Canadian National Research Articles

81 mRNA COVID-19 vaccine safety among children and adolescents from the Canadian National Vaccine Safety Network

Abstract Background The Canadian National Vaccine Safety Network (CANVAS) expanded its active safety surveillance for COVID-19 vaccines among children and adolescents during the COVID-19 pandemic. Objectives This analysis aimed to determine whether the first or second dose of mRNA COVID-19 vaccination is associated with health events in children and adolescents. Design/Methods Adolescents 15-19 years of age or parents/guardians of children 5-14 years of age were recruited from seven Canadian provinces/territories and followed for the occurrence of health events seven days after doses 1 and 2 or for a seven-day period for unvaccinated participants. The primary outcome was a health event that prevented daily activities, resulted in school absenteeism, and/or required a medical consultation, including emergency department visits or hospitalization. Aged-stratified multivariable logistic regression examined health events associated with mRNA COVID-19 vaccines (BNT162b2, mRNA1273, and mixed [different products for doses 1 and 2]) for children aged 5 to 11 years and adolescents aged 12 to 19 years. Results Between January 2021 and February 2023, a total of 249,418 (Children BNT162b2: 205,744, mRNA-1273: 36, and Adolescent BNT162b2: 39,628, mRNA-1273: 4,010) completed the first dose survey and 128,599 (Children BNT162b2: 109,625, mRNA-1273: 3, mixed: 235, and Adolescent BNT162b2: 17,202, mRNA-1273: 1,155, mixed: 474) had completed the second dose survey. A total of 668 unvaccinated participants (Children 431 and Adolescent 237) completed the control survey. In the week following dose 1, health event rates among vaccinated children and adolescents were <4% and lower than in unvaccinated counterparts (6.9%), and neither BNT162b2 nor mRNA-1273 were associated with health events in either age group. Following dose 2, among vaccinated adolescents health events rates (BNT162b2 4.6%, mRNA-1273 8.5%, mixed 10.4%) were higher than unvaccinated adolescents (3.4%), but were self-limiting and resolved within 7 days. Among children, there was no difference in health event rates between vaccinated and unvaccinated groups. Conclusion For children, mRNA COVID-19 vaccines were not associated with health events preventing daily activities, resulting in school absenteeism and/or requiring medical consultation. Similar to vaccinated adults our findings found vaccinated adolescents reported higher rates of health events after dose 2 mRNA COVID-19 vaccines, but these were self-limiting and resolved quickly. Our findings can be used to inform adolescents and their parents of what to expect following COVID-19 vaccination.

Canadian National Pancreas Conference 2023: A Review of Multidisciplinary Engagement in Pancreatic Cancer Care.

Pancreatic cancer is a complex malignancy associated with poor prognosis and high symptom burden. Optimal patient care relies on the integration of various sectors in the healthcare field as well as innovation through research. The Canadian National Pancreas Conference (NPC) was co-organized and hosted by Craig's Cause Pancreatic Cancer Society and The Royal College of Physicians and Surgeons in November 2023 in Montreal, Canada. The conference sought to bridge the gap between Canadian healthcare providers and researchers who share the common goal of improving the prognosis, quality of life, and survival for patients with pancreatic cancer. The accredited event featured discussion topics including diagnosis and screening, value-based and palliative care, pancreatic enzyme replacement therapy, cancer-reducing treatment, and an overview of the current management landscape. The present article reviews the NPC sessions and discusses the presented content with respect to the current literature.

How liberalism accommodates far-right social movements: on “mainstreaming” and the need for critical theory in far-right studies

Abstract Scholarship on social movements, racism, and nationalism increasingly falls under the purview of “extremism studies” and its subfield “far-right studies.” Prominent extremism scholars have developed generalist theories purportedly explaining far-right politics and power dynamics (or “mainstreaming”) across liberal societies. They define “far-right” as “illiberal” politics promoting dehumanization, exclusion, and inequality. Their theory of mainstreaming suggests that “the” far-right is a coherent entity that “enters” mainstream institutions or discourse from the outside. For these scholars, strengthening liberal-civic principles prevents far-right political power (mainstreaming). I call these approaches “grand theory templates,” which I critique for simplistic interpretations of power and for overlooking critical theory scholarship showing how liberalism accommodates far-right politics. Using the Canadian nationalist movement as a case study, I show how liberal chauvinism can be crucial to empowering right-wing populist movements. My data include over 40 hours of participant-observation at 20 right-wing events and 35 interviews with 42 current leaders and members of on-the-ground nationalist groups. Right-wing nationalists foregrounded liberal-civic ideas, such as “security,” “rights,” “objectivity,” and “tolerance,” to advance anti-Muslim sentiment and populist conspiracism. My findings suggest that far-right movements can gain power by embracing liberalism’s ambiguity and contradictions. In other words, mastering liberal messaging can be essential to the growth of far-right movements, challenging any easy dismissal of these politics as “illiberal.” Altogether, “top–down” grand theory templates oversimplify political distinctions and power, compromising research design and analysis. I advocate for more granular and “bottom–up” inductive approaches that prioritize sociological traditions over theories recently popularized by extremism scholars.

8749 Skeletal effects among pre and postmenopausal women with hypoparathyroidism (HypoPT); data from the Canadian National Hypoparathyroidism Registry (CNHR)

Abstract Disclosure: H. AbuAlrob: None. S. Hussein: None. H. Afifi: None. D.S. Ali: None. A. Almoulia: None. D. Bole: None. M. Braga: None. P. Chandra: None. A. Cheng: None. R. Cheung: None. J.E. Young: None. J. Hetal: None. S. Khan: None. T.S. Khan: None. J. Malhem: None. H. Malik: None. S. Mehmood: None. A. Millar: None. E. Morgante: None. F. Naveed: None. H. Niazi: None. T.L. Paul: None. A. Prebtani: None. Z. Punthakee: None. J.A. Shaban: None. R. Shah: None. M. Shrayyef: None. M. Shaikh: None. C. Tagra: None. S.R. Teschke: None. I.T. Tauqir: None. S. Van Uum: None. W. Robert: None. M. Ovize: Employee; Self; Amolyt. A.A. Khan: Research Investigator; Self; Amolyt, Ascend Therapeutics (A Besins Healthcare company), Takeda. Introduction: the CNHR registry was established in 2014 with the objectives of identifying the etiology, presentation, natural history and current treatment of hypoPT[1]. Methods: 101 patients with hypoPT were included in this prospective study. Patients completed baseline assessments including 3 site bone mineral density (BMD), trabecular bone score (TBS), fracture risk assessments, and bone biomarkers. Baseline data is presented. Results: A total of 101 participants were enrolled, 83 (82%) were female, and 18 (18%) were male. There were 35 (42%) premenopausal females and 48 (58%) postmenopausal females (PMF). Only PMF were on antiresorptive therapy. Seven (7/8) were on bisphosphonate therapy (i.e., alendronate), and 3 females were on denosumab. Among premenopausal females the average corrected calcium (Ca) was 2.03 mmol/L (SD=0.26), calcium phosphate product (Ca PO4) was 2.75 (SD=0.62), and the eGFR 94.63 mL/min (SD=18.08). The average bone turnover markers among premenopausal women for the Telopeptide-C (CTX) was 242.4 ng/L (SD=209.4) (CTX within the reference range (WRR) 136-689 ng/L) while the Propeptide 1 Collagen (P1NP) was 37.6 ug/L (SD=39.2) (P1NP WRR 19-83 ug/L). Among PMF, the average corrected Ca was 2.22 mmol/L (SD=0.18), Ca PO4 was 2.14 (SD=0.17), and the eGFR 73.9 mL/min (SD=23.0). The average bone turnover markers among PMF for CTX was 346.1 ng/L (SD=488.4) (WRR 177-1015 ng/L) while P1NP was 47.1 ug/L (SD=33.1) (WRR 16-98 ug/L). Among premenopausal women (n=35), the mean total hip Z-score was 0.87 (SD=1.29), L1-L4 Z-score 0.98 (SD=1.19), FN Z-score 0.59(SD=1.17), and 1/3R Z-score -0.04 (SD=0.77). Among PMF (n=48) the mean total hip T-score was -0.20 (SD=1.65), L1-L4 T-score -0.24 (SD=1.88), FN T-score -0.43(SD=1.59), and 1/3R T-score -0.94(SD=1.23).TBS scores in premenopausal women were normal (TBS=1.41 (SD=0.10)) however the TBS was partially degraded among PMF (TBS= 1.28(SD=0.15)). Fracture data has previously been reported3. Conclusion: The effects of hypoPT on bone strength needs further study2. Our data suggests that bone quality maybe impaired in PMF with hypoPT as noted by the presence of degraded TBS scores and the presence of fragility fracture in this population. Reference 1.Khan AA et al Canadian national hypoparathyroidism registry: an overview of hypoparathyroidism in Canada. Endocrine 2021. 2.Khan AA et al JBMR 2022 Evaluation and Management of Hypoparathyroidism Summary Statement and Guidelines from the Second International Workshop3.Hussein S et al. Skeletal effects of hypoparathyroidism (HypoPT); data from the Canadian National Hypoparathyroidism Registry (CNHR). Available here: https://amolytpharma.com/wp-content/uploads/2023/10/ASBMR-CNHR_FINAL.pdf Presentation: 6/2/2024

Virtual/Mobile Overdose Response in Canada: A Social Return on Investment Analysis

The overdose epidemic continues to be one of the leading causes of death in North America and continues to contribute to high healthcare costs. While harm reduction initiatives have significantly reduced the aforementioned costs, there is a dearth of evidence regarding overdose response hotlines and applications. We aim to evaluate the social return on investment (SROI) from a payer perspective of one such overdose response hotline, Canada's National Overdose Response Service, and its implications for service users, service operators, the Canadian healthcare system, and program funders. Outcome variables determined from theory of change models were developed in consultation with the aforementioned vested interest groups. Proxy values were attributed to each variable identified through values present within existing literature and databases. These values were then compared to operational costs accounting for deadweight, attribution, and displacement to determine a final SROI ratio. A discount rate was then applied based on the influence of risk on the outcome achieved. The ratio illustrating the value created for all stakeholders, resulting from the $1,592,00 investment made over two years, is $15.84 per single dollar invested. The value generated stems primarily from overdose prevention, mental health support, staff employment, reductions in emergency service utilization, service referrals, and volunteer well-being, which outweigh costs including operational funding, work-related stressors, compassion fatigue, and false calls. The results of our study demonstrate that the National Overdose Response Service provides a social value that far outweighs the costs attributed to the program's operation.

The Need for Decolonized Education: A Textual Analysis of Existing Literature in the Public Domain in Support of the Canadian National Inquiry Documents Calls for Education

The significance of this study sits in the importance of restorying for decolonial education. The textual analysis of literature in public domain in support of the Canadian national inquiry documents (2015, Truth and Reconciliation Calls (TRC) and the Murdered and Missing Indigenous Women and Girls (MMIWG) Calls, 2019) highlighted the magnitude of story to curriculum and Indigenous culture. Barriers included contemporary issues in mainstream schooling. The prominence of culture within the interconnected relationship with land-based learning in curriculum development and programming for wellness/well-being on Turtle Island (North America) are paramount. The present-day state of affairs in the mainstream educational Canadian landscape is not aligned with Indigenous appropriate methodologies and culture as a subjective measure and therefore falls short. Cultural, societal and land-linked factors must be considered as indicators.

Accessibility and usability of self-serve kiosks for blind and partially sighted Canadians

BACKGROUND: Approximately 7.4% of Canadians over the age of 15 report being blind or partially sighted; this impacts their daily functioning in public spaces [1]. Technological advances have included the proliferation of self-serve kiosk in many consumer settings. However, absent from discussions of community accessibility is the experiences of Canadians who are blind or partially sighted. OBJECTIVE: To better understand the experiences of this population with self-serve kiosks. METHODS: A descriptive cross-sectional study design was used to analyze survey data collected as part of a survey by Canadian National Institute for the Blind (CNIB) of people who are blind, Deafblind partially sighted about their use of self-serve kiosks. 731 participants were surveyed, representing a response rate of 3.5% across Canada. RESULTS: 64.14% of participants faced barriers in completing a task using self-serve technology. Human assistance was required to complete the tasks in most instances. 65.74% of participants reported they did not enjoy using self-serve kiosks and 60.90% of participants reported they would not continue to use self-serve kiosks in the future. CONCLUSIONS: The findings highlight a need to promote accessibility in the creation and implementation of self-serve kiosks in order to further their use and decrease exclusion of people who are blind and partially sighted.

Impact of recruitment strategies on individual participation practices in the Canadian National Vaccine Safety Network: prospective cohort study.

The Canadian National Vaccine Safety (CANVAS) network conducted a multi-center, prospective vaccine safety study to collect safety data after dose 1 and 2 of COVID-19 vaccines and follow up safety information 7 months after dose 1. This study aimed to describe and evaluate the recruitment methods used by CANVAS and the retention of participants by each modality. CANVAS deployed a multi-pronged recruitment approach to reach a larger sample, without in-person recruitment. Three primary recruitment strategies were used: passive recruitment, technology-assisted electronic invitation through the vaccine booking system (auto-invitation), or auto-registration through the vaccine registries (auto-enrollment). Between December 2020 and April 2022, approximately 1.3 million vaccinated adults either self-enrolled or were auto-enrolled in CANVAS, representing about 5% of the vaccinated adult Canadian population. Approximately 1 million participants were auto-enrolled, 300,000 were recruited by auto-invitation, and 5,000 via passive recruitment. Overall survey completion rates for dose 1, dose 2 and the 7-month follow-up surveys were 51.7% (681,198 of 1,318,838), 54.3% (369,552 of 681,198), and 66.4% (452,076 of 681,198), respectively. Completion rates were lower among auto-enrolled participants compared to passively recruited or auto-invited participants who self-enrolled. However, auto-enrolled samples were much larger, which offset the lower completion rates. Our data suggest that auto-enrollment provided an opportunity to reach and retain a larger number of individuals in the study compared to other recruitment modalities.

Using in situ measurements of δ13C in methane to investigate methane emissions from the western Canada sedimentary basin

During COP26, Canada joined the Global Methane Pledge aiming to reduce global methane (CH4) emissions by 30% below 2020 levels by 2030. Rapid reduction of anthropogenic CH4 emissions in the atmosphere is considered one of the most effective strategies to slow global warming in concert with carbon dioxide mitigation measures. In Canada, a large part of anthropogenic CH4 emissions can be attributed to the oil and gas industry in the Western Canada Sedimentary Basin (WCSB), which is the fourth largest reserve of fossil fuel in the world. Recent studies highlighted big discrepancies between CH4 emissions reported in Canada's National Inventory and emissions estimated with approaches using atmospheric measurements for the oil and gas sector. Measuring the isotopic signature of CH4 (δ13CH4) at different atmospheric monitoring stations and comparing these measurements to detailed archives of δ13CH4 from oil and gas wells and associated CH4 leaks in the WCSB could help better characterize the emissions from different CH4 sources over the region. In this study, we compare two independent sets of data: (1) thousands of δ13CH4 of samples from oil and gas production wells and their associated leaks (surface casing vents and ground migration) collected across the WCSB, and (2) atmospheric mixing ratios of CH4 and their δ13CH4 measured successively at three locations across this region between 2016 and 2020 combined with their atmospheric footprints modeled with HYSPLIT-STILT. We observed a gradient in the isotopic signatures of the oil and gas samples within the WCSB with δ13CH4 being more depleted in the Southeast than in the Northwest. The analysis of these samples showed that the isotopic signature of CH4 emitted by the production of fossil fuel depends on the geological formations from which it is extracted. Also, CH4 isotopic signatures vary more depending on the region where CH4 comes from than on the type of fossil fuel extracted (natural gas, oil, heavy oil, shale gas). The atmospheric measurements showed a strong seasonality of δ13CH4 at one of the atmospheric monitoring sites with isotopic signatures associated with thermogenic sources in winter and isotopic signatures associated with a mix of biogenic and thermogenic sources in summer. Using the δ13CH4 archive database from oil and gas samples, we estimated that 28–39 % of the CH4 emitted near this site in summer was coming from a biogenic source (most likely wetlands). Ultimately, atmospheric measurements collected during winter combined with their associated HYSPLIT-STILT footprints presented a spatial distribution of δ13CH4 over the WCSB comparable to the one observed in the archive database from the oil and gas sector, confirming that the oil and gas sector is the main source of CH4 in this region.

Towards a Canadian National River Water Quality-Modelling System: State of Science and Future Prospects

Water quality is of significant concern and ultimately critical to every Canadian’s quality of life and security. Canada has diverse and vast landscapes and stressors that impact various waterbodies differentially, with influencing factors including contaminant and nutrient loads from human activity (mining effluent, wastewater, agricultural runoff, plastics), landscape change (wetland drainage, urbanization) and climate change (warming water temperatures, longer open water seasons, extreme hydrological events, intensifying wildfires). Canadian rivers are especially important to the overall biogeochemistry, hydrology, biodiversity, and ultimate health of aquatic and terrestrial ecosystems. While each of Canada’s provinces and territories has extensive river water quality (physical, chemical, biotic) data and monitoring programs, Environment and Climate Change Canada coordinates various national programs that contribute to the collection and consolidation of these data and conducts extensive research into the study and modelling of key river water quality processes. Despite program-specific efforts, there remains poor capacity to predict current and future conditions in monitored and unmonitored Canadian rivers, particularly remote or northern rivers, due to a myriad of factors including lack of coordination amongst groups and examination of areas in which modelling efforts might be integrated. Herein, we review and analyse the current state of data availability, process studies, and modelling systems for Canadian river water quality. Our synthesis reveals that specific physical processes (water temperature, ice formation, permafrost thaw, sediment dynamics), biogeochemical processes (dissolved oxygen, dissolved organic matter, nutrient cycling, metals/contaminants) and ecological/biological features (biota mass, functional indicators) are well understood, though complex, and are amenable to empirical or mechanistic modelling. Review of this information assists us in identifying opportunities and challenges for developing a national water quality modelling system (NWQMS), that would eventually include similar modelling activities for parallel processes in lakes and integrated watersheds. We identify needs for stronger coordination of monitoring programs in remote areas, recommend use of novel remote sensing technologies, and development of a flexible, iterative ‘process’ for integrated modelling to which stakeholders beyond government can contribute. Such a platform would support short and long-term predictive models of Canadian water quality and ecosystem health, inform effluent concentration limits, and be an early warning system for source waters.

Canadian national sport organisations’ eating disorder-related policies and practice guidelines: a summative content analysis

ABSTRACT Athletes are at significant risk of developing eating disorders (EDs). To address EDs in sport, policies can support the prevention, management, and return to sport following EDs. Although Canadian National Sport Organisations (NSOs) must comply with a universal code of conduct to address maltreatment in sport, there may be a need for additional policies and guidelines to address EDs. The purpose of this study was to examine the scope and content of ED-related policies and practice guidelines within Canadian NSOs. We searched all publicly available policy and guideline documents from Canada’s 64 NSOs and screened them for keywords related to disordered eating, body image, nutrition, diet, and exercise, yielding 98 policies and 39 guidelines. We conducted a summative content analysis to examine the contextual use of our keywords and the sociocultural implications of such use. No NSO had specific policy or practice guidelines addressing EDs. Policies described body shaming-related maltreatment using standard language from the universal code of conduct. Within guidelines, ED-related topics were discussed in relation to mental health, athlete development, nutrition, coaching female athletes, positive body image, and weight management. Comparing content within policies and guidelines revealed a lack of coherence, wherein policies outlined ‘what not to do’ but guidelines did not provide adequate guidance on ‘what to do’, drawing instead on weight-normative and gendered discourse to address ED topics. This study provides insight into the current state of systemic (in)action surrounding EDs in Canadian sport and serves as a preliminary step towards the development of ED policy.

Quantification of Methane Emissions from Cold Heavy Oil Production with Sand Extraction in Alberta and Saskatchewan, Canada.

Cold heavy oil production with sand (CHOPS) is an extraction process for heavy oil in Canada, with the potential to lead to higher CH4 venting than conventional oil sites, that have not been adequately characterized. In order to quantify CH4 emissions from CHOPS activities, a focused aerial measurement campaign was conducted in the Canadian provinces of Alberta and Saskatchewan in June 2018. Total CH4 emissions from each of 10 clusters of CHOPS wells (containing 22-167 well sites per cluster) were derived using a mass balance computation algorithm that uses in situ wind data measurement on board aircraft. Results show that there is no statistically significant difference in CH4 emissions from CHOPS wells between the two provinces. Cluster-aggregated emission factors (EF) were determined using correspondingly aggregated production volumes. The average CH4 EF was 70.4 ± 36.9 kg/m3 produced oil for the Alberta wells and 55.1 ± 13.7 kg/m3 produced oil for the Saskatchewan wells. Using these EF and heavy oil production volumes reported to provincial regulators, the annual CH4 emissions from CHOPS were estimated to be 121% larger than CHOPS emissions extracted from Canada's National Inventory Report (NIR) for Saskatchewan. The EF were found to be positively correlated with the percentage of nonpiped production volumes in each cluster, indicating higher emissions for nonpiped wells while suggesting an avenue for methane emission reductions. A comparison with recent measurements indicates relatively limited effectiveness of regulations for Saskatchewan compared to those in Alberta. The results of this study indicate the substantial contribution of CHOPS operations to the underreporting observed in the NIR and provide measurement-based EF that can be used to develop improved emissions inventories for this sector and mitigate CH4 emissions from CHOPS operations.

An Evaluation of the Sharing Dance Public School Program on Physical Literacy.

Introduction: Physical literacy (PL) is a multidimensional concept that includes the domains of movement competence, positive affect, social participation, and the confidence, motivation, and knowledge and understanding necessary for regular engagement in physical activity. The Sharing Dance Public School Program was created by Canada's National Ballet School specifically designed to promote PL through dance. The objective of this study was to evaluate the effectiveness of the program to improve PL in grade 4 to 6 children over the course of a school year. Methods: Children were initially recruited from two schools including an intervention and a control school. However, due to the COVID-19 pandemic, data collection was prematurely terminated which resulted in baseline and mid-point data from the intervention group only. As such, participants included 57 children (n = 28 females, Mage = 10.34 ± 0.85 years) that engaged in the dance program once per week for 50 minutes. Assessments of PL included a direct measure of movement competence (PLAYfun) and a self-report measure (survey) to assess the other domains of PL. Results: Significant improvements were found in movement competence. However, significant decreases were found for fun and enjoyment, confidence, and social participation. No changes were observed for knowledge and understanding or overall PL. Conclusions: Findings from the present study are encouraging as they provide initial evidence for the support of community-based PL programs, such as the Sharing Dance Public School Program, to help children develop their movement competence. Future research is needed to further evaluate the effectiveness of the Sharing Dance Public School Program over a school year, and when compared to a control group, as was initially intended.

Invasive group A streptococcal disease surveillance in Canada, 2021-2022.

Invasive group A streptococcal (iGAS, Streptococcus pyogenes) disease has been a nationally notifiable disease in Canada since 2000. This report summarizes the demographics, emm types, and antimicrobial resistance of iGAS isolates collected in Canada in 2021 and 2022. The Public Health Agency of Canada's National Microbiology Laboratory collaborates with provincial and territorial public health laboratories to conduct national surveillance of invasive S. pyogenes. Emm typing was performed using the Centers for Disease Control and Prevention emm sequencing protocol or extracted from whole-genome sequencing data. Antimicrobial susceptibilities were determined using Kirby-Bauer disk diffusion according to Clinical and Laboratory Standards Institute guidelines or predicted from whole-genome sequencing data based on the presence of resistance determinants. Overall, the incidence of iGAS disease in Canada was 5.56 cases per 100,000 population in 2021, decreasing from the peak of 8.6 cases per 100,000 population in 2018. A total of 2,630 iGAS isolates were collected during 2022, representing an increase from 2021 (n=2,179). In particular, there was a large increase in isolates collected from October to December 2022. The most predominant emm type overall in 2021 and 2022 was emm49, at 21.5% (n=468) and 16.9% (n=444), respectively, representing a significant increase in prevalence since 2018 (p<0.0001). The former most prevalent type, emm1, increased from 0.5% (n=10) in 2021 to 4.8% (n=125) in 2022; similarly, emm12 increased from 1.0% (n=22) in 2021 to 5.8% (n=151) in 2022. These two types together accounted for almost 25% of isolates collected in late 2022 (October to December). Antimicrobial resistance rates in 2021 and 2022 included: 14.9%/14.1% erythromycin resistance, 4.8%/3.0% clindamycin resistance, and <1% chloramphenicol resistance. The increase of iGAS isolates collected in Canada is an important public health concern. Continued surveillance of iGAS is critical to monitor expanding emm types and antimicrobial resistance patterns.

MRNA COVID-19 vaccine safety among older adults from the Canadian National Vaccine Safety Network

This study examined short-to-medium term safety of COVID-19 vaccines among adults aged ≥65 years using the Canadian National Vaccine Safety Network active safety surveillance data. Both vaccinated and unvaccinated older adult participants recruited from seven provinces and territories were included in the analysis. Safety was assessed at 7 days after COVID-19 vaccination (dose 1, 2 and 3), and 7 months after dose 1. Multivariable logistic regression was used to examine the association between BNT162b2/mRNA-1273 COVID-19 vaccines and two short-term health events: 1) health event preventing daily activities and/or required medical consultation, 2) serious health events resulting in an emergency department visit and/or hospitalization within 7 days following each dose. We also assessed the rates of serious health events for the period between dose 1 and 2, and 7-months following dose 1. Between December 2020 and February 2022, a total of 173,038, 104,452, and 13,970 older adults completed dose 1, dose 2, and dose 3 surveys, respectively. The control survey was completed by 2,955 unvaccinated older adults. Health events occurred more frequently among recipients after dose 2 homologous mRNA-1273 (adjusted odds ratio [95 % confidence interval]: 2.91 [2.24–3.79]) and dose two heterologous (BNT162b2 followed by mRNA-1273): 1.50 [1.12–2.02] compared to unvaccinated counterparts. There was no difference in event rates after any dose of BNT162b2 and unvaccinated participants. The rates of serious health events following COVID-19 vaccination were very low (≤0.3 %) across all vaccine products and doses, and were not higher compared to unvaccinated controls, and were not associated with an emergency department visit or hospitalization within 7 days following vaccination. Reported symptoms were self-limited and rarely required medical assessment. Our findings further strengthen the current evidence that mRNA COVID-19 vaccines are safe and can be used to inform older adults about expected adverse events following COVID-19 vaccination.

A Longitudinal Investigation of Lower-Risk Gambling Limits in the Canadian National Study.

Recent years have seen increased attention given to identifying and describing the levels of gambling participation that confer a risk of harm in order to generate public health advice regarding lower-risk gambling. However, most of the existing literature has failed to explicitly assess these limits in a prospective manner. The purpose of this study is to employ a methodology consistent with prior investigations to evaluate the level of gambling participation associated with an increased risk of future gambling-related harm. Using data from the Alberta Gambling Research Institute's National Project Online Panel Survey, risk ratios and Receiver Operating Characteristic (ROC) analyses were used to determine the relative risk of gambling-related harm associated with participating in a greater number of gambling formats, gambling more days per month, and spending a greater proportion of income gambling. Prospective lower-risk limits were largely consistent with those identified in previous cross-sectional analyses (e.g., no more than two gambling formats, no more than once a week), with the exception that higher limits were found for the percent of household income spent gambling (3.4-6.4% vs. 1%). We advise that future research on lower-risk gambling limits consider the use of more granular assessment instruments and prospective methods to more closely evaluate the association between gambling participation and gambling harm.

Competencies for proficiency in basic point-of-care ultrasound in anesthesiology: national expert recommendations using Delphi methodology.

Point-of-care ultrasound (POCUS) allows for rapid bedside assessment and guidance of patient care. Recently, POCUS was included as a mandatory component of Canadian anesthesiology training; however, there is no national consensus regarding the competencies to guide curriculum development. We therefore aimed to define national residency competencies for basic perioperative POCUS proficiency. We adopted a Delphi process to delineate relevant POCUS competencies whereby we circulated an online survey to academic anesthesiologists identified as POCUS leads/experts (n = 25) at all 17 Canadian anesthesiology residency programs. After reviewing a list of competencies derived from the Royal College of Physicians and Surgeons of Canada's National Curriculum, we asked participants to accept, refine, delete, or add competencies. Three rounds were completed between 2022 and 2023. We discarded items with < 50% agreement, revised those with 50-79% agreement based upon feedback provided, and maintained unrevised those items with ≥ 80% agreement. We initially identified and circulated (Round 1) 74 competencies across 19 clinical domains (e.g., basics of ultrasound [equipment, nomenclature, clinical governance, physics]; cardiac [left ventricle, right ventricle, valve assessment, pericardial effusion, intravascular volume status] and lung ultrasound anatomy, image acquisition, and image interpretation; and clinical applications [monitoring and serial assessments, persistent hypotension, respiratory distress, cardiac arrest]). After three Delphi rounds (and 100% response rate maintained), panellists ultimately agreed upon 75 competencies. Through national expert consensus, this study identified POCUS competencies suitable for curriculum development and assessment in perioperative anesthesiology. Next steps include designing and piloting a POCUS curriculum and assessment tool(s) based upon these nationally defined competencies.

The Effects of Concomitant Traumatic Brain Injury (TBI) on the Epidemiology of Spinal Cord Injury (SCI), Access to Treatment Services, and Outcomes After Acute Traumatic SCI: A Propensity-score Matched Cohort Study Using Data from a Canadian National Registry (P7-11.011)

The Effects of Concomitant Traumatic Brain Injury (TBI) on the Epidemiology of Spinal Cord Injury (SCI), Access to Treatment Services, and Outcomes After Acute Traumatic SCI: A Propensity-score Matched Cohort Study Using Data from a Canadian National Registry (P7-11.011)

Behavioural correlates of active transport among Canadian adults during the COVID-19 pandemic: The Canadian national active transportation Survey, 2021

IntroductionThis study examined the impact of COVID-19-related restrictions on the active transportation (AT) of Canadian adults and associated motivational determinants of such behaviour. Design and methods: A survey was conducted with 2,868 Canadian adults recruited as part of the Canadian National Active Transportation Survey, 2021 in November and December of 2021. Along with demographic information, questions assessed current physical activity (PA), changes in transportation modalities (i.e., AT, private vehicle, public transport, ride hailing) related to the pandemic, and beliefs about AT according to the capability, opportunity, motivation, behaviour (COM-B) model. A series of multinomial regressions were constructed to examine associations between shifts in AT and the COM-B components. ResultsA substantial proportion of Canadian adults reported engaging in less AT for work (32.4%), school (30.8%), and community activities (29.9%) than prior to the onset of the COVID-19 pandemic. This was slightly less than reductions reported for use of private vehicles (31.8% to 36.3%), ride hailing services (35.5% to 37.6%), and public transportation (38.4% to 38.6%). Similarly, 36.4% reported less engagement in overall PA. The components of the COM-B model were associated with shifts in AT for work and community activities. In particular, physical opportunity (odds ratios ranging from 1.14 to 1.20), reflective motivation (odds ratios ranging from 1.11 to 1.25), and physical capability (odds ratios ranging from 1.11 to 1.25) were the only predictors of behaviour. ConclusionsIf Canadian adults were motivated, felt physically capable, and believed their environment offered opportunities for AT they were less likely to reduce their AT during the COVID-19 period. Thus, future investments in infrastructure to support AT should be accompanied by promotion campaigns to foster motivation and inform on safe opportunities for AT.

Proportional of wheezing events in asthmatic children post-vaccination of annual flu vaccine

Background: The common childhood chronic disease asthma causes hospitalisation and exacerbations due to respiratory tract viral infections like influenza. Due to uncertainty about the benefits and role of influenza vaccines in preventing asthma exacerbations, many children with asthma do not receive them, despite recommendations from organisations like the Canadian National Advisory Committee on Immunisation. There are two main types of influenza vaccines: intramuscular trivalent inactivated and intranasal cold-adapted, live attenuated. Both vaccines are highly immunogenic and induce an adequate immune response, but their clinical efficacy varies by season and age. Aim: The aim of this study was to investigate the occurrence of increased wheeze rates in stable asthmatic children who received the annual flu vaccine, compared to a control group of asthmatic children who did not receive the vaccine. Methods: A retrospective study at the Queen Rania Abdullah for Children Hospital in Amman, Jordan, examined the vaccination status of 200 asthmatic children aged 3-14. The study focused on recurrent wheezing episodes and the minimum 12-month period between the last annual flu vaccination and asthmatic exacerbation. The study excluded uncontrolled or partially controlled patients for the past 12 months. Data was collected from demographic information, vaccination history, and past wheezing episodes. The children were divided into two groups, one without the flu vaccine and the other with the flu vaccine. A comprehensive questionnaire was used to assess sociodemographic and disease-related factors. If children received the vaccination as per the National Vaccination Schedule, their vaccination status was considered complete. Results: A study of 200 asthmatic children in Jordan found that 35% did not receive a flu vaccine, placing them in Group I. 65% had received a flu vaccine in the previous year. Males had higher distribution rates in both flu-based groups, with a statistically insignificant positive correlation. Age categories showed similar distribution rates, with 21.0% for 3-6 years, 34.0% for 6-9 years, 37.5% for 9-12 years, and 7.5% for 12-15 years. No significant correlation was found between receiving the flu vaccine and wheezing rates in the last seasonal year. Frequent wheezing episodes were higher in experienced groups than in naïve groups.