Impact Of Canada Research Articles

Jurisdictional imaginaries as contested geographies: A metaphor analysis of reference cases about Canada's Impact Assessment Act

Jurisdictional imaginaries, defined as constitutive and productive fictions with real world effects, serve a distinct purpose in the context of debates over Canadian environmental impact assessment. Metaphors are one way in which jurisdictional imaginaries are maintained and contested. In creating associations between entities, metaphors mark storytelling about jurisdiction with the imprints of history and place, and shape thinking about arrangements of authority within contested geographies. In Canadian reference cases (questions posed by governments to courts to seek advice on legislation), the judiciary settle conflicts over jurisdiction through case-by-case assessments based on interpretations of the Canadian constitution in which debates about federalism loom large. Our analysis of two reference cases on Canada's Impact Assessment Act (IAA) evidenced disagreements in court decisions about the scope and significance of provincial and federal authority, which hinged on metaphors of separation and conflict, and drew on two competing imaginaries: a classical imaginary which envisions dualist, hierarchical, and exclusionary orders of authority between provincial and federal governments; and a modern imaginary which emphasizes jurisdictional overlap and flexibility in constitutional interpretation. Reading these divergent imaginaries against a backdrop of legal pluralism and ongoing settler colonialism, we argue that both imaginaries normalize, rather than unsettle, colonial political logics predicated on the replacement of Indigenous sovereignty by European legal orders. The IAA reference cases, far from mere technical assessments of the constitutionality of legislation, highlight political questions about what kind of society Canada is and could become.

Association between non-medical cannabis legalization and alcohol sales: Quasi-experimental evidence from Canada

BackgroundThere is increasing interest in understanding the impact of non-medical cannabis legalization on use of other substances, especially alcohol. Evidence on whether cannabis is a substitute or complement for alcohol is both mixed and limited. This study provides the first quasi-experimental evidence on the impact of Canada’s legalization of non-medical cannabis on beer and spirits sales. MethodsWe used the interrupted time series design and monthly data on beer sales between January 2012 and February 2020 and spirits sales between January 2016 and February 2020 across Canada to investigate changes in beer and spirits sales following Canada’s cannabis legalization in October 2018. We examined changes in total sales, nationally and in individual provinces, as well as changes in sales of bottled, canned and kegged beer. ResultsCanada-wide beer sales fell by 96 hectoliters per 100,000 population (p=0.011) immediately after non-medical cannabis legalization and by 4 hectoliters per 100,000 population (p>0.05) each month thereafter for an average monthly reduction of 136 hectoliters per 100,000 population (p<0.001) post-legalization. However, the legalization was associated with no change in spirits sales. Beer sales reduced in all provinces except the Atlantic provinces. By beer type, the legalization was associated with declines in sales of canned and kegged beer but there was no reduction in sales of bottled beer. ConclusionsNon-medical cannabis legalization was associated with a decline in beer sales in Canada, suggesting substitution of non-medical cannabis for beer. However, there was no change in spirits sales following the legalization.

Software tools in energy management: utilization and impact in Canada, USA, and Africa

This research paper investigates the utilization and impact of software tools in energy management across diverse contexts, focusing on Canada, the USA, and Africa. The paper identifies common challenges, including interoperability and cybersecurity concerns, by examining key sectors such as industry, commercial and residential spaces, and renewable energy integration. The impact assessment reveals positive strides in sustainability, economic outcomes, and resilience. However, challenges persist, necessitating future directions such as technological advancements, standardization, and inclusive approaches. The paper concludes by emphasizing the dynamic nature of the journey towards optimized energy management and the crucial role of innovation, collaboration, and adaptability in shaping resilient, sustainable, and inclusive energy ecosystems in these regions.

Chronic sleep disturbance among adult Canadians: Associations and implications to the evaluation of noise impacts under Canada's Impact Assessment Act

The Canadian Perspectives on Environmental Noise Survey was completed online by 6647 randomly selected Canadians 18 years of age and older between April 12 and May 25, 2021. The survey objective was to explore attitudes, perceptions, and expectations toward environmental noise in rural and non-rural Canada. The questionnaire assessed self-reported high sleep disturbance (HSD) in the previous year, at home. The prevalence of HSD was 7.8% overall. A list of potential sources of sleep disturbance was provided to the full sample, where 6.1%, 5.2%, and 3.0% reported HSD by noisy neighbors, road traffic noise and indoor noise, respectively. Stress/anxiety or worrying about something was selected most frequently at 12.9%. Finally, 7.6% and 5.5% reported pain/illness and partner's sleep disturbance, respectively, as sources of HSD. Reported HSD was significantly higher among respondents below 55 years of age, females, lower income groups, unemployed respondents, those on paid leave (sick, maternity, disability), and living in an urban area. Expectations of quiet, perceiving nighttime noise to have increased over time, high noise sensitivity, hearing and being highly annoyed by road traffic noise was also associated with an increased prevalence of reporting HSD. In contrast to hearing impairment and heart disease (including high blood pressure); rated physical health, mental health, anxiety/depression, and reporting a sleep disorder, were associated with increased HSD. The perceived affects of the COVID-19 pandemic on health and annoyance toward environmental and indoor noise also influenced HSD. In the fully adjusted multivariate logistic regression model, the effect of age, gender, changes in nighttime noise, road traffic noise annoyance, noise sensitivity and sleep disorder remained statistically significant. The univariate and multivariate models showed a similar prevalence of HSD between Indigenous Peoples and non-Indigenous Canadians. Results are discussed in relation to the provision of advice on sleep and health under Canada's Impact Assessment Act.

Impact of Canada's cannabis legalisation on youth emergency department visits for cannabis-related disorders and poisoning in Ontario and Alberta, 2015-2019.

Although there is momentum towards legalising adult recreational cannabis use worldwide, the extent of youth cannabis-related harm associated with legalisation is still uncertain. The current study aimed to assess whether the initial implementation of Canada's cannabis legalisation (via the Cannabis Act) on 17 October 2018 might be associated with youth harm, as assessed by emergency department visits for cannabis-related disorders/poisoning. We used Ontario and Alberta, Canada emergency department data from 1 April 2015 to 31 December 2019. We identified all cannabis-related disorders/poisoning (ICD-10 CA: F12.X, T40.7) emergency department visits of youth (n= 13,615), defined as patients younger than the minimum legal cannabis sales age (18 years, Alberta; 19 years, Ontario). Seasonal Autoregressive Integrated Moving Average (SARIMA) models were employed to assess the impact of legalisation on weekly counts of cannabis-related harms. The final SARIMA intervention (step) parameter indicated a post-legalisation increase of 14.7 (95% confidence interval [CI] 5.0; 24.3, p < 0.01) weekly youth cannabis-related disorder/poisoning presentations to Ontario/Alberta emergency department settings, equivalent to an increase of 20.0% (95% CI 6.2%; 33.9%). There was no evidence of associations between cannabis legalisation and comparison series of youth alcohol, opioid or appendicitis emergency department episodes. Our findings require replication and extension but are consistent with the possibility that the implementation of the Cannabis Act was associated with an increase in youth cannabis-related presentations to Ontario/Alberta emergency departments.

Dene, métis and inuvialuit peoples’ voices on the impact of Canada’s perinatal transport and non-medical escort policy in their communities: an outcome assessment approach and narrative literature review

ABSTRACT Historically, there is a documented lack of support for women leaving their communities to give birth. Due to an over-emphasis on risk discourse (no distinction between low- or high-risk pregnancies with options to birth at home, the large geographical distances to regional centres within circumpolar regions, remoteness of communities, lack of qualified staff, and limited resources), women are forced to travel great distances to give birth. In Canada until 2017, women travelled alone or bore the burden of paying out of pocket for someone to travel with them for support with the births of their babies. A recent policy change has allowed for one paid escort to accompany a pregnant woman. The purpose of this paper is to provide an outcome assessment of the perinatal transport and non-medical escort policy implemented by the federal government in Canada. The paper utilises a narrative literature review along with preliminary Indigenous photovoice results to illuminate the perspectives of Indigenous families. There are numerous challenges women face when travelling for birth including feelings of loneliness and fear, stress and separation from their children, lack of community connection, financial concerns, and a loss of self-determination. Women are given an opportunity in decision-making about who will travel with them as an escort. This does little to address the disparity of delivering their babies away from their families and communities, the burden of figuring out who cares for the children at home, and the impact their absences have on health of their families. Although, additional support has been provided for birthing women in northern Canada, there continues to be little effort to return to community birthing creating safety for Indigenous families through traditional practices, Indigenous midwifery, and community ceremonies and changing the disproportionate burden of poor outcomes experienced by Indigenous women.

Annoyance toward transportation and construction noise in rural suburban and urban regions across Canada

The Canadian Perspectives on Environmental Noise Survey investigated expectations and attitudes toward environmental noise in rural/remote, suburban and urban regions across Canada. A 26-item online questionnaire was completed by 6647 randomly selected Canadians 18 years of age and older between April 12, 2021 and May 25, 2021. Stepwise multivariate logistic regression modelled the odds of reporting very or extreme (i.e., high) noise annoyance toward road traffic, aircraft/helicopter, trains and construction noise. Five variables were common to all noise sources; 1) reporting the living area as very quiet, calm and relaxing; 2) sleep disturbance in general; 3) sleep disturbance attributed to road traffic noise; 4) noise sensitivity; and 5) reporting worsened annoyance toward environmental noise due to the COVID-19 pandemic. Duration of residency, perceived changes in nighttime and daytime noise over time, expectations of quiet, other specific causes of sleep disturbance, hearing impairment, road traffic audibility, and the impact of the pandemic on physical health, mental health, stress and indoor noise annoyance, each impacted the odds of reporting high annoyance to some, but not all modelled sources. Gender, rated physical and mental health (in general), anxiety or depression, overall well-being, and Indigenous status did not enter any of the multivariate models. Results are discussed in relation to the provision of advice on noise under Canada's Impact Assessment Act.

The impact of Canada's Menthol Cigarette Ban on quitting among menthol smokers and projections of impact in the European Union: Findings from the ITC Project

The impact of Canada's Menthol Cigarette Ban on quitting among menthol smokers and projections of impact in the European Union: Findings from the ITC Project

The Right to Assisted Dying: Constitutional Jurisprudence and Its Impact in Canada, Germany and Austria

Abstract Many states are grappling with the regulation of assistance in suicide and ending the life of another upon their request. Initially punishable in most countries, a growing number of jurisdictions have now introduced permissive frameworks decriminalising, to varying degrees, rendering assistance in dying. Other countries, however, have proceeded with the criminal prohibition and several courts have upheld the lawfulness of the respective criminal laws during human rights and constitutional challenges. Yet, the Supreme Court of Canada in 2015, the German Federal Constitutional Court in February 2020 and the Austrian Constitutional Court in December 2020 have respectively declared unconstitutional and void national criminal laws prohibiting rendering assistance in dying. This article first outlines the criminal law framework relating to assisted dying in Canada, Germany and Austria. It subsequently analyses the judgments before pondering their impact on the legal landscape in the three countries. The article concludes that while the Canadian Supreme Court decision appears to have had a significant impact on the introduction of subsequent legislation in Canada, the effects of the Constitutional Courts’ judgments seem much more subdued in Germany and are yet to unfold in Austria.

Advancing undergraduate synthetic biology education: insights from a Canadian iGEM student perspective.

The last two decades have seen vigorous activity in synthetic biology research and the ever-increasing applications of these technologies. However, pedagogical research pertaining to teaching synthetic biology is scarce, especially when compared to other science and engineering disciplines. Within Canada, there are only three universities that offer synthetic biology programs, two of which are at the undergraduate level. Rather than taking place in formal academic settings, many Canadian undergraduate students are introduced to synthetic biology through participation in the annual International Genetically Engineered Machine (iGEM) competition. Although the iGEM competition has had a transformative impact on synthetic biology training in other nations, its impact in Canada has been relatively modest. Consequently, the iGEM competition remains a major setting for synthetic biology education in Canada. To promote further development of synthetic biology education, we surveyed undergraduate students from the Canadian iGEM design teams of 2019. We extracted insights from these data using qualitative analysis to provide recommendations for best teaching practices in synthetic biology undergraduate education, which we describe through our proposed Framework for Transdisciplinary Synthetic Biology Education (FTSBE).

Treatment Patterns and Health/Economic Outcomes in Relapsed/Refractory Follicular Lymphoma: A Real-World Study

Background:Indolent non-Hodgkin lymphoma (iNHL) is a hematologic malignancy characterized by slow progression. Follicular lymphoma (FL) is the most common subtype of iNHL. Although responses to first-line therapy can be high, patients with FL often relapse repeatedly. There are no guidelines for the treatment of relapsed/refractory (R/R) FL and the economic impact in Canada is unknown. The objective of this study was to evaluate treatment patterns, as well as health care resource utilization and costs, associated with the management of R/R FL in Canada.Methods:A retrospective medical chart review was conducted in 3 Canadian Oncology centers. Eligible patients were ≥18 years, diagnosed with FL, had received prior treatment with ≥2 systemic therapies, and were refractory to rituximab and an alkylating agent (administered together or in succession). Date of inclusion in this study was defined as the date of FL diagnosis. Index date was defined as the date at which the patient met all eligibility criteria. End of study was defined as death, loss to follow-up, or March 31, 2015, whichever came first. To ensure a sufficient follow-up period, index date had to predate January 1, 2014. Data collected included patient, disease, and treatment characteristics, as well as health care resource utilization. Treatments and outcomes were collected from date of inclusion until end of study. Health care resource utilization was collected from index date to end of the study. Canadian unit costs were obtained from the literature and government publications.Results:A total of 24 patients with FL met the study eligibility criteria at these centers. FL diagnosis was established between April 1990 and January 2012 and index date was reached between May 2001 and October 2013. The median age at index date was 64 years (range, 47-82) and 62.5% were female. Most patients (83.4%) had a stage III or IV FL at index date. The median time from FL diagnosis to index date was 6.0 years (0.8-22.3) and the median time from index date to end of study was 2.6 years (0.1-13.9). The median number of treatment lines was 2 (2-4) prior to index date and 3.5 (2.0-5.0) through the overall study period. A total of 22 different treatment regimens were identified in this study, and each patient showed a unique treatment pattern. Following index date, 66.7% of treatments continued to consist of rituximab- and/or alkylating agent-based therapies, despite prior progression on, and refractoriness to, these regimens. Hematopoietic stem cell transplant was more common after the index date. Overall, median time to relapsed/refractory diagnosis (TRRD) was 18.2 months (1.2-107.2) before index date and 9.6 months (0.7-51.5) after index date. For patients who received a non-rituximab-containing regimen in first-line and a rituximab-containing regimen in second-line, median TTRD was 52.0 months (12.6-76.2); for patients who received a rituximab-containing regimen in first- and second-line, median TTRD was 4.0 months (1.3-5.5). In general, with each line of treatment, the proportion of different treatment regimens administered increased, whereas the number of patients receiving therapy decreased. Furthermore, median TTRD, treatment duration, and time between treatments generally decreased with each subsequent line of treatment. Median overall survival was not reached. Mean monthly cost per patient was C$4,793 including hospitalizations (56%, average of 2.6 days per month), treatments (24%), medical procedures (19%) and outpatient medical visits (1%).Conclusions:This study characterizes health and economic outcomes in a highly specific FL patient population refractory to rituximab and an alkylating agent. The results demonstrate that treatment patterns were heterogeneous and patients became less responsive to available therapies over time. Furthermore, there was no consistent standard of care for these R/R FL patients, with many continuing to receive rituximab and/or alkylating agents despite prior relapse on, and refractoriness to, these regimens. These results suggest that the management of patients with R/R FL becomes increasingly challenging throughout the course of the disease, and is associated with considerable costs driven mainly by hospitalizations. Thus, new effective treatment options are clearly warranted for R/R FL patients.Source of supportThis study was supported by Gilead Sciences Canada Inc. Disclosuresvan der Jagt:Lundbeck, Teva: Consultancy; Teva: Research Funding. Fleury:Novartis Pharmaceuticals Corporation: Consultancy; Merck: Consultancy; Janssen: Consultancy; Roche: Consultancy; Seattle Genetics: Consultancy; Gilead: Consultancy; Amgen: Consultancy; Lundbeck: Consultancy. Wagner:Gilead Sciences Canada: Employment, Equity Ownership. Toltl:Gilead Sciences Canada: Employment, Equity Ownership. Lachaine:Gilead Sciences Canada: Research Funding.

Sex, mines, and pipelines: Examining ‘Gender-based Analysis Plus’ in Canadian impact assessment resource extraction policy

The need for gendered and culturally sensitive analyses of the impacts of resource development is being echoed across Canada. Such an imperative is especially significant in rural, remote, and Indigenous communities where individuals, including women, girls, and gender diverse people, bear the embodied burden of the impacts of resource development. While the need for gender sensitive impact assessment (IA) is clear, what is less clear is how to design and conduct assessments that meaningfully include the impacts on sex and gender. This article explores the application of Gender-based Analysis Plus, a policy tool, in approaches to IA. We review the utility of indicator frameworks given Section 22 (s) of Canada's Impact Assessment Act (2019) which states that sex, gender and other identity factors must be taken into account during IA processes. Such a clause is an overdue response to the increasing awareness of the need for improved regulation and the development of social and cultural IA processes that consider axes of difference such as gender, class, ableism, racialization, and their intersections. This paper reviews key literature on gender-based analysis and IA, and argues that gender-based indicator frameworks, as currently imagined in the IA processes, remain in tension with calls for community-specific and culturally appropriate methods.

Boundary Regimes and the Gendered Racialized Production of Muslim Masculinities: Cases from Canada and Germany

Boundary regimes consist of multiple discursive and material registers in media, politics, law and everyday interaction. We show how “safety” and “danger,” as key concepts of symbolic boundaries, produce particular understandings of Muslim masculinities. In Canada, the government discussed (but did not enact) placing single Syrian men at the bottom of the admissible to-be-resettled refugee list in 2015. In Cologne, Germany, refugee men were accused of sexually assaulting a large number of women in 2015. Focusing on “safety” and “danger” discourses, we show that symbolic boundaries had limited material impact in Canada while they informed major legal changes in Germany.

Media, Community Building, and Refugee Resettlement Policies: The Impact of Canada’s Welcoming Culture and Media Coverage on the Settlement Outcomes of Resettled Syrian Refugees

This paper argues that positive online media coverage of Syrian refugees arriving in Canada, and the welcoming culture of Canadian society, have both influenced positive settlement and integration outcomes for Syrian refugees. It also provides a better understanding of Canada’s response to the Syrian refugee crisis and shows how the process of resettlement becomes stronger when local community members and citizens are involved. These arguments are demonstrated firstly by analyzing the relationship between welcoming cultures, positive media coverage, and the perception of refugees. Secondly, the role of media coverage in influencing welcoming cultures in Canada, as well as its role in encouraging community members and ordinary citizens to be involved in national humanitarian projects, is described. Finally, information related to Canada’s welcoming culture and positive media coverage are discussed relative to settlement outcomes, which portrays the strong influence of storytelling and inclusive communities on the success of new immigrants as they rebuild their lives in a new country. The various refugee resettlement programs in Canada are also outlined. The Canadian response to the Syrian refugee crisis has demonstrated to the world a different approach to civic engagement and humanitarian work. This national humanitarian response may be perceived as a major successful project. Nevertheless, it also leaves us with many unanswered questions around the topic, and most importantly, questions about the relationship between politics and power, citizenship, culture, online media and public opinions.

Creating a pharmacy elective course in Indigenous health

Background and purposeThere is a critical need for greater Indigenous health education and cultural safety training for pharmacists. The objective of this paper is to describe the creation, development, and impact of Canada's first offering of an undergraduate elective course specific to pharmaceutical care in Indigenous health. Educational activity and settingA three-credit elective course was developed and offered to bachelor of science pharmacy students at the University of British Columbia. A variety of pedagogical approaches including reflection, educational trips, video conferencing with Indigenous communities, and Indigenous community-based projects were used. Evaluation of student learning impact included quantitative and qualitative post-course survey data, student enrollment, and student work. FindingsFrom course inception in 2012 to 2017, 101 students participated. Survey respondents rated an average of 4.7 out of 5 on the five core elements of the curriculum design and pedagogical practice (i.e. learning objectives, instructional methods, assessments, organization, and workload). Thematic analysis identified three themes: 1) the qualities of the course instructors, 2) the unique curriculum design and pedagogical practices, and 3) significant personal and professional impact on students. SummaryThis course is one of few opportunities for pharmacy students to learn about cultural safety as it relates to the pharmaceutical care of Indigenous peoples. Extensive engagement with stakeholders and utilization of various teaching and assessment techniques were beyond the expected requirements of course offerings. Students highly rated this course as having personal and professional impact. This course plays a critical role in the overall Indigenization of pharmacy curricula.

An overview of C-SOX and directions for future research

PurposeThe purpose of this paper is to examine existing literature, including both academic and practitioner publications, related to Canadian SOX (or C-SOX as it is popularly known). The study discusses the origins of the Act, the underlying motivations for enacting this legislation in Canada and its impact on corporate decisions since its inception in 2003.Design/methodology/approachThe principal focus of this literature review is on C-SOX, its inception, reception, compliance and impact in Canada, both from business’ and investors’ critical perspectives. The authors have followed a two-step process to gather all the articles. First, the authors used a keyword search at Google Scholar and ProQuest (e.g. C-SOX, Canadian SOX, Bill 198, etc.) to gather all the articles. Second, the authors retained articles and abstracts that primarily dealt with the background framework and impact of the legislation. It is to be noted that C-SOX was mainly a reactionary legislation following the adoption of US-SOX in 2002. Any discussion of C-SOX is, therefore, incomplete without referencing the literature related to US-SOX.FindingsIn this review paper the evolution of C-SOX over time in Canada, as well as studies on its impacts and criticisms have been summarized. Based on the extensive research that followed the enactment of US-SOX, the authors also provide suggested research directions related to C-SOX in the future.Research limitations/implicationsC-SOX has been relatively underexplored and therefore, not much academic work is available presently. This study highlights this gap in the literature with the hope that researchers will devote their energy to understanding the broader ramifications of major legislations such as C-SOX which will potentially also inform future public policy choices.Practical implicationsThis research will help both businesses and investors to understand each other’s perspectives and concerns regarding C-SOX. This paper will also be helpful to policy makers to identify potential areas of improvement in this and future legislative decisions in the future.Originality/valueUsing a qualitative approach this study combines the development of C-SOX as a legislation in Canada, its overall effectivity/drawbacks and explores the areas it impacts, both positively and negatively, along with criticisms and appreciations.

Prevalence of Lung Function Abnormalities Following the Fort McMurray Wildfires

Air pollution contributes significant to the burden of respiratory diseases. Vehicular, industrial and increasingly, wildfire emissions are major sources of air pollution in Canada. Increased symptoms, hospitalizations and mortality immediately after wildfires are known; the long-term health impact have not been studied. The devastating 2016 Fort McMurray (FMM) wildfires forced the months-long evacuation of the entire town and destroyed many homes. Most residents returned several months later, chosing to stay and rebuild. The long-term health impact of wildfires, and the ongoing exposure to resuspended residual wildfire ash are not known. Our study aims to assess the long-term impact on lung health in the permanent residents of FMM.We report on the health status of the first 45 participants (26F, 19M; mean age&amp;#61;45&amp;#177;2 yrs, range 21-71 yrs) at 18 months after the onset of the fires. Target enrolment is 200 with follow-up of at least 5 years. All 45 are permanent residents (mean residency&amp;#61;16&amp;#177;12; range 3-46 yrs). 13 worked in the oils sands; 5 are current smokers and 18 ex-smokers. Spirometry revealed a higher than expected prevalence of airflow obstruction; 11% had an FEV1 (forced expiratory volume in 1 sec)/FVC (forced vital capacity) ratio &amp;lt;lower limit of normal (LLN). This was similar regardless of occupational exposures and smoking history; of the 22 never-smokers, 3 had FEV1/FVC&amp;lt;LLN, while 4 had FEV1/FVC&amp;lt;72.5%. 31% reported intermittent cough&amp;#177;sputum. Two had childhood asthma; only one is treated with inhaled steroids. One participant had COPD, treated with inhaled bronchodilators. The cohort was generally healthy with only 4 participants reporting underlying medical diseases other than lung disease. They were, however, obese with mean BMI&amp;#61;31&amp;#177;l.Our preliminary analyses found a higher than anticipated burden of unrecognized lung disease. Development of disease in this generally healthy young population will have significant social and public health impact in Canada.

Budget impact of a program for safely reducing caesarean sections in Canada

Introductionaudits of indications for cesarean section (CS), feedback for health professionals, and implementation of best practices, as compared with usual care (QUARISMA study), resulted in a small reduction in the rate of CS in Quebec and important cost savings from a health care payer perspective. Determining the budget impact would enable estimation of the financial consequences if the program is extended nationwide. Material and methodsa retrospective pre-post study design was used to estimate cost prior to and after the implementation of QUARISMA in Quebec (105,351 subjects). A prospective analysis was performed to measure the budget impact in Canada’s provinces. The primary analytic perspective was that of the Minister of Health, for a 4-year time horizon. Data were taken from the trial for Quebec and extrapolated to Canada’s provinces. A sensitivity analysis was conducted by varying more than one probability at a time. Findingsover 4 years, there was a decrease of more than $7.8 million in CS burden in Quebec, $11.9 million in vaginal birth and $9.8 million for neonatal complications. The impact on high-risk women was lower than that on low-risk. In years 1 and 2, the provinces would have to cover the cost of program implementation. ConclusionsQUARISMA led to savings of $27 million in Quebec over 4 years. In the short to medium term, extending the QUARISMA program nationwide could lead to savings of $150.5 million.

Stolen Words by M. Florence

Florence, Melanie. Stolen Words. Illus. Gabrielle Grimard. Second Story Press, 2017.Stolen Words is a sensitive and thoughtful story about the legacy and intergenerational impact of Canada’s residential school system, the reclamation of language, and the tender relationship between a seven-year-old nôsisim (granddaughter) and her nimosôm (grandfather). Florence draws on her own experience for the story, having never had the opportunity to speak to her own nimosôm about his Cree heritage.After making a dreamcatcher in school, Nôsisim goes to her nimosôm, asking how to say “grandfather” in Cree. Nimosôm replies that he “lost his words a long time ago.” He explains that he (and his words) were taken away from their home, “... to a school that was cold and lonely, where angry white faces raised their voices and their hands when we used our words.” Nôsisim wants to help Nimosôm “find your words again,” and the next day, brings home a Cree dictionary. Reading the long-forgotten words, Nimosôm’s language is reawakened, and he promises Nôsisim that he will teach her his words.Stolen Words does not shy from the realities and long-term impacts of the residential school system. However, Florence addresses these sensitively and age-appropriately. For example, Nimosôm talks about being separated from his family. While the pain of the separation is clear, Florence’s gentle prose ensures it is not overwhelming for young readers. Also, Grimard’s illustrations are evocative, highlighting the close relationship between Nôsisim and Nimosôm, and effectively showing how Nimosôm’s language was captured (and freed) using bird imagery.The phrasing of the sentences, and the inclusion of Cree words makes this a more appropriate read-aloud to younger readers, but it would be suitable for independent reading for students in mid-elementary school. While the subject matter is relevant for students in upper-elementary school, the text itself is below grade reading level. This book is highly recommended for both school and public libraries. Highly recommended: 4 out of 4 starsReviewer: Andrea QuaiattiniAndrea Quaiattini is a Public Services Librarian at the University of Alberta’s JW Scott Health Sciences Library. While working as a camp counsellor, she memorized Mortimer and The Paper Bag Princess by Robert Munsch as bedtime stories for the kids. She can still do all the voices.

« Il y a des gens d'humeur vagabonde qui déménagent tous les ans » : stratégies et mobilité sociale de la classe ouvrière de Québec durant la Longue Dépression de 1873

La Longue Dépression de 1873 correspond à la toute première crise capitaliste mondiale. Les analyses de ses répercussions au Canada se sont cependant concentrées sur les faillites d'entreprises et le marasme boursier. Aussi les rapports sociaux durant cette période singulière n'ont-ils guère retenu l'attention. Afin de comprendre les dynamiques internes de l'économie capitaliste, nous avons abordé la crise à partir de la question de la propriété et de la structure de classe. En cherchant à comprendre les relations entre propriétaires et locataires, d'une part, et le marché, d'autre part, nous mettons en lumière dans notre analyse sociohistorique les caractéristiques de la structure sociale du quartier Saint-Roch à Québec, en plus de la nature même de la crise.