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Historically transgender adults have experienced barriers in accessing primary care services. In Ontario, Canada, health care for transgender adults is accessed through primary care; however, a limited number of practitioners provide care, and patients are often waiting and/or traveling great distances to receive care. The purpose of this protocol is to understand how primary care is implemented and delivered for transgender adults. The paper presents how the case study method can be applied to explore implementation of health services delivery for the transgender population in primary care.
Case study methodology will be used to explore this phenomenon in different primary care contexts. Normalization Process Theory is used as a guide. Three cases known to provide transgender primary care and represent different Ontario primary care models have been identified. Comparing transgender care implementation and delivery across different models is vital to understanding how care provision to this population can be supported. Qualitative interviews will be conducted. Participants will also complete the NoMAD (NOrmalization MeAsure Development) survey, a tool measuring implementation processes. The tool will be modified to explore the implementation of primary care services for transgender individuals. Documentary evidence will be collected. Cross-case synthesis will be completed to compare the cases.
Findings will provide an Ontario perspective on the implementation and delivery of primary care for transgender adults in different primary care models. Results may be applicable to other primary care settings in Canada and other nations with similar systems. Barriers and facilitators in delivery and implementation will be identified. Providing an understanding and increasing awareness of the implementation and delivery of primary care may help to reduce the invisibility and disparities transgender individuals experience when accessing primary care services. Understanding delivery of care could allow care providers to implement primary care services for transgender individuals, improving access to health care for this vulnerable population.
Despite widespread attention to the recent past as an archaeological topic, few archaeologists have attended to the particular social and ecological stakes of one of the most defining material features of contemporary life: the long-term effects of toxic industrial waste. Identifying the present era as the high Capitalocene, this article highlights the contemporary as a period caught between the boom-and-bust cycles of capitalist production and the persistence of industrial waste. Drawing on an archaeological case study from Edmonton, Alberta, we outline how the working-class shanty town community of Ross Acreage (occupied 1900–1950) was formed in relation to the industrial waste that suffused its landscape. Drawing on data from both archaeological excavation and environmental testing, this article argues that the community of Ross Acreage was defined materially by its long-term relationship with industrial waste, what we term a ‘fence-line community’.
As the 1950s progressed, emigration acquired a new international dimension, affecting Israel’s relations with other countries and harming the ability of Israelis to travel freely in Europe.
From 1951 to 1953, emigration from Israel amounted to more than double the number in the preceding three years. Many of the emigrants intended to go to Canada, but due to Canadian procedures, many migrants got stranded in Europe en route from Israel to Canada. The complications reached their apogee in the Foehrenwald DP camp in Bavaria, which was closed only in 1957 and thus became a magnet for Israeli remigrants seeking sanctuary from the troubles they had encountered in Europe. The illicit movement into Foehrenwald was an impediment to the German efforts to close the camp and terminate the Jewish refugee problem in Germany. It also led to the ironic situation whereby Israeli remigrants were threatened with deportation from Germany to Israel. Their status developed into a diplomatic issue between the Israeli and West German governments. Other European governments also imposed restrictions on immigration from Israel.
Israeli emigration now drew negative international attention from government officials, relief officers, and Jewish community leaders, tuning it into a source of political embarrassment for Israel.
In the mid-1950s, the United States became the largest destination for Israeli emigration. While Israeli emigrants heading to the United States did not experience the troubles faced by remigrants in Europe, the movement to the United States was not free of frictions and hardships. Migrants faced obstacles emanating from American immigration policies and from the negative attitude of Jewish aid organizations towards emigration from Israel. This attitude in turn led to debates among American Jews regarding the proper attitude towards Jewish migrants moving from Israel to the United States. Emigration from Israel subsequently became a polarizing issue in the American Jewish community. As the chapter shows, it played a similar role, with varying degrees of intensity, in other Jewish communities in the Americas such as those of Brazil and Canada.
Despite these difficulties, however, tens of thousands of emigrants from Israel were able to settle in America – and as their testimonies reveal, many succeeded in building new lives there. They thus repudiated the concept of the rejection of exile and offered a tangible alternative to the idea that Jewish existence outside Israel was pointless or untenable.
Introduction: The Choosing Wisely Canada (CWC) initiative is dedicated towards optimizing patient care and reduce unnecessary resource use. Different specialty organizations create recommendations lists towards these outcomes. The goal of this study was to examine the applicability of non-Emergency Medicine (EM) recommendations towards EM practice. Methods: The entire master recommendations listings spreadsheet was downloaded from the CWC website (March 2019; n = 333). The EM-specific items from the CAEP checklist were deliberately excluded (n = 10). Items were rated by Niagara community EM physicians (n = 7) using the previously validated Best Evidence in Emergency Medicine (BEEM) rating scale (7 point Likert scale) to determine potential impact on EM practice. Items rated “6 or 7/7” were determine as “high relevance.” Redundant items were consolidated. Results: From the retrieved CWC master list, a total of 102 “highly relevant” recommendations were identified (41 items scored 6/7 [12%], 61 scored 7/7 [18%]; total 31%). Redundant items consolidated included antimicrobial avoidance (n = 18), opioid avoidance for pain (n = 11), reduction of unnecessary imaging (n = 11), and avoidance of routine low back imaging (n = 7). Conclusion: There are a large number of non-EM specialty recommendations highly relevant to EM practice in the CWC database (31%). Quality improvement initiatives looking to operational CWC recommendations in Canadian Emergency Departments should be aware of these as a part of optimizing patient care.
The chapter presents an analysis of the application of the proportionality doctrine in the case law of the Canadian Supreme Court. Based on both a qualitative and quantitative analysis of a large sample of case law applying proportionality, the chapter uses quantitative indicators to provide an overview of the characteristics of proportionality analysis in action, including the rights and subject matters to which proportionality is applied, the division of labour between the stages of the analysis when striking down measures, and termination rates for each stage following a failure. The findings reinforce the existing perception that minimal impairment is central to Canadian proportionality analysis: it is the stage where the largest number of cases fail and half of the time the Court does not proceed to even consider the final balancing stage. Even when cases fail at the substantial objective or rational connection stage – which happens more often than generally acknowledged – the court almost always continues the analysis to the minimal impairment stage for an additional failure. The chapter further analyses qualitatively the application in practice of each of proportionality's subtests, exposing the range of interpretations given and the content that has been infused into the different stages.
Commercially available business (CAB) datasets for food environments have been investigated for error in large urban contexts and some rural areas, but there is a relative dearth of literature that reports error across regions of variable rurality. The objective of the current study was to assess the validity of a CAB dataset using a government dataset at the provincial scale.
A ground-truthed dataset provided by the government of Newfoundland and Labrador (NL) was used to assess a popular commercial dataset. Concordance, sensitivity, positive-predictive value (PPV) and geocoding errors were calculated. Measures were stratified by store types and rurality to investigate any association between these variables and database accuracy.
The current analysis used store-level (ecological) data.
Of 1125 stores, there were 380 stores that existed in both datasets and were considered true-positive stores. The mean positional error between a ground-truthed and test point was 17·72 km. When compared with the provincial dataset of businesses, grocery stores had the greatest agreement, sensitivity = 0·64, PPV = 0·60 and concordance = 0·45. Gas stations had the least agreement, sensitivity = 0·26, PPV = 0·32 and concordance = 0·17. Only 4 % of commercial data points in rural areas matched every criterion examined.
The commercial dataset exhibits a low level of agreement with the ground-truthed provincial data. Particularly retailers in rural areas or belonging to the gas station category suffered from misclassification and/or geocoding errors. Taken together, the commercial dataset is differentially representative of the ground-truthed reality based on store-type and rurality/urbanity.
Biagioniite, ideally Tl2SbS2, is a new mineral from the Hemlo gold deposit, Marathon, Ontario, Canada. It occurs as very rare anhedral crystals up to 65 μm across associated with aurostibite, stibarsen and native gold in a calcite matrix. Biagioniite is opaque with a metallic lustre and shows a black streak. In reflected light biagioniite is moderately bireflectant and not pleochroic. Under crossed polars it is weakly anisotropic with blueish to light-blue rotation tints. Internal reflections are absent.
Reflectance percentages for the four standard wavelengths (Rmin and Rmax) are 35.9 and 37.5 (471.1 nm); 34.7 and 36.2 (548.3 nm); 33.8 and 35.3 (586.6 nm); and 31.5 and 33.7 (652.3 nm), respectively. A mean of four electron microprobe analyses gave: Tl 65.12(31), Ag 3.52(9), Sb 20.22(12), S 10.80(8), total 99.66 wt.%, corresponding, on the basis of a total of 5 atoms, to (Tl1.87Ag0.19)Σ2.06Sb0.97S1.97. Biagioniite is monoclinic, space group Pc, with a = 11.0895(9), b = 14.3124(11), c = 7.9352(6) Å, β = 96.230(8)°, V = 1252.02(17) Å3 and Z = 8. The four strongest powder-diffraction lines [d in Å (I/I0) (hkl)] are: 3.56 (100) (310); 3.37 (75) (
31); 3.79 (60) (012); 3.03 (60) (032). In the crystal structure [R1 = 0.024 for 2655 reflections with I > 2σ(I)], thallium adopts various coordinations extending from quasi-linear to quasi-tetrahedral. Antimony forms Sb–Sb pairs, which lead to the formula [Tl+1]4[Sb2]4+[S2–]4. Biagioniite is isostructural with dervillite, Ag2AsS2. The new mineral has been approved by the International Mineralogical Association Commission on New Minerals, Nomenclature and Classification (IMA2019–120) and named for Cristian Biagioni, Associate Professor of Mineralogy at the Department of Earth Sciences of the University of Pisa, Italy.
To examine the relationship between household food insecurity (FI) and children’s involvement in family meal choices and food preparation, used as proxies for children’s food skills, and to explore gender differences within these associations.
Households were classified as food-secure or food-insecure using the six-item, short-form Household Food Security Survey Module. Children’s involvement in family meal choices and food preparation were treated as proxies for children’s food skills. Mixed-effects multinomial logistic regression models were used.
Public schools in Nova Scotia, Canada.
5244 children in the fifth grade (10–11 years old) participating in the Children’s Lifestyle and School Performance Study (CLASS).
Most children reported being involved in family meal choices or food preparation at least weekly (74 and 68 %). The likelihood of helping choose family meals once a week was 33 % lower among girls from food-insecure households compared to girls from food-secure households. No differences in boys’ involvement in family meal choices were observed according to household FI status. Boys from food-insecure households were 65 % more likely than boys from food-secure households to assist with food preparation/cooking four times per week. No differences in girls’ involvement in food preparation were observed according to household FI status.
Findings support that household FI is not due to a lack of food skills but most likely due to inadequate access to resources. This supports the call for upstream policies targeting the structural issues underpinning household FI such as low income.
The War on Drugs failed and public opinion is turning against punishing marijuana users in much of the world and within the US. Individual states have become the “laboratories of democracy”, beginning with California’s legalization of medical marijuana in 1996. Latin American countries have become less likely to accept US military assistance to combat drug production. Portugal decriminalized all drugs in 2001 without experiencing increased rates of use and Uruguay legalized marijuana in 2013. In 2016 the UN declared the War on Drugs a failure while calling for “an end to the criminalization and incarceration of users….” In 2011 the California Medical Association (CMA) proposed a regulated legal marijuana market and the California Society of Addiction Medicine (CSAM) proposed a public health framework emphasizing directing tax revenue to services for adolescent substance users. Colorado and Washington state legalized marijuana in 2012, Oregon in 2014 and California in 2016. Implementation of the new industry is currently having difficulty suppressing the previously existing underground market. It still remains to be seen whether a legal marijuana industry that pays for whatever damage its products produce in vulnerable populations can successfully replace an illegal market already in place for years.
Volcanic rocks from the Davis Strait were studied to elucidate the tectonomagmatic processes during rifting and the start of seafloor spreading, and the formation of the Ungava transform zone between Canada and Greenland. The rocks are from the wells Hekja O-71, Gjoa G-37, Nukik-2 and Hellefisk-1, and from dredges on the northern Davis Strait High. Ages range from Danian to Thanetian (dinocyst palynozones P2 to P5, 62.5–57.2 Ma). The rocks are predominantly basaltic, but include picrites on the Davis Strait High. Calculated mantle potential temperatures for the Davis Strait High are c. 1500°C, suggesting the volume of magma generated was large; this is consistent with geophysical evidence for magmatic underplating in the region. The rare earth element patterns indicate residual mantle lithologies of spinel peridotite and, together with Sr–Nd isotopes, indicate melting beneath regionally extensive, depleted asthenosphere beneath a lithosphere of thickness similar to, or thinner than, beneath Baffin Island and distinctly thinner than beneath West Greenland. Some sites include basalts with more enriched compositions. Depleted and enriched basalts in the Hellefisk well show contemporaneous melting of depleted and enriched mantle components in the asthenosphere. The Hekja and Davis Strait High basalts and picrites have unique, ultradepleted compositions with (La/Sm)N < 0.5, (Tb/Lu)N < 1 and Nb/Zr = 0.013–0.027. We interpret these compositions as a product of the melting regime within the Ungava transform zone, where the melting column would be steep-sided in cross-section and not triangular as expected at normal spreading ridges. Magmatism along the transform stopped when the tectonic regime changed from transtension to transpression during earliest Eocene time.
Many nations have developed policies and enforced legal approaches for addressing the needs of species at risk of extinction. Generally, however, conservation reliance is not acknowledged legally and is therefore ignored. Increasingly, legal approaches reflect the importance of (1) values in addition to hunting and fishing, (2) wildlife as a shared resource, (3) intrinsic rather than instrumental value, (4) helping species to become self-sustaining, and (5) long-term support for imperiled species. The International Union for the Conservation of Naturehas provided an international standard for recognizing species status. In the United States, the Endangered Species Act and National Environmental Policy Act provide a legal framework for species conservation that has been effective (although these acts have also spawned many legal challenges that have consumed the time and resources of stakeholders). The effectiveness of imperiled species laws depends on funding that can vary, leading to varying implementation and enforcement. Conservation reliance is seldom addressed explicitly. Responsibility for implementation may be spread across national, state or province, and more local entities.
This chapter documents how British writer, Sir Thomas Henry Hall Caine used the Berne Convention to popularise authors’ rights on a speaking tour of Canada in 1895 (where on behalf of the Society of Authors, British Parliament and American publishers he was tasked with preventing Canada’s effective withdrawal from the Berne Convention). Caine’s efforts demonstrate how the tension between the utopian idea of copyright as a natural right and the political pragmatism that Ricketson identified as underpinning the Berne Convention 1886 played out in practice. This history helps us understand how the idea of a universal right of authors continues to influence the public imagination as the main rationale for copyright.
Artificial intelligence (AI) is a widely discussed topic in many fields including law. Legal studies scholars, particularly in the domain of technology and internet law, have expressed their hopes and concerns regarding AI. This project aims to study how Canada's courts have referred to AI, given the importance of the reasonings of justices to the policy makers who determine society's rules for the usage of AI in the future. Decisions from all levels of both Canada's provincial and federal courts are used as the data sources for this research. The findings indicate that there are four legal contexts in which AI has been referred to in the Canadian caselaw including: legal research, investment tax credits, trademarks and access to government records. In this article the authors use these findings to make suggestions for legal information management professionals on how to develop collections and reference services that are in line with the new information needs of their users regarding AI and the rule of law.
Comparing three of the major hydroelectric power-producing countries during the war – Canada, the United States, and Germany – this article considers the implications of expanding hydroelectricity for war production and strategy, and how wartime decisions structured the longer-term evolution of large technological systems. Despite different starting points, all three countries pursued similar strategies in attempting to mobilize hydroelectricity for the war effort. The different access to and use of hydro in these states produced a vital economic and ultimately military advantage or disadvantage. The global dimensions of hydroelectric development during the war, moreover, demonstrate that this conflict was a turning point in the history of electrification.
The regionalization of the Canadian party system is a topic that has occupied Canadian scholars for decades. While there have undoubtedly been periods of significant regionalization (for example, the 1990s) and while these periods have been well documented, there has been very little systematic study of regionalization/nationalization in the Canadian party system. We address this gap by exploring nationalization of the Canadian party system from 1867 to 2015. To do so, we apply two measures. First, we consider how nationalized party competition is by exploring the extent to which parties compete in districts across the entire country. Second, we compliment this approach by applying the Gini coefficient to vote shares, revealing the extent to which Canadian parties have (un)even electoral support from province to province. In doing so, we explore not only the system as a whole but individual parties as well.
Primary care physicians are in a position to recognize sexuality as a core component of health. Data examining the sexual behaviours of Canadians over the age of 50 and the role of primary care in this domain is lacking. A cross-sectional survey was administered to patients over the age of 50, which assessed the importance of sexual activity, problems, and preferences in discussing sexual health with their primary care providers. A total of 39 per cent of patients indicated ongoing sexual activity and 52% of male participants reported current sexual activity compared with 25 per cent of females (p < 0.01). More males reported sexual activity as important than did females (69% vs. 45%, p < 0.01). Participants identifying sexual health concerns discussed physical dysfunctions more than emotional, social, or global health concerns (p < 0.01). More male participants discussed sexual health concerns with their family physician than did females (p < 0.01). The results of our study indicate that many individuals over the age of 50 continue to be sexually active, and that physical and non-physical concerns directly impact participation in sexual activity.
This Article focuses on the overlap and interaction between the doctrine of proportionality and the doctrines used to assess the constitutionality of state violations of the right to equality. The Article has three main contributions to comparative constitutional literature. First, the Article pinpoints the difficulty that arises when courts try to apply the doctrine of proportionality on claimed violations of the right to equality. Analytically, as shown in this Article, the overlap and interaction between these two doctrines is problematic because they are both relational measures between means and ends. Second, this Article categorizes two models adopted by courts in the application of proportionality in the context of the violation of the right to equality. Third, this Article points out that the choice of the model used by each court is relevant to the ongoing discourse on the advantages and disadvantages of proportionality.
Geneviève Cartier introduces cities ‘as both subjects and agents on the international stage’. Traditionally seen as creatures of domestic law alone, cities are increasingly actively engaged in what is sometimes called ‘local foreign policy’. The legal boundary crossings implicated in such local/foreign action require a form of ‘normative mediation’ between the different fields of law involved: local government, constitutional, and international. She develops a double-facing conception of administrative law in which these boundaries do not disappear but are revealed to be ‘more porous than is usually assumed’. The resulting processes of normative travel and transfer, as in several of the other double-facing analyses in this volume, go in two directions. External norms and practices affect the content of domestic understandings of city power, while cities rely on their traditional status in domestic law to shape their actions on the international stage.