Search Results (4,462)

As an example of pedagogical approaches that blend online and face-to-face instruction, the flipped classroom model has seen exponential growth in business schools. To explore its effectiveness, expectancy-value theory and cognitive load theory were employed to develop a framework linking students’ perceived usefulness of the online and in-person content to their pre-class preparation, class participation, perceived learning, and skills development. A preliminary test of this framework was conducted using a flipped Organizational Behavior course within a business diploma program at a publicly funded Canadian college. The perceived usefulness of the online component was positively associated with students’ pre-class preparation, which, in turn, was positively related to both their perceived learning and skills development. Implications for practice and directions for future research are discussed. Full article

Person-centered navigation (PCN) in healthcare refers to a proactive collaboration among professionals, researchers, patients, and their families to guide individuals toward timely access to screening, treatment, follow-up, and psychosocial support. PCN—which includes professional, peer, and virtual guidance, is particularly crucial for rare cancers, where affected individuals face uncertainty, limited support, financial strain, and difficulties accessing relevant information, testing, and other services. The Canadian Cholangiocarcinoma Collaborative (C3) prioritizes PCN implementation to address these challenges in the context of Biliary Tract Cancers (BTCs). C3 uses a virtual PCN model and staffs a “C3 Research Navigator” who provides clinical and research navigation such as personalized guidance and support, facilitating access to molecular testing, clinical trials, and case reviews through national multidisciplinary rounds. C3 also supports a national network of BTC experts, a patient research registry, and advocacy activities. C3’s implementation strategies include co-design, timely delivery of support, and optimal outcomes across its many initiatives. Future priorities include expanding the C3 network, enhancing user engagement, and further integrating its innovative approach into routine care. Full article

CAPOX and FOLFOX are widely used chemotherapy regimens for colorectal cancer (CRC). The superiority of one regimen over the other in a real-world setting (RWE) could have significant clinical implications given their common use, but such RWE is limited. This study analyzed provincial database records of 13,461 Canadian patients treated from 2005 to 2017. The primary outcomes were rates of Emergency Department visits and/or hospitalizations (ED/H) and overall survival (OS). CAPOX was used less frequently (8.4%) than FOLFOX (91.6%), often in older patients (p < 0.003 for Stage I–III; p < 0.001 for Stage IV). CAPOX recipients had shorter treatment durations (median 15 vs. 20 weeks, p = 0.002) and higher unadjusted ED/H rates (60.8% vs. 50.9%, p < 0.001), though this difference was nonsignificant on multivariate analysis (MVA) (HR 1.05 (0.92, 1.20), p = 0.466). Patients receiving CAPOX had worse OS than those on FOLFOX, (5-year OS 70.1% vs. 77.2% (p < 0.001) non-metastatic; 16.6% vs. 33.2% (p < 0.001) metastatic). MVA confirmed inferior OS with CAPOX (HR 1.42, p < 0.001). Other predictors of shorter OS included older age, male sex, comorbidities, rural residence, and lower income. This administrative data is at risk of bias but highlights the need for careful patient selection and informed treatment decision making. Full article

Survivors of pediatric cancer are at risk for late effects and require risk-adapted long-term follow-up (LTFU) care. Yet less than 50% of survivors attend LTFU care. This study aimed to identify barriers and enablers of engaging with LTFU care as perceived by Canadian survivors of pediatric cancer and healthcare providers (HCPs). Survivors (n = 108) and HCPs (n = 20) completed surveys assessing barriers and enablers to attending LTFU care, summarized using descriptive statistics. Participants were invited to participate in survivor focus groups (n = 22) or HCP semi-structured interviews (n = 7). These were analyzed using reflexive thematic analysis and the Capability, Opportunity, and Motivation for Behaviour Change (COM-B) model, which explores how an individual’s capability, opportunity, and motivation influence a target behaviour. Structural barriers, transitioning from pediatric to adult care, and time constraints were highlighted as barriers that affect survivors’ physical opportunity to engage in LTFU care. Accessibility, financial support, HCPs and family support, and community resources were highlighted as enablers that better survivors’ physical and social opportunity to engage in LTFU care. In conclusion, Canadian survivors of pediatric cancer highlighted barriers that limited their physical opportunity to attend LTFU care, while factors that enhanced their physical and social opportunities facilitated greater engagement with LTFU care. Full article

Background/Objectives: Juvenile idiopathic arthritis (JIA) and inflammatory bowel disease (IBD) are chronic autoimmune conditions that impact the physical and psychological well-being of pediatric patients. While previous studies have shown a high prevalence of mental health challenges among youth with chronic conditions, the prevalence of mental health issues in Canadian pediatric patients with JIA and IBD remains unclear. We aimed to estimate the prevalence of documented mental health disorders and related medication use of youth with JIA or IBD at a tertiary care centre. Methods: We conducted a retrospective chart review of youths aged 12–17 diagnosed with JIA or IBD at McMaster Children’s Hospital (MCH) to understand the prevalence of generalized anxiety disorder (GAD), separation anxiety disorder, social anxiety disorder (SAD), obsessive–compulsive disorders (OCD), eating disorders, major depressive disorder (MDD), adolescent adjustment disorder, suicide attempt/suicide ideation, self-harm behaviour, substance use disorder, and attention deficit disorders (ADD). Results: We reviewed 429 patient charts, including 303 patients with IBD and 126 with JIA. Our findings identified 90 IBD patients and 20 JIA patients who had one or more documented mental health conditions. Proportionately, there was a higher prevalence of mental health conditions among IBD patients (30%) compared to JIA patients (16%). The most frequently observed conditions in both IBD and JIA patients were GAD (63%, 50%), ADD (33%, 35%), and MDD (29%, 15%). Conclusions: These findings highlight the critical need for early mental health screening and integrated care approaches that address both medical and psychosocial needs in adolescents with chronic illnesses. Future research should incorporate prospective study designs, include diverse geographic and demographic populations, and explore targeted interventions to improve mental and physical health outcomes in this vulnerable group. Full article

Weathering steel (WS) is widely used in bridge construction due to its high corrosion resistance, durability, and low maintenance requirements. This paper reviews the performance of WS bridges in Canadian climates, focusing on the formation of protective patina, influencing factors, and long-term maintenance strategies. The protective patina, composed of stable iron oxyhydroxides, develops over time under favorable wet–dry cycles but can be disrupted by environmental aggressors such as chlorides, sulfur dioxide, and prolonged moisture exposure. Key alloying elements like Cu, Cr, Ni, and Nb enhance corrosion resistance, while design considerations—such as drainage optimization and avoidance of crevices—are critical for performance. The study highlights the vulnerability of WS bridges to microenvironments, including de-icing salt exposure, coastal humidity, and debris accumulation. Regular inspections and maintenance, such as debris removal, drainage system upkeep, and targeted cleaning, are essential to mitigate corrosion risks. Climate change exacerbates challenges, with rising temperatures, altered precipitation patterns, and ocean acidification accelerating corrosion in coastal regions. Future research directions include optimizing WS compositions with advanced alloys (e.g., rare earth elements) and integrating climate-resilient design practices. This review highlights the need for a holistic approach combining material science, proactive maintenance, and adaptive design to ensure the longevity of WS bridges in evolving environmental conditions. Full article

The issue of school absenteeism has received increased attention in previous years due to the widespread absences caused by the COVID-19 pandemic. However, Canadian research is sparse on the topic, and a data-based picture of the extent of the problem does not exist. In this conceptual article, we briefly trace the origins of school absenteeism and outline the current status of prevalence data and research in the area of school absenteeism in Canada, drawing on a broad range of sources including national and international surveys. Our exploration suggests several recommendations to advance knowledge and practice in the area, including the identification and sharing of attendance-related data within and across provinces and territories, the development of partnerships between researchers and school boards, the integration of discipline-specific research in the area and the analysis of school absenteeism through nuanced, complex lenses. Full article

(1) Background: Evidence from non-human animal and spaceflight analog studies have suggested that traveling to outer space could have a significant impact on the structural properties of the hippocampus, a brain region within the medial temporal lobe that is critical for learning and memory. Here, we tested this hypothesis in a group of astronauts who participated in a six-month mission in the International Space Station (ISS). (2) Methods: We collected magnetic resonance imaging (MRI) scans from a sample of 17 (9 males, 8 females) astronauts before and after the ISS mission, and calculated percent gray matter volume changes in the whole hippocampus and its (anterior, body, and posterior) subregions in both hemispheres. (3) Following the six-month mission in the ISS, we found a significantly decreased volume in the whole left hippocampus; in addition, when looking at subregions separately, we detected a significantly decreased volume in the anterior subregion of the left hippocampus and the body subregion of the right hippocampus. We also found a significantly decreased volume in the whole right hippocampus of male astronauts as compared to female astronauts. (4) Conclusions: This study, providing the very first evidence of hippocampal volumetric changes in astronauts following a six-month mission to the ISS, could have significant implications for cognitive performance during future long-duration spaceflights. Full article

Canadian sawmills commonly use chipper-canters to process softwood logs into squared lumber and wood chips for pulp mills. However, the declining demand for newsprint and print paper has led to an oversupply of wood chips, resulting in economic losses and environmental concerns. To address this issue, a strander-canter capable of producing both softwood cants and strands for oriented strand board (OSB) presents a promising alternative. This study evaluates the feasibility of using jack pine strands generated by a novel strander-canter equipped with a cutterhead for OSB strand production. Strands were generated from frozen and unfrozen logs under varying cutting parameters and incorporated in the core layer of the panels. Industrial aspen strands were used for the surface layers. OSB panels were assessed for mechanical and physical properties following the CSA O325:21 standard. Strand size distribution and vertical density profiles were also analyzed. The results indicated that panels made from jack pine strands demonstrated bending and internal bond properties that were either comparable to or superior to those of the control panels. However, including jack pine strands in the core layer increased the thickness swelling of the panels. Full article

Background/Objectives: Violence is a significant occupational health issue for paramedics, yet underreporting limits efforts to identify and mitigate risk. Leveraging a novel, point-of-event violence reporting system, we aimed to identify characteristics of 9-1-1 calls associated with an increased risk of violence in a single paramedic service in Ontario, Canada. Methods: We retrospectively analyzed all electronic violence and patient care reports filed by paramedics in Peel Region and used logistic regression to identify call-level predictors of any violence and, more specifically, physical or sexual assault. Results: In total, 374 paramedics filed 974 violence reports, 40% of which documented an assault, corresponding to a rate of 4.18 violent encounters per 1000 9-1-1 calls. In adjusted models, the risk of violence was elevated for calls originating from non-residential locations (e.g., streets, hotels, bars), occurring during afternoon or overnight shifts, and involving young or working-age males. Presenting problems related to intoxication, mental health, or altered mental status were strongly associated with increased risk, with particularly high adjusted odds ratios for assault. Conclusions: These findings support the utility of near-miss and violence surveillance systems and highlight the need for multidisciplinary crisis response to high-risk calls, especially those involving mental health or substance use. Full article

Background/Objectives: Healthcare workers (HCW) have increased the risk of occupational stress injuries and adverse mental health outcomes, which were exacerbated during the COVID-19 pandemic. Understanding HCW psychological distress patterns and help-seeking behaviors can inform responsive resource development that may mitigate negative outcomes in future crises. This paper provides insights on monthly trends in HCW distress and support utilization at a large Canadian hospital over a 14-month period. Methods: As part of a hospital-wide wellness initiative during COVID-19, the STEADY program emailed monthly confidential wellness assessments to hospital staff from April 2020 to May 2021. The assessments included screens for burnout, anxiety, depression and posttraumatic stress, types of support accessed, and demographic information. Repeated cross-sectional data were summarized as monthly proportions and examined alongside longitudinal COVID-19 data. Results: A total of 2498 wellness assessments were submitted (M = ~168 monthly, range: 17–945). Overall, 67% of assessments had at least one positive screen for distress. Average positive screens were 44% for anxiety, 29% for depression, 31% for posttraumatic stress, and 53% for burnout. Despite high distress, most respondents used informal supports (e.g., family/friends), highlighting limited formal support use. Conclusions: HCWs experienced sustained high levels of psychological distress during the COVID-19 pandemic, with burnout remaining a predominant and persistent concern. The limited use of formal support services may indicate barriers to accessing these types of supports. Our findings underscore the need for accessible and acceptable mental health supports for HCW during prolonged crises. Full article

Blackness, both as a racial identity and a marker of cultural difference, disrupts the hegemonic norms embedded in dominant forms of cultural capital. This article examines how first- and second-generation Haitian and Jamaican communities in Ontario and Quebec negotiate Blackness within a Canadian context. Drawing from international literature, it introduces distinctly Canadian concepts—such as polite racism, racial ignominy, and duplicity of consciousness—to illuminate local racial dynamics. Using Yosso’s (2005) framework of community cultural wealth, the study analyzes six forms of cultural capital—linguistic, aspirational, social, navigational, resistant, and familial—as employed by Afro-Caribbeans to navigate systemic exclusion. The article expands the limited Canadian discourse on Black identity and offers theoretical tools for understanding how cultural capital is shaped and constrained by race in multicultural democracies. Full article

Background: In Canada, despite universal healthcare coverage, dental care remains predominantly privately financed, creating financial barriers that prevent many from accessing essential services. This case study is part of a larger initiative, the One Smile Research program, which evaluates the impact of cost-free dental care on the oral health and overall well-being of individuals who have been unable to access dental services in the past two years due to financial constraints. Participants in the program receive necessary dental care and attend follow-up appointments to assess the long-term effects of continuous cost-free care. Clinical Case: This mixed-methods case report focuses on a 26-year-old male participant and integrates a qualitative semi-structured interview with clinical and self-reported data, providing an in-depth understanding of his experiences. Results: Clinical outcomes demonstrated the effectiveness of the provided dental treatments, while self-reported measures indicated improved oral health, satisfaction with dental appearance, enhanced psychosocial well-being, increased self-esteem, reduced dental anxiety, and better oral hygiene habits. The qualitative interview identified three key themes reflecting positive experiences with the program: ease of admission, staff kindness, and overall well-being improvement. The integration of both quantitative and qualitative analyses revealed significant advancements in both objective and subjective measures, particularly regarding overall well-being. Conclusions: The continuity of cost-free dental care effectively addressed the participant’s oral health and overall well-being, with most benefits sustained even at the two-year follow-up. These individual-level outcomes offer preliminary insight into the potential advantages of universal dental coverage within the Canadian healthcare system. Full article

According to Victor Ernest Shelford’s ‘Law of Tolerance,’ organisms within ecosystems thrive optimally when environmental conditions are favorable. Applying this principle to ecosystems and agro-ecosystems facing water scarcity or environmental challenges can significantly enhance their productivity. In these ecosystems, phytocenosis adjusts its conditions by utilizing water with varying salinity levels. Moreover, establishing optimal drinking water conditions for human populations within an ecosystem can help mitigate future negative succession processes. The purpose of this study is to evaluate the quality of two distinct water sources in the Amudarya district of the Republic of Karakalpakstan, Uzbekistan: collector-drainage water and groundwater at depths of 10 to 25 m. This research is highly relevant in the context of climate change, as improper management of water salinity, particularly in collector-drainage water, may exacerbate soil salinization and degrade drinking water quality. The primary methodology of this study is as follows: The Food and Agriculture Organization of the United Nations (FAO) standard for collector-drainage water is applied, and the water quality index is assessed using the CCME WQI model. The Canadian Council of Ministers of the Environment (CCME) model is adapted to assess groundwater quality using Uzbekistan’s national drinking water quality standards. The results of two years of collected data, i.e., 2021 and 2023, show that the water quality index of collector-drainage water indicates that it has limited potential for use as secondary water for the irrigation of sensitive crops and has been classified as ‘Poor’. As a result, salinity increased by 8.33% by 2023. In contrast, groundwater quality was rated as ‘Fair’ in 2021, showing a slight deterioration by 2023. Moreover, a comparative analysis of CCME WQI values for collector-drainage and groundwater in the region, in conjunction with findings from Ethiopia, India, Iraq, and Turkey, indicates a consistent decline in water quality, primarily due to agriculture and various other anthropogenic pollution sources, underscoring the critical need for sustainable water resource management. This study highlights the need to use organic fertilizers in agriculture to protect drinking water quality, improve crop yields, and promote soil health, while reducing reliance on chemical inputs. Furthermore, adopting WQI models under changing climatic conditions can improve agricultural productivity, enhance groundwater quality, and provide better environmental monitoring systems. Full article

The global youth mental health crisis is increasingly intertwined with climate change, as young people experience heightened climate anxiety and ecological grief. This study examines the relationship between nature connectedness, climate worry, coping strategies, and mental health outcomes among Canadian university students. Drawing on Pihkala’s process model of eco-anxiety, we propose the Developing Ecological Consciousness Model, a three-act framework that traces young people’s journey from climate awareness to meaningful engagement. Using path analysis on two independent samples (N = 1825), we found that nature connectedness predicts increased climate worry, which in turn correlates with higher levels of depression and anxiety. However, meaning-focused coping emerged as a protective factor, mitigating these negative mental health impacts. Problem-focused coping alone was insufficient, highlighting the need for balanced strategies. The study underscores the dual role of nature connectedness—both as a source of climate distress and a foundation for resilience. These findings highlight the need for interventions that foster ecological consciousness while addressing the emotional toll of climate change, offering insights for policymakers, educators, and mental health practitioners working with youth in a warming world. Full article