Modelling spatial & temporal variability of air pollution in an area of unconventional natural gas operations.

Despite the growing unconventional natural gas production industry in northeastern British Columbia, Canada, few studies have explored the air quality implications on human health in nearby communities. Researchers who have worked with pregnant women in this area have found higher levels of volatile organic compounds (VOCs) in the indoor air of their homes associated with higher density and closer proximity to gas wells. To inform ongoing exposure assessments, this study develops land use regression (LUR) models to predict ambient air pollution at the homes of pregnant women by using natural gas production activities as predictor variables. Using the existing monitoring network, the models were developed for three temporal scales for 12 air pollutants. The models predicting monthly, bi-annual, and annual mean concentrations explained 23%-94%, 54%-94%, and 73%-91% of the variability in air pollutant concentrations, respectively. These models can be used to investigate associations between prenatal exposure to air pollutants associated with natural gas production and adverse health outcomes in northeastern British Columbia.

Developing Formative Strategies to Support Undergraduate Nursing Student's Learning in the Lab.

BACKGROUND: Undergraduate nursing education consists of supporting students' learning about psychomotor skills. There is variation in strategies used to facilitate learning in the lab setting because there is no single accepted or preferred educational approach. METHOD: Formative learning strategies were integrated into lab courses throughout a nursing curriculum for undergraduate students at a Canadian university. These strategies included developing and implementing guidelines, a rubric, and an addendum. RESULTS: Students enrolled in lab courses that used these strategies received ongoing verbal and written feedback from their instructor and were provided with an opportunity to engage in reflective practice and refine clinical judgment skills. CONCLUSION: Using consistent and effective formative strategies to support students' learning in the lab requires further empirical exploration and consideration. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Does E-learning Facilitate Medical Education in Pediatric Neurology?

BACKGROUND: E-learning has become commonplace in medical education. Incorporation of multimedia, clinical cases, and interactive elements has increased its attractiveness over textbooks. Although there has been an expansion of e-learning in medicine, the feasibility of e-learning in pediatric neurology is unclear. This study evaluates knowledge acquisition and satisfaction using pediatric neurology e-learning compared to conventional learning. METHODS: Residents of Canadian pediatrics, neurology, and pediatric neurology programs and medical students from Queens University, Western University, and the University of Ottawa were invited to participate. Learners were randomly assigned two review papers and two ebrain modules in a four-topic crossover design. Participants completed pre-tests, experience surveys, and post-tests. We calculated the median change in score from pre-test to post-test and constructed a mixed-effects model to determine the effect of variables on post-test scores. RESULTS: In total, 119 individuals participated (53 medical students; 66 residents). Ebrain had a larger positive change than review papers in post-test score from pre-test score for the pediatric stroke learning topic but a smaller positive change for Duchenne muscular dystrophy, childhood absence epilepsy, and acute disseminated encephalomyelitis. Learning topics showed statistical relationship to post-test scores (p = 0.04). Depending on topic, 57-92% (N = 59-66) of respondents favored e-learning over review article learning. CONCLUSIONS: Ebrain users scored higher on post-tests than review paper users. However, the effect is small and it is unclear if it is educationally meaningful. Although the difference in scores may not be substantially different, most learners preferred e-learning. Future projects should focus on improving the quality and efficacy of e-learning modules.

Estimating the environmental impacts of global lithium-ion battery supply chain: A temporal, geographical, and technological perspective.

A sustainable low-carbon transition via electric vehicles will require a comprehensive understanding of lithium-ion batteries' global supply chain environmental impacts. Here, we analyze the cradle-to-gate energy use and greenhouse gas emissions of current and future nickel-manganese-cobalt and lithium-iron-phosphate battery technologies. We consider existing battery supply chains and future electricity grid decarbonization prospects for countries involved in material mining and battery production. Currently, around two-thirds of the total global emissions associated with battery production are highly concentrated in three countries as follows: China (45%), Indonesia (13%), and Australia (9%). On a unit basis, projected electricity grid decarbonization could reduce emissions of future battery production by up to 38% by 2050. An aggressive electric vehicle uptake scenario could result in cumulative emissions of 8.1 GtCO2eq by 2050 due to the manufacturing of nickel-based chemistries. However, a switch to lithium iron phosphate-based chemistry could enable emission savings of about 1.5 GtCO2eq. Secondary materials, via recycling, can help reduce primary supply requirements and alleviate the environmental burdens associated with the extraction and processing of materials from primary sources, where direct recycling offers the lowest impacts, followed by hydrometallurgical and pyrometallurgical, reducing greenhouse gas emissions by 61, 51, and 17%, respectively. This study can inform global and regional clean energy strategies to boost technology innovations, decarbonize the electricity grid, and optimize the global supply chain toward a net-zero future.

The complex relationship between carbon literacy and pro-environmental actions among engineering students.

Lifestyle choices and consumption play a large role in contributing to per capita greenhouse gas emissions. Certain activities, like fossil fuel ground transportation, long-haul flights, diets with animal products and residential heating and cooling contribute significantly to per capita emissions. There is uncertainty around whether literacy about these actions encourages individuals to act pro-environmentally to reduce personal carbon footprints or to prioritize the most effective actions. This study investigated the relationship between carbon literacy and pro-environmental actions performed to reduce greenhouse gas emissions among undergraduate engineering students at the University of Toronto. The pro-environmental actions by the participants produced an average carbon footprint of 4.8 tCO2 (within the subset of actions included in the survey) which was lower than the average for residents each of Toronto, Ontario, and Canada overall but still higher than the global target of ∼2.8 tCO2e. The carbon literacy by participants was best for high impact actions like ground transportation and dietary choices but less so for air travel and there was mixed awareness for the moderate and low impact actions. For high impact actions and many moderate and low impact actions, participants who thought the action was high impact (even if incorrect) had lower carbon footprints related to the associated activity than those who thought the action was moderate or low impact. The overall relationship between pro-environmental action and carbon literacy was weak. It showed that for high impact actions, there is a slight negative correlation between carbon literacy and personal carbon footprint whereas for moderate and low impact actions, there is a positive correlation.

Understanding variability in petroleum jet fuel life cycle greenhouse gas emissions to inform aviation decarbonization.

A pressing challenge facing the aviation industry is to aggressively reduce greenhouse gas emissions in the face of increasing demand for aviation fuels. Climate goals such as carbon-neutral growth from 2020 onwards require continuous improvements in technology, operations, infrastructure, and most importantly, reductions in aviation fuel life cycle emissions. The Carbon Offsetting Scheme for International Aviation of the International Civil Aviation Organization provides a global market-based measure to group all possible emissions reduction measures into a joint program. Using a bottom-up, engineering-based modeling approach, this study provides the first estimates of life cycle greenhouse gas emissions from petroleum jet fuel on regional and global scales. Here we show that not all petroleum jet fuels are the same as the country-level life cycle emissions of petroleum jet fuels range from 81.1 to 94.8 gCO2e MJ-1, with a global volume-weighted average of 88.7 gCO2e MJ-1. These findings provide a high-resolution baseline against which sustainable aviation fuel and other emissions reduction opportunities can be prioritized to achieve greater emissions reductions faster.

Greenhouse Gas Emission Mitigation Pathways for Urban Passenger Land Transport under Ambitious Climate Targets.

Urban passenger land transport is an important source of greenhouse gas (GHG) emissions globally, but it is challenging to mitigate these emissions as this sector interacts with many other economic sectors. We develop the Climate change constrained Urban passenger Transport Integrated Life cycle assessment (CURTAIL) model to outline mitigation pathways of urban passenger land transport that are consistent with ambitious climate targets. CURTAIL uses the transport activity of exogenously defined modal shares to simulate the associated annual vehicle stocks, sales, and life cycle GHG emissions. It estimates GHG emission budgets that are consistent with global warming below 2 and 1.5 °C above preindustrial levels and seeks mitigation strategies to remain within the budgets. We apply it to a case study of Singapore, a city-state. Meeting a 1.5 °C target requires strong commitments in the transport and electricity sectors, such as reducing the motorized passenger activity, accelerating the deployment of public transit and of electrification, and decarbonizing the power generation system. Focusing on one mitigation technology or one mode of transport alone will not be sufficient to meet the target. Our novel model could be applied to any city to provide insights relevant to the design of urban climate change mitigation targets and policies.

Serum Neurofilament Light Chain Measurement in MS: Hurdles to Clinical Translation.

Measurement of serum neurofilament light chain concentration (sNfL) promises to become a convenient, cost effective and meaningful adjunct for multiple sclerosis (MS) prognostication as well as monitoring disease activity in response to treatment. Despite the remarkable progress and an ever-increasing literature supporting the potential role of sNfL in MS over the last 5 years, a number of hurdles remain before this test can be integrated into routine clinical practice. In this review we highlight these hurdles, broadly classified by concerns relating to clinical validity and analytical validity. After setting out an aspirational roadmap as to how many of these issues can be overcome, we conclude by sharing our vision of the current and future role of sNfL assays in MS clinical practice.

Optimizing the Use of a Constrained Resource to Minimize Regional Greenhouse Gas Emissions: The Case Study of Slag in Ontario's Concrete.

Green policies currently incentivize concrete producers to replace portland cement with industrial byproducts to reduce their greenhouse gas (GHG) emissions. However, policies are based on attributional life cycle assessments (LCAs) that do not account for market constraints and consider byproducts either available burden-free to the user (cutoff approach) or partially responsible for the emissions generated in the upstream processes (allocation). The goal of this study was to investigate whether these approaches (and incentives) could lead to a mismanagement of byproducts and to suboptimal solutions in terms of regional GHG emissions. The use of ground granulated blast-furnace slag (GGBS) in Ontario was studied, and an optimization model to find the least GHG-intense way of using GGBS was developed. Results showed that producers should replace 30 to 40% of portland cement in high-strength concrete to minimize the regional GHG emissions associated with concrete. However, traditional LCA approaches do not suggest this solution and are estimated to lead to up to a 10% increase in concrete GHG emissions in Ontario. The substitution method, which assigns emissions or credits to byproducts based on emissions associated with the products they may displace, can yield decisions consistent with the regional emission optimization model. A revision of current policies is recommended to include market constraints.

A pilot study of a longitudinal mindfulness curriculum in undergraduate medical education.

BACKGROUND: To support student well-being, a mindfulness curriculum in undergraduate medical education was launched at our university in 2014. We describe the program and report 3-year results. METHODS: Medical students responded to online questionnaires on mindfulness (Freiburg Mindfulness Inventory), empathy (Jefferson Scale of Physician Empathy), resilience (Connor-Davidson Resilience Scale) and perceived stress (Perceived Stress Scale) and were surveyed for demographics, home practice, and subjective experience at curriculum launch and yearly for 3 years. RESULTS: In respondents, high stress (19.2 (SD=6)) and low resilience (71.2 (SD=12.5)) scores were seen throughout training. Scores for mindfulness correlated positively with those for empathy (r=.217 p < 0.01) and resilience (r = .539, p < 0.01), and negatively with stress scores (r = -.380, p < 0.01). While overall scale scores did not statistically change after curriculum implementation, statistically significant increases were seen in mindfulness (12%, p = 0.008), empathy (5%, p = 0.045), and resilience scores (12%, p = 0.002) with a trend toward lower stress scores (8%, p =0.080) in respondents who felt they applied the curriculum principles. Two hours of reported home practice per week was associated with statistically significant changes (14% increased mindfulness scores p < 0.001; 6% increased empathy scores p < 0.001, 10% increased resilience scores p = 0.003; 11% decreased stress scores p = 0.008). Despite positive program evaluations for both mandatory and elective sessions, student attendance at elective sessions was low. CONCLUSION: A mindfulness curriculum integrated into formal undergraduate medical education is feasible. Benefits may be confined to those students who apply curriculum principles and practice regularly. Further study is needed.Résumé. CONTEXTE: Pour soutenir le bien-être des étudiants, un cursus de méditation pleine conscience dans le cadre du programme de doctorat en médecine a été lancé à notre université en 2014. Nous décrivons le programme et communiquons les résultats après trois ans. MÉTHODES: Des étudiants en médecine ont répondu à des questionnaires en ligne sur la pleine conscience (inventaire de pleine conscience de Freiburg), l'empathie (Échelle de Jefferson sur l'empathie du médecin), la résilience (échelle de résilience de Connor-Davidson) et le stress perçu (échelle du stress perçu) et ont été interrogés pour les caractéristiques démographiques, la pratique de la méditation pleine conscience à domicile et l'expérience subjective au moment du lancement du cursus et, ensuite, annuellement pendant trois ans. RÉSULTATS: Chez les répondants, un degré de stress élevé (19,2 (ET=6)) et une faible résilience (71,2 (ET=12,5)) ont été observés tout au long de la formation. Il y avait une corrélation positive entre les la pleine conscience et l'empathie (r=0,17, p<0,01) et de la résilience (r=0,539, p<0,01), et négative avec le stress (r=-0,380, p<0,01). Alors que les résultats globaux ne changent pas statistiquement après la mise en œuvre du cursus, des augmentations statistiquement significatives ont été observées pour la pleine conscience (12%, p=0,008), l'empathie (5%, p=0,045) et la résilience (12%, p=0,002) avec une tendance vers des résultats inférieurs pour le stress (8%, p=0,080) chez les répondants qui estimaient avoir appliqué les principes du programme. On retrouvait des changements significatifs chez les répondants qui rapportaient avoir pratiqué deux heures par semaine à domicile (résultats accrus de 14% pour la pleine conscience (p<0,001), de 6% pour l'empathie (p<0,001) et de 10% pour la résilience (p= 0,003), et réduits de 11% pour le stress (p=0,008)). Malgré des évaluations de programme positives pour les sessions obligatoires et optionnelles, l'assiduité des étudiants aux sessions optionnelles était faible. CONCLUSION: Un cursus de méditation pleine conscience intégré dans des études formelles de doctorat en médecine est faisable. Les avantages peuvent être confinés aux étudiants qui appliquent les principes du programme et qui le pratiquent sur une base régulière. D'autres études sont requises.

Experiences and perceptions of spousal/partner caregivers providing care for community-dwelling adults with dementia: a qualitative systematic review.

OBJECTIVE: The objective of this review was to synthesize evidence on the experiences and perceptions of spousal/partner caregivers of community-dwelling adults with dementia. INTRODUCTION: Currently 47 million people in the world have a diagnosis of dementia, and this number is predicted to climb to 75 million by 2030. The majority of care is provided by family members, particularly spouses/partners. Quantitative systematic reviews of spouse/partner caregivers demonstrate negative health effects for these caregivers. This review synthesized the qualitative evidence on the experiences of spousal/partner caregivers of people with dementia to further understanding how this care and the context of care contribute to the health and well-being of spousal/partner caregivers. INCLUSION CRITERIA: This review considered qualitative studies that explored the experiences of spousal/partner caregivers providing care for adults with dementia. The focus was on qualitative designs including, but not limited to, phenomenology, grounded theory, ethnography, action research, critical research and feminist research. METHODS: The search strategy used a three-step approach and was aimed at locating both published and unpublished studies. Key databases included MEDLINE, CINAHL, Embase, PsycINFO, Sociological Abstracts, ISI Web of Science, and Dissertation Abstracts International. Gray literature was searched using keywords from the database searches. The databases were searched from inception to February 2017, and a mix of controlled vocabulary (i.e. MeSH, CINAHL headings) and keywords were used to capture all existing qualitative studies related to the experiences and perceptions of spousal/partner caregivers providing unpaid care for adults with dementia. During the title and abstract screening, only English and French articles were included. The recommended JBI approach to study selection, critical appraisal, data extraction and data synthesis was used. Seven of the 10 critical appraisal criteria were deemed essential, with exceptions identified for criteria 1, 6 and 7. RESULTS: Nineteen studies were included in the review. Study designs included phenomenology (eight), grounded theory (five), qualitative description (four), ethnography (one) and narrative inquiry (one). The total number of participants was 248 (164 women and 84 men). The overall quality of the studies was rated as moderate on the ConQual score, with dependability rated as moderate and credibility rated as high. One hundred and fifty-five findings were aggregated into four categories and two synthesized findings. The two synthesized findings were "the expectation to care in the midst of uncertainty and unpredictability" and "the caregiver as hostage". CONCLUSIONS: This review provides a comprehensive understanding that can inform spousal/partner caregiver policies and programs. Evidence is required on the experiences and perceptions of caregivers across the gender continuum. Interventions and interventional research that mobilizes the evidence to date is essential for the future of caregivers. The limitations to this review include the possibility of missed studies, all study participants being in heterosexual relationships, and the majority of participants being Caucasian. Recommendations for practice, policy and research include the need for awareness of the extent of change in the lives of the person with dementia and the spousal/partner caregiver, the importance of support and respite, the need to tangibly recognize the value of the unpaid caregiver in a way that preserves the health and well-being of this group, and research is required that is culturally sensitive and reflects the experiences of the lesbian, gay, bisexual, transgender, transsexual, queer, questioning, intersex, asexual, ally, pansexual populations.

Neurotoxicity after hematopoietic stem cell transplant in multiple sclerosis.

OBJECTIVE: Accelerated brain volume loss has been noted following immunoablative autologous hematopoietic stem cell transplantation (IAHSCT) for multiple sclerosis. As with other MS treatments, this is often interpreted as 'pseudoatrophy', related to reduced inflammation. Treatment-related neurotoxicity may be contributory. We sought objective evidence of post-IAHSCT toxicity by quantifying levels of Neurofilament Light Chain (sNfL) and Glial Fibrillary Acidic Protein (sGFAP) before and after treatment as markers of neuroaxonal and glial cell damage. METHODS: Sera were collected from 22 MS patients pre- and post-IAHSCT at 3, 6, 9, and 12 months along with 28 noninflammatory controls. sNfL and sGFAP quantification was performed using the SiMoA single-molecule assay. RESULTS: Pre-IAHSCT levels of sNfL and sGFAP were elevated in MS patients compared with controls (geometric mean sNfL 21.8 vs. 6.4 pg/mL, sGFAP 107.4 vs. 50.7 pg/mL, P = 0.0001 for both). Three months after IAHSCT, levels of sNfL and sGFAP increased from baseline by 32.1% and 74.8%, respectively (P = 0.0029 and 0.0004). sNfL increases correlated with total busulfan dose (P = 0.034), EDSS score worsening at 6 months (P = 0.041), and MRI grey matter volume loss at 6 months (P = 0.0023). Subsequent NfL levels reduced to less than baseline (12-month geometric mean 11.3 pg/mL P = 0.0001) but were still higher than controls (P = 0.0001). sGFAP levels reduced more slowly but at 12 months were approaching baseline levels (130.7 pg/mL). INTERPRETATION: There is direct evidence of transient CNS toxicity immediately after IAHSCT which may be chemotherapy mediated and contributes to transient increases in MRI atrophy.

Environmental Aspects of Biotechnology.

A key motivation behind the development and adoption of industrial biotechnology is the reduction of negative environmental impacts. However, accurately assessing these impacts remains a formidable task. Environmental impacts of industrial biotechnology may be significant across a number of categories that include, but may not be limited to, nonrenewable resource depletion, water withdrawals and consumption, climate change, and natural land transformation/occupation. In this chapter, we highlight some key environmental issues across two broad areas: (a) processes that use biobased feedstocks and (b) industrial activity that is supported by biological processes. We also address further issues in accounting for related environmental impacts such as geographic and temporal scope, co-product management, and uncertainty and variability in impacts. Case studies relating to (a) lignocellulosic ethanol, (b) biobased plastics, and (c) enzyme use in the detergent industry are then presented, which illustrate more specific applications. Finally, emerging trends in the area of environmental impacts of biotechnology are discussed.

Working to Have a Normal Life With Cystic Fibrosis in an Adherence-Driven Health Care System.

BACKGROUND: Adults with cystic fibrosis (CF) must continuously manage their condition, while working for a living, and want a normal life. Adherence rates to treatments/medications are less than optimal. Existing theory offers little to explain adherence rates. The purpose of this study was to develop a theory to further the understanding of how people with CF manage their condition in an adherence-driven health care system. METHODS: Constructivist Grounded Theory methodology was used to conduct 27 semistructured interviews with adults with CF, family members, and health care providers. Data collection and analysis were simultaneous, using constant comparative methods, initial and focused coding, and category identification and reduction to develop a theory. RESULTS: Doing what works to balance life and CF is the theory generated from this study. The main concern of participants was to be seen as normal. The theory depicts what participants with CF and their family members do about their concerns and involves 4 interrelated processes: working overtime, receiving support, passing as normal, and facing disease progression. CONCLUSION: Participants did not relate to the term nonadherent; rather they described working overtime to manage CF, to work, and to have a normal life. Health care provider and researcher perspectives on adherence differ from those of people with CF. Engaging adults with CF and health care providers in a dialogue in which expectations are shared may lead to individualized treatment regimens that work, because adults with CF will do what works.

A Dynamic Fleet Model of U.S Light-Duty Vehicle Lightweighting and Associated Greenhouse Gas Emissions from 2016 to 2050.

Substituting conventional materials with lightweight materials is an effective way to reduce the life cycle greenhouse gas (GHG) emissions from light-duty vehicles. However, estimated GHG emission reductions of lightweighting depend on multiple factors including the vehicle powertrain technology and efficiency, lightweight material employed, and end-of-life material recovery. We developed a fleet-based life cycle model to estimate the GHG emission changes due to lightweighting the U.S. light-duty fleet from 2016 to 2050, using either high strength steel or aluminum as the lightweight material. Our model estimates that implementation of an aggressive lightweighting scenario using aluminum reduces 2016 through 2050 cumulative life cycle GHG emissions from the fleet by 2.9 Gt CO2 eq (5.6%), and annual emissions in 2050 by 11%. Lightweighting has the greatest GHG emission reduction potential when implemented in the near-term, with two times more reduction per kilometer traveled if implemented in 2016 rather than in 2030. Delaying implementation by 15 years sacrifices 72% (2.1 Gt CO2 eq) of the cumulative GHG emission mitigation potential through 2050. Lightweighting is an effective solution that could provide important near-term GHG emission reductions especially during the next 10-20 years when the fleet is dominated by conventional powertrain vehicles.

Research-to-Practice Gaps in Multiple Sclerosis Care for Patients with Subjective Cognitive, Mental Health, and Psychosocial Concerns in a Canadian Center.

BACKGROUND: People with multiple sclerosis (MS) are at increased risk for cognitive impairment, mental health concerns, and psychosocial issues, which can negatively affect disease outcomes and quality of life. Current MS care guidelines recommend integrated interdisciplinary services to address these concerns; however, issues can be overlooked during routine care. To date, there is inadequate research on how often these issues are identified and addressed during routine MS care. METHODS: One hundred medical records were randomly selected and reviewed (55 relapsing-remitting MS, 17 secondary progressive MS, 8 primary progressive MS, and 20 other or subtype not indicated). All visits to, and contacts with (ie, telephone, e-mail), an MS clinic over 1 year were included in the analysis to determine the proportion of patients presenting with cognitive, mental health, and psychosocial concerns and the proportion of patients offered associated services. RESULTS: Of the 25 patients with at least one identified concern, treatment recommendations occurred for 13 (52%). Rates of identification of cognitive, mental health, and psychosocial concerns in standard clinical practice were significantly lower than the identified prevalence in epidemiologic studies. Demographic factors had no bearing on who was offered treatment. Patients with concerns access MS clinic services more often than those without. CONCLUSIONS: Discrepancies between reported and expected frequencies may be due to overreliance on patient self-disclosure and concerns by the health care team that inadequate resources are available to address issues. An interdisciplinary team model may help address these issues.

Feasibility and effectiveness of an online mindfulness meditation program for medical students.

BACKGROUND: The need to incorporate tools to promote medical student wellness in medical education is underscored by the concerning rates of psychological distress among them. The objective of this prospective cohort study was to obtain preliminary data on the feasibility and effectiveness of an online mindfulness intervention for medical student wellness. METHODS: A convenience sample of 52 medical students consented to participate in this study. Feasibility was assessed by ease of recruitment, number of modules completed, satisfaction with the program, and adherence to a regular meditation practice. Participants completed the Maslach Burnout Inventory, the Jefferson Scale of Empathy-medical student version, the Five Face of Mindfulness Questionnaire-short form, and the Self Compassion Scale-short form pre and post intervention. RESULTS: The convenience sample was recruited within a two-month period. Forty-five participants completed at least one of seven modules. Descriptive statistics (mean±standard deviation) revealed that the mean number of modules completed was 4.85±2.7. Mean satisfaction with the modules was 7.07±1.1 out of 10. Adherence to a regular formal meditation practice was poor; the average amount of formal meditation practice per module was 34.14±27.44 minutes. Self-compassion and the "observe and describe" facets of mindfulness practice significantly statistically increased from baseline, but no such change was observed for levels of burnout and empathy. CONCLUSION: The present study indicates that an online mindfulness meditation program may be of interest to medical students. The results did not provide any evidence that the program was effective but we believe further research and development is warranted.

Trait Mindfulness and Wellness in Multiple Sclerosis.

Multiple sclerosis (MS) is a chronic, progressive, autoimmune, neurodegenerative disorder that can interfere with physical and psychological functioning, negatively affecting health-related quality of life (HRQoL). Fostering mindfulness may mitigate the negative consequences of MS on HRQoL. The relationship between mindfulness, mood and MS-related quality of life was investigated. In total, 52 individuals with MS completed questionnaires to examine the relationship between trait mindfulness and wellness. Higher levels of trait mindfulness were associated with better HRQoL, lower depression and anxiety, lower fatigue impact and fewer perceived cognitive deficits. Mindfulness interventions have the potential to enhance wellness in those living with MS.

Evaluation of Variability in Greenhouse Gas Intensity of Canadian Oil Sands Surface Mining and Upgrading Operations.

We present a statistically enhanced version of the GreenHouse gas emissions of current Oil Sands Technologies model that facilitates characterization of variability of greenhouse gas (GHG) emissions associated with mining and upgrading of bitumen from Canadian oil sands. Over 30 years of publicly available project-specific operating data are employed as inputs, enabling Monte Carlo simulation of individual projects and the entire industry, for individual years and project life cycles. We estimate that median lifetime GHG intensities range from 89 to 137 kg CO2eq/bbl synthetic crude oil (SCO) for projects that employ upgrading. The only project producing dilbit that goes directly to a refinery has a median lifetime GHG intensity of 51 kg CO2eq/bbl dilbit. As SCO and dilbit are distinct products with different downstream processing energy requirements, a life cycle assessment ("well to wheel") is needed to properly compare them. Projects do not reach steady-state in terms of median GHG intensity. Projects with broader distributions of annual GHG intensities and higher median values are linked to specific events (e.g., project expansions). An implication for policymakers is that no specific technology or operating factor can be directly linked to GHG intensity and no particular project or year of operation can be seen as representative of the industry or production technology.