presence of migraine was assessed by self-report of a health professional diagnosis. Current depression was measured using the CIDI-SF, and suicidal ideation was based on a question about serious consideration of suicide at any point during the respondent's lifetime. Migraineurs were found to have elevated odds of depression (men: OR = 2.02; 95% CI = 1.70, 2.41; women: OR = 1.89; 95% CI = 1.71, 2.10 and suicidal ideation (men: OR = 1.70; 95% CI = 1.55, 1.96; women: OR = 1.72; 95% CI = 1.59, 1.86 even when adjusting for sociodemographic variables and disability status. The odds of depression and suicidal ideation were higher among both genders of migraineurs who were younger, unmarried and had more activity limitations; associations with poverty and race depended on gender and whether the focus was on depression or suicidal ideation. While screening for depression is already recommended for those with migraine, this research helps identify which migraineurs may require more immediate attention, including those who are younger, unmarried, and experiencing limitations in their activities.

  10. Comparative study on membership legislation in Canadian and Chinese agricultural co-operative laws

    Institute of Scientific and Technical Information of China (English)

    CHU Zhihong; GUO Xiangyu

    2007-01-01

    For centuries, groups of people desiring to supply themselves with goods, to market their products, or to obtain services of various kinds on a co-operative basis, have made increasing use of co-operative associations to achieve these purposes. During the period, legislation designed especially for the incorporation and conduct of such associations has been enacted by different counties.Since a co-operative is established and carried on by and for the use of its members, this essay makes a comparison between Canadian and Chinese co-operative laws in terms of membership in the aspects of qualifications, rights and obligations and withdrawal of membership, so as to probe the function of co-operative legislation and find some enlightment from it.

  11. Progress in welding studies for Canadian nuclear fuel waste disposal containers

    International Nuclear Information System (INIS)

    Maak, P.Y.Y.

    1985-11-01

    This report describes the progress in the development of closure-welding technology for Canadian nuclear fuel waste disposal containers. Titanium, copper and Inconel 625 are being investigated as candidate materials for fabrication of these containers. Gas-tungsten-arc welding, gas metal-arc-welding, resistance-heated diffusion bonding and electron beam welding have been evaluated as candidate closure welding processes. Characteristic weldment properties, relative merits of welding techniques, suitable weld joint configurations and fit-up tolerances, and welding parameter control ranges have been identified for various container designs. Furthermore, the automation requirements for candidate welding processes have been assessed. Progress in the development of a computer-controlled remote gas-shielded arc welding system is described

  12. Studies of cesium and strontium migration in unconsolidated Canadian geological materials

    International Nuclear Information System (INIS)

    Gillham, R.W.; Lindsay, L.E.; Reynolds, W.D.; Kewen, T.J.; Cherry, J.A.; Reddy, M.R.

    1981-06-01

    Distribution coefficients (Ksub(d)) were measured for cesium and strontium in 16 samples of Canadian unconsolidated geological materials. The samples were collected to cover a wide range of grain size, clay-mineral composition, cation exchange capacity and carbonate mineral content. Distribution coefficients ranged between 10 2 and 2.0 x 10 4 ml/g for cesium and between 2.5 and 10 2 ml/g for strontium, indicating that most unconsolidated geological materials have a substantial ability to retard the migration of cesium, while strontium could generally be expected to be somewhat more mobile. The measured K values were not significantly correlated with the measured soil properties, but appeared to be significantly affected by the background concentration of stable isotopes of the respective radionuclides

  13. Stigma in Male Depression and Suicide: A Canadian Sex Comparison Study.

    Science.gov (United States)

    Oliffe, John L; Ogrodniczuk, John S; Gordon, Susan J; Creighton, Genevieve; Kelly, Mary T; Black, Nick; Mackenzie, Corey

    2016-04-01

    Stigma in men's depression and suicide can restrict help-seeking, reduce treatment compliance and deter individuals from confiding in friends and family. In this article we report sex comparison findings from a national survey of English-speaking adult Canadians about stigmatized beliefs concerning male depression and suicide. Among respondents without direct experience of depression or suicide (n = 541) more than a third endorsed the view that men with depression are unpredictable. Overall, a greater proportion of males endorsed stigmatizing views about male depression compared to female respondents. A greater proportion of female respondents endorsed items indicating that men who suicide are disconnected, lost and lonely. Male and female respondents with direct personal experience of depression or suicide (n = 360) strongly endorsed stigmatizing attitudes toward themselves and a greater proportion of male respondents indicated that they would be embarrassed about seeking help for depression.

  14. Methods used for immunization coverage assessment in Canada, a Canadian Immunization Research Network (CIRN) study.

    Science.gov (United States)

    Wilson, Sarah E; Quach, Susan; MacDonald, Shannon E; Naus, Monika; Deeks, Shelley L; Crowcroft, Natasha S; Mahmud, Salaheddin M; Tran, Dat; Kwong, Jeff; Tu, Karen; Gilbert, Nicolas L; Johnson, Caitlin; Desai, Shalini

    2017-08-03

    Accurate and complete immunization data are necessary to assess vaccine coverage, safety and effectiveness. Across Canada, different methods and data sources are used to assess vaccine coverage, but these have not been systematically described. Our primary objective was to examine and describe the methods used to determine immunization coverage in Canada. The secondary objective was to compare routine infant and childhood coverage estimates derived from the Canadian 2013 Childhood National Immunization Coverage Survey (cNICS) with estimates collected from provinces and territories (P/Ts). We collected information from key informants regarding their provincial, territorial or federal methods for assessing immunization coverage. We also collected P/T coverage estimates for select antigens and birth cohorts to determine absolute differences between these and estimates from cNICS. Twenty-six individuals across 16 public health organizations participated between April and August 2015. Coverage surveys are conducted regularly for toddlers in Quebec and in one health authority in British Columbia. Across P/Ts, different methodologies for measuring coverage are used (e.g., valid doses, grace periods). Most P/Ts, except Ontario, measure up-to-date (UTD) coverage and 4 P/Ts also assess on-time coverage. The degree of concordance between P/T and cNICS coverage estimates varied by jurisdiction, antigen and age group. In addition to differences in the data sources and processes used for coverage assessment, there are also differences between Canadian P/Ts in the methods used for calculating immunization coverage. Comparisons between P/T and cNICS estimates leave remaining questions about the proportion of children fully vaccinated in Canada.

  15. Will an Unsupervised Self-Testing Strategy Be Feasible to Operationalize in Canada? Results from a Pilot Study in Students of a Large Canadian University

    Directory of Open Access Journals (Sweden)

    Nitika Pant Pai

    2014-01-01

    Full Text Available Background. A convenient, private, and accessible HIV self-testing strategy stands to complement facility-based conventional testing. Over-the-counter oral HIV self-tests are approved and available in the United States, but not yet in Canada. Canadian data on self-testing is nonexistent. We investigated the feasibility of offering an unsupervised self-testing strategy to Canadian students. Methods. Between September 2011 and May 2012, we recruited 145 students from a student health clinic of a large Canadian university. Feasibility of operationalization (i.e., self-test conduct, acceptability, convenience, and willingness to pay was evaluated. Self-test conduct was computed with agreement between the self-test performed by the student and the test repeated by a healthcare professional. Other metrics were measured on a survey. Results. Participants were young (median age: 22 years, unmarried (97%, and 47% were out of province or international students. Approximately 52% self-reported a history of unprotected casual sex and sex with multiple partners. Self-test conduct agreement was high (100%, so were acceptability (81%, convenience (99%, and willingness to pay (74% for self-tests. Concerns included accuracy of self-tests and availability of expedited linkages. Conclusion. An unsupervised self-testing strategy was found to be feasible in Canadian students. Findings call for studies in at-risk populations to inform Canadian policy.

  16. Canadian seismic agreement

    International Nuclear Information System (INIS)

    Wetmiller, R.J.; Lyons, J.A.; Shannon, W.E.; Munro, P.S.; Thomas, J.T.; Andrew, M.D.; Lamontagne, M.; Wong, C.; Anglin, F.M.; Plouffe, M.; Lapointe, S.P.; Adams, J.; Drysdale, J.A.

    1990-04-01

    This is the twenty-first progress report under the agreement entitled Canadian Seismic Agreement between the US Nuclear Regulatory Commission (NRC) and the Canadian Commercial Corporation. Activities undertaken by the Geophysics Division of the Geological Survey of Canada (GD/GSC) during the period from July 01, 1988 to June 30, 1989 and supported in part by the NRC agreement are described below under four headings; Eastern Canada Telemetred Network and local network developments, Datalab developments, strong motion network developments and earthquake activity. In this time period eastern Canada experienced its largest earthquake in over 50 years. This earthquake, which has been christened the Saguenay earthquake, has provided a wealth of new data pertinent to earthquake engineering studies in eastern North America and is the subject of many continuing studies, which are presently being carried out at GD and elsewhere. 41 refs., 21 figs., 7 tabs

  17. Dynamics of brain activity underlying working memory for music in a naturalistic condition

    OpenAIRE

    Burunat Pérez, Iballa

    2012-01-01

    Working memory (WM) is at the core of any cognitive function as it is necessary for the integration of information over time. Despite WM’s critical role in high-level cognitive functions, its implementation in the neural tissue is poorly understood. Preliminary studies on auditory WM show differences between linguistic and musical memory, leading to the speculation of specific neural networks encoding memory for music. Moreover, in neuroscience WM has not been studied in naturalistic listenin...

  18. Shift Work and Obesity among Canadian Women: A Cross-Sectional Study Using a Novel Exposure Assessment Tool.

    Science.gov (United States)

    McGlynn, Natalie; Kirsh, Victoria A; Cotterchio, Michelle; Harris, M Anne; Nadalin, Victoria; Kreiger, Nancy

    2015-01-01

    It has been suggested that the association between shift work and chronic disease is mediated by an increase in obesity. However, investigations of the relationship between shift work and obesity reveal mixed findings. Using a recently developed exposure assessment tool, this study examined the association between shift work and obesity among Canadian women from two studies: a cohort of university alumni, and a population-based study. Self-administered questionnaire data were used from healthy, currently employed females in a population-based study, the Ontario Women's Diet and Health case-control study (n = 1611 controls), and from a subset of a of university alumni from the Canadian Study of Diet, Lifestyle, and Health (n = 1097) cohort study. Overweight was defined as BMI≥25 to shift work value derived from Survey of Labour and Income Dynamics data. Regular evenings, nights, or rotating work comprised shift work. Polytomous logistic regression estimated the association between probability of shift work, categorized as near nil, low, medium, and high probability of shift work, on overweight and obesity, controlling for detected confounders. In the population-based sample, high probability of shift work was associated with obesity (reference = near nil probability of shift work, OR: 1.88, 95% CI: 1.01-3.51, p = 0.047). In the alumni cohort, no significant association was detected between shift work and overweight or obesity. As these analyses found a positive association between high probability of shift work exposure and obesity in a population-based sample, but not in an alumni cohort, it is suggested that the relationship between shift work and obesity is complex, and may be particularly susceptible to occupational and education-related factors within a given population.

  19. A queer day in Canada: examining Canadian high school students' experiences with school-based homophobia in two large-scale studies.

    Science.gov (United States)

    Peter, Tracey; Taylor, Catherine; Chamberland, Line

    2015-01-01

    The goal of the study is to examine how location (nationally, compared to Canadian regions) is related to indicators of a hostile school environment for sexual minority youth, particularly when physical abuse is used as the outcome variable. Data representing 5,766 Canadian students were analyzed using bivariate and multivariate techniques. Results from the multivariate analyses showed that non-physical abuse was the most significant predictor of homophobically based physical abuse, for both LGBQ and non-LGBQ students. Findings reiterate the importance of considering the progression of harmful events as an escalation of violence as well as the need to view homophobic bullying as having a significant impact on all students. Finally, while the presence of homophobia is prevalent across all Canadian regions, there are, nevertheless, many regional differences, which could be used to inform region-specific action plans.

  20. A 10-Year Follow-Up of Urinary and Fecal Incontinence among the Oldest Old in the Community: The Canadian Study of Health and Aging

    Science.gov (United States)

    Ostbye,Truls; Seim, Arnfinn; Krause, Katrina M.; Feightner, John; Hachinski, Vladimir; Sykes, Elizabeth; Hunskaar, Steinar

    2004-01-01

    Urinary incontinence is common in the elderly. The epidemiology of fecal and double (urinary and fecal) incontinence is less known. The Canadian Study of Health and Aging (CSHA) is a national study of elderly living in the community at baseline (n = 8,949) and interviewed in 1991-1992, 1996, and 2001. Using data from the CSHA, we report the…

  1. Canadian valuation of EQ-5D health states: preliminary value set and considerations for future valuation studies.

    Directory of Open Access Journals (Sweden)

    Nick Bansback

    Full Text Available The EQ-5D is a preference based instrument which provides a description of a respondent's health status, and an empirically derived value for that health state often from a representative sample of the general population. It is commonly used to derive Quality Adjusted Life Year calculations (QALY in economic evaluations. However, values for health states have been found to differ between countries. The objective of this study was to develop a set of values for the EQ-5D health states for use in Canada.Values for 48 different EQ-5D health states were elicited using the Time Trade Off (TTO via a web survey in English. A random effect model was fitted to the data to estimate values for all 243 health states of the EQ-5D. Various model specifications were explored. Comparisons with EQ-5D values from the UK and US were made. Sensitivity analysis explored different transformations of values worse than dead, and exclusion criteria of subjects.The final model was estimated from the values of 1145 subjects with socio-demographics broadly representative of Canadian general population with the exception of Quebec. This yielded a good fit with observed TTO values, with an overall R2 of 0.403 and a mean absolute error of 0.044.A preference-weight algorithm for Canadian studies that include the EQ-5D is developed. The primary limitations regarded the representativeness of the final sample, given the language used (English only, the method of recruitment, and the difficulty in the task. Insights into potential issues for conducting valuation studies in countries as large and diverse as Canada are gained.

  2. Impact of naturalistic lighting on hospitalized stroke patients in a rehabilitation unit

    DEFF Research Database (Denmark)

    West, Anders; Jennum, Poul; Simonsen, Sofie Amalie

    2017-01-01

    Introduction and rationale: Stroke is a major cause of acquired cerebral disability among adults, frequently accompanied by depression, anxiety, cognitive impairment, disrupted sleep and fatigue. New ways of intervention to prevent these complications are therefore needed. The major circadian...... a positive impact on the health of poststroke patients admitted to rehabilitation. We test specifically for improved sleep and less fatigue (questionnaires, polysomnography, Actiwatch), improved well-being (questionnaires), lessen anxiety and depression (questionnaires), improved cognition (tests...... on patients during long-term hospitalization in a real hospital setting. The hypotheses are based on preclinical research, as studies using naturalistic light have never been performed before. Investigating the effects of naturalistic light in a clinical setting is therefore much needed....

  3. A Questionnaire-Based Study on the Perceptions of Canadian Seniors About Cognitive, Social, and Psychological Benefits of Digital Games.

    Science.gov (United States)

    Duplàa, Emmanuel; Kaufman, David; Sauvé, Louise; Renaud, Lise

    2017-06-01

    This study explored the perceptions of seniors who play digital games on the potential benefits of these games and on the factors associated with these perceptions. We developed and administered a questionnaire to a sample of 590 Canadian seniors in British Columbia and Quebec that addressed demographics, digital game practices, and perceived benefits. Results of administering the questionnaire showed that cognitive benefits were reported more frequently than social or psychological benefits. First language and gender were associated with the benefits reported, with fewer Francophones and women reporting benefits. The most important factor found was whether or not they played online, as playing online was associated with greater perceptions of social, as well as cognitive, benefits. Social and cognitive benefits are reported by seniors from playing digital games and should be investigated through future experimental and quasi-experimental research.

  4. Solar PV electricity and market characteristics: two Canadian case-studies

    International Nuclear Information System (INIS)

    Rowlands, I.H.

    2005-01-01

    To determine whether solar electricity (that is, electricity generated by photovoltaics) is, on an average, more valuable - in market terms - than the electricity generated in power systems as a whole, this article investigates the extent to which solar resource availability in two Canadian locations is associated with peak electricity market demand and peak electricity market price. More specifically, solar radiation and electricity market data for the period 1 May 2002 to 30 April 2004 are examined for Calgary, Alta. and Guelph, Ont. A variety of visual and statistical investigations reveal that solar radiation values coincide closely with peak electricity market demand and, though to a somewhat lesser extent, peak electricity market prices during the summertime in each location. While more detailed investigation is needed in order to determine the specific impact of different levels of PV penetration upon provincial electricity markets, the article provides ample encouragement for further research. The article also shows how different techniques can be used-in any location-to investigate the relationship among solar electricity potential, system-wide demand and market prices. With electricity industries being restructured around the world, it continues to be important for solar energy proponents to participate in discussions regarding economic costs and benefits. Techniques used in this article can help them advance the solar electricity case more effectively and thus catalyse the deployment of photovoltaics in markets around the world. (author)

  5. Economic consequences incurred by living kidney donors: a Canadian multi-center prospective study.

    Science.gov (United States)

    Klarenbach, S; Gill, J S; Knoll, G; Caulfield, T; Boudville, N; Prasad, G V R; Karpinski, M; Storsley, L; Treleaven, D; Arnold, J; Cuerden, M; Jacobs, P; Garg, A X

    2014-04-01

    Some living kidney donors incur economic consequences as a result of donation; however, these costs are poorly quantified. We developed a framework to comprehensively assess economic consequences from the donor perspective including out-of-pocket cost, lost wages and home productivity loss. We prospectively enrolled 100 living kidney donors from seven Canadian centers between 2004 and 2008 and collected and valued economic consequences ($CAD 2008) at 3 months and 1 year after donation. Almost all (96%) donors experienced economic consequences, with 94% reporting travel costs and 47% reporting lost pay. The average and median costs of lost pay were $2144 (SD 4167) and $0 (25th-75th percentile 0, 2794), respectively. For other expenses (travel, accommodation, medication and medical), mean and median costs were $1780 (SD 2504) and $821 (25th-75th percentile 242, 2271), respectively. From the donor perspective, mean cost was $3268 (SD 4704); one-third of donors incurred cost >$3000, and 15% >$8000. The majority of donors (83%) reported inability to perform usual household activities for an average duration of 33 days; 8% reported out-of-pocket costs for assistance with these activities. The economic impact of living kidney donation for some individuals is large. We advocate for programs to reimburse living donors for their legitimate costs. © 2014 The Authors. American Journal of Transplantation Published by Wiley Periodicals, Inc. on behalf of American Society of Transplant Surgeons.

  6. School and community predictors of smoking: a longitudinal study of Canadian high schools.

    Science.gov (United States)

    Lovato, Chris; Watts, Allison; Brown, K Stephen; Lee, Derrick; Sabiston, Catherine; Nykiforuk, Candace; Eyles, John; Manske, Steve; Campbell, H Sharon; Thompson, Mary

    2013-02-01

    We identified the most effective mix of school-based policies, programs, and regional environments associated with low school smoking rates in a cohort of Canadian high schools over time. We collected a comprehensive set of student, school, and community data from a national cohort of 51 high schools in 2004 and 2007. Hierarchical linear modeling was used to predict school and community characteristics associated with school smoking prevalence. Between 2004 and 2007, smoking prevalence decreased from 13.3% to 10.7% in cohort schools. Predictors of lower school smoking prevalence included both school characteristics related to prevention programming and community characteristics, including higher cigarette prices, a greater proportion of immigrants, higher education levels, and lower median household income. Effective approaches to reduce adolescent smoking will require interventions that focus on multiple factors. In particular, prevention programming and high pricing for cigarettes sold near schools may contribute to lower school smoking rates, and these factors are amenable to change. A sustained focus on smoking prevention is needed to maintain low levels of adolescent smoking.

  7. Management practices associated with pain in cattle on western Canadian cow-calf operations: A mixed methods study.

    Science.gov (United States)

    Moggy, M A; Pajor, E A; Thurston, W E; Parker, S; Greter, A M; Schwartzkopf-Genswein, K S; Campbell, J R; Windeyer, M C

    2017-02-01

    The implementation of on-farm pain mitigation strategies is dependent on feasibility and importance to producers. Currently, there is a lack of information regarding adoption of management practices associated with pain in cattle within the Canadian beef industry. The objective of this mixed methods study was to describe pain-associated practices implemented on farm and producer perceptions toward pain mitigation strategies. A questionnaire about calving management and calf processing was delivered to 109 cow-calf producers in western Canada. In addition, 15 respondents were purposively selected based on questionnaire responses to participate in individual semistructured, on-farm interviews. The prevalence of pain mitigation strategies used for dystocia and cesarean section by respondents were 46 and 100%, respectively. The majority of operations reported castrating and dehorning calves before 3 mo of age (95 and 89%, respectively). The majority of operations did not use pain mitigation strategies for castration and dehorning (90 and 85%, respectively). Branding was practiced by 57% of respondents, 4% of which used pain mitigation. Thematic content analysis revealed that producers' perception of pain were influenced by what they referred to as "common sense," relatability to cattle, visual evidence of pain, and age of the animal. Factors that influenced participant rationale for the implementation of pain mitigation practices included access to information and resources, age of the animal, benefit to the operation, cost and logistics, market demands, and personal conscience. Overall, management practices were generally in compliance with published Canadian guidelines. Results of this study may provide direction for future policy making, research, and extension efforts to encourage the adoption of pain mitigation strategies.

  8. Opportunities for prevention and intervention with young children: lessons from the Canadian incidence study of reported child abuse and neglect

    Directory of Open Access Journals (Sweden)

    Fallon Barbara

    2013-02-01

    Full Text Available Abstract Background The most effective way to provide support to caregivers with infants in order to promote good health, social, emotional and developmental outcomes is the subject of numerous debates in the literature. In Canada, each province adopts a different approach which range from universal to targeted programs. Nonetheless, each year a group of vulnerable infants is identified to the child welfare system with concerns about their well-being and safety. This study examines maltreatment-related investigations in Canada involving children under the age of one year to identify which factors determine service provision at the conclusion of the investigation. Methods A secondary analysis of the Canadian Incidence Study of Reported Child Abuse and Neglect CIS-2008 (PHAC, 2010 dataset was conducted. Multivariate analyses were conducted to understand the profile of investigations involving infants (n=1,203 and which predictors were significant in the decision to transfer a case to ongoing services at the conclusion of the investigation. Logistic Regression and Classification and Regression Trees (CART were conducted to examine the relationship between the outcome and predictors. Results The results suggest that there are three main sources that refer infants to the Canadian child welfare system: hospital, police, and non-professionals. Infant maltreatment-related investigations involve young caregivers who struggle with poverty, single-parenthood, drug/solvent and alcohol abuse, mental health issues, lack of social supports, and intimate partner violence. Across the three referral sources, primary caregiver risk factors are the strongest predictor of the decision to transfer a case to ongoing services. Conclusions Multivariate analyses indicate that the presence of infant concerns does not predict ongoing service provision, except when the infant is identified with positive toxicology at birth. The opportunity for early intervention and the

  9. Canadian small wind market

    International Nuclear Information System (INIS)

    Moorhouse, E.

    2010-01-01

    This PowerPoint presentation discussed initiatives and strategies adopted by the Canadian Wind Energy Association (CanWEA) to support the development of Canada's small wind market. The general public has shown a significant interest in small wind projects of 300 kW. Studies have demonstrated that familiarity and comfort with small wind projects can help to ensure the successful implementation of larger wind projects. Small wind markets include residential, farming and commercial, and remote community applications. The results of CanWEA market survey show that the small wind market grew by 78 percent in 2008 over 2007, and again in 2009 by 32 percent over 2008. The average turbine size is 1 kW. A total of 11,000 turbines were purchased in 2007 and 2008. Global small wind market growth increased by 110 percent in 2008, and the average turbine size was 2.4 kW. Eighty-seven percent of the turbines made by Canadian mid-size wind turbine manufacturers are exported, and there is now a significant risk that Canada will lose its competitive advantage in small wind manufacturing as financial incentives have not been implemented. American and Canadian-based small wind manufacturers were listed, and small wind policies were reviewed. The presentation concluded with a set of recommendations for future incentives, educational programs and legislation. tabs., figs.

  10. 'Who's a good boy?!' Dogs prefer naturalistic dog-directed speech.

    Science.gov (United States)

    Benjamin, Alex; Slocombe, Katie

    2018-05-01

    Infant-directed speech (IDS) is a special speech register thought to aid language acquisition and improve affiliation in human infants. Although IDS shares some of its properties with dog-directed speech (DDS), it is unclear whether the production of DDS is functional, or simply an overgeneralisation of IDS within Western cultures. One recent study found that, while puppies attended more to a script read with DDS compared with adult-directed speech (ADS), adult dogs displayed no preference. In contrast, using naturalistic speech and a more ecologically valid set-up, we found that adult dogs attended to and showed more affiliative behaviour towards a speaker of DDS than of ADS. To explore whether this preference for DDS was modulated by the dog-specific words typically used in DDS, the acoustic features (prosody) of DDS or a combination of the two, we conducted a second experiment. Here the stimuli from experiment 1 were produced with reversed prosody, meaning the prosody and content of ADS and DDS were mismatched. The results revealed no significant effect of speech type, or content, suggesting that it is maybe the combination of the acoustic properties and the dog-related content of DDS that modulates the preference shown for naturalistic DDS. Overall, the results of this study suggest that naturalistic DDS, comprising of both dog-directed prosody and dog-relevant content words, improves dogs' attention and may strengthen the affiliative bond between humans and their pets.

  11. Technology assessment and resource allocation for predictive genetic testing: A study of the perspectives of Canadian genetic health care providers

    Directory of Open Access Journals (Sweden)

    Einsiedel Edna

    2009-06-01

    Full Text Available Abstract Background With a growing number of genetic tests becoming available to the health and consumer markets, genetic health care providers in Canada are faced with the challenge of developing robust decision rules or guidelines to allocate a finite number of public resources. The objective of this study was to gain Canadian genetic health providers' perspectives on factors and criteria that influence and shape resource allocation decisions for publically funded predictive genetic testing in Canada. Methods The authors conducted semi-structured interviews with 16 senior lab directors and clinicians at publically funded Canadian predictive genetic testing facilities. Participants were drawn from British Columbia, Alberta, Manitoba, Ontario, Quebec and Nova Scotia. Given the community sampled was identified as being relatively small and challenging to access, purposive sampling coupled with snowball sampling methodologies were utilized. Results Surveyed lab directors and clinicians indicated that predictive genetic tests were funded provincially by one of two predominant funding models, but they themselves played a significant role in how these funds were allocated for specific tests and services. They also rated and identified several factors that influenced allocation decisions and patients' decisions regarding testing. Lastly, participants provided recommendations regarding changes to existing allocation models and showed support for a national evaluation process for predictive testing. Conclusion Our findings suggest that largely local and relatively ad hoc decision making processes are being made in relation to resource allocations for predictive genetic tests and that a more coordinated and, potentially, national approach to allocation decisions in this context may be appropriate.

  12. Does Mental Health Status Influence Susceptibility to the Physiologic Effects of Air Pollution? A Population Based Study of Canadian Children.

    Science.gov (United States)

    Dales, Robert E; Cakmak, Sabit

    2016-01-01

    Both air pollution exposure and the presence of mental illness are associated with an increased risk of physical illness. To determine whether or not children with less favourable mental health are more susceptible to pulmonary and cardiovascular effects of ambient air pollution, compared to those who are mentally healthy. We carried out a cross-sectional study of 1,883 children between the ages of 6 and 17 years of age who participated in the Canadian Health Measures population survey between 2007 and 2009. Subjects were assigned the air pollution values obtained from the National Air Pollution monitor closest to their neighborhood. Lung function, heart rate and blood pressure were stratified by indicators of mental health. The latter were ascertained by questions about feelings of happiness, a diagnosed mood disorder, and the emotional symptom subscale of the Strengths and Difficulties Questionnaire. Among those who reported a mood disorder, an interquartile increase in ozone was associated with increases in systolic and diastolic pressures of 3.8 mmHg (95% CI 1.6, 5.9) and 3.0mmHg (95%CI 0.9, 5.2) respectively, and a decreases in FVC of 7.6% (95% CI 2.9, 12.3). No significant changes in these variables were observed in those who did not report a mood disorder. Among those with unfavourable emotional symptoms, ozone was associated with a 6.4% (95% CI 1.7, 11.3) increase in heart rate, a 4.1% (95%CI 1.2, 7.1) increase in systolic blood pressure, and a 6.0% (95% CI 1.4, 10.6) decrease in FEVl. No significant effect was seen in these variables among those with no emotional symptoms. In the Canadian population, children who report mood disorders or unfavourable emotional symptoms appear to be more vulnerable to the adverse physiologic effects of air pollution.

  13. Use of synchrotron tomography to image naturalistic anatomy in insects

    Science.gov (United States)

    Socha, John J.; De Carlo, Francesco

    2008-08-01

    Understanding the morphology of anatomical structures is a cornerstone of biology. For small animals, classical methods such as histology have provided a wealth of data, but such techniques can be problematic due to destruction of the sample. More importantly, fixation and physical slicing can cause deformation of anatomy, a critical limitation when precise three-dimensional data are required. Modern techniques such as confocal microscopy, MRI, and tabletop x-ray microCT provide effective non-invasive methods, but each of these tools each has limitations including sample size constraints, resolution limits, and difficulty visualizing soft tissue. Our research group at the Advanced Photon Source (Argonne National Laboratory) studies physiological processes in insects, focusing on the dynamics of breathing and feeding. To determine the size, shape, and relative location of internal anatomy in insects, we use synchrotron microtomography at the beamline 2-BM to image structures including tracheal tubes, muscles, and gut. Because obtaining naturalistic, undeformed anatomical information is a key component of our studies, we have developed methods to image fresh and non-fixed whole animals and tissues. Although motion artifacts remain a problem, we have successfully imaged multiple species including beetles, ants, fruit flies, and butterflies. Here we discuss advances in biological imaging and highlight key findings in insect morphology.

  14. Naturalistic driving observations of manual and visual-manual interactions with navigation systems and mobile phones while driving.

    NARCIS (Netherlands)

    Christoph, M. Nes, N. van & Knapper, A.

    2014-01-01

    This paper discusses a naturalistic driving study on the use of mobile phones and navigation systems while driving. Manual interactions with these devices while driving can cause distraction from the driving task and reduce traffic safety. In this study 21 subjects were observed for 5 weeks. Their

  15. Cocaine behavioral economics: From the naturalistic environment to the controlled laboratory setting

    Science.gov (United States)

    Greenwald, Mark K.; Steinmiller, Caren L.

    2017-01-01

    Background We previously observed that behavioral economic factors predict naturalistic heroin seeking behavior that correlates with opioid seeking in the experimental laboratory. The present study sought to replicate and extend these prior findings with regular cocaine users. Methods Participants (N = 83) completed a semi-structured interview to establish income-generating and cocaine-purchasing/use repertoire during the past month. Questions addressed sources/amounts of income and expenditures; price (money and time) per purchase; and frequency/amounts of cocaine purchased and consumed. Naturalistic cocaine purchasing and use patterns were: (1) analyzed as a function of income quartile, (2) perturbed by hypothetical changes in cost factors to assess changes in purchasing/use habits, and (3) correlated with experimental cocaine seeking. Results Income was positively related to naturalistic cocaine seeking/use pattern (i.e., income elastic), and behaviors were cost-efficient and sensitive to supply chain. Income was unrelated to proportional expenditure on cocaine (≈55%) but inversely related to food expenditure. In all hypothetical scenarios (changes in income or dealer, loss of income assistance from government or family/friends, and increasing arrest risk when purchasing), the high-income group reported they would continue to use more cocaine daily than other groups. Number of laboratory cocaine choices significantly correlated with cocaine purchase time (positively) and purity of cocaine (negatively) in the naturalistic setting. Conclusions These results replicate and extend findings with regular heroin users, demonstrate the importance of income, cost-efficiency and supply-mindedness in cocaine seeking/use, and suggest that this interview-based approach has good external validity. PMID:24878248

  16. Supporting the Transition into Employment: A Study of Canadian Young Adults Living with Disabilities.

    Science.gov (United States)

    Jetha, Arif; Bowring, Julie; Furrie, Adele; Smith, Frank; Breslin, Curtis

    2018-04-25

    Objective To examine the job accommodation and benefit needs of young adults with disabilities as they transition into employment, and their perceived barriers to meeting support needs. Methods An online survey was conducted of 155 Canadian young adults with disabilities (mean age = 25.8 years). Respondents were either employed or seeking employment, and were asked about their need for health benefits, and soft (e.g., flexible scheduling) and hard accommodations (e.g., ergonomic interventions), and perceived accommodation barriers. Disability characteristics (e.g., disability type), demographic details and work context information were collected. Multivariable logistic analyses were conducted to examine the factors associated with a greater need for health benefits and hard and soft accommodations. Result Participants reported having a physical (79%), psychological (79%) or cognitive/learning disability (77%); 68% had > 1 disability. Over half (55%) were employed. Health benefits and soft accommodations were most needed by participants. Also, an average of six perceived accommodation barriers were indicated; difficulty with disability disclosure was most frequently reported. More perceived accommodation barriers were associated with a greater need for health benefits (OR 1.17, 95% CI 1.04-1.31) and soft accommodations (OR 1.13, 95% CI 1.01-1.27). A psychological disability was a associated with a greater need for health benefits (OR 2.91, 95% CI 1.09-7.43) and soft accommodations (OR 3.83, 95% CI 1.41-10.42). Discussion Employers can support the employment of young adults with disabilities through provision of extended health benefits and soft accommodations. Addressing accommodation barriers could minimize unmet workplace need, and improve employment outcomes for young adults with disabilities as they begin their career and across the life course.

  17. Getting Real: A Naturalistic Methodology for Using Smartphones to Collect Mediated Communications

    Directory of Open Access Journals (Sweden)

    Chad C. Tossell

    2012-01-01

    Full Text Available This paper contributes an intentionally naturalistic methodology using smartphone logging technology to study communications in the wild. Smartphone logging can provide tremendous access to communications data from real environments. However, researchers must consider how it is employed to preserve naturalistic behaviors. Nine considerations are presented to this end. We also provide a description of a naturalistic logging approach that has been applied successfully to collecting mediated communications from iPhones. The methodology was designed to intentionally decrease reactivity and resulted in data that were more accurate than self-reports. Example analyses are also provided to show how data collected can be analyzed to establish empirical patterns and identify user differences. Smartphone logging technologies offer flexible capabilities to enhance access to real communications data, but methodologies employing these techniques must be designed appropriately to avoid provoking naturally occurring behaviors. Functionally, this methodology can be applied to establish empirical patterns and test specific hypotheses within the field of HCI research. Topically, this methodology can be applied to domains interested in understanding mediated communications such as mobile content and systems design, teamwork, and social networks.

  18. The "Canadian" in Canadian Children's Literature.

    Science.gov (United States)

    Bainbridge, Joyce; Wolodko, Brenda

    2001-01-01

    Notes that a rich body of Canadian children's literature exists that reflects the country's literary and socio-cultural values, beliefs, themes and images, including those of geography, history, language and identity. Discusses how Canadians tend to identify themselves first by region or province and then by nation. (SG)

  19. Naturalistic distraction and driving safety in older drivers.

    Science.gov (United States)

    Aksan, Nazan; Dawson, Jeffrey D; Emerson, Jamie L; Yu, Lixi; Uc, Ergun Y; Anderson, Steven W; Rizzo, Matthew

    2013-08-01

    In this study, we aimed to quantify and compare performance of middle-aged and older drivers during a naturalistic distraction paradigm (visual search for roadside targets) and to predict older drivers performance given functioning in visual, motor, and cognitive domains. Distracted driving can imperil healthy adults and may disproportionally affect the safety of older drivers with visual, motor, and cognitive decline. A total of 203 drivers, 120 healthy older (61 men and 59 women, ages 65 years and older) and 83 middle-aged drivers (38 men and 45 women, ages 40 to 64 years), participated in an on-road test in an instrumented vehicle. Outcome measures included performance in roadside target identification (traffic signs and restaurants) and concurrent driver safety. Differences in visual, motor, and cognitive functioning served as predictors. Older drivers identified fewer landmarks and drove slower but committed more safety errors than did middle-aged drivers. Greater familiarity with local roads benefited performance of middle-aged but not older drivers.Visual cognition predicted both traffic sign identification and safety errors, and executive function predicted traffic sign identification over and above vision. Older adults are susceptible to driving safety errors while distracted by common secondary visual search tasks that are inherent to driving. The findings underscore that age-related cognitive decline affects older drivers' management of driving tasks at multiple levels and can help inform the design of on-road tests and interventions for older drivers.

  20. Protest: The Canadian pulse

    International Nuclear Information System (INIS)

    Lott, J.E.

    1979-01-01

    This popularly written article compares Canadian attitudes to protests against nuclear power to those in the United States. Canadian protesters are more peaceful, expressing their opinions within the law. The article describes the main anti-nuclear groups in Canada and presents the results of public opinion surveys of Canadians on the use of nuclear power for generating electricity. (TI)

  1. The clinical utility of naturalistic action test in differentiating mild cognitive impairment from early dementia in memory clinic.

    Science.gov (United States)

    Bruce, Irene; Ntlholang, Ontefetse; Crosby, Lisa; Cunningham, Conal; Lawlor, Brian

    2016-03-01

    This study aimed to examine the validity of the Naturalistic Action Test in differentiating Mild Cognitive Impairment from early dementia compared to clinical diagnosis and ascertain Naturalistic Action Test cut-off points. This was a cross-sectional study of 70 consecutive patients diagnosed with Mild Cognitive Impairment attending the memory clinic in St James's Hospital, Dublin, Ireland. Patients with a diagnosis of Mild Cognitive Impairment who attended for routine annual assessment were asked to participate in the study. The Naturalistic Action Test was carried out after the patient had completed their routine assessment in the clinic. The Area under the Curve, AUC ± SE was 0.808 ± 0.058, p Cognitive Impairment in our study (PPV 50%, NPV 91%, sensitivity 78%, specificity 73% and accuracy of 74%). There was discrepancy in 18 patients using the new cut-off point (≥11 for Mild Cognitive Impairment vs ≤10 for dementia). The Naturalistic Action Test is a useful tool that can increase diagnostic accuracy in differentiating Mild Cognitive Impairment from early dementia. Copyright © 2015 John Wiley & Sons, Ltd.

  2. Quality of Childcare and Otitis Media: Relationship to Children's Language during Naturalistic Interactions at 18, 24, and 36 Months

    Science.gov (United States)

    Vernon-Feagans, Lynne; Hurley, Megan M.; Yont, Kristine M.; Wamboldt, Patricia M.; Kolak, Amy

    2007-01-01

    The purpose of this study was to examine the relationship between the quality of childcare and experience with otitis media (middle ear disease) as they relate to children's early naturalistic language development. Sixty children were followed longitudinally from childcare entry in the first year of life until three years of age. Half the children…

  3. Interpretive signs designed to trigger naturalist intelligence at two American zoos

    Science.gov (United States)

    Bryant, Martha

    An investigation of interpretive graphics was conducted in 2005 at two mid-sized AZA-accredited zoos, Lowry Park Zoo, Tampa, Florida and Knoxville Zoo, Knoxville, Tennessee. The Lowry Park Zoo study investigated signs at a red-tailed hawk and sandhill crane exhibit. Combination signs and wordless signs were more effective helping visitors see animals, increasing holding time, and number of engagements than treatments of no signs, or signs with words only. A second study, at Knoxville Zoo, tested combination and wordless signs in a children's zoo, investigating 31 signs at a 3.5-acre exhibit. Comparisons of visitors seeing the animals/using interactive exhibit elements, holding time, and engagement activities, showed wordless signs were more effective than combination signs. Differences in gender ratio, age, group size, and other demographics were not significant. Visit motivation differed between zoos, with visitors from Lowry Park Zoo more often articulating reason for a visit as wanting to see animals. Visitors at Knoxville Zoo most often said they wanted to spend time with family and friends. Differences in potential for naturalist intelligence were probably related to local practices rather than to innate differences in naturalist intelligence. The number of communities in Florida that regulate pet ownership and provide lawn service could account for the lower number of people who have pets and plants. At both institutions, behaviors supported educational theories. The importance of signs as advanced organizers was shown where signs were removed at the bird exhibit at Lowry Park Zoo, with fewer visitors seeing the animals. Social interaction was noted at both zoos, with intra- and inter-group conversations observed. If naturalist intelligence is necessary to see animals, visitors run a continuum. Some are unable to see animals with signs and assistance from other visitors; others see animals with little difficulty. The importance of honing naturalist

  4. The Canadian HIV and aging cohort study - determinants of increased risk of cardio-vascular diseases in HIV-infected individuals: rationale and study protocol.

    Science.gov (United States)

    Durand, Madeleine; Chartrand-Lefebvre, Carl; Baril, Jean-Guy; Trottier, Sylvie; Trottier, Benoit; Harris, Marianne; Walmsley, Sharon; Conway, Brian; Wong, Alexander; Routy, Jean-Pierre; Kovacs, Colin; MacPherson, Paul A; Monteith, Kenneth Marc; Mansour, Samer; Thanassoulis, George; Abrahamowicz, Michal; Zhu, Zhitong; Tsoukas, Christos; Ancuta, Petronela; Bernard, Nicole; Tremblay, Cécile L

    2017-09-11

    With potent antiretroviral drugs, HIV infection is becoming a chronic disease. Emergence of comorbidities, particularly cardiovascular disease (CVD) has become a leading concern for patients living with the infection. We hypothesized that the chronic and persistent inflammation and immune activation associated with HIV disease leads to accelerated aging, characterized by CVD. This will translate into higher incidence rates of CVD in HIV infected participants, when compared to HIV negative participants, after adjustment for traditional CVD risk factors. When characterized further using cardiovascular imaging, biomarkers, immunological and genetic profiles, CVD associated with HIV will show different characteristics compared to CVD in HIV-negative individuals. The Canadian HIV and Aging cohort is a prospective, controlled cohort study funded by the Canadian Institutes of Health Research. It will recruit patients living with HIV who are aged 40 years or older or have lived with HIV for 15 years or more. A control population, frequency matched for age, sex, and smoking status, will be recruited from the general population. Patients will attend study visits at baseline, year 1, 2, 5 and 8. At each study visit, data on complete medical and pharmaceutical history will be captured, along with anthropometric measures, a complete physical examination, routine blood tests and electrocardiogram. Consenting participants will also contribute blood samples to a research biobank. The primary outcome is incidence of a composite of: myocardial infarction, coronary revascularization, stroke, hospitalization for angina or congestive heart failure, revascularization or amputation for peripheral artery disease, or cardiovascular death. Preplanned secondary outcomes are all-cause mortality, incidence of the metabolic syndrome, incidence of type 2 diabetes, incidence of renal failure, incidence of abnormal bone mineral density and body fat distribution. Patients participating to the

  5. Health practices of Canadian physicians.

    Science.gov (United States)

    Frank, Erica; Segura, Carolina

    2009-08-01

    To study the health and health practices of Canadian physicians, which can often influence patient health. Mailed survey. Canada. A random sample of 8100 Canadian physicians; 7934 were found to be eligible and 3213 responded (40.5% response rate). Factors that influence health, such as consumption of fruits and vegetables, amount of exercise and alcohol consumption, smoking status, body mass idex, and participation in preventive health screening measures, as well as work-life balance and emotional stability. Canadian physicians are healthy. More than 90% reported being in good to excellent health, and only 5% reported that poor physical or mental health made it difficult to handle their workload more than half the time in the previous month (although a quarter had reduced work activity because of long-term health conditions). Eight percent were obese, 3% currently smoked cigarettes, and 1% typically consumed 5 drinks or more on days when they drank alcohol. Physicians averaged 4.7 hours of exercise per week and ate fruits and vegetables 4.8 times a day. Their personal screening practices were largely compliant with Canadian Task Force on Preventive Health Care recommendations. They averaged 38 hours per week on patient care and 11 hours on other professional activities. Fifty-seven percent agreed that they had a good work-life balance, and 11% disagreed with the statement "If I can, I work when I am ill." Compared with self-reports from the general Canadian population, Canadian physicians, like American physicians, seem to be healthy and to have generally healthy behaviour. There is, however, room for improvement in physicians' personal and professional well-being, and improving their personal health practices could be an efficient and beneficent way to improve the health of all Canadians.

  6. An appraisal of the naturalistic fallacy | Okon | Sophia: An African ...

    African Journals Online (AJOL)

    Abstract The phrase 'naturalistic fallacy' smacks of a violation of any rules of logic. This becomes more worrisome especially fresh students of philosophy and the lay reader when it is observed that the context of the problem is ethics not logic. Thus, the first question is "how tenable is the phraseology within an ethical ...

  7. Canadian geologic isolation program

    International Nuclear Information System (INIS)

    Dyne, P.J.

    1976-01-01

    The Canadian geologic isolation program is directed at examining the potential of (1) salt deposits and (2) hard rock as repositories for radioactive wastes. It was felt essential from the inception that alternative host rocks be evaluated over a fairly large geographical area. The studies on salt deposits to date are based on existing geological information and have identified the areas that show some potential and merit further study. The factors considered include depth, thickness and purity of the deposit, overlying aquifers, and the potential for gas and oil exploration as well as potash recovery. The studies on hard rock are restricted to plutonic igneous rocks in the Ontario part of the Canadian Shield. Because geological information on their nature and extent is sparse, the study is limited to bodies that are well exposed and for which information is available.for which information is available. Field studies in the next two seasons are aimed at mapping the fault and joint patterns and defining the geologic controls on their development. In 1977 and 1978, two or three of the more favorable sites will be mapped in greater detail, and an exploratory drilling program will be established to determine the extent of fracturing at depth and the hydrology of these fractures. Conceptual designs of mined repositories in hard rock are also being made with the hope of identifying, at an early stage in this program, special problems in hard-rock repositories that may require development and study

  8. Employment goals, expectations, and migration intentions of nursing graduates in a Canadian border city: a mixed methods study.

    Science.gov (United States)

    Freeman, Michelle; Baumann, Andrea; Akhtar-Danesh, Noori; Blythe, Jennifer; Fisher, Anita

    2012-12-01

    Internationally, nurse migration in border cities has received little attention. Nurses who graduate from nursing programs in Canadian border communities have the option of working in Canada or the United States. They are able to cross the international border each day as commuter migrants returning to their home country after work. Despite recent investment by Canada to increase the number of nursing students, the migration intentions of graduating nurses and the factors influencing their decision making has not been explored. The objective of this study is to explore the migration intentions of a graduating class of baccalaureate nursing students in a Canadian border community and the factors influencing their decision making. An explanatory sequential mixed methods design was used. In the first quantitative phase, data was collected by a web-based self-report survey. In the qualitative phase, semi-structured interviews were conducted. Data collection took place between February and July 2011. The response rate to the survey was 40.9% (n=115). Eighty-six percent of graduates preferred to work in Canada although two thirds identified that they were considering migrating for work outside of Canada. Knowing a nurse who worked in the US (Michigan) influenced intention to migrate and living in a border community was a strong predictor of migration. Migrants had significantly higher expectations that their economic, professional development, healthy work environment, adventure and autonomy values would be met in another country than Canada. Evidence from the interviews revealed that clinical instructors and clinical experiences played a significant role in framing students' perceptions of the work environment, influencing their choice of specialty, and where they secured their first job. The value-expectancy framework offered a novel approach to identifying job factors driving migration intentions. The study offered a snapshot of the graduates' perception of the work

  9. Canadian attitudes to nuclear power

    International Nuclear Information System (INIS)

    Davies, J.E.O.; Dobson, J.K.; Baril, R.G.

    1977-05-01

    A national assessment was made of public attitudes towards nuclear power, along with regional studies of the Maritimes and mid-western Canada and a study of Canadian policy-makers' views on nuclear energy. Public levels of knowledge about nuclear power are very low and there are marked regional differences. Opposition centers on questions of safety and is hard to mollify due to irrational fear and low institutional credibility. Canadians rate inflation as a higher priority problem than energy and see energy shortages as a future problem (within 5 years) and energy independence as a high priority policy. (E.C.B.)

  10. Pilot study investigating ambient air toxics emissions near a Canadian kraft pulp and paper facility in Pictou County, Nova Scotia.

    Science.gov (United States)

    Hoffman, Emma; Guernsey, Judith R; Walker, Tony R; Kim, Jong Sung; Sherren, Kate; Andreou, Pantelis

    2017-09-01

    Air toxics are airborne pollutants known or suspected to cause cancer or other serious health effects, including certain volatile organic compounds (VOCs), prioritized by the US Environmental Protection Agency (EPA). While several EPA-designated air toxics are monitored at a subset of Canadian National Air Pollution Surveillance (NAPS) sites, Canada has no specific "air toxics" control priorities. Although pulp and paper (P&P) mills are major industrial emitters of air pollutants, few studies quantified the spectrum of air quality exposures. Moreover, most NAPS monitoring sites are in urban centers; in contrast, rural NAPS sites are sparse with few exposure risk records. The objective of this pilot study was to investigate prioritized air toxic ambient VOC concentrations using NAPS hourly emissions data from a rural Pictou, Nova Scotia Kraft P&P town to document concentration levels, and to determine whether these concentrations correlated with wind direction at the NAPS site (located southwest of the mill). Publicly accessible Environment and Climate Change Canada data (VOC concentrations [Granton NAPS ID: 31201] and local meteorological conditions [Caribou Point]) were examined using temporal (2006-2013) and spatial analytic methods. Results revealed several VOCs (1,3-butadiene, benzene, and carbon tetrachloride) routinely exceeded EPA air toxics-associated cancer risk thresholds. 1,3-Butadiene and tetrachloroethylene were significantly higher (p towns and contribute to poor health in nearby communities.

  11. A review of recent analyses of the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS

    Directory of Open Access Journals (Sweden)

    D. Potter

    2015-01-01

    Full Text Available Introduction: The objective of this analysis is to identify, assess the quality and summarize the findings of peer-reviewed articles that used data from the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS published since November 2011 and data from provincial oversamples of the CIS as well as to illustrate evolving uses of these datasets. Methods: Articles were identified from the Public Health Agency of Canada's data request records tracking access to CIS data and publications produced from that data. At least two raters independently reviewed and appraised the quality of each article. Results: A total of 32 articles were included. Common strengths of articles included clearly stated research aims, appropriate control variables and analyses, sufficient sample sizes, appropriate conclusions and relevance to practice or policy. Common problem areas of articles included unclear definitions for variables and inclusion criteria of cases. Articles frequently measured the associations between maltreatment, child, caregiver, household and agency/referral characteristics and investigative outcomes such as opening cases for ongoing services and placement. Conclusion: Articles using CIS data were rated positively on most quality indicators. Researchers have recently focussed on inadequately studied categories of maltreatment (exposure to intimate partner violence [IPV], neglect and emotional maltreatment and examined factors specific to First Nations children. Data from the CIS oversamples have been underutilized. The use of multivariate analysis techniques has increased.

  12. Canadian heavy water production

    International Nuclear Information System (INIS)

    Dahlinger, A.; Lockerby, W.E.; Rae, H.K.

    1977-01-01

    The paper reviews Canadian experience in the production of heavy water, presents a long-term supply projection, relates this projection to the anticipated long-term electrical energy demand, and highlights principal areas for further improvement that form the bulk of the Canadian R and D programme on heavy water processes. Six Canadian heavy water plants with a total design capacity of 4000Mg/a are in operation or under construction. All use the Girdler-Sulphide (GS) process, which is based on deuterium exchange between water and hydrogen sulphide. Early operating problems have been overcome and the plants have demonstrated annual capacity factors in excess of 70%, with short-term production rates equal to design rates. Areas for further improvement are: to increase production rates by optimizing the control of foaming to give both higher sieve tray efficiency and higher flow rates, to reduce the incapacity due to deposition of pyrite (FeS 2 ) and sulphur (between 5% and 10%), and to improve process control and optimization of operating conditions by the application of mathematical simulations of the detailed deuterium profile throughout each plant. Other processes being studied, which look potentially attractive are the hydrogen-water exchange and the hydrogen-amine exchange. Even if they become successful competitors to the GS process, the latter is likely to remain the dominant production method for the next 10-20 years. This programme, when related to the long-term electricity demand, indicates that heavy water supply and demand are in reasonable balance and that the Candu programme will not be inhibited because of shortages of this commodity. (author)

  13. Students' drinker prototypes and alcohol use in a naturalistic setting.

    Science.gov (United States)

    Spijkerman, Renske; Larsen, Helle; Gibbons, Frederick X; Engels, Rutger C M E

    2010-01-01

    Perceptions about the type of people who drink, also referred to as drinker prototypes, may strengthen young people's motivation to engage in alcohol use. Previous research has shown that drinker prototypes are related to alcohol consumption in both adolescents and young adults. However, the evidence for the strength of these relationships remains inconclusive. One of the caveats in former studies is that all insights about prototype relations are based on self-reported data from youngsters themselves, mostly gathered in a class situation, which may contain bias due to memory distortions and self-presentation concerns. The present study examined the impact of drinker prototypes on young adults' drinking patterns by using a less obtrusive measure to assess alcohol consumption, i.e. ad lib drinking among friend groups in the naturalistic setting of a bar lab. Drinker prototypes, self-reported alcohol use in the past, and observed alcohol intake in the bar lab were assessed among 200 college students. Relations between participants' drinker prototypes and their self-reported and observed drinking behavior were examined by computing correlations and conducting multilevel analyses. Drinker prototypes were related to both self-reported and observed alcohol use. However, the drinking patterns of friend group members had a strong impact on participants' individual drinking rates in the bar lab. After these group effects had been controlled for, only heavy drinker prototypes showed relations with observed alcohol intake in the bar lab. These findings further establish the value of drinker prototypes in predicting young adults' drinking behavior and suggest that people's motivation to drink alcohol in real-life drinking situations is related to their perceptions about heavy drinkers.

  14. "Things I did not know": Retrospectives on a Canadian rural male youth suicide using an instrumental photovoice case study.

    Science.gov (United States)

    Creighton, Genevieve M; Oliffe, John L; Lohan, Maria; Ogrodniczuk, John S; Palm, Emma

    2017-11-01

    In Canada, it is young, rural-based men who are at the greatest risk of suicide. While there is no consensus on the reasons for this, evidence points to contextual social factors including isolation, lack of confidential services, and pressure to uphold restrictive norms of rural masculinity. In this article, we share findings drawn from an instrumental photovoice case study to distil factors contributing to the suicide of a young, Canadian, rural-based man. Integrating photovoice methods and in-depth qualitative, we conducted interviews with seven family members and close friends of the deceased. The interviews and image data were analyzed using constant comparative methods to discern themes related to participants' reflections on and perceptions about rural male suicide. Three inductively derived themes, "Missing the signs," "Living up to his public image," and "Down in Rural Canada," reflect the challenges that survivors and young rural men can experience in attempting to be comply with restrictive dominant ideals of masculinity. We conclude that community-based suicide prevention efforts would benefit from gender-sensitive and place-specific approaches to advancing men's mental health by making tangibly available and affirming an array of masculinities to foster the well-being of young, rural-based men.

  15. Employers' perceptions and attitudes toward the Canadian national standard on psychological health and safety in the workplace: A qualitative study.

    Science.gov (United States)

    Kunyk, Diane; Craig-Broadwith, Morgan; Morris, Heather; Diaz, Ruth; Reisdorfer, Emilene; Wang, JianLi

    2016-01-01

    The estimated societal and economic costs of mental illness and psychological injury in the workplace is staggering. Governments, employers and other stakeholders have been searching for policy solutions. This qualitative, exploratory study sought to uncover organizational receptivity to a voluntary comprehensive standard for dealing with psychological health and safety in the workplace. A series of five focus groups were conducted in a large Western Canadian city in November 2013. The seventeen participants were from the fields of healthcare, construction/utilities, manufacturing industries, business services, and finance. They worked in positions of management, consulting, human resources, health promotion, health and safety, mediation, and occupational health and represented organizations ranging in size from 20 to 100,000 employees. The findings confirm and illustrate the critical role that psychological health and safety plays across workplaces and occupations. This standard resonated across the represented organizations and fit with their values. This alignment posed challenges with articulating its added value. There appears to be a need for simplified engagement and implementation strategies of the standard that can be tailored to the nuanced differences between types and sizes of industries. It appears that organizations in the most need of improving psychological health and safety may be the least receptive. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Population specific biomarkers of human aging: a big data study using South Korean, Canadian and Eastern European patient populations.

    Science.gov (United States)

    Mamoshina, Polina; Kochetov, Kirill; Putin, Evgeny; Cortese, Franco; Aliper, Alexander; Lee, Won-Suk; Ahn, Sung-Min; Uhn, Lee; Skjodt, Neil; Kovalchuk, Olga; Scheibye-Knudsen, Morten; Zhavoronkov, Alex

    2018-01-11

    Accurate and physiologically meaningful biomarkers for human aging are key to assessing anti-aging therapies. Given ethnic differences in health, diet, lifestyle, behaviour, environmental exposures and even average rate of biological aging, it stands to reason that aging clocks trained on datasets obtained from specific ethnic populations are more likely to account for these potential confounding factors, resulting in an enhanced capacity to predict chronological age and quantify biological age. Here we present a deep learning-based hematological aging clock modeled using the large combined dataset of Canadian, South Korean and Eastern European population blood samples that show increased predictive accuracy in individual populations compared to population-specific hematologic aging clocks. The performance of models was also evaluated on publicly-available samples of the American population from the National Health and Nutrition Examination Survey (NHANES). In addition, we explored the association between age predicted by both population-specific and combined hematological clocks and all-cause mortality. Overall, this study suggests a) the population-specificity of aging patterns and b) hematologic clocks predicts all-cause mortality. Proposed models added to the freely available Aging.AI system allowing improved ability to assess human aging. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America.

  17. Priority setting of ICU resources in an influenza pandemic: a qualitative study of the Canadian public's perspectives

    Directory of Open Access Journals (Sweden)

    Silva Diego S

    2012-03-01

    Full Text Available Abstract Background Pandemic influenza may exacerbate existing scarcity of life-saving medical resources. As a result, decision-makers may be faced with making tough choices about who will receive care and who will have to wait or go without. Although previous studies have explored ethical issues in priority setting from the perspective of clinicians and policymakers, there has been little investigation into how the public views priority setting during a pandemic influenza, in particular related to intensive care resources. Methods To bridge this gap, we conducted three public town hall meetings across Canada to explore Canadian's perspectives on this ethical challenge. Town hall discussions group discussions were digitally recorded, transcribed, and analyzed using thematic analysis. Results Six interrelated themes emerged from the town hall discussions related to: ethical and empirical starting points for deliberation; criteria for setting priorities; pre-crisis planning; in-crisis decision-making; the need for public deliberation and input; and participants' deliberative struggle with the ethical issues. Conclusions Our findings underscore the importance of public consultation in pandemic planning for sustaining public trust in a public health emergency. Participants appreciated the empirical and ethical uncertainty of decision-making in an influenza pandemic and demonstrated nuanced ethical reasoning about priority setting of intensive care resources in an influenza pandemic. Policymakers may benefit from a better understanding the public's empirical and ethical 'starting points' in developing effective pandemic plans.

  18. Canadian Physicians' Use of Antiobesity Drugs and Their Referral Patterns to Weight Management Programs or Providers: The SOCCER Study

    Directory of Open Access Journals (Sweden)

    R. S. Padwal

    2011-01-01

    Full Text Available Antiobesity pharmacotherapy and programs/providers that possess weight management expertise are not commonly used by physicians. The underlying reasons for this are not known. We performed a cross-sectional study in 33 Canadian medical practices (36 physicians examining 1788 overweight/obese adult patients. The frequency of pharmacotherapy use and referral for further diet, exercise, behavioral management and/or bariatric surgery was documented. If drug treatment or referral was not made, reasons were documented by choosing amongst preselected categories. Logistic regression models were used to identify predictors of antiobesity drug use. No single antiobesity management strategy was recommended by physicians in more than 50% of patients. Referral was most common for exercise (49% of cases followed by dietary advice (46%, and only 5% of eligible patients were referred for bariatric surgery. Significant predictors of initiating/continuing pharmacotherapy were male sex (OR 0.70; 95% CI 0.52–0.94, increasing BMI (1.02; 95% CI 1.01–1.03, and private drug coverage (1.78; 95% CI 1.39–2.29. “Not considered” and “patient refusal” were the main reasons for not initiating further weight management. We conclude that both physician and patient factors act as barriers to the use of weight management strategies and both need to be addressed to increase uptake of these interventions.

  19. A population-based study of sport and recreation-related head injuries treated in a Canadian health region.

    Science.gov (United States)

    Harris, Andrew W; Jones, C Allyson; Rowe, Brian H; Voaklander, Donald C

    2012-07-01

    To report the rates of SR-related HIs presenting to EDs in a Canadian population-based sample. Descriptive epidemiology study. Using administrative data, sport and recreation-related emergency department presentations for persons 0-35 years of age, from April 1997 through March 2008, were obtained from the Edmonton Zone (formerly the Capital Health Region), Alberta Health Services through the Ambulatory Care Classification System. Of the 3,230,890 visits to the emergency departments of the five hospitals in Edmonton, 63,219 sport and recreation-related injury records and 4935 sport and recreation-head injury records were identified. Head injuries were most frequently treated for the activities of hockey (20.7%), cycling (12.0%), and skiing/snowboarding/sledding. Males accounted for 71.9% (n=3546) and patients less than 18 years of age sustained 3446 (69.8%) sport and recreation-head injuries. Sport and recreation-related head injuries most frequently treated in emergency departments involve common activities such as hockey, cycling, skiing/snowboarding/sledding, and soccer. Males and those less than 18 years of age sustain the majority of sport and recreation-related head injuries treated in emergency departments. These findings underscore the importance of sport-specific policies and safety promotion for the prevention of head injuries, in sports and recreational activities. Copyright © 2011 Sports Medicine Australia. All rights reserved.

  20. The influence of impulsiveness on binge eating and problem gambling: A prospective study of gender differences in Canadian adults.

    Science.gov (United States)

    Farstad, Sarah M; von Ranson, Kristin M; Hodgins, David C; El-Guebaly, Nady; Casey, David M; Schopflocher, Don P

    2015-09-01

    This study investigated the degree to which facets of impulsiveness predicted future binge eating and problem gambling, 2 theorized forms of behavioral addiction. Participants were 596 women and 406 men from 4 age cohorts randomly recruited from a Canadian province. Participants completed self-report measures of 3 facets of impulsiveness (negative urgency, sensation seeking, lack of persistence), binge-eating frequency, and problem-gambling symptoms. Impulsiveness was assessed at baseline, and assessments of binge eating and problem gambling were followed up after 3 years. Weighted data were analyzed using zero-inflated negative binomial and Poisson regression models. We found evidence of transdiagnostic and disorder-specific predictors of binge eating and problem gambling. Negative urgency emerged as a common predictor of binge eating and problem gambling among women and men. There were disorder-specific personality traits identified among men only: High lack-of-persistence scores predicted binge eating and high sensation-seeking scores predicted problem gambling. Among women, younger age predicted binge eating and older age predicted problem gambling. Thus, there are gender differences in facets of impulsiveness that longitudinally predict binge eating and problem gambling, suggesting that treatments for these behaviors should consider gender-specific personality and demographic traits in addition to the common personality trait of negative urgency. (c) 2015 APA, all rights reserved).

  1. Priority setting of ICU resources in an influenza pandemic: a qualitative study of the Canadian public's perspectives.

    Science.gov (United States)

    Silva, Diego S; Gibson, Jennifer L; Robertson, Ann; Bensimon, Cécile M; Sahni, Sachin; Maunula, Laena; Smith, Maxwell J

    2012-03-26

    Pandemic influenza may exacerbate existing scarcity of life-saving medical resources. As a result, decision-makers may be faced with making tough choices about who will receive care and who will have to wait or go without. Although previous studies have explored ethical issues in priority setting from the perspective of clinicians and policymakers, there has been little investigation into how the public views priority setting during a pandemic influenza, in particular related to intensive care resources. To bridge this gap, we conducted three public town hall meetings across Canada to explore Canadian's perspectives on this ethical challenge. Town hall discussions group discussions were digitally recorded, transcribed, and analyzed using thematic analysis. Six interrelated themes emerged from the town hall discussions related to: ethical and empirical starting points for deliberation; criteria for setting priorities; pre-crisis planning; in-crisis decision-making; the need for public deliberation and input; and participants' deliberative struggle with the ethical issues. Our findings underscore the importance of public consultation in pandemic planning for sustaining public trust in a public health emergency. Participants appreciated the empirical and ethical uncertainty of decision-making in an influenza pandemic and demonstrated nuanced ethical reasoning about priority setting of intensive care resources in an influenza pandemic. Policymakers may benefit from a better understanding the public's empirical and ethical 'starting points' in developing effective pandemic plans.

  2. Transnational archives: the Canadian case

    Directory of Open Access Journals (Sweden)

    Julia Creet

    2011-05-01

    Full Text Available This paper is a brief overview of the concept of the transnational archive as a counterpoint to the idea that a national archive is necessarily a locus of a static idea of nation. The Canadian national archives is used as a case study of an archives that was transnational in its inception, and one that has continued to change in its mandate and materials as a response to patterns in migration and changing notions of multiculturalism as a Canadian federal policy. It introduces the most recent formation of the transnational archive and its denizens: the genealogical archive inhabited by family historians.

  3. Low dose ionizing radiation exposure and cardiovascular disease mortality: cohort study based on Canadian national dose registry of radiation workers

    International Nuclear Information System (INIS)

    Zielinski, J. M.; Band, P. R.; Ashmore, P. J.; Jiang, H.; Shilnikova, N. S.; Tait, V. K.; Krewski, D.

    2009-01-01

    The purpose of our study was to assess the risk of cardiovascular disease (CVD) mortality in a Canadian cohort of 337 397 individuals (169 256 men and 168 141 women) occupationally exposed to ionizing radiation and included in the National Dose Registry (NDR) of Canada. Material and Methods: Exposure to high doses of ionizing radiation, such as those received during radiotherapy, leads to increased risk of cardiovascular diseases. The emerging evidence of excess risk of CVDs after exposure to doses well below those previously considered as safe warrants epidemiological studies of populations exposed to low levels of ionizing radiation. In the present study, the cohort consisted of employees at nuclear power stations (nuclear workers) as well as medical, dental and industrial workers. The mean whole body radiation dose was 8.6 mSv for men and 1.2 mSv for women. Results: During the study period (1951 - 1995), as many as 3 533 deaths from cardiovascular diseases have been identified (3 018 among men and 515 among women). In the cohort, CVD mortality was significantly lower than in the general population of Canada. The cohort showed a significant dose response both among men and women. Risk estimates of CVD mortality in the NDR cohort, when expressed as excess relative risk per unit dose, were higher than those in most other occupational cohorts and higher than in the studies of Japanese atomic bomb survivors. Conclusions: The study has demonstrated a strong positive association between radiation dose and the risk of CVD mortality. Caution needs to be exercised when interpreting these results, due to the potential bias introduced by dosimetry uncertainties, the possible record linkage errors, and especially by the lack of adjustment for non-radiation risk factors. (authors)

  4. Barriers and supports to implementation of MDI/spacer use in nine Canadian pediatric emergency departments: a qualitative study

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    Graham Ian D

    2009-10-01

    Full Text Available Abstract Background Despite recent research supporting the use of metered dose inhalers with spacer devices (MDI/spacers in pediatric emergency departments (PEDs for acute exacerbations of asthma, uptake of this practice has been slow. The objectives of this study were to determine the barriers and supports to implementing MDI/spacer research and to identify factors associated with early and late adoption of MDI/spacers in Canadian PEDs. Methods Using a comparative case study design, we classified nine tertiary care pediatric hospital PEDs based on their stage of implementation. Data were collected using focus group interviews with physicians, registered nurses (RNs, and respiratory therapists (RTs, and individual interviews with both patient care and medical directors at each site. Initial coding was based on the Ottawa Model of Research Use (OMRU categories of elements known to influence the uptake of innovations. Results One hundred and fifty healthcare professionals from nine different healthcare institutions participated in this study. Lack of leadership in the form of a research champion, a lack of consensus about the benefits of MDI/spacers among staff, perceived resistance from patients/parents, and perceived increased cost and workload associated with MDI/spacer use were the most prevalent barriers to the adoption of the MDI/spacer. Common strategies used by early-adopting sites included the active participation of all professional groups in the adoption process in addition to a well-planned and executed educational component for staff, patients, and families. Early adopter sites were also more likely to have the MDI/spacer included in a clinical protocol/pathway. Conclusion Potential barriers and supports to implementation have been identified that will help EDs adopt MDI/spacer use. Future interventions intended to increase MDI/spacer use in PEDs will need to be sensitive to the barriers identified in this study.

  5. Identifying socio-environmental factors that facilitate resilience among Canadian palliative family caregivers: a qualitative case study.

    Science.gov (United States)

    Giesbrecht, Melissa; Wolse, Faye; Crooks, Valorie A; Stajduhar, Kelli

    2015-06-01

    In Canada, friends and family members are becoming increasingly responsible for providing palliative care in the home. This is resulting in some caregivers experiencing high levels of stress and burden that may ultimately surpass their ability to cope. Recent palliative care research has demonstrated the potential for caregiver resilience within such contexts. This research, however, is primarily focused on exploring individual-level factors that contribute to resilience, minimizing the inherent complexity of this concept, and how it is simultaneously influenced by one's social context. Therefore, our study aims to identify socio-environmental factors that contribute to palliative family caregiver resilience in the Canadian homecare context. Drawing on ethnographic fieldnotes and semistructured interviews with family caregivers, care recipients, and homecare nurses, this secondary analysis employs an intersectionality lens and qualitative case study approach to identify socio-environmental factors that facilitate family caregivers' capacity for resilience. Following a case study methodology, two cases are purposely selected for analysis. Findings demonstrate that family caregiver resilience is influenced not only by individual-level factors but also by the social environment, which sets the lived context from which caregiving roles are experienced. Thematic findings of the two case studies revealed six socio-environmental factors that play a role in shaping resilience: access to social networks, education/knowledge/awareness, employment status, housing status, geographic location, and life-course stage. Findings contribute to existing research on caregiver resilience by empirically demonstrating the role of socio-environmental factors in caregiving experiences. Furthermore, utilizing an intersectional approach, these findings build on existing notions that resilience is a multidimensional and complex process influenced by numerous related variables that intersect

  6. Cross-Language Measurement Equivalence of the Center for Epidemiologic Studies Depression (CES-D) Scale in Systemic Sclerosis: A Comparison of Canadian and Dutch Patients

    Science.gov (United States)

    Kwakkenbos, Linda; Arthurs, Erin; van den Hoogen, Frank H. J.; Hudson, Marie; van Lankveld, Wim G. J. M.; Baron, Murray; van den Ende, Cornelia H. M.; Thombs, Brett D.

    2013-01-01

    Objectives Increasingly, medical research involves patients who complete outcomes in different languages. This occurs in countries with more than one common language, such as Canada (French/English) or the United States (Spanish/English), as well as in international multi-centre collaborations, which are utilized frequently in rare diseases such as systemic sclerosis (SSc). In order to pool or compare outcomes, instruments should be measurement equivalent (invariant) across cultural or linguistic groups. This study provides an example of how to assess cross-language measurement equivalence by comparing the Center for Epidemiologic Studies Depression (CES-D) scale between English-speaking Canadian and Dutch SSc patients. Methods The CES-D was completed by 922 English-speaking Canadian and 213 Dutch SSc patients. Confirmatory factor analysis (CFA) was used to assess the factor structure in both samples. The Multiple-Indicator Multiple-Cause (MIMIC) model was utilized to assess the amount of differential item functioning (DIF). Results A two-factor model (positive and negative affect) showed excellent fit in both samples. Statistically significant, but small-magnitude, DIF was found for 3 of 20 items on the CES-D. The English-speaking Canadian sample endorsed more feeling-related symptoms, whereas the Dutch sample endorsed more somatic/retarded activity symptoms. The overall estimate in depression scores between English and Dutch was not influenced substantively by DIF. Conclusions CES-D scores from English-speaking Canadian and Dutch SSc patients can be compared and pooled without concern that measurement differences may substantively influence results. The importance of assessing cross-language measurement equivalence in rheumatology studies prior to pooling outcomes obtained in different languages should be emphasized. PMID:23326538

  7. Canadian Postcolonialism: Recovering British Roots

    Science.gov (United States)

    Doughty, Howard A.

    2005-01-01

    The field of Postcolonial Studies is one of the academic fashions that has arisen in an attempt to amend or replace radical theories of social power since the alleged discrediting of Marxism. The Canadian case is more ambiguous. Postcolonialism, already an essentially contested concept, is especially conflicted where Canada is concerned. Canada…

  8. Organisational characteristics associated with shift work practices and potential opportunities for intervention: findings from a Canadian study.

    Science.gov (United States)

    Hall, Amy L; Smit, Andrea N; Mistlberger, Ralph E; Landry, Glenn J; Koehoorn, Mieke

    2017-01-01

    Shift work is a common working arrangement with wide-ranging implications for worker health. Organisational determinants of shift work practices are not well characterised; such information could be used to guide evidence-based research and best practices to mitigate shift work's negative effects. This exploratory study aimed to describe and assess organisational-level determinants of shift work practices thought to affect health, across a range of industry sectors. Data on organisational characteristics, shift work scheduling, provision of shift work education materials/training to employees and night-time lighting policies in the workplace were collected during phone interviews with organisations across the Canadian province of British Columbia. Relationships between organisational characteristics and shift work practices were assessed using multivariable logistic regression models. The study sample included 88 participating organisations, representing 30 700 shift workers. Long-duration shifts, provision of shift work education materials/training to employees and night-time lighting policies were reported by approximately one-third of participating organisations. Odds of long-duration shifts increased in larger workplaces and by industry. Odds of providing shift work education materials/training increased in larger workplaces, in organisations reporting concern for shift worker health and in organisations without seasonal changes in shift work. Odds of night-time lighting policies in the workplace increased in organisations reporting previous workplace accidents or incidents that occurred during non-daytime hours, site maintenance needs and client service or care needs. This study points to organisational determinants of shift work practices that could be useful for targeting research and workplace interventions. Results should be interpreted as preliminary in an emerging body of literature on shift work and health. Published by the BMJ Publishing Group

  9. Spatiotemporal air pollution exposure assessment for a Canadian population-based lung cancer case-control study

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    Hystad Perry

    2012-04-01

    Full Text Available Abstract Background Few epidemiological studies of air pollution have used residential histories to develop long-term retrospective exposure estimates for multiple ambient air pollutants and vehicle and industrial emissions. We present such an exposure assessment for a Canadian population-based lung cancer case-control study of 8353 individuals using self-reported residential histories from 1975 to 1994. We also examine the implications of disregarding and/or improperly accounting for residential mobility in long-term exposure assessments. Methods National spatial surfaces of ambient air pollution were compiled from recent satellite-based estimates (for PM2.5 and NO2 and a chemical transport model (for O3. The surfaces were adjusted with historical annual air pollution monitoring data, using either spatiotemporal interpolation or linear regression. Model evaluation was conducted using an independent ten percent subset of monitoring data per year. Proximity to major roads, incorporating a temporal weighting factor based on Canadian mobile-source emission estimates, was used to estimate exposure to vehicle emissions. A comprehensive inventory of geocoded industries was used to estimate proximity to major and minor industrial emissions. Results Calibration of the national PM2.5 surface using annual spatiotemporal interpolation predicted historical PM2.5 measurement data best (R2 = 0.51, while linear regression incorporating the national surfaces, a time-trend and population density best predicted historical concentrations of NO2 (R2 = 0.38 and O3 (R2 = 0.56. Applying the models to study participants residential histories between 1975 and 1994 resulted in mean PM2.5, NO2 and O3 exposures of 11.3 μg/m3 (SD = 2.6, 17.7 ppb (4.1, and 26.4 ppb (3.4 respectively. On average, individuals lived within 300 m of a highway for 2.9 years (15% of exposure-years and within 3 km of a major industrial emitter for 6.4 years (32% of exposure-years. Approximately 50

  10. International Relations as a Field of Study in the Canadian System of Higher Education

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    Istomina, Kateryna

    2015-01-01

    The research presents an attempt to investigate the current state of international relations as a field of study in the context of higher education system in Canada. It contains a general overview of the field of study, focusing predominantly on the role and function of the given academic discipline. The scientific investigation covers the issue…

  11. African Studies in a Canadian Academy: A Tool for Liberation or Marginalization?

    Science.gov (United States)

    Fredua-Kwarteng, Eric

    2006-01-01

    This research uses critical race theory (CRT) as a conceptual perspective to study and analyze the experiences of ten students of African descent who enrolled in several African studies courses or related courses in an Ontarian university. The students, two females and eight males were interviewed between June and August 2005, using…

  12. The association between anthropometric measures and lung function in a population-based study of Canadian adults.

    Science.gov (United States)

    Rowe, A; Hernandez, P; Kuhle, S; Kirkland, S

    2017-10-01

    Decreased lung function has health impacts beyond diagnosable lung disease. It is therefore important to understand the factors that may influence even small changes in lung function including obesity, physical fitness and physical activity. The aim of this study was to determine the anthropometric measure most useful in examining the association with lung function and to determine how physical activity and physical fitness influence this association. The current study used cross-sectional data on 4662 adults aged 40-79 years from the Canadian Health Measures Survey Cycles 1 and 2. Linear regression models were used to examine the association between the anthropometric and lung function measures (forced expiratory volume in 1 s [FEV 1 ] and forced vital capacity [FVC]); R 2 values were compared among models. Physical fitness and physical activity terms were added to the models and potential confounding was assessed. Models using sum of 5 skinfolds and waist circumference consistently had the highest R 2 values for FEV 1 and FVC, while models using body mass index consistently had among the lowest R 2 values for FEV 1 and FVC and for men and women. Physical activity and physical fitness were confounders of the relationships between waist circumference and the lung function measures. Waist circumference remained a significant predictor of FVC but not FEV 1 after adjustment for physical activity or physical fitness. Waist circumference is an important predictor of lung function. Physical activity and physical fitness should be considered as potential confounders of the relationship between anthropometric measures and lung function. Copyright © 2017. Published by Elsevier Ltd.

  13. Three-Year Outcomes of a Canadian Multicenter Study of Accelerated Partial Breast Irradiation Using Conformal Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Berrang, Tanya S., E-mail: tberrang@bccancer.bc.ca [British Columbia Cancer Agency-Vancouver Island, BC (Canada); University of British Columbia, BC (Canada); Olivotto, Ivo [British Columbia Cancer Agency-Vancouver Island, BC (Canada); University of British Columbia, BC (Canada); Kim, Do-Hoon [Juravinski Cancer Centre, Ontario (Canada); McMaster University, Ontario (Canada); Nichol, Alan [British Columbia Cancer Agency-Vancouver Centre, BC (Canada); University of British Columbia, BC (Canada); Cho, B.C. John [Princess Margaret Hospital, Ontario (Canada); University of Toronto, Ontario (Canada); Mohamed, Islam G. [British Columbia Cancer Agency-Southern Interior, BC (Canada); University of British Columbia, BC (Canada); Parhar, Tarnjit [British Columbia Cancer Agency-Vancouver Centre, BC (Canada); University of British Columbia, BC (Canada); Wright, J.R. [Juravinski Cancer Centre, Ontario (Canada); McMaster University, Ontario (Canada); Truong, Pauline [British Columbia Cancer Agency-Vancouver Island, BC (Canada); University of British Columbia, BC (Canada); Tyldesley, Scott [British Columbia Cancer Agency-Vancouver Centre, BC (Canada); University of British Columbia, BC (Canada); Sussman, Jonathan [Juravinski Cancer Centre, Ontario (Canada); McMaster University, Ontario (Canada); Wai, Elaine [British Columbia Cancer Agency-Vancouver Island, BC (Canada); University of British Columbia, BC (Canada); Whelan, Tim [Juravinski Cancer Centre, Ontario (Canada); McMaster University, Ontario (Canada)

    2011-12-01

    Purpose: To report 3-year toxicity, cosmesis, and efficacy of a multicenter study of external beam, accelerated partial breast irradiation (APBI) for early-stage breast cancer. Methods and Materials: Between March 2005 and August 2006, 127 women aged {>=}40 years with ductal carcinoma in situ or node-negative invasive breast cancer {<=}3 cm in diameter, treated with breast-conserving surgery achieving negative margins, were accrued to a prospective study involving five Canadian cancer centers. Women meeting predefined dose constraints were treated with APBI using 3 to 5 photon beams, delivering 35 to 38.5 Gy in 10 fractions, twice a day, over 1 week. Patients were assessed for treatment-related toxicities, cosmesis, and efficacy before APBI and at specified time points for as long as 3 years after APBI. Results: 104 women had planning computed tomography scans showing visible seromas, met dosimetric constraints, and were treated with APBI to doses of 35 Gy (n = 9), 36 Gy (n = 33), or 38.5 Gy (n = 62). Eighty-seven patients were evaluated with minimum 3-year follow-up after APBI. Radiation dermatitis, breast edema, breast induration, and fatigue decreased from baseline levels or stabilized by the 3-year follow-up. Hypopigmentation, hyperpigmentation, breast pain, and telangiectasia slightly increased from baseline levels. Most toxicities at 3 years were Grade 1. Only 1 patient had a Grade 3 toxicity with telangiectasia in a skin fold inside the 95% isodose. Cosmesis was good to excellent in 86% (89/104) of women at baseline and 82% (70/85) at 3 years. The 3-year disease-free survival was 97%, with only one local recurrence that occurred in a different quadrant away from the treated site and two distant recurrences. Conclusions: At 3 years, toxicity and cosmesis were acceptable, and local control and disease-free survival were excellent, supporting continued accrual to randomized APBI trials.

  14. Feasibility and utility of mapping disease risk at the neighbourhood level within a Canadian public health unit: an ecological study

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    Wanigaratne Susitha

    2010-05-01

    Full Text Available Abstract Background We conducted spatial analyses to determine the geographic variation of cancer at the neighbourhood level (dissemination areas or DAs within the area of a single Ontario public health unit, Wellington-Dufferin-Guelph, covering a population of 238,326 inhabitants. Cancer incidence data between 1999 and 2003 were obtained from the Ontario Cancer Registry and were geocoded down to the level of DA using the enhanced Postal Code Conversion File. The 2001 Census of Canada provided information on the size and age-sex structure of the population at the DA level, in addition to information about selected census covariates, such as average neighbourhood income. Results Age standardized incidence ratios for cancer and the prevalence of census covariates were calculated for each of 331 dissemination areas in Wellington-Dufferin-Guelph. The standardized incidence ratios (SIR for cancer varied dramatically across the dissemination areas. However, application of the Moran's I statistic, a popular index of spatial autocorrelation, suggested significant spatial patterns for only two cancers, lung and prostate, both in males (p Conclusion This paper demonstrates the feasibility and utility of a systematic approach to identifying neighbourhoods, within the area served by a public health unit, that have significantly higher risks of cancer. This exploratory, ecologic study suggests several hypotheses for these spatial patterns that warrant further investigations. To the best of our knowledge, this is the first Canadian study published in the peer-reviewed literature estimating the risk of relatively rare public health outcomes at a very small areal level, namely dissemination areas.

  15. Movement disorders in elderly users of risperidone and first generation antipsychotic agents: a Canadian population-based study.

    Directory of Open Access Journals (Sweden)

    Irina Vasilyeva

    Full Text Available Despite concerns over the potential for severe adverse events, antipsychotic medications remain the mainstay of treatment of behaviour disorders and psychosis in elderly patients. Second-generation antipsychotic agents (SGAs; e.g., risperidone, olanzapine, quetiapine have generally shown a better safety profile compared to the first-generation agents (FGAs; e.g., haloperidol and phenothiazines, particularly in terms of a lower potential for involuntary movement disorders. Risperidone, the only SGA with an official indication for the management of inappropriate behaviour in dementia, has emerged as the antipsychotic most commonly prescribed to older patients. Most clinical trials evaluating the risk of movement disorders in elderly patients receiving antipsychotic therapy have been of limited sample size and/or of relatively short duration. A few observational studies have produced inconsistent results.A population-based retrospective cohort study of all residents of the Canadian province of Manitoba aged 65 and over, who were dispensed antipsychotic medications for the first time during the time period from April 1, 2000 to March 31, 2007, was conducted using Manitoba's Department of Health's administrative databases. Cox proportional hazards models were used to determine the risk of extrapyramidal symptoms (EPS in new users of risperidone compared to new users of FGAs.After controlling for potential confounders (demographics, comorbidity and medication use, risperidone use was associated with a lower risk of EPS compared to FGAs at 30, 60, 90 and 180 days (adjusted hazard ratios [HR] 0.38, 95% CI: 0.22-0.67; 0.45, 95% CI: 0.28-0.73; 0.50, 95% CI: 0.33-0.77; 0.65, 95% CI: 0.45-0.94, respectively. At 360 days, the strength of the association weakened with an adjusted HR of 0.75, 95% CI: 0.54-1.05.In a large population of elderly patients the use of risperidone was associated with a lower risk of EPS compared to FGAs.

  16. Naturalistic perspectives of traditional Tibetan medicine and contemporary relevance

    OpenAIRE

    Chengxin ZHAO; Li TONG

    2016-01-01

    Traditional Tibetan Medicine (TTM) has unique naturalistic connotation. Understanding naturalism from the TTM helps us to increase our understanding of organic cosmology and naturalism itself. It also helps us to realize the potential of naturalism. Hopefully this will show us a broader Asian naturalism and multidimensional prospect of the international organic cosmology. This paper intends to describe and analyze the naturalism hidden in the TTM by combining the source, theory, system and pr...

  17. Human mesostriatal response tracks motivational tendencies under naturalistic goal conflict.

    Science.gov (United States)

    Gonen, Tal; Soreq, Eyal; Eldar, Eran; Ben-Simon, Eti; Raz, Gal; Hendler, Talma

    2016-06-01

    Goal conflict situations, involving the simultaneous presence of reward and punishment, occur commonly in real life, and reflect well-known individual differences in the behavioral tendency to approach or avoid. However, despite accumulating neural depiction of motivational processing, the investigation of naturalistic approach behavior and its interplay with individual tendencies is remarkably lacking. We developed a novel ecological interactive scenario which triggers motivational behavior under high or low goal conflict conditions. Fifty-five healthy subjects played the game during a functional magnetic resonance imaging scan. A machine-learning approach was applied to classify approach/avoidance behaviors during the game. To achieve an independent measure of individual tendencies, an integrative profile was composed from three established theoretical models. Results demonstrated that approach under high relative to low conflict involved increased activity in the ventral tegmental area (VTA), peri-aquaductal gray, ventral striatum (VS) and precuneus. Notably, only VS and VTA activations during high conflict discriminated between approach/avoidance personality profiles, suggesting that the relationship between individual personality and naturalistic motivational tendencies is uniquely associated with the mesostriatal pathway. VTA-VS further demonstrated stronger coupling during high vs low conflict. These findings are the first to unravel the multilevel relationship among personality profile, approach tendencies in naturalistic set-up and their underlying neural manifestation, thus enabling new avenues for investigating approach-related psychopathologies. © The Author (2016). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  18. Human mesostriatal response tracks motivational tendencies under naturalistic goal conflict

    Science.gov (United States)

    Gonen, Tal; Soreq, Eyal; Eldar, Eran; Ben-Simon, Eti; Raz, Gal

    2016-01-01

    Goal conflict situations, involving the simultaneous presence of reward and punishment, occur commonly in real life, and reflect well-known individual differences in the behavioral tendency to approach or avoid. However, despite accumulating neural depiction of motivational processing, the investigation of naturalistic approach behavior and its interplay with individual tendencies is remarkably lacking. We developed a novel ecological interactive scenario which triggers motivational behavior under high or low goal conflict conditions. Fifty-five healthy subjects played the game during a functional magnetic resonance imaging scan. A machine-learning approach was applied to classify approach/avoidance behaviors during the game. To achieve an independent measure of individual tendencies, an integrative profile was composed from three established theoretical models. Results demonstrated that approach under high relative to low conflict involved increased activity in the ventral tegmental area (VTA), peri-aquaductal gray, ventral striatum (VS) and precuneus. Notably, only VS and VTA activations during high conflict discriminated between approach/avoidance personality profiles, suggesting that the relationship between individual personality and naturalistic motivational tendencies is uniquely associated with the mesostriatal pathway. VTA–VS further demonstrated stronger coupling during high vs low conflict. These findings are the first to unravel the multilevel relationship among personality profile, approach tendencies in naturalistic set-up and their underlying neural manifestation, thus enabling new avenues for investigating approach-related psychopathologies. PMID:26833917

  19. Comparing diagnostic classification of neurobehavioral disorder associated with prenatal alcohol exposure with the Canadian fetal alcohol spectrum disorder guidelines: a cohort study.

    Science.gov (United States)

    Sanders, James L; Breen, Rebecca E Hudson; Netelenbos, Nicole

    2017-01-01

    Diagnostic criteria have recently been introduced in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), for neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE). The purpose of this study is to assess the classification of this condition using the Canadian fetal alcohol spectrum disorder (FASD) multidisciplinary diagnostic guidelines as the standard of comparison. First, classification of ND-PAE was compared with Canadian FASD diagnoses of fetal alcohol syndrome (FAS), partial FAS and alcohol-related neurodevelopmental disorder. Second, classification of ND-PAE was compared with FAS and pFAS only, a criterion for which includes facial features highly predictive of prenatal alcohol exposure and effects. Eighty-two patients underwent multidisciplinary clinical evaluations using the Canadian FASD diagnostic guidelines between 2011 and 2015. Two clinicians independently reviewed patient files for evidence of diagnostic criteria for ND-PAE when applying an impairment cut-off level of 2 or more standard deviations below the mean, or clinically significant impairment in the absence of standardized norm-referenced measures. Good interrater reliability was established between clinicians (κ = 0.79). Classifications of ND-PAE and Canadian FASD diagnoses, including alcohol-related neurodevelopmental disorder, were moderately correlated (Cramer V [82] = 0.44, p 0.05). Although there is considerable overlap between both sets of criteria, ND-PAE was less likely to identify patients with FASD. Although the neurobehavioral domains assessed by ND-PAE are supported in research, its diagnostic structure restricts the identification of FASD at the impairment threshold of 2 or more standard deviations. A disconnect remains with regard to impairment thresholds between FASD, which relies on neurodevelopmental data, and ND-PAE, which relies on clinical judgment.

  20. Radiation processing technology for cosmetics: a report on a Canadian study

    International Nuclear Information System (INIS)

    Reid, B.D.; Wilson, B.K.

    1993-01-01

    For several years some cosmetic raw materials and finished products have been successfully treated with irradiation to control microbial growth. Basic studies have been initiated to test the successful application of irradiation to a raw material or finished product in the cosmetics industry. Acceptance of this technology by industry and by regulatory agencies, is dependent upon the correct application of the technology and documenting the results of carefully controlled studies. A short list of raw materials was selected on which the immediate test work was undertaken. It includes talc, starch, gelatin and bentonite. This will increase confidence and expertise in this technology. (author)

  1. An Articulated Pan-Canadian Core Curriculum: Are We Dreaming in Colour? The Tourism Learning System. An Association of Canadian Community Colleges Sponsored Sectoral Case Study.

    Science.gov (United States)

    Bird, Geoffrey; Hood, Terry; White, Brian

    This paper offers findings from a case study of western Canada's Tourism Learning System (TLS) initiative. TLS aims to facilitate possible adoption of a national tourism learning system, as well as adaptation of development principles to other industries. The tourism industry now accounts for more than 25% of the world's trade and nearly 10% of…

  2. Relationship between disease characteristics and orofacial manifestations in systemic sclerosis: Canadian Systemic Sclerosis Oral Health Study III.

    Science.gov (United States)

    Baron, Murray; Hudson, Marie; Tatibouet, Solène; Steele, Russell; Lo, Ernest; Gravel, Sabrina; Gyger, Geneviève; El Sayegh, Tarek; Pope, Janet; Fontaine, Audrey; Masetto, Ariel; Matthews, Debora; Sutton, Evelyn; Thie, Norman; Jones, Niall; Copete, Maria; Kolbinson, Dean; Markland, Janet; Nogueira, Getulio; Robinson, David; Fritzler, Marvin; Gornitsky, Mervyn

    2015-05-01

    Systemic sclerosis (SSc; scleroderma) is associated with decreased saliva production and interincisal distance, more missing teeth, and periodontal disease. We undertook this study to determine the clinical correlates of SSc with these oral abnormalities. Subjects were recruited from the Canadian Scleroderma Research Group cohort. Detailed dental and clinical examinations were performed according to standardized protocols. Associations between dental abnormalities and selected clinical and serologic manifestations of SSc were examined. One hundred sixty-three SSc subjects were included: 90% women, mean ± SD age 56 ± 11 years, mean ± SD disease duration 14 ± 8 years, 72% with limited cutaneous disease, and 28% with diffuse cutaneous disease. Decreased saliva production was associated with Sjögren's syndrome-related autoantibodies (β = -43.32; 95% confidence interval [95% CI] -80.89, -5.75), but not with disease severity (β = -2.51; 95% CI -8.75, 3.73). Decreased interincisal distance was related to disease severity (β = -1.02; 95% CI -1.63, -0.42) and the modified Rodnan skin thickness score (β = -0.38; 95% CI -0.53, -0.23). The number of missing teeth was associated with decreased saliva production (relative risk [RR] 0.97; 95% CI 0.94, 0.99), worse hand function (RR 1.52; 95% CI 1.13, 2.02), and the presence of gastroesophageal reflux disease (GERD; RR 1.68 [95% CI 1.14, 2.46]). No clinical or serologic variables were correlated with periodontal disease. In SSc, diminished interincisal distance is related to overall disease severity. Decreased saliva production is related to concomitant Sjögren's syndrome antibodies. Tooth loss is associated with poor upper extremity function, GERD, and decreased saliva. The etiology of excess periodontal disease is likely multifactorial and remains unclear. © 2015, American College of Rheumatology.

  3. Relationship Between Disease Characteristics and Oral Radiologic Findings in Systemic Sclerosis: Results From a Canadian Oral Health Study.

    Science.gov (United States)

    Baron, Murray; Hudson, Marie; Dagenais, Marie; Macdonald, David; Gyger, Geneviève; El Sayegh, Tarek; Pope, Janet; Fontaine, Audrey; Masetto, Ariel; Matthews, Debora; Sutton, Evelyn; Thie, Norman; Jones, Niall; Copete, Maria; Kolbinson, Dean; Markland, Janet; Nogueira-Filho, Getulio; Robinson, David; Fritzler, Marvin; Wang, Mianbo; Gornitsky, Mervyn

    2016-05-01

    Systemic sclerosis (SSc; scleroderma) is associated with a wide periodontal ligament (PDL) and mandibular erosions. We investigated the clinical correlates of SSc with these radiologic abnormalities. Subjects from the Canadian Scleroderma Research Group cohort underwent detailed radiologic examinations. Associations between radiologic abnormalities and clinical manifestations of SSc were examined with univariate and multivariate analyses. The study included 159 subjects; 90.6% were women, the mean ± SD age was 56 ± 10 years, diffuse disease was present in 28.3%, and mean ± SD disease duration was 13.7 ± 8.4 years. Widening of the PDL involving at least 1 tooth was present in 38% of subjects, and 14.5% had at least 1 site in the mandible with an erosion. In analyses adjusting for age, disease duration, sex, smoking, and education, we found significant associations between the number of teeth with widening of the PDL and disease severity assessed by the physician global assessment (PGA) (relative risk [RR] 1.19, 95% confidence interval [95% CI] 1.02-1.39, P = 0.028). Analyses replacing the PGA with the skin score, disease subset, or anti-topoisomerase I antibodies confirmed the relationship with indices of disease severity. There was no relationship between either the number of teeth with periodontal disease or the number of missing teeth, and the number of teeth with wide PDL. A smaller interdental distance (RR 0.89, 95% CI 0.82-0.97, P = 0.006), but not disease severity, facial skin score, or ischemia was associated with a larger number of erosions. In SSc, a wide PDL may reflect generalized overproduction of collagen, and mandibular erosions are related to local factors in the oral cavity. © 2016, American College of Rheumatology.

  4. Patient-reported dietetic care post hospital for free-living patients: a Canadian Malnutrition Task Force Study.

    Science.gov (United States)

    Keller, H; Payette, H; Laporte, M; Bernier, P; Allard, J; Duerksen, D; Gramlich, L; Jeejeebhoy, K

    2018-02-01

    Transitions out of hospital can influence recovery. Ideally, malnourished patients should be followed by someone with nutrition expertise, specifically a dietitian, post discharge from hospital. Predictors of dietetic care post discharge are currently unknown. The present study aimed to determine the patient factors independently associated with 30-days post hospital discharge dietetic care for free-living patients who transitioned to the community. Nine hundred and twenty-two medical or surgical adult patients were recruited in 16 acute care hospitals in eight Canadian provinces on admission. Eligible patients could speak English or French, provide their written consent, were anticipated to have a hospital stay of ≥2 days and were not considered palliative. Telephone interviews were completed with 747 (81%) participants using a standardised questionnaire to determine whether dietetic care occurred post discharge; 544 patients discharged to the community were included in the multivariate analyses, excluding those who were admitted to nursing homes or rehabilitation facilities. Covariates during and post hospitalisation were collected prospectively and used in logistic regression analyses to determine independent patient-level predictors. Dietetic care post discharge was reported by 61/544 (11%) of participants and was associated with severe malnutrition [Subjective Global Assessment category C: odd's ratio (OR) 2.43 (1.23-4.83)], weight loss post discharge [(OR 2.86 (1.45-5.62)], comorbidity [(OR 1.09 (1.02-1.17)] and a dietitian consultation on admission [(OR 3.41 (1.95-5.97)]. Dietetic care post discharge occurs in few patients, despite the known high prevalence of malnutrition on admission and discharge. Dietetic care in hospital was the most influential predictor of post-hospital care. © 2017 The British Dietetic Association Ltd.

  5. Calcium Nutrition Perceptions among Food Bank Users: A Canadian Case Study

    Science.gov (United States)

    Johnson, Shanthi; Hawkins, Nicki

    2010-01-01

    The present study examined the differences in the food bank users' perceptions related to calcium nutrition across sex and employment status using a cross-sectional, prospective design at a large food bank in Canada. A total of 197 individuals participated for a response rate of 97%. A structured survey was developed and pilot tested before it was…

  6. Perceptions of ESL Program Management in Canadian Higher Education: A Qualitative Case Study

    Science.gov (United States)

    Eaton, Sarah Elaine

    2017-01-01

    ESL programs at post-secondary institutions must often generate revenue in addition to teaching students English. Institutions often impose explicit expectations on these programs to generate profit, creating unique challenges for those who administer them. This qualitative case study investigated challenges faced by ESL program directors at one…

  7. Viewpoint: Back to the Basics in Social Studies? Personal Statements by Three Canadian Educators

    Science.gov (United States)

    Sutherland, Neil; And Others

    1977-01-01

    Neil Sutherland discusses the historical context of the back to basics movement in social studies. Ken Osborne points out that the movement is stifling innovation. Max van Manen addresses the question of what curricula should be considered basic. (Author/RM)

  8. The Role of Attachment in Facebook Usage: A Study of Canadian College Students

    Science.gov (United States)

    Teo, Timothy; Doleck, Tenzin; Bazelais, Paul

    2018-01-01

    Considering the increasingly ubiquitous and frequent use of Facebook among college students, this study sought to explicate and unravel the salient determinants of Facebook use. Specifically, the main goal was to ascertain the factors influencing "Collège d'enseignement général et professionnel" (CEGEP) students' Facebook use, for which…

  9. High School Music Programmes as Potential Sites for Communities of Practice--A Canadian Study

    Science.gov (United States)

    Countryman, June

    2009-01-01

    My exploration of the nature of the high school music experience was undertaken with 33 young adults who had graduated from high school one to six years previous to the data collection. All of these participants had been involved in their school music programmes and 30 had not continued formal music study following graduation. One might predict…

  10. Exploring the use of lesson study with six Canadian middle-school science teachers

    Science.gov (United States)

    Bridges, Terry James

    This qualitative case study explores the use of lesson study over a ten-week period with six Ontario middle school science teachers. The research questions guiding this study were: (1) How does participation in science-based lesson study influence these teachers': (a) science subject matter knowledge (science SMK), (b) science pedagogical content knowledge (science PCK), and (c) confidence in teaching science?, and (2) What benefits and challenges do they associate with lesson study? Data sources for this study were: teacher questionnaires, surveys, reflections, pre- and post- interviews, and follow-up emails; researcher field notes and reflections; pre- and post- administration of the Science Teaching Efficacy Belief Instrument; and audio recordings of group meetings. The teachers demonstrated limited gains in science SMK. There was evidence for an overall improvement in teacher knowledge of forces and simple machines, and two teachers demonstrated improvement in over half of the five scenarios assessing teacher science SMK. Modest gains in teacher science PCK were found. One teacher expressed more accurate understanding of students' knowledge of forces and a better knowledge of effective science teaching strategies. The majority of teachers reported that they would be using three-part lessons and hands-on activities more in their science teaching. Gains in teacher pedagogical knowledge (PK) were found in four areas: greater emphasis on anticipation of student thinking and responses, recognition of the importance of observing students, more intentional teaching, and anticipated future use of student video data. Most teachers reported feeling more confident in teaching structures and mechanisms, and attributed this increase in confidence to collaboration and seeing evidence of student learning and engagement during the lesson teachings. Teacher benefits included: learning how to increase student engagement and collaboration, observing students, including video data

  11. A qualitative study of health information technology in the Canadian public health system

    OpenAIRE

    Zinszer, Kate; Tamblyn, Robyn; Bates, David W; Buckeridge, David L

    2013-01-01

    Background: Although the adoption of health information technology (HIT) has advanced in Canada over the past decade, considerable challenges remain in supporting the development, broad adoption, and effective use of HIT in the public health system. Policy makers and practitioners have long recognized that improvements in HIT infrastructure are necessary to support effective and efficient public health practice. The objective of this study was to identify aspects of health information technol...

  12. Momentum Investment Strategy : (An Empirical Study of the Canadian Stock Market and the Swedish Stock Market)

    OpenAIRE

    Ludvigsson, Anita

    2008-01-01

    Abstract Market efficiency is a highly debated topic within the academic research field of finance. Several studies have presented that the return on stocks may be predictable by employing the momentum investment strategy, which contradicts the Efficient Market Hypothesis in exchange market. There is extensive international evidence, on an academic level that the momentum investment strategy yields positive abnormal returns when short-term periods are considered. This paper examines the profi...

  13. The Search for Meaningful E-Learning at Canadian Universities: A Multi-Institutional Research Study

    Science.gov (United States)

    Salyers, Vincent; Carter, Lorraine; Carter, Alanna; Myers, Sue; Barrett, Penelope

    2014-01-01

    While e-learning is now characterized by a past and trends within that past, there continues to be uncertainty about how e-learning is defined and conceptualized, whether or not we like e-learning, and whether or not it is as meaningful to us as face to face learning. The purpose of this study was to document the e-learning perceptions of students…

  14. Framing Canadian federalism

    National Research Council Canada - National Science Library

    Saywell, John; Anastakis, Dimitry; Bryden, Penny E

    2009-01-01

    ... the pervasive effects that federalism has on Canadian politics, economics, culture, and history, and provide a detailed framework in which to understand contemporary federalism. Written in honour of John T. Saywell's half-century of accomplished and influential scholarly work and teaching, Framing Canadian Federalism is a timely and fitting t...

  15. A study of cycling of 90Sr in a natural forest on the Canadian Shield

    International Nuclear Information System (INIS)

    Cooper, E.L.; Rahman, M.M.

    1994-01-01

    A study of the cycling of 90 Sr in a natural forest growing over a shallow zone of low-level 90 Sr-contaminated groundwater was carried out at the Chalk River Laboratories of AECL Research. The contamination is about 1 m below the surface under most of the site and evidence from earlier studies indicates that 90 Sr is being brought to the surface by deeper rooting trees. Once it is on the surface, the 90 Sr becomes available for uptake by other biota in the area. The study was initiated by taking an inventory of 90 Sr in various compartments including: soil, leaf litter, wood and foliage. Samples of leaf fall, stemflow and throughfall were also collected in order to estimate the relative importance of these mechanisms in cycling 90 Sr to the forest floor. Most of the 90 Sr on or near the surface is in the leaf litter and the top 8 cm of soil, as well as in the vegetation. Downward migration of 90 Sr through the unsaturated zone is slow. This may be due to strong retention by the soil; however, it could also be due to recycling of 90 Sr by the vegetation. The accumulated inventory in the leaf litter is about equal to the input from leaf fall over a period of 3 years

  16. Comparison of two simulation methods for testing of algorithms to detect cyclist and pedestrian accidents in naturalistic data

    OpenAIRE

    Madsen, Tanja; Christensen, Mads; Sloth Andersen, Camilla; Varhelyi, Andras; Laureshyn, Aliaksei; Moeslund, Thomas; Lahrmann, Harry

    2017-01-01

    Naturalistic studies can potentially be used to detect accidents of vulnerable road users and thus overcome the large degree of under-reporting in the official accident records. In this study, simulated cycling and walking accidents were performed by a stuntman and with a crash test dummy to test how they differ from each other and the potential implications of using simulated accidents as an alternative to real accidents. The study consisted of simulations of common accident types for cyclis...

  17. Comparison of two simulation methods for testing of algorithms to detect cyclist and pedestrian accidents in naturalistic data

    OpenAIRE

    Madsen, Tanja Kidholm Osmann; Christensen, Mads Bock; Andersen, Camilla Sloth; Várhelyi, András; Laureshyn, Aliaksei; Moeslund, Thomas B.; Lahrmann, Harry Spaabæk

    2017-01-01

    Naturalistic studies can potentially be used to detect accidents of vulnerable road users and thus overcome the large degree of under-reporting in the official accident records. In this study, simulated cycling and walking accidents were performed by a stunt man and with a crash test dummy to test how they differ from each other and the potential implications of using simulated accidents as an alternative to real accidents. The study consisted of simulations of common accident types for cycli...

  18. CHAracteristics of research studies that iNfluence practice: a GEneral survey of Canadian orthopaedic Surgeons (CHANGES): a pilot survey.

    Science.gov (United States)

    de Sa, Darren; Thornley, Patrick; Evaniew, Nathan; Madden, Kim; Bhandari, Mohit; Ghert, Michelle

    2015-01-01

    Evidence Based Medicine (EBM) is increasingly being applied to inform clinical decision-making in orthopaedic surgery. Despite the promotion of EBM in Orthopaedic Surgery, the adoption of results from high quality clinical research seems highly unpredictable and does not appear to be driven strictly by randomized trial data. The objective of this study was to pilot a survey to determine if we could identify surgeon opinions on the characteristics of research studies that are perceived as being most likely to influence clinical decision-making among orthopaedic surgeons in Canada. A 28-question electronic survey was distributed to active members of the Canadian Orthopaedic Association (COA) over a period of 11 weeks. The questionnaire sought to analyze the influence of both extrinsic and intrinsic characteristics of research studies and their potential to influence practice patterns. Extrinsic factors included the perceived journal quality and investigator profiles, economic impact, peer/patient/industry influence and individual surgeon residency/fellowship training experiences. Intrinsic factors included study design, sample size, and outcomes reported. Descriptive statistics are provided. Of the 109 members of the COA who opened the survey, 95 (87%) completed the survey in its entirety. The overall response rate was 11% (95/841). Surgeons achieved consensus on the influence of three key designs on their practices: 1) randomized controlled trials 94 (99%), 2) meta-analysis 83 (87%), and 3) systematic reviews 81 (85%). Sixty-seven percent of surgeons agreed that studies with sample sizes of 101-500 or more were more likely to influence clinical practice than smaller studies (n = design influencing adoption included 1) reputation of the investigators (99%) and 2) perceived quality of the journal (75%). Although study design and sample size (i.e. minimum of 100 patients) have some influence on clinical decision making, surgeon respondents are equally influenced

  19. Dietary patterns and colorectal cancer: results from a Canadian population-based study.

    Science.gov (United States)

    Chen, Zhi; Wang, Peizhong Peter; Woodrow, Jennifer; Zhu, Yun; Roebothan, Barbara; Mclaughlin, John R; Parfrey, Patrick S

    2015-01-15

    The relationship between major dietary patterns and colorectal cancer (CRC) in other populations largely remains consistent across studies. The objective of the present study is to assess if dietary patterns are associated with the risk of CRC in the population of Newfoundland and Labrador (NL). Data from a population based case-control study in the province of NL were analyzed, including 506 CRC patients (306 men and 200 women) and 673 controls (400 men and 273 women), aged 20-74 years. Dietary habits were assessed by a 169-item food frequency questionnaire (FFQ). Logistic regression analyses were performed to investigate the association between dietary patterns and the CRC risk. Three major dietary patterns were derived using factor analysis, namely a Meat-diet pattern, a Plant-based diet pattern and a Sugary-diet pattern. In combination the three dietary patterns explained 74% of the total variance in food intake. Results suggest that the Meat-diet and the Sugary-diet increased the risk of CRC with corresponding odds ratios (ORs) of 1.84 (95% CI: 1.19-2.86) and 2.26 (95% CI: 1.39-3.66) for people in the highest intake quintile compared to those in the lowest. Whereas plant-based diet pattern decreases the risk of CRC with a corresponding OR of 0.55 (95% CI: 0.35-0.87). Even though odds ratios (ORs) were not always statistically significant, largely similar associations across three cancer sites were found: the proximal colon, the distal colon, and the rectum. The finding that Meat-diet/Sugary-diet patterns increased and Plant-based diet pattern decreased the risk of CRC would guide the promotion of healthy eating for primary prevention of CRC in this population.

  20. Interventions performed by community pharmacists in one Canadian province: a cross-sectional study.

    Science.gov (United States)

    Young, Stephanie W; Bishop, Lisa D; Conway, Amy

    2012-01-01

    Interventions made by pharmacists to resolve issues when filling a prescription ensure the quality, safety, and efficacy of medication therapy for patients. The purpose of this study was to provide a current estimate of the number and types of interventions performed by community pharmacists during processing of prescriptions. This baseline data will provide insight into the factors influencing current practice and areas where pharmacists can redefine and expand their role. A cross-sectional study of community pharmacist interventions was completed. Participants included third-year pharmacy students and their pharmacist preceptor as a data collection team. The team identified all interventions on prescriptions during the hours worked together over a 7-day consecutive period. Full ethics approval was obtained. Nine student-pharmacist pairs submitted data from nine pharmacies in rural (n = 3) and urban (n = 6) centers. A total of 125 interventions were documented for 106 patients, with a mean intervention rate of 2.8%. The patients were 48% male, were mostly ≥18 years of age (94%), and 86% had either public or private insurance. Over three-quarters of the interventions (77%) were on new prescriptions. The top four types of problems requiring intervention were related to prescription insurance coverage (18%), drug product not available (16%), dosage too low (16%), and missing prescription information (15%). The prescriber was contacted for 69% of the interventions. Seventy-two percent of prescriptions were changed and by the end of the data collection period, 89% of the problems were resolved. Community pharmacists are impacting the care of patients by identifying and resolving problems with prescriptions. Many of the issues identified in this study were related to correcting administrative or technical issues, potentially limiting the time pharmacists can spend on patient-focused activities.

  1. Occupational exposures and non-Hodgkin's lymphoma: Canadian case-control study

    Directory of Open Access Journals (Sweden)

    Spinelli John J

    2008-08-01

    Full Text Available Abstract Background The objective was to study the association between Non-Hodgkin's Lymphoma (NHL and occupational exposures related to long held occupations among males in six provinces of Canada. Methods A population based case-control study was conducted from 1991 to 1994. Males with newly diagnosed NHL (ICD-10 were stratified by province of residence and age group. A total of 513 incident cases and 1506 population based controls were included in the analysis. Conditional logistic regression was conducted to fit statistical models. Results Based on conditional logistic regression modeling, the following factors independently increased the risk of NHL: farmer and machinist as long held occupations; constant exposure to diesel exhaust fumes; constant exposure to ionizing radiation (radium; and personal history of another cancer. Men who had worked for 20 years or more as farmer and machinist were the most likely to develop NHL. Conclusion An increased risk of developing NHL is associated with the following: long held occupations of faer and machinist; exposure to diesel fumes; and exposure to ionizing radiation (radium. The risk of NHL increased with the duration of employment as a farmer or machinist.

  2. Interventions performed by community pharmacists in one Canadian province: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Young SW

    2012-12-01

    Full Text Available Stephanie W Young, Lisa D Bishop, Amy ConwaySchool of Pharmacy, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, CanadaPurpose: Interventions made by pharmacists to resolve issues when filling a prescription ensure the quality, safety, and efficacy of medication therapy for patients. The purpose of this study was to provide a current estimate of the number and types of interventions performed by community pharmacists during processing of prescriptions. This baseline data will provide insight into the factors influencing current practice and areas where pharmacists can redefine and expand their role.Patients and methods: A cross-sectional study of community pharmacist interventions was completed. Participants included third-year pharmacy students and their pharmacist preceptor as a data collection team. The team identified all interventions on prescriptions during the hours worked together over a 7-day consecutive period. Full ethics approval was obtained.Results: Nine student–pharmacist pairs submitted data from nine pharmacies in rural (n = 3 and urban (n = 6 centers. A total of 125 interventions were documented for 106 patients, with a mean intervention rate of 2.8%. The patients were 48% male, were mostly ≥18 years of age (94%, and 86% had either public or private insurance. Over three-quarters of the interventions (77% were on new prescriptions. The top four types of problems requiring intervention were related to prescription insurance coverage (18%, drug product not available (16%, dosage too low (16%, and missing prescription information (15%. The prescriber was contacted for 69% of the interventions. Seventy-two percent of prescriptions were changed and by the end of the data collection period, 89% of the problems were resolved.Conclusion: Community pharmacists are impacting the care of patients by identifying and resolving problems with prescriptions. Many of the issues identified in this study were related

  3. An Exploratory Study of Fatigue and Physical Activity in Canadian Thyroid Cancer Patients.

    Science.gov (United States)

    Alhashemi, Ahmad; Jones, Jennifer M; Goldstein, David P; Mina, Daniel Santa; Thabane, Lehana; Sabiston, Catherine M; Chang, Eugene K; Brierley, James D; Sawka, Anna M

    2017-09-01

    Fatigue is common among cancer survivors, but fatigue in thyroid cancer (TC) survivors may be under-appreciated. This study investigated the severity and prevalence of moderate and severe fatigue in TC survivors. Potential predictive factors, including physical activity, were explored. A cross-sectional, written, self-administered TC patient survey and retrospective chart review were performed in an outpatient academic Endocrinology clinic in Toronto, Canada. The primary outcome measure was the global fatigue score measured by the Brief Fatigue Inventory (BFI). Physical activity was evaluated using the International Physical Activity Questionnaire-7 day (IPAQ-7). Predictors of BFI global fatigue score were explored in univariate analyses and a multivariable linear regression model. The response rate was 63.1% (205/325). Three-quarters of the respondents were women (152/205). The mean age was 52.5 years, and the mean time since first TC surgery was 6.8 years. The mean global BFI score was 3.5 (standard deviation 2.4) out of 10 (10 is worst). The prevalence of moderate-severe fatigue (global BFI score 4.1-10 out of 10) was 41.4% (84/203). Individuals who were unemployed or unable to work due to disability reported significantly higher levels of fatigue compared to the rest of the study population, in uni-and multivariable analyses. Furthermore, increased physical activity was associated with reduced fatigue in uni- and multivariable analyses. Other socio-demographic, disease, or biochemical variables were not significantly associated with fatigue in the multivariable model. Moderate or severe fatigue was reported in about 4/10 TC survivors. Independent predictors of worse fatigue included unemployment and reduced physical activity.

  4. A Canadian Study toward Changing Local Practice in the Diagnosis of Pediatric Celiac Disease

    Directory of Open Access Journals (Sweden)

    Seema Rajani

    2016-01-01

    Full Text Available Background. The European Society for Pediatric Gastroenterology, Hepatology and Nutrition endorses serological diagnosis (SD for pediatric celiac disease (CD. The objective of this study was to pilot SD and to prospectively evaluate gastrointestinal permeability and mucosal inflammation at diagnosis and after one year on the gluten-free diet (GFD. We hypothesized that SD would be associated with similar short term outcomes as ED. Method. Children, 3–17 years of age, referred for possible CD were eligible for SD given aTTG level ≥200 U/mL, confirmed by repeat aTTG and HLA haplotypes. Gastrointestinal permeability, assessed using sugar probes, and inflammation, assessed using fecal calprotectin (FC, at baseline and after one year on a GFD were compared to patients who had ED. Results. Enrolled SD (n=40 and ED (n=48 patients had similar demographics. ED and SD groups were not different in baseline lactulose: mannitol ratio (L : M (0.049 versus 0.034; p=0.07, fractional excretion of sucrose (%FES; 0.086 versus 0.092; p=0.44, or fecal calprotectin (FC; 89.6 versus 51.4; p=0.05. At follow-up, urine permeability improved and was similar between groups, L : M (0.022 versus 0.025; p=0.55 and %FES (0.040 versus 0.047; p=0.87 (p>0.05. FC improved but remained higher in the SD group (37.1 versus 15.9; p=0.04. Conclusion. Patients on the GFD showed improved intestinal permeability and mucosal inflammation regardless of diagnostic strategy. This prospective study supports that children diagnosed by SD have resolving mucosal disease early after commencing a GFD.

  5. Sampling Ozone Exposure of Canadian Forests at Different Scales: Some Case Studies

    Directory of Open Access Journals (Sweden)

    R.M. Cox

    2001-01-01

    Full Text Available The use of passive samplers in extensive monitoring, such as that used in national forest health monitoring plots, indicates that these devices are able to determine both spatial and temporal differences in ozone exposure of the plots. This allows for categorisation of the plots and the potential for cause-effect analysis of certain forest health responses. Forest exposure along a gradient of air pollution deposition demonstrates large variation in accumulated exposures. The efficacy of using passive samplers for in situ monitoring of forest canopy exposure was also demonstrated. The sampler data produced weak relationships with ozone values from the nearest �continuous� monitor, even though data from colocated samplers showed strong relationships. This spatial variation and the apparent effect of elevation on ozone exposure demonstrate the importance of topography and tree canopy characteristics in plant exposure on a regional scale. In addition, passive sampling may identify the effects of local pollutant gases, such as NO, which may scavenge ozone locally only to increase the production of this secondary pollutant downwind, as atmospheric reactions redress the equilibrium between concentrations of this precursor and those of the generated ozone. The use of passive samplers at the stand level is able to resolve vertical profiles within the stand and edge effects that are important in exposure of understorey and ground flora. Recent case studies using passive samplers to determine forest exposure to ozone indicate a great potential for the development of spatial models on a regional, landscape, and stand level scale.

  6. A study of institutional origins and change in a Canadian urban commons

    Directory of Open Access Journals (Sweden)

    James P. Robson

    2015-09-01

    Full Text Available Kenora is a small city located in northwestern Ontario, Canada. The study presented here focuses on Tunnel Island, 300 acres of forested land adjacent to Kenora’s downtown. The island is used and valued by both city residents and members of three nearby Ojibway nations. As a multiple-use, common-pool resource accessed by different groups for a range of non-extractive activities, the site has become an experiment in multicultural commons governance, and presents an excellent opportunity to examine the origins and development of institutions for managing collective environmental resources in an urban setting. Using participant observation, internet- and field-based user surveys, and semi-structured interviews, our research finds that grassroots ‘governance’ of the site is emerging through subtle processes of individual and social construction, with the strategies and norms (codes of conduct employed by users providing relative harmony on the trails, which suggests functioning commons institutions. Nevertheless, values-based and epistemic tensions exist among users, pointing to governance challenges for planned joint management of the site, and specifically the need to develop formal, legitimate, and yet flexible and inclusive arrangements that can operate in conjunction with the social practice of existing users.

  7. Occupational Contact Dermatitis in the Canadian Aircraft Industry: A 25-Year Retrospective Study.

    Science.gov (United States)

    Loranger, Camille; Moreau, Linda; Sasseville, Denis

    2018-03-24

    Aircraft building exposes workers to irritant and sensitizing products. The aim of this article was to study occupational dermatoses among aircraft workers over 25 years. The files of aerospace workers referred between 1990 and 2015 were extracted from the database of the McGill University Health Centre contact dermatitis clinic. These were subdivided according to demographics, type of work, patch testing results, and final diagnosis. Of 305 workers, 58% were 40 years or younger; one third were women. Onset of dermatitis varied from 2 months to 25 years, but 120 cases (39%) occurred during the first 3 years. Fifty-one percent of the cases involved assemblers, and 27% were composite material technicians, which were overrepresented as they constitute 10% of the workforce. Of the 305 workers, 152 suffered from allergic contact dermatitis, and 96 had irritant contact dermatitis. Of those with allergic contact dermatitis, 124 reacted to epoxy-based workplace products, but only 48 had positive patch tests to commercially available epoxy allergens. More than 60% of the cases of epoxy allergy would have been missed without testing with workplace products.

  8. Transmission of hepatitis D virus between spouses: A longitudinal study of the first reported Canadian case

    Directory of Open Access Journals (Sweden)

    Carla Osiowy

    2017-01-01

    Full Text Available In chronic hepatitis B (CHB, hepatitis D virus (HDV superinfection can lead to acute liver failure. The incidence of HDV superinfection is unknown, but is often detected in immigrants from HDV endemic countries. In this report, we characterize long-term clinical and virological outcomes in a hepatitis B virus (HBV infected carrier before and after HDV superinfection, acquired from their spouse having HBV/HDV co-infection. A 38 year-old Mongolian male with CHB on anti-HBV therapy developed acute liver failure following HDV superinfection. Although he recovered, avoiding the need for liver transplant, HDV serological and molecular markers of infection persisted for the subsequent 16-month follow-up period, suggesting the development of CHB/HDV co-infection. The source of his HDV was from his wife of 10 years, a 34-year old Mongolian female known to have inactive CHB/HDV co-infection but who was not on anti-HBV therapy. Phylogenetic analysis of the complete HDV genome from the couple showed >99% similarity, with post-transmission longitudinal sequence revealing specific nucleotide substitutions between both spouse’s HDV genome sequences. This study highlights the ongoing risk of HDV superinfection due to long-term co-habitation or sexual transmission in CHB patients. The fact that transmission occurred after almost a decade of marriage may be due to host immune or environmental factors that created a more favorable condition for transmission.

  9. Creation of the Naturalistic Engagement in Secondary Tasks (NEST) distracted driving dataset.

    Science.gov (United States)

    Owens, Justin M; Angell, Linda; Hankey, Jonathan M; Foley, James; Ebe, Kazutoshi

    2015-09-01

    Distracted driving has become a topic of critical importance to driving safety research over the past several decades. Naturalistic driving data offer a unique opportunity to study how drivers engage with secondary tasks in real-world driving; however, the complexities involved with identifying and coding relevant epochs of naturalistic data have limited its accessibility to the general research community. This project was developed to help address this problem by creating an accessible dataset of driver behavior and situational factors observed during distraction-related safety-critical events and baseline driving epochs, using the Strategic Highway Research Program 2 (SHRP2) naturalistic dataset. The new NEST (Naturalistic Engagement in Secondary Tasks) dataset was created using crashes and near-crashes from the SHRP2 dataset that were identified as including secondary task engagement as a potential contributing factor. Data coding included frame-by-frame video analysis of secondary task and hands-on-wheel activity, as well as summary event information. In addition, information about each secondary task engagement within the trip prior to the crash/near-crash was coded at a higher level. Data were also coded for four baseline epochs and trips per safety-critical event. 1,180 events and baseline epochs were coded, and a dataset was constructed. The project team is currently working to determine the most useful way to allow broad public access to the dataset. We anticipate that the NEST dataset will be extraordinarily useful in allowing qualified researchers access to timely, real-world data concerning how drivers interact with secondary tasks during safety-critical events and baseline driving. The coded dataset developed for this project will allow future researchers to have access to detailed data on driver secondary task engagement in the real world. It will be useful for standalone research, as well as for integration with additional SHRP2 data to enable the

  10. PTSD following childbirth: a prospective study of incidence and risk factors in Canadian women.

    Science.gov (United States)

    Verreault, Nancy; Da Costa, Deborah; Marchand, André; Ireland, Kierla; Banack, Hailey; Dritsa, Maria; Khalifé, Samir

    2012-10-01

    The goals of the present study were to estimate the incidence and course of full and partial Post-Traumatic Stress Disorder (PTSD) following childbirth and to prospectively identify factors associated with the development of PTSD symptoms at 1month following childbirth. The sample comprised 308 women, with assessments at four time points: 25-40weeks gestation, 4-6weeks postpartum, 3 and 6months postpartum. Current and prior PTSD were assessed by the Structured Clinical Interview for DSM-IV (SCID-I) and the Modified PTSD Symptom Scale Self-Report (MPSS-SR). Incidence rates of PTSD varied according to time of measurement and instrument used, with higher rates of full and partial PTSD using the MPSS-SR at 1month postpartum (7.6% and 16.6%, respectively). Multivariate logistic regression showed that higher anxiety sensitivity (OR=1.75; 95% CI=1.19‒2.57, p=.005), history of sexual trauma (OR=2.81; 95% CI=1.07‒7.37, p=.036), a more negative childbirth experience than expected (OR=0.96; 95% CI=0.94‒0.98, p=.001), and less available social support at 1month postpartum (OR=0.40; 95% CI=0.17‒0.96, p=.041) independently predicted full or partial PTSD at 1month following childbirth. Our results indicate that a history of sexual trauma and anxiety sensitivity can increase the probability of developing PTSD after childbirth. The findings highlight the importance of screening and providing more tailored services for women at high risk. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

  11. Canadian beef quality audit.

    Science.gov (United States)

    Van Donkersgoed, J; Jewison, G; Mann, M; Cherry, B; Altwasser, B; Lower, R; Wiggins, K; Dejonge, R; Thorlakson, B; Moss, E; Mills, C; Grogan, H

    1997-01-01

    A study was conducted in 4 Canadian processing plants in 1995-96 to determine the prevalence of quality defects in Canadian cattle. One percent of the annual number of cattle processed in Canada were evaluated on the processing floor and 0.1% were graded in the cooler. Brands were observed on 37% and multiple brands on 6% of the cattle. Forty percent of the cattle had horns, 20% of which were scurs, 33% were stubs, 10% were tipped, and 37% were full length. Tag (mud and manure on the hide) was observed on 34% of the cattle. Bruises were found on 78% of the carcasses, 81% of which were minor in severity. Fifteen percent of the bruises were located on the round, 29% on the loin, 40% on the rib, 16% on the chuck, and 0.02% on the brisket. Grubs were observed in 0.02% of the steers, and injection sites were observed in 1.3% of whole hanging carcasses. Seventy percent of the livers were passed for human food and 14% for pet food; 16% were condemned. Approximately 71% of the liver condemnations were due to liver abscesses. Four percent of the heads, 6% of the tongues, and 0.2% of whole carcasses were condemned. The pregnancy rate in female cattle was approximately 6.7%. The average hot carcass weight was 357 kg (s = 40) in steers, 325 kg (s = 41) in heifers, 305 kg (s = 53) in cows, 388 kg (s = 62) in virgin bulls and 340 kg (s = 39) in mature bulls. The average ribeye area in all cattle was 84 cm2 (s = 12); range 29 cm2 to 128 cm2. Grade fat was highly variable and averaged 9 mm (s = 4) for steers and heifers, 6 mm (s = 6) for cows, 5 mm (s = 1) for virgin bulls, and 4 mm (s = 0.5) for mature bulls. The average lean meat yield was 59.7% in cattle (s = 3.4); range 39% to 67%. One percent of the carcasses were devoid of marbling, 1% were dark cutters, and 0.05% of the steer carcasses were staggy. Six percent of the carcasses had poor conformation, 3.7% were underfinished, and 0.7% were overfinished. Yellow fat was observed in 4% of the carcasses; 10% of carcasses were

  12. Assessment of the toxicity of a substance under Canadian environmental protection act, a case study. Polycyclic aromatic hydrocarbons

    Energy Technology Data Exchange (ETDEWEB)

    Nadon, B.; Germain, A.; Coillie, R. van [Environment Canada, Montreal (Canada)

    1995-12-31

    The Canadian Environmental Protection Act (CEPA) proclaimed in 1988 requires the Canadian Ministers of the Environment and of National Health and Welfare to assess the toxicity of different substances. A Priority Substances List containing 44 substances was developed and their assessments had to determine if they were `toxic`, according to the CEPA definition. This definition states that `a substance is toxic if it is entering or may enter the environment in a quantity or concentration or under conditions (a) having or that may have an immediate or long-term harmful effect on the environment, (b) constituting or that may constitute a danger to the environment on which human life depends; or (c) constituting or that may constitute a danger in Canada to human life of health.` This presentation use the assessment of the polycyclic aromatic hydrocarbons (PAHs) as an example of this procedure. (author)

  13. Assessment of the toxicity of a substance under Canadian environmental protection act, a case study. Polycyclic aromatic hydrocarbons

    Energy Technology Data Exchange (ETDEWEB)

    Nadon, B; Germain, A; Coillie, R van [Environment Canada, Montreal (Canada)

    1996-12-31

    The Canadian Environmental Protection Act (CEPA) proclaimed in 1988 requires the Canadian Ministers of the Environment and of National Health and Welfare to assess the toxicity of different substances. A Priority Substances List containing 44 substances was developed and their assessments had to determine if they were `toxic`, according to the CEPA definition. This definition states that `a substance is toxic if it is entering or may enter the environment in a quantity or concentration or under conditions (a) having or that may have an immediate or long-term harmful effect on the environment, (b) constituting or that may constitute a danger to the environment on which human life depends; or (c) constituting or that may constitute a danger in Canada to human life of health.` This presentation use the assessment of the polycyclic aromatic hydrocarbons (PAHs) as an example of this procedure. (author)

  14. Access to health-care in Canadian immigrants: a longitudinal study of the National Population Health Survey.

    Science.gov (United States)

    Setia, Maninder Singh; Quesnel-Vallee, Amelie; Abrahamowicz, Michal; Tousignant, Pierre; Lynch, John

    2011-01-01

    Immigrants often lose their health advantage as they start adapting to the ways of the new society. Having access to care when it is needed is one way that individuals can maintain their health. We assessed the healthcare access in Canadian immigrants and the socioeconomic factors associated with access over a 12-year period. We compared two measures of healthcare access (having a regular doctor and reporting an unmet healthcare need in the past 12 months) among immigrants and Canadian-born men and women, aged more than 18 years. We applied a logistic random effects model to evaluate these outcomes separately, in 3081 males and 4187 females from the National Population Health Survey (1994-2006). Adjusting for all covariates, immigrant men and women (white and non-white) had similar odds of having a regular doctor than the Canadian-born individuals (white immigrants: males OR: 1.32, 95% C.I.: 0.89-1.94, females OR: 1.14, 95% C.I.: 0.78-1.66; non-white immigrants: males OR: 1.28, 95% C.I.: 0.73-2.23, females OR: 1.23, 95% C.I.: 0.64-2.36). Interestingly, non-white immigrant women had significantly fewer unmet health needs (OR: 0.32, 95% C.I.: 0.17-0.59). Among immigrants, time since immigration was associated with having access to a regular doctor (OR per year: 1.02, 95% C.I.: 1.00-1.04). Visible minority female immigrants were least likely to report an unmet healthcare need. In general, there is little evidence that immigrants have worse access to health-care than the Canadian-born population. © 2010 Blackwell Publishing Ltd.

  15. Leading Lean: a Canadian healthcare leader's guide.

    Science.gov (United States)

    Fine, Benjamin A; Golden, Brian; Hannam, Rosemary; Morra, Dante

    2009-01-01

    Canadian healthcare organizations are increasingly asked to do more with less, and too often this has resulted in demands on staff to simply work harder and longer. Lean methodologies, originating from Japanese industrial organizations and most notably Toyota, offer an alternative - tried and tested approaches to working smarter. Lean, with its systematic approaches to reducing waste, has found its way to Canadian healthcare organizations with promising results. This article reports on a study of five Canadian healthcare providers that have recently implemented Lean. We offer stories of success but also identify potential obstacles and ways by which they may be surmounted to provide better value for our healthcare investments.

  16. An Open-Source Strategy for Documenting Events: The Case Study of the 42nd Canadian Federal Election on Twitter

    Directory of Open Access Journals (Sweden)

    Nick Ruest

    2016-04-01

    Full Text Available This article examines the tools, approaches, collaboration, and findings of the Web Archives for Historical Research Group around the capture and analysis of about 4 million tweets during the 2015 Canadian Federal Election. We hope that national libraries and other heritage institutions will find our model useful as they consider how to capture, preserve, and analyze ongoing events using Twitter. While Twitter is not a representative sample of broader society - Pew research shows in their study of US users that it skews young, college-educated, and affluent (above $50,000 household income – Twitter still represents an exponential increase in the amount of information generated, retained, and preserved from 'everyday' people. Therefore, when historians study the 2015 federal election, Twitter will be a prime source.On August 3, 2015, the team initiated both a Search API and Stream API collection with twarc, a tool developed by Ed Summers, using the hashtag #elxn42. The hashtag referred to the election being Canada's 42nd general federal election (hence 'election 42' or elxn42. Data collection ceased on November 5, 2015, the day after Justin Trudeau was sworn in as the 42nd Prime Minister of Canada. We collected for a total of 102 days, 13 hours and 50 minutes. To analyze the data set, we took advantage of a number of command line tools, utilities that are available within twarc, twarc-report, and jq. In accordance with the Twitter Developer Agreement & Policy, and after ethical deliberations discussed below, we made the tweet IDs and other derivative data available in a data repository. This allows other people to use our dataset, cite our dataset, and enhance their own research projects by drawing on #elxn42 tweets. Our analytics included: breaking tweet text down by day to track change over time; client analysis, allowing us to see how the scale of mobile devices affected medium interactions; URL analysis, comparing both to Archive

  17. Waste management in Canadian nuclear programs

    International Nuclear Information System (INIS)

    Dyne, P.J.

    The objectives of the Canadian radioactive waste management program are described. Recycling actinides through reactors is being studied. Low and medium level waste treatments such as reverse osmosis concentration, immobilization in bitumen and plastics, and incineration are under study. Spent fuel can be stored dry in concrete canisters above ground and ultimate storage of wastes in salt deposits or hard rock is appropriate to Canadian conditions. (E.C.B.)

  18. South Asian Canadian experiences of depression

    OpenAIRE

    Grewal, Amarjit

    2010-01-01

    This narrative research study explored the socio-cultural context surrounding depression through semi-structured interviews with six South Asian Canadian participants, who self identified as having experienced depression. The study sought to expand on the knowledge of depression and South Asian Canadians by considering the roles of the family, the community, and the culture in the experiences of depression. Thematic analysis of the participant interviews resulted in five major themes: the exp...

  19. Back to basics: a naturalistic assessment of the experience and regulation of emotion.

    Science.gov (United States)

    Heiy, Jane E; Cheavens, Jennifer S

    2014-10-01

    Emotion regulation research links regulatory responding to important outcomes in psychological well-being, physical health, and interpersonal relations, but several fundamental questions remain. As much of the previous research has addressed generalized regulatory habits, far less is known about the ways in which individuals respond to emotions in daily life. The literature is particularly sparse in explorations of positive emotion regulation. In the current study, we provide an assessment of naturalistic experiences and regulation of emotion, both positive and negative in valence. Using an electronic experience sampling methodology, participants reported on their use of 40 regulatory strategies in response to 14 emotions for 10 consecutive days. On average, participants used 15 different regulatory strategies in response to negative emotions over this time, most frequently relying on acceptance, behavioral activation, and rumination. Participants used a similarly large repertoire of strategies, approximately 16 total, in response to positive emotions, particularly savoring, future focus, and behavioral activation. Participants' mood ratings following strategy use, however, indicated that the most frequently used strategies were often not the most effective strategies. The results of this study provide estimates of the frequency and effectiveness of a large number of emotion regulation strategies in response to both negative and positive emotions. Such findings characterize naturalistic emotion regulation, and estimates of normative emotion regulation processes are imperative to determining the ways in which deviations (e.g., small emotion regulation repertoires, insufficient attention to regulation of positive emotions) impact emotional functioning. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  20. Constructivism: a naturalistic methodology for nursing inquiry.

    Science.gov (United States)

    Appleton, J V; King, L

    1997-12-01

    This article will explore the philosophical underpinnings of the constructivist research paradigm. Despite its increasing popularity in evaluative health research studies there is limited recognition of constructivism in popular research texts. Lincoln and Guba's original approach to constructivist methodology is outlined and a detailed framework for nursing research is offered. Fundamental issues and concerns surrounding this methodology are debated and differences between method and methodology are highlighted.

  1. Feasibility of using administrative data for identifying medical reasons to delay hip fracture surgery: a Canadian database study.

    Science.gov (United States)

    Guy, Pierre; Sheehan, Katie J; Morin, Suzanne N; Waddell, James; Dunbar, Michael; Harvey, Edward; Sirett, Susan; Sobolev, Boris; Kuramoto, Lisa; Tang, Michael

    2017-10-05

    Failure to account for medically necessary delays may lead to an underestimation of early surgery benefits. This study investigated the feasibility of using administrative data to identify the National Institute for Health and Care Excellence (NICE) 124 guideline list of conditions that appropriately delay hip fracture surgery. We assembled a list of diagnosis and procedure codes to reflect the NICE 124 conditions. The list was reviewed and updated by an advanced clinical coder. The list was refined by five clinical experts. We then screened Canadian Institute for Health Information discharge abstracts for 153 918 patients surgically treated for a non-pathological first hip fracture between 1 January 2004 and 31 December 2012 for diagnosis codes present on admission and procedure codes that antedated hip fracture surgery. We classified abstracts as having medical reasons for delaying surgery based on the presence of these codes. In total, 10 237 (6.7%; 95% CI 6.5% to 6.8%) patients had diagnostic and procedure codes indicating medical reasons for delay. The most common reasons for medical delay were exacerbation of a chronic chest condition (35.9%) and acute chest infection (23.2%). The proportion of patients with reasons for medical delays increased with time from admission to surgery: 3.9% (95% CI 3.6% to 4.1%) for same day surgery; 4.7% (95% CI 4.5% to 4.8%) for surgery 1 day after admission; 7.1% (95% CI 6.9% to 7.4%) for surgery 2 days after admission; and 15.5% (95% CI 15.1% to 16.0%) for surgery more than 2 days after admission. The trend was seen for admissions on weekday working hours, weekday after hours and on weekends. Administrative data can be considered to identify conditions that appropriately delay hip fracture surgery. Accounting for medically necessary delays can improve estimates of the effectiveness of early surgery. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

  2. Dual vs. single computer monitor in a Canadian hospital Archiving Department: a study of efficiency and satisfaction.

    Science.gov (United States)

    Poder, Thomas G; Godbout, Sylvie T; Bellemare, Christian

    This paper describes a comparative study of clinical coding by Archivists (also known as Clinical Coders in some other countries) using single and dual computer monitors. In the present context, processing a record corresponds to checking the available information; searching for the missing physician information; and finally, performing clinical coding. We collected data for each Archivist during her use of the single monitor for 40 hours and during her use of the dual monitor for 20 hours. During the experimental periods, Archivists did not perform other related duties, so we were able to measure the real-time processing of records. To control for the type of records and their impact on the process time required, we categorised the cases as major or minor, based on whether acute care or day surgery was involved. Overall results show that 1,234 records were processed using a single monitor and 647 records using a dual monitor. The time required to process a record was significantly higher (p= .071) with a single monitor compared to a dual monitor (19.83 vs.18.73 minutes). However, the percentage of major cases was significantly higher (p= .000) in the single monitor group compared to the dual monitor group (78% vs. 69%). As a consequence, we adjusted our results, which reduced the difference in time required to process a record between the two systems from 1.1 to 0.61 minutes. Thus, the net real-time difference was only 37 seconds in favour of the dual monitor system. Extrapolated over a 5-year period, this would represent a time savings of 3.1% and generate a net cost savings of $7,729 CAD (Canadian dollars) for each workstation that devoted 35 hours per week to the processing of records. Finally, satisfaction questionnaire responses indicated a high level of satisfaction and support for the dual-monitor system. The implementation of a dual-monitor system in a hospital archiving department is an efficient option in the context of scarce human resources and has the

  3. Metals exposure and risk of small-for-gestational age birth in a Canadian birth cohort: The MIREC study

    International Nuclear Information System (INIS)

    Thomas, Shari; Arbuckle, Tye E.; Fisher, Mandy; Fraser, William D.; Ettinger, Adrienne; King, Will

    2015-01-01

    Background: Lead, mercury, cadmium and arsenic are some of the most common toxic metals to which Canadians are exposed. The effect of exposure to current low levels of toxic metals on fetal growth restriction is unknown. Objective: The aim of this study was to examine relationships between exposure to lead, mercury, cadmium and arsenic during pregnancy, and risk of small for gestational age (SGA) birth. Methods: Lead, mercury, cadmium and arsenic levels were measured in blood samples from the first and third trimesters in 1835 pregnant women from across Canada. Arsenic species in first trimester urine were also assessed. Relative risks and 95% confidence intervals were estimated using log binomial multivariate regression. Important covariates including maternal age, parity, pre-pregnancy BMI, and smoking, were considered in the analysis. An exploratory analysis was performed to examine potential effect modification of these relationships by single nucleotide polymorphisms (SNPs) in GSTP1 and GSTO1 genes. Results: No association was found between blood lead, cadmium or arsenic and risk for SGA. We observed an increased risk for SGA for the highest compared to the lowest tertile of exposure for mercury (>1.6 µg/L, RR=1.56.; 95% CI=1.04–2.58) and arsenobetaine (>2.25 µg/L, RR=1.65; 95% CI=1.10–2.47) after adjustment for the effects of parity and smoking. A statistically significant interaction was observed in the relationship between dimethylarsinic acid (DMA) levels in urinary arsenic and SGA between strata of GSTO1 A104A (p for interaction=0.02). A marginally significant interaction was observed in the relationship between blood lead and SGA between strata of GSTP1 A114V (p for interaction=0.06). Conclusions: These results suggest a small increase in risk for SGA in infants born to women exposed to mercury and arsenic. Given the conflicting evidence in the literature this warrants further investigation in other pregnant populations. - Highlights: • Metals

  4. Metals exposure and risk of small-for-gestational age birth in a Canadian birth cohort: The MIREC study

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, Shari [Department of Public Health Sciences, Queen’s University, Kingston, Ontario (Canada); Arbuckle, Tye E., E-mail: Tye.Arbuckle@hc-sc.gc.ca [Population Studies Division, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa (Canada); Fisher, Mandy [Population Studies Division, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa (Canada); Fraser, William D. [Sainte Justine University Hospital Research Center, University of Montreal, Montreal (Canada); Ettinger, Adrienne [Center for Perinatal, Pediatric & Environmental Epidemiology, Yale School of Public Health, New Haven, CT (United States); King, Will [Department of Public Health Sciences, Queen’s University, Kingston, Ontario (Canada)

    2015-07-15

    Background: Lead, mercury, cadmium and arsenic are some of the most common toxic metals to which Canadians are exposed. The effect of exposure to current low levels of toxic metals on fetal growth restriction is unknown. Objective: The aim of this study was to examine relationships between exposure to lead, mercury, cadmium and arsenic during pregnancy, and risk of small for gestational age (SGA) birth. Methods: Lead, mercury, cadmium and arsenic levels were measured in blood samples from the first and third trimesters in 1835 pregnant women from across Canada. Arsenic species in first trimester urine were also assessed. Relative risks and 95% confidence intervals were estimated using log binomial multivariate regression. Important covariates including maternal age, parity, pre-pregnancy BMI, and smoking, were considered in the analysis. An exploratory analysis was performed to examine potential effect modification of these relationships by single nucleotide polymorphisms (SNPs) in GSTP1 and GSTO1 genes. Results: No association was found between blood lead, cadmium or arsenic and risk for SGA. We observed an increased risk for SGA for the highest compared to the lowest tertile of exposure for mercury (>1.6 µg/L, RR=1.56.; 95% CI=1.04–2.58) and arsenobetaine (>2.25 µg/L, RR=1.65; 95% CI=1.10–2.47) after adjustment for the effects of parity and smoking. A statistically significant interaction was observed in the relationship between dimethylarsinic acid (DMA) levels in urinary arsenic and SGA between strata of GSTO1 A104A (p for interaction=0.02). A marginally significant interaction was observed in the relationship between blood lead and SGA between strata of GSTP1 A114V (p for interaction=0.06). Conclusions: These results suggest a small increase in risk for SGA in infants born to women exposed to mercury and arsenic. Given the conflicting evidence in the literature this warrants further investigation in other pregnant populations. - Highlights: • Metals

  5. Evolutionary theory and the naturalist fallacy

    DEFF Research Database (Denmark)

    Grodal, Torben Kragh

    2008-01-01

    that great work of art are also automatically fitness-enhancing in the present day environment, at that there are simple correllations between whether a work of art has a high aesthetic value and whether it is fitness-enhancing or not.  Keywords :  Evolutionary aesthetics, film theory, literary theory......The article is an invited response to a target article by Joseph Carroll entitled "An evolutionary paradigm for literary study". It argues that the target article  misuse the fact that works of art are based on adaptations that were fitness-enhancing in the era of evolutionary adaptations to claim...

  6. Expert analogy use in a naturalistic setting

    Science.gov (United States)

    Kretz, Donald R.; Krawczyk, Daniel C.

    2014-01-01

    The use of analogy is an important component of human cognition. The type of analogy we produce and communicate depends heavily on a number of factors, such as the setting, the level of domain expertise present, and the speaker's goal or intent. In this observational study, we recorded economics experts during scientific discussion and examined the categorical distance and structural depth of the analogies they produced. We also sought to characterize the purpose of the analogies that were generated. Our results supported previous conclusions about the infrequency of superficial similarity in subject-generated analogs, but also showed that distance and depth characteristics were more evenly balanced than in previous observational studies. This finding was likely due to the nature of the goals of the participants, as well as the broader nature of their expertise. An analysis of analogical purpose indicated that the generation of concrete source examples of more general target concepts was most prevalent. We also noted frequent instances of analogies intended to form visual images of source concepts. Other common purposes for analogies were the addition of colorful speech, inclusion (i.e., subsumption) of a target into a source concept, or differentiation between source and target concepts. We found no association between depth and either of the other two characteristics, but our findings suggest a relationship between purpose and distance; i.e., that visual imagery typically entailed an outside-domain source whereas exemplification was most frequently accomplished using within-domain analogies. Overall, we observed a rich and diverse set of spontaneously produced analogical comparisons. The high degree of expertise within the observed group along with the richly comparative nature of the economics discipline likely contributed to this analogical abundance. PMID:25505437

  7. Expert Analogy Use in a Naturalistic Setting

    Directory of Open Access Journals (Sweden)

    Donald R Kretz

    2014-11-01

    Full Text Available The use of analogy is an important component of human cognition. The type of analogy we produce and communicate depends heavily on a number of factors, such as the setting, the level of domain expertise present, and the speaker’s goal or intent. In this observational study, we recorded economics experts during scientific discussion and examined the categorical distance and structural depth of the analogies they produced. We also sought to characterize the purpose of the analogies that were generated. Our results supported previous conclusions about the infrequency of superficial similarity in subject-generated analogs, but also showed that distance and depth characteristics were more evenly balanced than in previous observational studies. This finding was likely due to the nature of the goals of the participants, as well as the broader nature of their expertise. An analysis of analogical purpose indicated that the generation of concrete source examples of more general target concepts was most prevalent. We also noted frequent instances of analogies intended to form visual images of source concepts. Other common purposes for analogies were the addition of colorful speech, inclusion (i.e., subsumption of a target into a source concept, or differentiation between source and target concepts. We found no association between depth and either of the other two characteristics, but our findings suggest a relationship between purpose and distance; i.e., that visual imagery typically entailed an outside-domain source whereas exemplification was most frequently accomplished using within-domain analogies. Overall, we observed a rich and diverse set of spontaneously produced analogical comparisons. The high degree of expertise within the observed group along with the richly comparative nature of the economics discipline likely contributed to this analogical abundance.

  8. Affective State Level Recognition in Naturalistic Facial and Vocal Expressions.

    Science.gov (United States)

    Meng, Hongying; Bianchi-Berthouze, Nadia

    2014-03-01

    Naturalistic affective expressions change at a rate much slower than the typical rate at which video or audio is recorded. This increases the probability that consecutive recorded instants of expressions represent the same affective content. In this paper, we exploit such a relationship to improve the recognition performance of continuous naturalistic affective expressions. Using datasets of naturalistic affective expressions (AVEC 2011 audio and video dataset, PAINFUL video dataset) continuously labeled over time and over different dimensions, we analyze the transitions between levels of those dimensions (e.g., transitions in pain intensity level). We use an information theory approach to show that the transitions occur very slowly and hence suggest modeling them as first-order Markov models. The dimension levels are considered to be the hidden states in the Hidden Markov Model (HMM) framework. Their discrete transition and emission matrices are trained by using the labels provided with the training set. The recognition problem is converted into a best path-finding problem to obtain the best hidden states sequence in HMMs. This is a key difference from previous use of HMMs as classifiers. Modeling of the transitions between dimension levels is integrated in a multistage approach, where the first level performs a mapping between the affective expression features and a soft decision value (e.g., an affective dimension level), and further classification stages are modeled as HMMs that refine that mapping by taking into account the temporal relationships between the output decision labels. The experimental results for each of the unimodal datasets show overall performance to be significantly above that of a standard classification system that does not take into account temporal relationships. In particular, the results on the AVEC 2011 audio dataset outperform all other systems presented at the international competition.

  9. Differences in Anticipatory Behaviour between Rats (Rattus norvegicus Housed in Standard versus Semi-Naturalistic Laboratory Environments.

    Directory of Open Access Journals (Sweden)

    I Joanna Makowska

    Full Text Available Laboratory rats are usually kept in relatively small cages, but research has shown that they prefer larger and more complex environments. The physiological, neurological and health effects of standard laboratory housing are well established, but fewer studies have addressed the sustained emotional impact of a standard cage environment. One method of assessing affective states in animals is to look at the animals' anticipatory behaviour between the presentation of a cue signalling the arrival of a reward and the arrival of that reward. The primary aim of this study was to use anticipatory behaviour to assess the affective state experienced by female rats a reared and housed long-term in a standard laboratory cage versus a semi-naturalistic environment, and b before and after treatment with an antidepressant or an anxiolytic. A secondary aim was to add to the literature on anticipatory behaviour by describing and comparing the frequency and duration of individual elements of anticipatory behaviour displayed by rats reared in these two systems. In all experiments, total behavioural frequency was higher in standard-housed rats compared to rats from the semi-naturalistic condition, suggesting that standard-housed rats were more sensitive to rewards and experiencing poorer welfare than rats reared in the semi-naturalistic environment. What rats did in anticipation of the reward also differed between housing treatments, with standard-housed rats mostly rearing and rats from the semi-naturalistic condition mostly sitting facing the direction of the upcoming treat. Drug interventions had no effect on the quantity or form of anticipatory behaviour, suggesting that the poorer welfare experienced by standard-housed rats was not analogous to depression or anxiety, or alternatively that the drug interventions were ineffective. This study adds to mounting evidence that standard laboratory housing for rats compromises rat welfare, and provides further

  10. Differences in Anticipatory Behaviour between Rats (Rattus norvegicus) Housed in Standard versus Semi-Naturalistic Laboratory Environments.

    Science.gov (United States)

    Makowska, I Joanna; Weary, Daniel M

    2016-01-01

    Laboratory rats are usually kept in relatively small cages, but research has shown that they prefer larger and more complex environments. The physiological, neurological and health effects of standard laboratory housing are well established, but fewer studies have addressed the sustained emotional impact of a standard cage environment. One method of assessing affective states in animals is to look at the animals' anticipatory behaviour between the presentation of a cue signalling the arrival of a reward and the arrival of that reward. The primary aim of this study was to use anticipatory behaviour to assess the affective state experienced by female rats a) reared and housed long-term in a standard laboratory cage versus a semi-naturalistic environment, and b) before and after treatment with an antidepressant or an anxiolytic. A secondary aim was to add to the literature on anticipatory behaviour by describing and comparing the frequency and duration of individual elements of anticipatory behaviour displayed by rats reared in these two systems. In all experiments, total behavioural frequency was higher in standard-housed rats compared to rats from the semi-naturalistic condition, suggesting that standard-housed rats were more sensitive to rewards and experiencing poorer welfare than rats reared in the semi-naturalistic environment. What rats did in anticipation of the reward also differed between housing treatments, with standard-housed rats mostly rearing and rats from the semi-naturalistic condition mostly sitting facing the direction of the upcoming treat. Drug interventions had no effect on the quantity or form of anticipatory behaviour, suggesting that the poorer welfare experienced by standard-housed rats was not analogous to depression or anxiety, or alternatively that the drug interventions were ineffective. This study adds to mounting evidence that standard laboratory housing for rats compromises rat welfare, and provides further scientific support for

  11. Reporting of financial conflicts of interest in clinical practice guidelines: a case study analysis of guidelines from the Canadian Medical Association Infobase.

    Science.gov (United States)

    Shnier, Adrienne; Lexchin, Joel; Romero, Mirna; Brown, Kevin

    2016-08-15

    Clinical practice guidelines are widely distributed by medical associations and relied upon by physicians for the best available clinical evidence. International findings report that financial conflicts of interest (FCOI) with drug companies may influence drug recommendations and are common among guideline authors. There is no comparable study on exclusively Canadian guidelines; therefore, we provide a case study of authors' FCOI declarations in guidelines from the Canadian Medical Association (CMA) Infobase. We also assess the financial relationships between guideline-affiliated organizations and drug companies. Using a population approach, we extracted first-line drug recommendations and authors' FCOI disclosures in guidelines from the CMA Infobase. We contacted the corresponding authors on guidelines when FCOI disclosures were missing for some or all authors. We also extracted guideline-affiliated organizations and searched each of their websites to determine if they had financial relationships with drug companies. We analyzed 350 authors from 28 guidelines. Authors were named on one, two, or three guidelines, yielding 400 FCOI statements. In 75.0 % of guidelines at least one author, and in 21.4 % of guidelines all authors, disclosed FCOI with drug companies. In 54.0 % of guidelines at least one author, and in 28.6 % of guidelines over half of the authors, disclosed FCOI with manufacturers of drugs that they recommended. Twenty of 48 authors on multiple guidelines reported different FCOI in their disclosures. Eight guidelines identified affiliated organizations with financial relationships with manufacturers of drugs recommended in those guidelines. This is the first study to systematically describe FCOI disclosures by authors of Canadian guidelines and financial relationships between guideline-affiliated organizations and pharmaceutical companies. These financial relationships are common. Because authoritative value is assigned to guidelines distributed by

  12. An epidemiological investigation of the early phase of the porcine epidemic diarrhea (PED) outbreak in Canadian swine herds in 2014: A case-control study.

    Science.gov (United States)

    Perri, Amanda M; Poljak, Zvonimir; Dewey, Cate; Harding, John C S; O'Sullivan, Terri L

    2018-02-01

    The first case of porcine epidemic diarrhea (PED) in Canada was diagnosed in January 2014 in Ontario, approximately 9 months after PED emerged in the United States. An early investigation of the Canadian outbreak suspected that the probable source of the virus was contaminated feed. The objective of this study was to evaluate the role of feed and other possible factors in the early phase of the PED outbreak in Canadian swine herds. The study period of interest for this case-control study was January 22nd to March 1st, 2014. A case herd was defined as a swine herd with a confirmed positive laboratory diagnostic test (RT-PCR) results for PED virus, along with pigs exhibiting typical clinical signs at the herd level during the study period. A questionnaire was administered to participating producers from the 22 Canadian swine herds enrolled (n = 9 case and n = 13 control herds). Case herd producers were asked to provide information from the initial day of onset of clinical signs and 30 days prior to that day. Control herds were matched to a case herd on the basis of province, herd type and approximate size. The period of interest for a control herd was matched to the initial day of clinical signs of PED for the case herd, along with the 30 days prior to this day. The questionnaire questions focused on herd demographics, biosecurity protocols, live animal movements onto and off sites, deadstock movements, feed and people movements for both the case and control herds. The questionnaire for control herds were based on their matched case's period of interest, and together with case herds formed a matched stratum. Multivariable exact conditional logistic regression and mixed multivariable logistic regression models, with the matched stratum as a random effect, were used to assess the association between various risk factors and the odds of PED introduction into a herd. After adjusting for biosecurity practices, the odds of a PED occurrence was 38.1 (95% CI: 2

  13. Analysis and Comparison of Naturalistic Themes in Iranian and Britain Modern Children's Poems

    Directory of Open Access Journals (Sweden)

    Shayesteh Ebrahimi

    2016-08-01

    Full Text Available Today, children's literature given the concept of childhood, has gained a special status in the studies of humanities. Children's poetry is one of the branches of this type of literature. Naturalistic themes have the highest frequency among the themes of children poems in two countries. The population of this research consists of collections that have been published from 1921 to 2011. Children's literature was born in England in the eighteenth century and before that the first didactic books for children had come into existence in England. In addition, due to industrial growth, the emergence of the new middle class and expansion of formal education the UK was pioneering among Europe and the world countries. Therefore, to find the roots of the formation of children's literature should be referred to the UK. Therefore, in this paper Britain children’s poem has been selected to be compared with Iranian children’s poem so that by revealing the similarities and differences one can deal with the pathology of poems for children in Iran and to detect shortcomings and strengths and present some guidelines that be helpful for children and young poets as well as critics and researchers in this field. Keywords: Naturalistic themes, children literature, Iranian children's poems, Britain children's poems, comparative literature

  14. The New Indices of Religious Orientation Revised (NIROR: A Study among Canadian Adolescents Attending a Baptist Youth Mission and Service Event

    Directory of Open Access Journals (Sweden)

    Leslie J. Francis

    2016-05-01

    Full Text Available This study explores the properties of the New Indices of Religious Orientation Revised (NIROR among a sample of 521 Canadian adolescents attending a Baptist youth mission and service event, ranging in age from 12 to 19 years. This revision simplified the language of the original instrument to increase its accessibility among young people. The data support the internal consistency reliability and construct validity of the three revised nine-item scales designed to operationalise extrinsic religious orientation, intrinsic religious orientation, and quest religious orientation.

  15. Canadian nuclear risk experience

    International Nuclear Information System (INIS)

    Hamel, P.E.

    1982-05-01

    Risk assessment in the Canadian nuclear fuel cycle is a very important and complex subject. Many levels of government are involved in deciding the acceptable limits for the risks, taking into account the benefits for society [fr

  16. Nuclear power and the Canadian public

    Energy Technology Data Exchange (ETDEWEB)

    Greer-Wootten, B; Mitson, L

    1976-06-01

    The purpose of the study was to ascertain the opinions and attitudes of Canadians to the use of nuclear power for generating electricity, as an initial step in developing information programs attuned to the demonstrated needs of the public. This report presents the findings from the survey of the Canadian public aged 18 years and over. Over 2100 persons responded to our interviewers, generating about 200,000 answers to the questions.

  17. Fording Canadian Coal Trust

    Energy Technology Data Exchange (ETDEWEB)

    Popowich, J.; Millos, R. [Elk Valley Coal Corporation, Calgary, AB (Canada)

    2004-07-01

    This is the first of five slide/overhead presentations presented at the Fording Canadian Coal Trust and Tech Cominco Ltd. investor day and mine tour. The Fording Canadian Coal Trust is described. The Trust's assets comprise six Elk Valley metallurgical coal mines and six wollastonite operations (in the NYCO Group). Trust structure, corporate responsibility, organizational structure, reserves and resources, management philosophy, operating strategies, steel market dynamics, coal market, production expansion, sales and distribution are outlined. 15 figs., 5 tabs.

  18. Association between neighbourhood fast-food and full-service restaurant density and body mass index: a cross-sectional study of Canadian adults.

    Science.gov (United States)

    Hollands, Simon; Campbell, M Karen; Gilliland, Jason; Sarma, Sisira

    2014-05-07

    Frequent fast-food consumption is a well-known risk factor for obesity. This study sought to determine whether the availability of fast-food restaurants has an influence on body mass index (BMI). BMI and individual-level confounding variables were obtained from the 2007-08 Canadian Community Health Survey. Neighbourhood socio-demographic variables were acquired from the 2006 Canadian Census. The geographic locations of all restaurants in Canada were assembled from a validated business registry database. The density of fast-food, full-service and non-chain restaurants per 10,000 individuals was calculated for respondents' forward sortation area. Multivariable regression analyses were conducted to analyze the association between restaurant density and BMI. Fast-food, full-service and non-chain restaurant density variables were statistically significantly associated with BMI. Fast-food density had a positive association whereas full-service and non-chain restaurant density had a negative association with BMI (additional 10 fast-food restaurants per capita corresponded to a weight increase of 1 kilogram; p<0.001). These associations were primarily found in Canada's major urban jurisdictions. This research was the first to investigate the influence of fast-food and full-service restaurant density on BMI using individual-level data from a nationally representative Canadian survey. The finding of a positive association between fast-food restaurant density and BMI suggests that interventions aiming to restrict the availability of fast-food restaurants in local neighbourhoods may be a useful obesity prevention strategy.

  19. Naturalistic speeding data: Drivers aged 75 years and older

    Directory of Open Access Journals (Sweden)

    Anna Chevalier

    2016-09-01

    Full Text Available The data presented in this article are related to the research article entitled “A longitudinal investigation of the predictors of older drivers׳ speeding behavior” (Chevalier et al., 2016 [1], wherein these speed events were used to investigate older drivers speeding behavior and the influence of cognition, vision, functional decline, and self-reported citations and crashes on speeding behavior over a year of driving. Naturalistic speeding behavior data were collected for up to 52 weeks from volunteer drivers aged 75–94 years (median 80 years, 52% male living in the suburban outskirts of Sydney. Driving data were collected using an in-vehicle monitoring device. Global Positioning System (GPS data were recorded at each second and determined driving speed through triangulation of satellite collected location data. Driving speed data were linked with mapped speed zone data based on a service-provider database. To measure speeding behavior, speed events were defined as driving 1 km/h or more, with a 3% tolerance, above a single speed limit, averaged over 30 s. The data contains a row per 124,374 speed events. This article contains information about data processing and quality control. Keywords: Older drivers, Speed, Road safety, Naturalistic, In-vehicle monitoring, Device

  20. Detection of Risky Driving Behaviors in the Naturalistic Environment in Healthy Older Adults and Mild Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Jennifer D. Davis

    2018-03-01

    Full Text Available Analyzing naturalistic driving behavior recorded with in-car cameras is an ecologically valid method for measuring driving errors, but it is time intensive and not easily applied on a large scale. This study validated a semi-automated, computerized method using archival naturalistic driving data collected for drivers with mild Alzheimer’s disease (AD; n = 44 and age-matched healthy controls (HC; n = 16. The computerized method flagged driving situations where safety concerns are most likely to occur (i.e., rapid stops, lane deviations, turns, and intersections. These driving epochs were manually reviewed and rated for error type and severity, if present. Ratings were made with a standardized scoring system adapted from DriveCam®. The top eight error types were applied as features to train a logistic model tree classifier to predict diagnostic group. The sensitivity and specificity were compared among the event-based method, on-road test, and composite ratings of two weeks of recorded driving. The logistic model derived from the event-based method had the best overall accuracy (91.7% and sensitivity (97.7% and high specificity (75.0% compared to the other methods. Review of driving situations where risk is highest appears to be a sensitive data reduction method for detecting cognitive impairment associated driving behaviors and may be a more cost-effective method for analyzing large volumes of naturalistic data.

  1. Comprehensive Evidence-Based Assessment and Prioritization of Potential Antidiabetic Medicinal Plants: A Case Study from Canadian Eastern James Bay Cree Traditional Medicine

    Directory of Open Access Journals (Sweden)

    Pierre S. Haddad

    2012-01-01

    Full Text Available Canadian Aboriginals, like others globally, suffer from disproportionately high rates of diabetes. A comprehensive evidence-based approach was therefore developed to study potential antidiabetic medicinal plants stemming from Canadian Aboriginal Traditional Medicine to provide culturally adapted complementary and alternative treatment options. Key elements of pathophysiology of diabetes and of related contemporary drug therapy are presented to highlight relevant cellular and molecular targets for medicinal plants. Potential antidiabetic plants were identified using a novel ethnobotanical method based on a set of diabetes symptoms. The most promising species were screened for primary (glucose-lowering and secondary (toxicity, drug interactions, complications antidiabetic activity by using a comprehensive platform of in vitro cell-based and cell-free bioassays. The most active species were studied further for their mechanism of action and their active principles identified though bioassay-guided fractionation. Biological activity of key species was confirmed in animal models of diabetes. These in vitro and in vivo findings are the basis for evidence-based prioritization of antidiabetic plants. In parallel, plants were also prioritized by Cree Elders and healers according to their Traditional Medicine paradigm. This case study highlights the convergence of modern science and Traditional Medicine while providing a model that can be adapted to other Aboriginal realities worldwide.

  2. Neighbourhood social and built environment factors and falls in community-dwelling canadian older adults: A validation study and exploration of structural confounding

    Directory of Open Access Journals (Sweden)

    Afshin Vafaei

    2016-12-01

    Full Text Available Older persons are vulnerable to the ill effects of their social and built environment due to age-related limitations in mobility and bio-psychological vulnerability. Falls are common in older adults and result from complex interactions between individual, social, and contextual determinants. We addressed two methodological issues of neighbourhood-health and social epidemiological studies in this analysis: (1 validity of measures of neighbourhood contexts, and (2 structural confounding resulting from social sorting mechanisms. Baseline data from International Mobility in Aging Study were used. Samples included community-dwelling Canadians older than 65 living in Kingston (Ontario and St-Hyacinthe (Quebec. We performed factor analysis and ecometric analysis to assess the validity of measures of neighbourhood social capital, socioeconomic status, and the built environment and stratified tabular analyses to explore structural confounding. The scales all demonstrated good psychometric and ecometric properties. There was an evidence of the existence of structural confounding in this sample of Canadian older adults as some combinations of strata for the three neighbourhood measures had no population. This limits causal inference in studying relationships between neighbourhood factors and falls and should be taken into account in aetiological aging research. Keywords: Ecometric analysis, Falls, Social and built environment, Neighbourhoods, Older adults, Social Capital, Structural confounding, Validity

  3. Cultural differences in self- and other-evaluations and well-being: a study of European and Asian Canadians.

    Science.gov (United States)

    Kim, Hyunji; Schimmack, Ulrich; Oishi, Shigehiro

    2012-04-01

    Anusic, Schimmack, Pinkus, and Lockwood (2009) developed the halo-alpha-beta (HAB) model to separate halo variance from variance due to valid personality traits and other sources of measurement error in self-ratings of personality. The authors used a twin-HAB model of self-ratings and ratings of a partner (friend or dating partner) to test several hypotheses about culture, evaluative biases in self- and other-perceptions, and well-being. Participants were friends or dating partners who reported on their own and their partner's personality and well-being (N = 906 students). European Canadians had higher general evaluative biases (GEB) than Asian Canadians. There were no cultural differences in self-enhancement or other-enhancement. GEB significantly predicted self-ratings of life satisfaction, but not informant ratings of well-being. GEB fully mediated the effect of culture on self-ratings of life satisfaction. The results suggest that North American culture encourages positive biases in self- and other-perceptions. These biases also influence self-ratings of life satisfaction but have a much weaker effect on informant ratings of life satisfaction. The implications of these findings for cultural differences in well-being are discussed. (c) 2012 APA, all rights reserved.

  4. Cognitive aspects of sexual functioning: differences between East Asian-Canadian and Euro-Canadian women.

    Science.gov (United States)

    Morton, Heather; Gorzalka, Boris B

    2013-11-01

    The purpose of this study was to investigate the sexual beliefs of female undergraduates, as well as the thoughts they experience during sexual experiences. The study aimed to determine potential differences in these variables between East Asian-Canadians and Euro-Canadians, as well as the influence of acculturation on these variables. In addition, the relationships between sexual beliefs, automatic thoughts, and specific aspects of sexual functioning were examined. Euro-Canadian (n = 77) and East Asian-Canadian (n = 123) undergraduate women completed the Sexual Dysfunctional Beliefs Questionnaire, the Sexual Modes Questionnaire, the Female Sexual Function Index, and the Vancouver Index of Acculturation. East Asian women endorsed almost all sexual beliefs assessed in this study more than did Euro-Canadian women, and endorsement of these beliefs was associated with acculturation. In addition, East Asian-Canadian and Euro-Canadian women differed in the frequency of experiencing negative automatic thoughts. Results also revealed associations between difficulties in sexual functioning, and both sexual beliefs and automatic thoughts. Together, these results provide preliminary support for the hypothesis that differences in cognitive aspects of sexuality may underlie the differences in sexual functioning previously observed between these two groups.

  5. Stability of normative data for the SF-36: results of a three-year prospective study in middle-aged Canadians.

    Science.gov (United States)

    Hopman, Wilma M; Berger, Claudie; Joseph, Lawrence; Towheed, Tanveer; vandenKerkhof, Elizabeth; Anastassiades, Tassos; Cranney, Ann; Adachi, Jonathan D; Loannidis, George; Poliquin, Suzette; Brown, Jacques P; Murray, Timothy M; Hanley, David A; Papadimitropoulos, Emmanuel A; Tenenhouse, Alan

    2004-01-01

    The SF-36 is widely used to assess health-related quality of life (HRQOL), but with few longitudinal studies in healthy populations, it is difficult to quantify its natural history. This is important because any measure of change following an intervention may be confounded by natural changes in HRQOL. This paper assesses mean changes in SF-36 scores over a 3-year period in men and women between the ages of 40 and 59 years at baseline. Subjects were randomly selected from nine Canadian cities. Mean SF-36 changes over a 3-year period (1996/1997-1999/2000) were calculated for each gender within 5-year age categories. Multiple imputation was used to correct for potential bias due to missing data. The baseline cohort included 1,974 women and 975 men between 40 and 59 years. Mean changes in HRQOL tended to be small. Women demonstrated small average declines in 22 of the 32 age and domain groupings (4 age groups, 8 SF-36 domains) while men showed declines in 14/32. Most participants stayed within 10 points of their original baseline score. Mean SF-36 scores change only slightly over three years in middle-aged Canadians, although there is much individual variation. It may be necessary to adjust for the natural evolution of SF-36 scores when interpreting results from longitudinal studies.

  6. Environmental Factors Influencing Adoption of Canadian Guidelines on Smoking Cessation in Dental Healthcare Settings in Quebec: A Qualitative Study of Dentists’ Perspectives

    Directory of Open Access Journals (Sweden)

    Pascaline Kengne Talla

    2016-11-01

    Full Text Available Background: This study aimed to understand dentists’ perspective of the environmental determinants which positively or negatively influence the implementation of Canadian smoking cessation clinical practice guidelines (5As: Ask-Advise-Assess-Assist-Arrange in private dental clinics in Quebec. Methods: This study used a qualitative design and an integrative conceptual framework composed of three theoretical perspectives. Data collection was conducted in individual semi-directed interviews with 20 private dentists lasting between 35 and 45 min. The audio-recorded data were transcribed verbatim, followed by a directed content analysis. Results: Some of the barriers identified to counselling in smoking cessation were lack of time, patient attitude, lack of prescription of nicotine replacement therapies, lack of reimbursement, and the lack of training of the dental team. Enablers cited by participants were the style of dentist’s leadership, the availability of community, human and material resources, the perception of counselling as a professional duty, and the culture of dental medicine. In addition to these variables, dentists’ attitude and behaviour were affected by different organisations giving initial or continual training to dentists, governmental policies, and the compatibility of Canadian smoking cessation guidelines with the practice of dentistry. Conclusion: Our findings will inform the development of smoking cessation interventions in dental healthcare settings.

  7. A Fresh Pair of Eyes : A Blind Observation Method for Evaluating Social Skills of Children with ASD in a Naturalistic Peer Situation in School

    NARCIS (Netherlands)

    Dekker, Vera; Nauta, Maaike H.; Mulder, Erik J.; Sytema, Sjoerd; de Bildt, Annelies

    The Social skills Observation Measure (SOM) is a direct observation method for social skills used in naturalistic everyday situations in school. This study describes the development of the SOM and investigates its psychometric properties in 86 children with Autism spectrum disorder, aged 9.8-13.1

  8. A Fresh Pair of Eyes: A Blind Observation Method for Evaluating Social Skills of Children with ASD in a Naturalistic Peer Situation in School

    Science.gov (United States)

    Dekker, Vera; Nauta, Maaike H.; Mulder, Erik J.; Sytema, Sjoerd; de Bildt, Annelies

    2016-01-01

    The Social skills Observation Measure (SOM) is a direct observation method for social skills used in naturalistic everyday situations in school. This study describes the development of the SOM and investigates its psychometric properties in 86 children with Autism spectrum disorder, aged 9.8-13.1 years. The interrater reliability was found to be…

  9. Mercury in Canadian crude oil

    International Nuclear Information System (INIS)

    Hollebone, B.P.

    2005-01-01

    Estimates for average mercury concentrations in crude oil range widely from 10 ng/g of oil to 3,500 ng/g of oil. With such a broad range of estimates, it is difficult to determine the contributions of the petroleum sector to the total budget of mercury emissions. In response to concerns that the combustion of petroleum products may be a major source of air-borne mercury pollution, Environment Canada and the Canadian Petroleum Products Institute has undertaken a survey of the average total mercury concentration in crude oil processed in Canadian refineries. In order to calculate the potential upper limit of total mercury in all refined products, samples of more than 30 different types of crude oil collected from refineries were measured for their concentration of mercury as it enters into a refinery before processing. High temperature combustion, cold vapour atomic absorption and cold vapour atomic fluorescence were the techniques used to quantify mercury in the samples. The results of the study provide information on the total mass of mercury present in crude oil processed in Canada each year. Results can be used to determine the impact of vehicle exhaust emissions to the overall Canadian mercury emission budget. 17 refs., 2 tabs., 2 figs

  10. Estimation of lung tissue doses following exposure to low-LET radiation in the Canadian study of cancer following multiple fluoroscopies

    International Nuclear Information System (INIS)

    Howe, G.R.; Yaffe, M.

    1992-02-01

    Lung tissue doses from exposure to external low-LET radiation have been estimated for each year between 1930 and 1960 for 92,707 tuberculosis patients first treated in Canadian institutions between 1930 and 1952. Many of these patients received multiple chest fluoroscopies together with treatment by artificial pneumothorax, and thus accumulated doses up to 15.7 grays. The estimated doses have been used in a statistical analysis of lung cancer mortality between 1950 and 1987 occurring among 64,698 patients known to be alive at the start of 1950, and followed by linkage to the Canadian national mortality data base. There were substantial variations in the total cumulative lung tissue dose received by the cohort, with 2,490 individuals having doses in excess of 1.7 grays. A total of 1,156 lung cancer deaths was observed in the cohort, and these have been used to estimate relative risks. The most appropriate risk model appears to be a simple linear relative risk function, with an excess relative risk coefficient of 0.089 for an absorbed dose of 1 gray. This contrasts with estimates of relative risk based on the atomic bomb survivors study, for which the excess relative risk coefficient for males 20 years after the first exposure is estimated to be 0.64. The difference is statistically significant. It is postulated that fractionation and dose rate effectiveness factors may account for some of the discrepancy. (Modified author abstract) (14 refs., 20 tabs.)

  11. Changes in body mass index in Canadians over a five-year period: Results of a prospective, population-based study

    Directory of Open Access Journals (Sweden)

    Poliquin Suzette

    2007-07-01

    Full Text Available Abstract Background The initiation of the Canadian Multicentre Osteoporosis Study in 1996, and subsequent follow-up of the cohort 5 years later, provided longitudinal body mass index (BMI data for a random sample of Canadians. Methods Height and weight were measured at baseline and 5 years and used to calculate BMI and assign one of six weight categories. Multiple imputation was used to adjust for missing weight at year 5. Data were stratified by age and gender. The proportion of participants moving between categories was generated, and multivariable linear regression was used to identify factors associated with weight change. Results Baseline data were available for 8548 participants, year 5 data for 6721, and year 5 weight was imputed for 1827 (17.6%. Mean BMI for every age and gender group exceeded healthy weight guidelines. Most remained within their BMI classification over 5 years, but when change occurred, BMI category was more likely to increase than decrease. Several sociodemographic, lifestyle and clinical characteristics were associated with change. Conclusion Mean baseline BMI tended to be higher than recommended. Moreover, on average, men under age 45 and women under age 55 were gaining approximately 0.45 kilograms (one pound per year, which leveled off with increased age and reversed in the oldest age groups. These findings underscore the need for public health efforts aimed at combating obesity.

  12. Changes in body mass index in Canadians over a five-year period: results of a prospective, population-based study.

    Science.gov (United States)

    Hopman, Wilma M; Leroux, Cristine; Berger, Claudie; Joseph, Lawrence; Barr, Susan I; Prior, Jerilynn C; Harrison, Mark; Poliquin, Suzette; Towheed, Tanveer; Anastassiades, Tassos; Goltzman, David

    2007-07-09

    The initiation of the Canadian Multicentre Osteoporosis Study in 1996, and subsequent follow-up of the cohort 5 years later, provided longitudinal body mass index (BMI) data for a random sample of Canadians. Height and weight were measured at baseline and 5 years and used to calculate BMI and assign one of six weight categories. Multiple imputation was used to adjust for missing weight at year 5. Data were stratified by age and gender. The proportion of participants moving between categories was generated, and multivariable linear regression was used to identify factors associated with weight change. Baseline data were available for 8548 participants, year 5 data for 6721, and year 5 weight was imputed for 1827 (17.6%). Mean BMI for every age and gender group exceeded healthy weight guidelines. Most remained within their BMI classification over 5 years, but when change occurred, BMI category was more likely to increase than decrease. Several sociodemographic, lifestyle and clinical characteristics were associated with change. Mean baseline BMI tended to be higher than recommended. Moreover, on average, men under age 45 and women under age 55 were gaining approximately 0.45 kilograms (one pound) per year, which leveled off with increased age and reversed in the oldest age groups. These findings underscore the need for public health efforts aimed at combating obesity.

  13. Leaching studies of natural and synthetic titanite, a potential host for wastes from the reprocessing of Canadian nuclear fuel

    International Nuclear Information System (INIS)

    Hayward, P.J.; Doern, F.E.; Cecchetto, E.V.; Mitchell, S.L.

    1983-01-01

    Glass ceramics (i.e., glasses subjected to controlled crystallization) with synthetic titanite as the major crystalline phase are being considered as potential hosts for the radioactive wastes arising from possible future reprocessing of nuclear fuel in Canada. In order to assess the stability of titanite in the anticipated environment of a disposal vault sited 500-1000 m deep within a granitic pluton in the Canadian Shield, leaching experiments have been performed with natural and synthetic titanite, using a synthetic groundwater whose composition is based on findings from a recent borehole-survey. The results are in qualitative agreement with calculations of solution equilibria for titanite and its main alteration products, and indicate that titanite should be stable and suffer no net leaching under anticipated conditions in the vault

  14. The contribution of zoos and aquaria to Aichi Biodiversity Target 12: A case study of Canadian zoos

    Directory of Open Access Journals (Sweden)

    Andrea Olive

    2017-04-01

    Full Text Available The purpose of Aichi Biodiversity Target 12 is to prevent extinction of known threaten species, and improve the decline of the world’s most imperiled species. Governments and NGOs around the world are actively working toward this goal. This article examines the role of zoos and aquaria in the conservation of species at risk through an in-depth examination of four accredited Canadian zoos and aquaria. Through site visits, interviews with staff, and research into the programs at each institution, this paper demonstrates that captive breeding, reintroductions, and headstarting projects are each a large component of conservation efforts. Interviews with zoo staff reveal strong consensus that zoo offer two critical components for species at risk conservation: space and expertise. Overall, this article calls for greater attention to the types of conservation actives occurring and the ways in which zoos are working together to protect and recover global biodiversity.

  15. Transferability of geodata from European to Canadian (Ontario) sedimentary rocks to study gas transport from nuclear wastes repositories

    International Nuclear Information System (INIS)

    Fall, M.; Ghafari, H.; Evgin, E.; Nguyen, T.S.

    2010-01-01

    Document available in extended abstract form only. A deep geological repository (DGR) for low and intermediate level waste in southern Ontario is currently proposed, at a depth of approximately 680 m in an argillaceous limestone formation (Cobourg Limestone) overlain by 200 m of low permeability shale (Ordovician Shale). Significant quantities of gas could be generated in the aforementioned DGR from several processes (e.g., degradation of waste forms, corrosion of waste containers). The accumulation and release of such gases from the repository system may affect a number of processes that influence its long-term safety. Consequently, safety assessments of the proposed DGR need to be supported by a solid understanding of the main mechanisms associated with gas generation and migration and the capability to mathematically model those mechanisms. The development of those mathematical models would usually require the consideration of complex coupled thermo-hydro-mechanical- chemical (THMC) processes. A research program is being conducted in the Department of Civil Engineering of the University of Ottawa in collaboration with the Canadian Nuclear Safety Commission (CNSC) to model the coupled THMC processes associated with gas migration and their impacts on the safety of DGR in southern Ontario. The development and validation of such model as well as the assessment of the impact of gas migration need the acquisition of sufficient amount of (good quality) data on the geomechanical, geochemical, hydraulic, thermal properties of the sedimentary rocks in Southern Ontario as well as relevant gas transport parameters, such as gas entry pressure, Klinkenberg effect, intrinsic permeability, capillary pressure-water saturation relationship. During the past fifteen years, several laboratory and field investigations have been conducted in several countries to acquire geo-data to study and model the THMC processes associated with gas migration in DGR in sedimentary rocks. However

  16. Canadian competitive advantage

    International Nuclear Information System (INIS)

    Wills, J.

    1997-01-01

    The evolution of the Canadian petrochemical industry was outlined, emphasizing the proximity to feedstocks as the principal advantage enjoyed by the industry over its international competitors. Annual sales statistics for 1995 were provided. Key players in the Canadian petrochemical industry (Nova, Dow, DuPont, Methanex, Esso, Union Carbide, Shell and Celanese), their share of the market and key products were noted. Manufacturing facilities are located primarily in Alberta, southern Ontario and Quebec. The feedstock supply infrastructure, historical and alternative ethane pricing in Canada and the US, the North American market for petrochemicals, the competitiveness of the industry, tax competitiveness among Canadian provinces and the US, the Canada - US unit labour cost ratio, ethylene facility construction costs in Canada relative to the US Gulf Coast, and projected 1997 financial requirements were reviewed. 19 figs

  17. Evaluation of a Short Message Service diary methodology in a nonclinical, naturalistic setting.

    Science.gov (United States)

    Walsh, Erin I; Brinker, Jay K

    2012-11-01

    Particularly suited to repeated measures in naturalistic settings, Short Message Service (SMS) is garnering increasing attention as a viable method of data collection. The current study explored issues of practical importance for the development of this methodology, including factors impacting on attrition and compliance, and participant perception of SMS. Using a business-card-sized questionnaire key, 98 university students were sent prompt SMS messages nightly for a week. Completion and compliance were very high in all participants who responded to at least one prompt SMS; those who responded at least once (n=63) responded to 83 percent of all seven prompts, with 95 percent of responses containing appropriate alphanumeric answers to all questions. However, a time lag between recruitment and participation was associated with a failure to commence the diary study. Participants reported positive perceptions of SMS privacy and convenience.

  18. A Naturalistic, Randomized Pilot Trial of E-Cigarettes: Uptake, Exposure, and Behavioral Effects.

    Science.gov (United States)

    Carpenter, Matthew J; Heckman, Bryan W; Wahlquist, Amy E; Wagener, Theodore L; Goniewicz, Maciej L; Gray, Kevin M; Froeliger, Brett; Cummings, K Michael

    2017-12-01

    Background: Most studies of electronic nicotine delivery systems (ENDS) compare self-selected users versus nonusers. The few randomized studies to date generally support a positive impact on reducing smoking behavior, but these studies are focused on guided ENDS use. This study presents a randomized, naturalistic trial of ENDS with prospective outcomes of uptake and behavioral changes in smoking. Methods: Adult smokers with minimal ENDS history were randomized in a 2:1 ratio to receive product for 3 weeks ( n = 46), or not ( n = 22). Changes in nicotine delivery (16 vs. 24 mg), midway through the study allowed a compelling opportunity to examine two ENDS products compared with the control group. Primary outcomes, assessed via daily diaries during sampling period and in-person laboratory visits over 4 months, included uptake and usage of ENDS, cessation-related outcomes, and exposure to smoke constituents. Results: All ENDS participants tried product at least once, with 48% of 24 mg and 30% of 16 mg using their assigned product for the entire sampling period. Within the 24 mg ENDs group, 57% made an independent purchase of ENDS, versus 28% of 16 mg, and 14% of control participants ( P = 0.01). Smokers in both ENDS groups significantly reduced their smoking, whereas control participants did not ( P = 0.03). Cessation behaviors (quit attempts, biologically verified abstinence) numerically but not statistically favored ENDS participants. Conclusions: Results suggest that cigarette smokers are willing to use ENDS with trends toward reduced cigarette smoking and positive changes in cessation-related behaviors. Impact: Randomized, naturalistic trials such as presented herein are needed to understand the population impact of e-cigarettes. Cancer Epidemiol Biomarkers Prev; 26(12); 1795-803. ©2017 AACR . ©2017 American Association for Cancer Research.

  19. Participant selection for lung cancer screening by risk modelling (the Pan-Canadian Early Detection of Lung Cancer [PanCan] study): a single-arm, prospective study.

    Science.gov (United States)

    Tammemagi, Martin C; Schmidt, Heidi; Martel, Simon; McWilliams, Annette; Goffin, John R; Johnston, Michael R; Nicholas, Garth; Tremblay, Alain; Bhatia, Rick; Liu, Geoffrey; Soghrati, Kam; Yasufuku, Kazuhiro; Hwang, David M; Laberge, Francis; Gingras, Michel; Pasian, Sergio; Couture, Christian; Mayo, John R; Nasute Fauerbach, Paola V; Atkar-Khattra, Sukhinder; Peacock, Stuart J; Cressman, Sonya; Ionescu, Diana; English, John C; Finley, Richard J; Yee, John; Puksa, Serge; Stewart, Lori; Tsai, Scott; Haider, Ehsan; Boylan, Colm; Cutz, Jean-Claude; Manos, Daria; Xu, Zhaolin; Goss, Glenwood D; Seely, Jean M; Amjadi, Kayvan; Sekhon, Harmanjatinder S; Burrowes, Paul; MacEachern, Paul; Urbanski, Stefan; Sin, Don D; Tan, Wan C; Leighl, Natasha B; Shepherd, Frances A; Evans, William K; Tsao, Ming-Sound; Lam, Stephen

    2017-11-01

    Results from retrospective studies indicate that selecting individuals for low-dose CT lung cancer screening on the basis of a highly predictive risk model is superior to using criteria similar to those used in the National Lung Screening Trial (NLST; age, pack-year, and smoking quit-time). We designed the Pan-Canadian Early Detection of Lung Cancer (PanCan) study to assess the efficacy of a risk prediction model to select candidates for lung cancer screening, with the aim of determining whether this approach could better detect patients with early, potentially curable, lung cancer. We did this single-arm, prospective study in eight centres across Canada. We recruited participants aged 50-75 years, who had smoked at some point in their life (ever-smokers), and who did not have a self-reported history of lung cancer. Participants had at least a 2% 6-year risk of lung cancer as estimated by the PanCan model, a precursor to the validated PLCOm2012 model. Risk variables in the model were age, smoking duration, pack-years, family history of lung cancer, education level, body-mass index, chest x-ray in the past 3 years, and history of chronic obstructive pulmonary disease. Individuals were screened with low-dose CT at baseline (T0), and at 1 (T1) and 4 (T4) years post-baseline. The primary outcome of the study was incidence of lung cancer. This study is registered with ClinicalTrials.gov, number NCT00751660. 7059 queries came into the study coordinating centre and were screened for PanCan risk. 15 were duplicates, so 7044 participants were considered for enrolment. Between Sept 24, 2008, and Dec 17, 2010, we recruited and enrolled 2537 eligible ever-smokers. After a median follow-up of 5·5 years (IQR 3·2-6·1), 172 lung cancers were diagnosed in 164 individuals (cumulative incidence 0·065 [95% CI 0·055-0·075], incidence rate 138·1 per 10 000 person-years [117·8-160·9]). There were ten interval lung cancers (6% of lung cancers and 6% of individuals with cancer

  20. A naturalistic decision making model for simulated human combatants

    International Nuclear Information System (INIS)

    HUNTER, KEITH O.; HART, WILLIAM E.; FORSYTHE, JAMES C.

    2000-01-01

    The authors describe a naturalistic behavioral model for the simulation of small unit combat. This model, Klein's recognition-primed decision making (RPD) model, is driven by situational awareness rather than a rational process of selecting from a set of action options. They argue that simulated combatants modeled with RPD will have more flexible and realistic responses to a broad range of small-scale combat scenarios. Furthermore, they note that the predictability of a simulation using an RPD framework can be easily controlled to provide multiple evaluations of a given combat scenario. Finally, they discuss computational issues for building an RPD-based behavior engine for fully automated combatants in small conflict scenarios, which are being investigated within Sandia's Next Generation Site Security project

  1. A study of the Canadian public's attitudes toward the energy situation in Canada. Wave 4. A quantitative trend study conducted in selected major urban centres in Canada, of the attitudes of both men and women toward the subject of energy

    Energy Technology Data Exchange (ETDEWEB)

    1978-01-01

    This report presents the results of a yearly study designed to examine the attitudes of the Canadian public to certain energy-related issues. The study attempts to measure: the extent to which Canadians regard energy as a problem, relative to other issues such as unemployment and inflation; the extent and manner in which the public can help alleviate the problem; the role governments should play in solving the energy problem; perceived benefits and effects of turning to new energy sources; and shifts in opinions from earlier studies. A new section, not included in previous surveys, covers the extent of readership of government publications on energy conservation. Data were collected based on telephone interviews with respondents in seven cities across Canada. A selection of what is considered to be meaningful and pertinent data is presented, and some data from earlier surveys are also included. A supplement to this report includes summary tables and copies of the questionnaires used in the surveys. 49 tabs.

  2. Establishing the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS): Operationalizing Community-based Research in a Large National Quantitative Study.

    Science.gov (United States)

    Loutfy, Mona; Greene, Saara; Kennedy, V Logan; Lewis, Johanna; Thomas-Pavanel, Jamie; Conway, Tracey; de Pokomandy, Alexandra; O'Brien, Nadia; Carter, Allison; Tharao, Wangari; Nicholson, Valerie; Beaver, Kerrigan; Dubuc, Danièle; Gahagan, Jacqueline; Proulx-Boucher, Karène; Hogg, Robert S; Kaida, Angela

    2016-08-19

    Community-based research has gained increasing recognition in health research over the last two decades. Such participatory research approaches are lauded for their ability to anchor research in lived experiences, ensuring cultural appropriateness, accessing local knowledge, reaching marginalized communities, building capacity, and facilitating research-to-action. While having these positive attributes, the community-based health research literature is predominantly composed of small projects, using qualitative methods, and set within geographically limited communities. Its use in larger health studies, including clinical trials and cohorts, is limited. We present the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS), a large-scale, multi-site, national, longitudinal quantitative study that has operationalized community-based research in all steps of the research process. Successes, challenges and further considerations are offered. Through the integration of community-based research principles, we have been successful in: facilitating a two-year long formative phase for this study; developing a novel survey instrument with national involvement; training 39 Peer Research Associates (PRAs); offering ongoing comprehensive support to PRAs; and engaging in an ongoing iterative community-based research process. Our community-based research approach within CHIWOS demanded that we be cognizant of challenges managing a large national team, inherent power imbalances and challenges with communication, compensation and volunteering considerations, and extensive delays in institutional processes. It is important to consider the iterative nature of community-based research and to work through tensions that emerge given the diverse perspectives of numerous team members. Community-based research, as an approach to large-scale quantitative health research projects, is an increasingly viable methodological option. Community-based research has several

  3. Correlates of joint child protection and police child sexual abuse investigations: results from the Canadian Incidence Study of Reported Child Abuse and Neglect-2008

    Directory of Open Access Journals (Sweden)

    L. Tonmyr

    2015-01-01

    Full Text Available Introduction: Our study examines the frequency of joint investigations by child protection workers and the police in sexual abuse investigations compared to other maltreatment types and the association of child-, caregiver-, maltreatment- and investigation-related characteristics in joint investigations, focussing specifically on investigations involving sexual abuse. Methods: We analyzed data from the Canadian Incidence Study of Reported Child Abuse and Neglect-2008 using logistic regression. Results: The data suggest that sexual abuse (55%, and then physical abuse, neglect and emotional maltreatment, are most often co-investigated. Substantiation of maltreatment, severity of maltreatment, placement in out-of-home care, child welfare court involvement and referral of a family member to specialized services was more likely when the police were involved in an investigation. Conclusion: This study adds to the limited information on correlates of joint child protection agency and police investigations. Further research is needed to determine the effectiveness of these joint investigations.

  4. Canadian Irradiation Centre

    International Nuclear Information System (INIS)

    1987-05-01

    The Canadian Irradiation Centre is a non-profit cooperative project between Atomic Energy of Canada Limited, Radiochemical Company and Universite du Quebec, Institut Armand-Frappier, Centre for Applied Research in Food Science. The Centre's objectives are to develop, demonstrate and promote Canada's radiation processing technology and its applications by conducting applied research; training technical, professional and scientific personnel; educating industry and government; demonstrating operational and scientific procedures; developing processing procedures and standards, and performing product and market acceptance trials. This pamphlet outlines the history of radoation technology and the services offered by the Canadian Irradiation Centre

  5. Radioactive waste disposal - ethical and environmental considerations - A Canadian perspective

    International Nuclear Information System (INIS)

    Roots, F.

    1994-01-01

    This work deals with ethical and environmental considerations of radioactive waste disposal in Canada. It begins with the canadian attitudes toward nature and environment. Then are given the canadian institutions which reflect an environmental ethic, the development of a canadian radioactive waste management policy, the establishment of formal assessment and review process for a nuclear fuel waste disposal facility, some studies of the ethical and risk dimensions of nuclear waste decisions, the canadian societal response to issues of radioactive wastes, the analysis of risks associated with fuel waste disposal, the influence of other energy related environmental assessments and some common ground and possible accommodation between the different views. (O.L.). 50 refs

  6. Sources of social support associated with health and quality of life: a cross-sectional study among Canadian and Latin American older adults

    Science.gov (United States)

    Bélanger, Emmanuelle; Ahmed, Tamer; Vafaei, Afshin; Curcio, Carmen Lucia; Phillips, Susan P; Zunzunegui, Maria Victoria

    2016-01-01

    Objectives To examine whether the association between emotional support and indicators of health and quality of life differs between Canadian and Latin American older adults. Design Cross-sectional analysis of the International Mobility in Aging Study (IMIAS). Social support from friends, family members, children and partner was measured with a previously validated social network and support scale (IMIAS-SNSS). Low social support was defined as ranking in the lowest site-specific quartile. Prevalence ratios (PR) of good health, depression and good quality of life were estimated with Poisson regression models, adjusting for age, gender, education, income and disability in activities of daily living. Setting Kingston and Saint-Hyacinthe in Canada, Manizales in Colombia and Natal in Brazil. Participants 1600 community-dwelling adults aged 65–74 years, n=400 at each site. Outcome measures Likert scale question on self-rated health, Center for Epidemiological Studies Depression Scale and 10-point analogical quality-of-life (QoL) scale. Results Relationships between social support and study outcomes differed between Canadian and Latin American older adults. Among Canadians, those without a partner had a lower prevalence of good health (PR=0.90; 95% CI 0.82 to 0.98), and those with high support from friends had a higher prevalence of good health (PR=1.09; 95% CI 1.01 to 1.18). Among Latin Americans, depression was lower among those with high levels of support from family (PR=0.63; 95% CI 0.48 to 0.83), children (PR=0.60; 95% CI 0.45 to 0.80) and partner (PR=0.57; 95% CI 0.31 to 0.77); good QoL was associated with high levels of support from children (PR=1.54; 95% CI 1.20 to 1.99) and partner (PR=1.31; 95% CI 1.03 to 1.67). Conclusions Among older adults, different sources of support were relevant to health across societies. Support from friends and having a partner were related to good health in Canada, whereas in Latin America, support from family, children and

  7. Mortality study of Canadian military personnel exposed to radiation: atomic test blasts and Chalk River nuclear reactor clean-ups, 1950's

    International Nuclear Information System (INIS)

    Raman, S.; Dulberg, C.S.; Spasoff, R.A.

    1984-08-01

    This report describes a historical cohort study of the group of Canadian military personnel exposed to radiation in the 1950s at atomic bomb test blasts in the U.S. and Australia, and at clean-up operations at the Chalk River Nuclear Laboratories. Overall and cause-specific mortality in the exposed group was compared to that of the control cohort of unexposed military personnel, matched on age, service, rank and trade. Analyses indicated no elevation in the exposed cohort, in overall or cause-specific mortality due to diseases associated with radiation. Since this study was restricted to an investigation of mortality, we must stress that we cannot generalize these results or conclusions to current morbidity experienced by the exposed cohort

  8. Proceedings of the 2009 Annual Meeting of the Canadian Mathematics Education Study Group = Actes de la Rencontre Annuelle 2009 du Groupe Canadien d'Etude en Didactique des Mathematiques (33rd, Toronto, Ontario, Canada, June 5-June 9, 2009)

    Science.gov (United States)

    Liljedahl, Peter, Ed.; Oesterle, Susan, Ed.; Abu-Bakare, Veda, Ed.

    2010-01-01

    This submission contains the Proceedings of the 2009 Annual Meeting of the Canadian Mathematics Education Study Group (CMESG), held at York University in Toronto, Ontario. The CMESG is a group of mathematicians and mathematics educators who meet annually to discuss mathematics education issues at all levels of learning. The aims of the Study Group…

  9. Breast Cancer Risk Estimation and Personal Insurance: A Qualitative Study Presenting Perspectives from Canadian Patients and Decision Makers

    Directory of Open Access Journals (Sweden)

    Gratien Dalpé

    2017-09-01

    Full Text Available Genetic stratification approaches in personalized medicine may considerably improve our ability to predict breast cancer risk for women at higher risk of developing breast cancer. Notwithstanding these advantages, concerns have been raised about the use of the genetic information derived in these processes, outside of the research and medical health care settings, by third parties such as insurers. Indeed, insurance applicants are asked to consent to insurers accessing their medical information (implicitly including genetic to verify or determine their insurability level, or eligibility to certain insurance products. This use of genetic information may result in the differential treatment of individuals based on their genetic information, which could lead to higher premium, exclusionary clauses or even the denial of coverage. This phenomenon has been commonly referred to as “Genetic Discrimination” (GD. In the Canadian context, where federal Bill S-201, An Act to prohibit and prevent genetic discrimination, has recently been enacted but may be subject to constitutional challenges, information about potential risks to insurability may raise issues in the clinical context. We conducted a survey with women in Quebec who have never been diagnosed with breast cancer to document their perspectives. We complemented the research with data from 14 semi-structured interviews with decision-makers in Quebec to discuss institutional issues raised by the use of genetic information by insurers. Our results provide findings on five main issues: (1 the reluctance to undergo genetic screening test due to insurability concerns, (2 insurers' interest in genetic information, (3 the duty to disclose genetic information to insurers, (4 the disclosure of potential impacts on insurability before genetic testing, and (5 the status of genetic information compared to other health data. Overall, both groups of participants (the women surveyed and the decision

  10. Canadian heavy water production

    International Nuclear Information System (INIS)

    Dahlinger, A.; Lockerby, W.E.; Rae, H.K.

    1977-05-01

    The paper reviews Canadian experience in the production of heavy water, presents a long-term supply projection, relates this projection to the anticipated long-term electrical energy demand, and highlights principal areas for further improvement that form the bulk of our research and development program on heavy water processes

  11. Canadian petroleum industry review

    International Nuclear Information System (INIS)

    Feick, R. M.

    1997-01-01

    A wide ranging discussion about the factors that have influenced oil and natural gas prices, the differences of the Canadian market from international markets, the differences between eastern and western Canadian markets, and shareholders' perspectives on recent commodity price developments was presented. Developments in the OPEC countries were reviewed, noting that current OPEC production of 25 mmbbls is about 60 per cent higher than it was in 1985. It is expected that OPEC countries will continue to expand capacity to meet expected demand growth and the continuing need created by the UN embargo on Iraqi oil sales. Demand for natural gas is also likely to continue to rise especially in view of the deregulation of the electricity industry where natural gas may well become the favored fuel for incremental thermal generation capacity. Prices of both crude oil and natural gas are expected to hold owing to unusually low storage levels of both fuels. The inadequacy of infrastructure, particularly pipeline capacity as a key factor in the Canadian market was noted, along with the dynamic that will emerge in the next several years that may have potential consequences for Canadian production - namely the reversal of the Sarnia to Montreal pipeline. With regard to shareholders' expectations the main issues are (1) whether international markets reach back to the wellhead, hence the producer's positioning with respect to transportation capacity and contract portfolios, and (2) whether the proceeds from increased prices are invested in projects that are yielding more than the cost of capital. 28 figs

  12. Canadian hydrogen safety program

    International Nuclear Information System (INIS)

    MacIntyre, I.; Tchouvelev, A.V.; Hay, D.R.; Wong, J.; Grant, J.; Benard, P.

    2007-01-01

    The Canadian hydrogen safety program (CHSP) is a project initiative of the Codes and Standards Working Group of the Canadian transportation fuel cell alliance (CTFCA) that represents industry, academia, government, and regulators. The Program rationale, structure and contents contribute to acceptance of the products, services and systems of the Canadian Hydrogen Industry into the Canadian hydrogen stakeholder community. It facilitates trade through fair insurance policies and rates, effective and efficient regulatory approval procedures and accommodation of the interests of the general public. The Program integrates a consistent quantitative risk assessment methodology with experimental (destructive and non-destructive) failure rates and consequence-of-release data for key hydrogen components and systems into risk assessment of commercial application scenarios. Its current and past six projects include Intelligent Virtual Hydrogen Filling Station (IVHFS), Hydrogen clearance distances, comparative quantitative risk comparison of hydrogen and compressed natural gas (CNG) refuelling options; computational fluid dynamics (CFD) modeling validation, calibration and enhancement; enhancement of frequency and probability analysis, and Consequence analysis of key component failures of hydrogen systems; and fuel cell oxidant outlet hydrogen sensor project. The Program projects are tightly linked with the content of the International Energy Agency (IEA) Task 19 Hydrogen Safety. (author)

  13. Canadian Nuclear Association

    International Nuclear Information System (INIS)

    Reid, John

    1992-01-01

    It is the view of the Canadian Nuclear Association that continuing creation of economic wealth is vital to sustainable development. A plentiful supply of cheap energy is essential. Nuclear energy provides the cleanest source of bulk energy generation essential to any path of sustainable development

  14. Does Joshua Greene’s Dual Process Theory of Moral Judgment Commit the Naturalistic Fallacy?

    Directory of Open Access Journals (Sweden)

    Javier Gracia Calandín

    2017-02-01

    Full Text Available In this article I analyse whether Joshua Greene’s dual process theory of moral judgment commits the naturalistic fallacy. Firstly, and against current authors such as Patricia S. Churchland, I uphold the validity of the naturalistic fallacy denounced by Moore for more than a century. Secondly, I highlight and question Greene’s naturalized way of understanding Deontologism. Thirdly, I assert the distinction between "neural basis" and "moral foundation" as the key to avoid committing the naturalistic fallacy. Finally and according to that key distinction I assess Greene’s neuroethical approach and I analyse some of its most critical aspects related to normative issues.

  15. Differential Item Functioning in the SF-36 Physical Functioning and Mental Health Sub-Scales: A Population-Based Investigation in the Canadian Multicentre Osteoporosis Study.

    Science.gov (United States)

    Lix, Lisa M; Wu, Xiuyun; Hopman, Wilma; Mayo, Nancy; Sajobi, Tolulope T; Liu, Juxin; Prior, Jerilynn C; Papaioannou, Alexandra; Josse, Robert G; Towheed, Tanveer E; Davison, K Shawn; Sawatzky, Richard

    2016-01-01

    Self-reported health status measures, like the Short Form 36-item Health Survey (SF-36), can provide rich information about the overall health of a population and its components, such as physical, mental, and social health. However, differential item functioning (DIF), which arises when population sub-groups with the same underlying (i.e., latent) level of health have different measured item response probabilities, may compromise the comparability of these measures. The purpose of this study was to test for DIF on the SF-36 physical functioning (PF) and mental health (MH) sub-scale items in a Canadian population-based sample. Study data were from the prospective Canadian Multicentre Osteoporosis Study (CaMos), which collected baseline data in 1996-1997. DIF was