Ascertaining the Francophone population in Ontario: validating the language variable in health data.

BACKGROUND: Language barriers can impact health care and outcomes. Valid and reliable language data is central to studying health inequalities in linguistic minorities. In Canada, language variables are available in administrative health databases; however, the validity of these variables has not been studied. This study assessed concordance between language variables from administrative health databases and language variables from the Canadian Community Health Survey (CCHS) to identify Francophones in Ontario. METHODS: An Ontario combined sample of CCHS cycles from 2000 to 2012 (from participants who consented to link their data) was individually linked to three administrative databases (home care, long-term care [LTC], and mental health admissions). In total, 27,111 respondents had at least one encounter in one of the three databases. Language spoken at home (LOSH) and first official language spoken (FOLS) from CCHS were used as reference standards to assess their concordance with the language variables in administrative health databases, using the Cohen kappa, sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV). RESULTS: Language variables from home care and LTC databases had the highest agreement with LOSH (kappa = 0.76 [95%CI, 0.735-0.793] and 0.75 [95%CI, 0.70-0.80], respectively) and FOLS (kappa = 0.66 for both). Sensitivity was higher with LOSH as the reference standard (75.5% [95%CI, 71.6-79.0] and 74.2% [95%CI, 67.3-80.1] for home care and LTC, respectively). With FOLS as the reference standard, the language variables in both data sources had modest sensitivity (53.1% [95%CI, 49.8-56.4] and 54.1% [95%CI, 48.3-59.7] in home care and LTC, respectively) but very high specificity (99.8% [95%CI, 99.7-99.9] and 99.6% [95%CI, 99.4-99.8]) and predictive values. The language variable from mental health admissions had poor agreement with all language variables in the CCHS. CONCLUSIONS: Language variables in home care and LTC health databases were most consistent with the language often spoken at home. Studies using language variables from administrative data can use the sensitivity and specificity reported from this study to gauge the level of mis-ascertainment error and the resulting bias.

Piloting the home ship: Understanding the deployment experience of Canadian Special Operations Forces Command spouses.

Special Operations Forces (SOF) members are frequently deployed to hostile environments for prolonged periods of time, and their families are exposed to unique difficulties and stressors. The purpose of this study was to describe the lived experience of Canadian Special Operations Forces Command (CANSOFCOM) spouses as it relates to the intensity of the SOF deployment process. As part of a larger study, semi-structured interviews were conducted with 29 spouses of CANSOFCOM members. The interviews were coded and analyzed using thematic analysis to identify the central dimensions of spouses' experience with deployment. Participants reflected on their experiences, from pre-deployment to post-deployment, and as they transitioned between deployments, across social/relational, practical/instrumental, and psychological/emotional dimensions. The findings raised important concerns regarding perpetual transitions for the family unit and exhaustion among spouses faced with a deployment loop that never closes. Although results echoed previous studies, in terms of the strain of solo-parenting and coping with children's emotional needs, communication and maintaining connections, these aspects were uniquely affected by repeated deployments, prolonged time away, operations security, and high organizational demands. Although many spouses acquired the strength and skills to cope with the lifestyle, the findings suggest several opportunities to tailor resources and support services to their dynamic needs.

Randomized trial of cognitive behaviour group therapy and a mindfulness-based intervention for social anxiety disorder: Preliminary findings.

Recent studies have evaluated the possible efficacy of mindfulness-based interventions (MBIs) for social anxiety disorder (SAD). However, few trials have compared MBIs with a first-line treatment. This study evaluated the relative efficacy of an MBI adapted for SAD (MBI-SAD) to cognitive behaviour group therapy (CBGT) for SAD. Participants were randomized to 12 weekly group sessions of the MBI-SAD (n = 52) or CBGT (n = 45). Results revealed that CBGT fared better than the MBI-SAD in reducing clinician- and self-rated social anxiety severity. The difference between the MBI-SAD and CBGT exceeded the prespecified noninferiority margin for our primary outcome the Liebowitz Social Anxiety Scale, but findings are inconclusive as the width of the confidence interval extended in both directions surrounding the noninferiority margin. The MBI-SAD compared favourably with CBGT in improving other indices of well-being (depression, self-esteem, satisfaction with life, social adjustment). Contrary to expectation, the MBI-SAD did not produce greater changes in mindfulness and self-compassion than CBGT. Overall, results confirm that CBGT is robust treatment for SAD and should be considered as first-line treatment.

The impact of hospital language on the rate of in-hospital harm. A retrospective cohort study of home care recipients in Ontario, Canada.

BACKGROUND: Patients who live in minority language situations are generally more likely to experience poor health outcomes, including harmful events. The delivery of healthcare services in a language-concordant environment has been shown to mitigate the risk of poor health outcomes related to chronic disease management in primary care. However, data assessing the impact of language-concordance on the risk of in-hospital harm are lacking. We conducted a population-based study to determine whether admission to a language-discordant hospital is a risk factor for in-hospital harm. METHODS: We used linked administrative health records to establish a retrospective cohort of home care recipients (from 2007 to 2015) who were admitted to a hospital in Eastern or North-Eastern Ontario, Canada. Patient language (obtained from home care assessments) was coded as English (Anglophone group), French (Francophone group), or other (Allophone group); hospital language (English or bilingual) was obtained using language designation status according to the French Language Services Act. We identified in-hospital harmful events using the Hospital Harm Indicator developed by the Canadian Institute for Health Information. RESULTS: The proportion of hospitalizations with at least 1 harmful event was greater for Allophones (7.63%) than for Anglophones (6.29%, p <  0.001) and Francophones (6.15%, p <  0.001). Overall, Allophones admitted to hospitals required by law to provide services in both French and English (bilingual hospitals) had the highest rate of harm (9.16%), while Francophones admitted to these same hospitals had the lowest rate of harm (5.93%). In the unadjusted analysis, Francophones were less likely to experience harm in bilingual hospitals than in hospitals that were not required by law to provide services in French (English-speaking hospitals) (RR = 0.88, p = 0.048); the opposite was true for Anglophones and Allophones, who were more likely to experience harm in bilingual hospitals (RR = 1.17, p <  0.001 and RR = 1.41, p <  0.001, respectively). The risk of harm was not significant in the adjusted analysis. CONCLUSIONS: Home care recipients residing in Eastern and North-Eastern Ontario were more likely to experience harm in language-discordant hospitals, but the risk of harm did not persist after adjusting for confounding variables.

Incorporating a Physical Activity Program into an Assertive Community Treatment Team: Impact and Strategies.

The objective of this brief report is to present an overview of the main benefits and key characteristics of an individualized physical activity program delivered by an assertive community treatment team in Ottawa, Canada. A mixed-method case study was conducted over a 9-month period. Findings revealed significant reductions in weight, BMI and waist circumference (p < .05) and improvements in self-esteem, autonomy, socialization and other health behaviors. Key characteristics of the program included building a relationship of trust with clients and deploying active efforts to eliminate barriers to PA engagement. Results offer preliminary evidence for integrating an individualized PA program into the ACT team model.

[Physical activity programs and severe mental illness: A case study of an Assertive Community Treatment (ACT) team]. / Programme d'activité physique et troubles graves de santé mentale : étude de cas d'une équipe communautaire de traitement intensif (ÉCTI).

Context : As a therapeutic intervention, physical activity has the potential to improve the quality of life of individuals with severe mental illnesses.Objectives : The goal of this case study was to conduct an in-depth examination of an individualized physical activity program for patients suffering from severe mental illnesses that was implemented by an Assertive Community Treatment (ACT) team in Ottawa, Canada.Method : Using a mixed-methods design, physical health parameters were measured over a nine-month period and semi-structured interviews were conducted with fourteen patients and five staff members.Results : The findings showed a significant reduction in weight following the evaluation period, as well as positive effects in terms of patients' self-esteem, autonomy, and socialization. The quality of the therapeutic relationship, the elimination of barriers, and the continued involvement of staff members were some of the key characteristics that led to the program's success.Discussion/conclusion : These promising results are an indication of the feasibility of this type of intervention among patients with severe mental illnesses as a therapeutic approach to improve their quality of life and support their recovery and social integration.

The Need to Objectively Measure Physical Activity During Pregnancy: Considerations for Clinical Research and Public Health Impact.

Engaging in recommended levels of physical activity during pregnancy can provide a host of physical and mental health benefits for the expecting mother and her child. However, methodological issues related to physical activity measurement have plagued many studies examining the effects of physical activity during this important life stage. Burgeoning support exists for the more widespread use of objective methods, and accelerometers specifically, for an accurate appraisal of maternal physical activity. In this commentary, we highlight discrepancies between activity estimates obtained via self-report and objective measures and describe the implications of erroneous measurement when making clinical recommendations and in conducting future physical activity and pregnancy research. Most importantly, we aim to foster academic discussion and propose a call to action requiring a paradigm shift where we acknowledge the shortcomings of self-report and move toward an empirically driven approach for physical activity measurement. Results from more high-quality research studies will help support public health messaging and facilitate trust among health care providers, clinical researchers, and expecting mothers regarding the health benefits of physical activity recommendations.

An Examination of Exercise-Induced Feeling States and Their Association With Future Participation in Physical Activity Among Older Adults.

Although exercise-induced feeling states may play a role in driving future behavior, their role in relation to older adults' participation in physical activity (PA) has seldom been considered. The objectives of this study were to describe changes in older adults' feeling states during exercise, and examine if levels of and changes in feeling states predicted their future participation in PA. Self-reported data on feeling states were collected from 82 older adults immediately before, during, and after a moderate-intensity exercise session, and on participation in PA 1 month later. Data were analyzed using latent growth modeling. Feelings of revitalization, positive engagement, and tranquility decreased during exercise, whereas feelings of physical exhaustion increased. Feelings of revitalization immediately before the exercise session predicted future participation in PA; changes in feeling states did not. This study does not provide empirical evidence that older adults' exercise-induced feeling states predict their future participation in PA.

Trajectories of mood and stress and relationships with protective factors during the transition to menopause: results using latent class growth modeling in a Canadian cohort.

The menopause transition is characterized by significant hormonal changes that may predispose women to psychosocial maladjustment. Prospective studies to date have focused primarily on negative mood states and show equivocal findings. The primary goal of this study was to identify patterns of change with respect to positive and negative mood states (vigor, depression, tension, and stress) over a 5-year period in a cohort of women undergoing the transition to menopause. A secondary aim was to determine whether the identified trajectories were associated with menopause status as well as baseline health-related and psychological characteristics. This longitudinal study observed 102 healthy Canadian women who were premenopausal at baseline (age 47-55 years). Analyses consisted of latent class growth modeling. Mood states were predominantly normal and stable, raising doubts regarding the notion that psychosocial distress is a common and natural occurrence during the transition to menopause. Neither time spent in perimenopause nor BMI had a significant influence on levels of mood indicators. However, higher scores on body image, self-esteem, and general health perceptions were predictive of more positive psychological outcomes over the 5-year period. Targeting improvements in self-perceptions may promote a healthier psychological adjustment during this natural transitional period in a women's lifespan.

From a Vital Sign to Vitality: Selling Exercise So Patients Want to Buy It.

Exercise is Medicine (EIM) and physical activity as a vital sign are based on health-focused research and reflect ideal frames and messages for clinicians. However, they are nonoptimal for patients because they do not address what drives patients' decision-making and motivation. With the growing national emphasis on patient-centered and value-based care, it is the perfect time for EIM to evolve and advance a second-level consumer-oriented exercise prescription and communication strategy. Through research on decision-making, motivation, consumer behavior, and meaningful goal pursuit, this article features six evidence-based issues to help clinicians make physical activity more relevant and compelling for patients to sustain in ways that concurrently support patient-centered care. Physical activity prescriptions and counseling can evolve to reflect affective and behavioral science and sell exercise so patients want to buy it.

Feeling the Strain: Understanding the Relationship between Stress and Physical Activity in Members of the Royal Canadian Navy.

INTRODUCTION: Research finds that experiencing psychological stress can be associated with engaging in less physical activity, a critical contributor to operational readiness and overall health and well-being. As navy personnel tend to engage in lower levels of physical activity than other military personnel, the purpose of this study was to examine the relationship between stress and physical activity in the Royal Canadian Navy (RCN) and identify moderators of this relationship. MATERIALS AND METHODS: Data for this study were obtained from an electronic workplace well-being survey administered to a stratified random sample of 930 members in hard sea occupations managed by the RCN. Multivariable logistic regressions examined the associations between indicators of stress (e.g., job stress, burnout, work-life conflict, and psychological distress) and physical activity engagement; the moderating effects of demographic/military characteristics and health status (e.g., rank, gender, sailing status, general health status, and body mass index [BMI]) were examined. RESULTS: Navy personnel who were married or in common-law relationships and those who reported poorer overall health were less likely to be physically active. Navy personnel with lower psychological distress were more likely be active (P = .03); however, direct associations with other indicators of stress were not significant. BMI was the only significant moderator of the relationship between stress and physical activity. Specifically, for members classified as obese, higher levels of burnout and work-life conflict were associated with being more physically active. Conversely, nonobese members with elevated burnout reported less physical activity. CONCLUSIONS: The findings of this study support a complex relationship between experiencing stress and engaging in physical activity, which showed varying patterns based on BMI classification. Although the cross-sectional nature of the data precludes any inferences about the direction of these effects, the results suggest that some members of the RCN are more at risk of experiencing decrements in physical activity. Future research should examine the types of physical activity supports and incentives that are needed to ensure that navy personnel derive the benefits of an active lifestyle, especially in times of stress.

Association between newborn hypoglycemia screening and breastfeeding success in an Ottawa, Ontario, hospital: a retrospective cohort study.

BACKGROUND: There has been limited investigation of the unintended effects of routine screening for asymptomatic hypoglycemia in at-risk newborns. This study aimed to explore whether rates of exclusive breastfeeding were lower in screened babies than in unscreened babies. METHODS: This retrospective cohort study conducted in Ottawa, Canada, used data from Hôpital Montfort's electronic health information system. Healthy singleton newborns discharged between Feb. 1, 2014, and June 30, 2018, were included. We excluded babies and mothers with conditions expected to interfere with breastfeeding (e.g., twins). We investigated the association between postnatal screening for hypoglycemia and initial exclusive breastfeeding (in the first 24 hours of life). RESULTS: We included 10 965 newborns; of these, 1952 (17.8%) were fully screened for hypoglycemia. Of screened newborns, 30.6% exclusively breastfed and 64.6% took both formula and breastmilk in the first 24 hours of life. Of unscreened newborns, 45.4% exclusively breastfed and 49.8% received both formula and breastmilk. The adjusted odds ratio for exclusive breastfeeding in the first 24 hours of life among newborns screened for hypoglycemia was 0.57 (95% confidence interval 0.51-0.64). INTERPRETATION: The association of routine newborn hypoglycemia screening with a lower initial rate of exclusive breastfeeding suggests a potential effect of screening on early breastfeeding success. Confirmation of these findings might warrant a re-evaluation of the net benefit of asymptomatic postnatal hypoglycemia screening for different newborn populations at risk of hypoglycemia.

Promoting physical activity: development and testing of self-determination theory-based interventions.

A growing number of studies have pulled from Deci and Ryan's Self-Determination Theory to design interventions targeting health behavior change. More recently, researchers have begun using SDT to promote the adoption and maintenance of an active lifestyle. In this review, we aim to highlight how researchers and practitioners can draw from the SDT framework to develop, implement, and evaluate intervention efforts centered on increasing physical activity levels in different contexts and different populations. In the present paper, the rationale for using SDT to foster physical activity engagement is briefly reviewed before particular attention is given to three recent randomized controlled trials, the Canadian Physical Activity Counseling (PAC) Trial, the Empower trial from the UK, and the Portuguese PESO (Promotion of Health and Exercise in Obesity) trial, each of which focused on promoting physical activity behavior. The SDT-based intervention components, procedures, and participants are highlighted, and the key findings that have emanated from these three trials are presented. Lastly, we outline some of the limitations of the work conducted to date in this area and we acknowledge the challenges that arise when attempting to design, deliver, and test SDT-grounded interventions in the context of physical activity promotion.

Association between substance use and professional outcomes among medical students: Findings from a Canadian cross-sectional survey.

Background: While substance use is common among medical students, there is limited research on this topic involving Canadian medical students or exploring its associations with professional outcomes. The present study examines the association between Canadian medical students' substance use and related counselling attitudes and practices, career satisfaction, academic/clinical workload, and the medical school environment. Methods: We sent an electronic cross-sectional survey to students attending all 17 Canadian medical schools between November 2015 and March 2016. A total of 4,438 participants completed the survey across four years of study, with a participation rate of 40.2%. We considered four categories of substance use: cannabis, alcohol, non-medical use of prescription stimulants (NPS), and cigarettes. Covariates included professional attitudes (e.g., career satisfaction, distress, patient counselling on alcohol or smoking cessation), specialty of interest, learner mistreatment, and perceived medical school support. We used multivariate logistic regression models, generating adjusted odds ratios (AORs), to examine covariates associated with substance use and how substance use (as a covariate) was associated with different professional outcomes. Results: Individuals more interested in "lifestyle" specialties (AOR, 1.81; 95% CI, 1.08-3.05) and surgical specialties (AOR, 1.69; 95% CI, 1.16-2.47) were more likely to report excessive alcohol use. Those interested in primary care were more likely to report cannabis use in the past 12 months (AOR, 1.85; 95% CI, 1.14-3.00). We did not identify significant associations between specialty of interest and current cigarette or NPS use in the past 12 months. However, excessive alcohol use was associated with greater career satisfaction (AOR, 1.24; 95% CI: 1.04-1.49), whereas NPS in the past 12 months was associated with poorer career satisfaction (AOR, 0.63; 95% CI: 0.42-0.93). In addition, there was a negative association between NPS use and the ability to handle workloads due to physical (AOR, 0.31; 95% CI, 0.18-0.54) or mental health issues (AOR, 0.46; 95% CI, 0.30-0.71), but not for other substances. We also found significant negative associations between current cigarette use and the perceived relevance of smoking cessation counselling (AOR, 0.48; 95% CI: 0.29-0.80) and alcohol cessation counselling (AOR, 0.42; 95% CI: 0.25-0.70). Conclusions: These findings suggest that specific patterns of substance use in medical students appeared to be significantly associated with some professional outcomes, specialty of interest, and attitudes towards addiction-related clinical practice. Encouraging medical students to practise healthy habits, including minimizing harmful substance use behaviours, could be an important target for improving medical students' health and their patient care.

Contexte: Bien que la consommation d'alcool et de drogues soit courante chez les étudiants en médecine, peu d'études sur ce sujet ont été menées auprès d'étudiants canadiens en médecine ou ont exploré ses liens avec les résultats professionnels. La présente étude examine l'association entre la consommation de substances psychoactives des étudiants canadiens en médecine et les comportements et habitudes en matière de suivi psychologique, la satisfaction à l'égard de la carrière, la charge de travail universitaire/en clinique et l'environnement de la faculté de médecine. Méthodes: Nous avons fait parvenir une enquête transversale électronique aux étudiants fréquentant les 17 facultés de médecine canadiennes entre novembre 2015 et mars 2016. Au total, 4 438 participants ont répondu à l'enquête sur quatre années d'études, avec un taux de participation de 40,2 %. Nous avons considéré quatre catégories de consommation de substances : le cannabis, l'alcool, l'utilisation non médicale de stimulants sur ordonnance (NSO) et les cigarettes. Les covariables comprenaient les attitudes professionnelles (par exemple, la satisfaction professionnelle, la détresse, les conseils aux patients sur l'arrêt de l'alcool ou du tabac), la spécialité choisie, les maltraitances infligées aux étudiants et le soutien perçu de la faculté de médecine. Nous avons utilisé des modèles de régression logistique multivariés, générant des rapports de cotes ajustés (RCA), pour examiner les covariables associées à la consommation de substances et la façon dont la consommation de substances (en tant que covariable) était associée à différents résultats professionnels. Résultats: Les personnes plus intéressées par les spécialités "mode de vie" (RCA, 1,81 ; IC 95 %, 1,08-3,05) et les spécialités chirurgicales (RCA, 1,69 ; IC 95 %, 1,16-2,47) étaient plus susceptibles de déclarer une consommation excessive d'alcool. Les personnes intéressées par les soins primaires étaient plus susceptibles de déclarer avoir consommé du cannabis au cours des 12 derniers mois (RCA, 1,85 ; IC à 95 %, 1,14-3,00). Nous n'avons pas identifié d'associations significatives entre la spécialité choisie et la consommation de cigarettes ou de NSO au cours des 12 derniers mois. Toutefois, la consommation excessive d'alcool était associée à une plus grande satisfaction professionnelle (RCA, 1,24 ; IC à 95 % : 1,04-1,49), tandis que la consommation de NSO au cours des 12 derniers mois était associé à une plus faible satisfaction professionnelle (RCA, 0,63 ; IC à 95 % : 0,42-0,93). En outre, il existe une association négative entre la consommation de NSO et la capacité à gérer la charge de travail en raison de problèmes de santé physique (RCA, 0,31 ; IC à 95%, 0,18-0,54) ou mentale (RCA, 0,46 ; IC à 95%, 0,30-0,71), mais pas pour les autres substances. Nous avons également constaté des associations négatives significatives entre l'usage de la cigarette et la pertinence perçue des conseils en matière d'arrêt du tabac (RCA, 0,48 ; IC 95 % : 0,29-0,80) et des conseils en matière d'arrêt de l'alcool (RCA, 0,42 ; IC 95 % : 0,25-0,70). Conclusions: Ces résultats suggèrent que des modèles spécifiques de consommation de substances psychoactives chez les étudiants en médecine semblent être significativement associés à certains résultats professionnels, à la spécialité choisie et aux attitudes envers la pratique clinique liée à la dépendance. Encourager les étudiants en médecine à adopter des habitudes saines, notamment en minimisant les comportements nocifs liés à la consommation de substances, pourrait être un objectif important pour améliorer la santé des étudiants en médecine et les soins aux patients. Motsclés: Consommation de substances psychoactives ; Étudiants en médecine ; Enquête ; Canada.

In-Hospital Patient Harm Across Linguistic Groups: A Retrospective Cohort Study of Home Care Recipients.

OBJECTIVE: Research examining the impact of language barriers on patient safety is limited. We conducted a population-based study to determine whether patients whose primary language is not English are more likely to experience harm when admitted to hospitals in Ontario, Canada. METHODS: We used linked administrative health records to establish a retrospective cohort of home care recipients (from 2010 to 2015) who were subsequently admitted to hospital. Patient language (obtained from home care assessments) was coded as English, French, or other. Harmful events were identified using the Hospital Harm Indicator developed by the Canadian Institute for Health Information. RESULTS: We included 190,724 patients (156,186 Anglophones, 5,110 Francophones, and 29,428 Allophones). There was no significant difference in the unadjusted risk of harm for Francophones compared with Anglophones (relative risk [RR], 0.94; 95% confidence interval [CI], 0.87-1.02). However, Allophones were more likely to experience harm when compared with Anglophones (RR, 1.14; 95% CI, 1.10-1.18). The risk of harm was even greater for Allophones with low English proficiency (RR, 1.18; 95% CI, 1.13-1.24). After adjusting for potential confounders, Anglophones and Allophones were equally likely to experience harm of any type, but Allophones more likely to experience harm from infections and procedures. CONCLUSIONS: Patients whose primary language was not English or French were more likely to experience harm after admission to hospital, especially if they had low English proficiency. For these patients, the risk of harm from infections and procedures persisted in the adjusted analysis, but the overall risk of harm did not.

Trials and tribulations among members of Canada's Defence Team early in the pandemic: key insights from the COVID-19 Defence Team Survey. / Les défis auxquels ont fait face les membres de l'Équipe de la Défense du Canada au début de la pandémie : principales conclusions du sondage de l'Équipe de la Défense sur la COVID-19.

INTRODUCTION: Due to the unprecedented impact of COVID-19, there is a need for research assessing pandemic-related challenges and stressors. The current study aimed to assess key concerns and general well-being among members of Canada's Defence Team, including Canadian Armed Forces personnel and members of the Department of National Defence (DND) Public Service. METHODS: The COVID-19 Defence Team Survey was administered electronically to Defence Team staff in April and May of 2020 and was completed by 13 688 Regular Force, 5985 Reserve Force and 7487 civilian DND Public Service personnel. Along with demographic information, the survey included assessments of work arrangement, pandemic-related concerns, general well-being and social and organizational support. Weighted data (to ensure representation) were used in all analyses. RESULTS: The majority of respondents were working from home, with a small minority unable to work due to restrictions. Though many concerns were endorsed by a substantial proportion of respondents, the most prevalent concerns were related to the health and well-being of loved ones. The majority of respondents reported their partner, family, supervisors, friends, colleagues and children provided general support. Half of the civilian defence staff and one-third of military respondents reported a decline in mental health. Women, younger respondents, those with dependents and, in some cases, those who were single without children were at risk of lower well-being. CONCLUSION: The pandemic has negatively impacted a substantial portion of the Defence Team. When responding to future crises, it is recommended that leaders of organizations provide additional supports to higher-risk groups and to supervisors who are ideally positioned to support employees during challenging times.

Quality and Safety in Long-Term Care in Ontario: The Impact of Language Discordance.

OBJECTIVES: This study compared quality indicators across linguistic groups and sought to determine whether disparities are influenced by resident-facility language discordance in long-term care. DESIGN: Population-based retrospective cohort study using linked databases. SETTING AND PARTICIPANTS: Retrospective cohort of newly admitted residents of long-term care facilities in Ontario, Canada, between 2010 and 2016 (N=47,727). Individual residents' information was obtained from the Resident Assessment Instrument Minimum Data Set (RAI-MDS) to determine resident's primary language, clinical characteristics, and health care indicators. MEASURES: Main covariates of interest were primary language of the resident and predominant language of the long-term care facility, which was determined using the French designation status as defined in the French Language Services Act. Primary outcomes were a set of quality and safety indicators related to long-term care: worsening of depression, falls, moderate-severe pain, use of antipsychotic medication, and physical restraints. Multivariable logistic regression models were used to assess the impact of resident's primary language, facility language, and resident-facility language discordance on each quality indicator. RESULTS: Overall, there were few differences between francophones and anglophones for quality and safety indicators. Francophones were more likely to report pain (10.9% vs 9.9%; P = .001) and be physically restrained (7.3% vs 5.2%; P < .001), whereas a greater proportion of anglophones experienced worsening of depressive symptoms (24.0% vs 22.9%; P = .001). However, quality indicators were generally worse for francophones in Non-Designated facilities, except for pain, which was more commonly reported by francophones in French-Designated facilities. Anglophones were more likely to be physically restrained in French-Designated facilities (6.7% vs 5.1%; P < .001). CONCLUSIONS AND IMPLICATIONS: For francophones, quality indicators tended to be worse in the presence of resident-facility language discordance. However, these findings did not persist after adjusting for individual- and facility-level characteristics, suggesting that the disparities observed at the population level cannot be attributed to linguistic factors alone.

Screen time is independently associated with serum brain-derived neurotrophic factor (BDNF) in youth with obesity.

Low levels of brain derived-neurotrophic factor (BDNF) and excessive screen exposure are risk factors for neurocognitive deficits and obesity in youth, but the relationship between screen time and BDNF remains unknown. This study examined whether duration and/or type of sedentary screen time behaviour (TV viewing, video games, recreational computer use) are associated with serum BDNF levels in youth with obesity. The sample consisted of 250 inactive, postpubertal adolescents with obesity (172 females/78 males, aged 15.5 ± 1.4 years) at the baseline assessment of the Healthy Eating, Aerobic, Resistance Training in Youth Study. After controlling for self-reported age, sex, race, parental education, puberty stage, physical activity, and diet, higher total screen exposure was significantly associated with lower serum BDNF levels (ß = -0.21, p = 0.002). TV viewing was the only type of screen behaviour that was associated with BDNF levels (ß = -0.22, p = 0.001). Higher exposure to traditional forms of screen time was independently associated with lower serum BDNF levels, and this association appears to be driven primarily by TV viewing. Future intervention research is needed to determine whether limiting screen time is an effective way to increase BDNF and associated health benefits in a high-risk population of youth with obesity. Trial Registration: ClinicalTrials.Gov NCT00195858. Novelty: This study is the first to show that recreational screen time is inversely associated with serum BDNF levels. The inverse association between screen time and BDNF is driven primarily by TV viewing, indicating the type of screen might matter.

Efficient, quick and easy-to-use DNA replication timing analysis with START-R suite.

DNA replication must be faithful and follow a well-defined spatiotemporal program closely linked to transcriptional activity, epigenomic marks, intranuclear structures, mutation rate and cell fate determination. Among the readouts of the spatiotemporal program of DNA replication, replication timing analyses require not only complex and time-consuming experimental procedures, but also skills in bioinformatics. We developed a dedicated Shiny interactive web application, the START-R (Simple Tool for the Analysis of the Replication Timing based on R) suite, which analyzes DNA replication timing in a given organism with high-throughput data. It reduces the time required for generating and analyzing simultaneously data from several samples. It automatically detects different types of timing regions and identifies significant differences between two experimental conditions in ∼15 min. In conclusion, START-R suite allows quick, efficient and easier analyses of DNA replication timing for all organisms. This novel approach can be used by every biologist. It is now simpler to use this method in order to understand, for example, whether 'a favorite gene or protein' has an impact on replication process or, indirectly, on genomic organization (as Hi-C experiments), by comparing the replication timing profiles between wild-type and mutant cell lines.