Prevalence of test accommodations for the Medical Council of Canada Qualifying Exam Part I, 2013-2021.

Introduction: Previous articles have highlighted the laborious process of acquiring disability accommodations in medical education. We endeavoured to characterize the trends of test accommodations on the MCCQE Part I. Methods: Data was obtained from the Medical Council of Canada on the number of applicants who attained test accommodations on the MCCQE Part I between 2013 and 2021. The number of test takers for the same period was obtained from the Medical Council of Canada's Annual Technical Reports; this data was not publicly available for 2013, 2014, or 2021. Prevalence rates and graphs were produced. Results: The number of test takers who attained test accommodations ranged from 35 to 126 between 2013 and 2021. The percentage of test takers who attained test accommodations ranged from 0.89% to 2.01% between 2015 and 2020. Per correspondence with the Medical Council of Canada, no applicant who provided all required documentation was denied test accommodations during this period. Discussion: The number and rate of test takers attaining test accommodations on the MCCQE Part I have increased substantially during this period. It is unclear whether this increase is due to greater rates of students with disabilities, or a reduction in stigma around using test accommodations.

Introduction: Des articles publiés antérieurement ont montré à quel point le processus d'obtention d'accommodements pour les personnes handicapées dans le cadre de la formation médicale peut être laborieux. Nous avons voulu explorer les tendances en matière d'accommodements pour l'examen d'aptitude du Conseil médical du Canada (EACMC), partie I. Méthodes: Le Conseil médical du Canada nous a communiqué le nombre de candidats qui ont obtenu des accommodements pour l'EACMC, partie I, entre 2013 et 2021. Le nombre de candidats ayant passé l'examen au cours de la même période a été obtenu en consultant les rapports techniques annuels du Conseil médical du Canada; les données pour 2013, 2014 et 2021 n'étaient pas accessibles au public. Nous présentons des taux de prévalence et des graphiques. Résultats: Le nombre de candidats ayant bénéficié d'accommodements a varié de 35 à 126 entre 2013 et 2021. Le pourcentage de ces candidats a varié de 0,89 % à 2,01 % entre 2015 et 2020. Selon la correspondance du Conseil médical du Canada, aucun candidat ayant fourni les documents requis ne s'est vu refuser un accommodement d'examen au cours de cette période. Discussion: Le nombre et le taux de candidats bénéficiant d'accommodements pour l'EACMC, partie I, ont considérablement augmenté au cours de la période visée. On ne sait pas si cette hausse est due à une augmentation du nombre d'étudiants handicapés ou à une réduction de la stigmatisation liée au recours aux accommodements d'examen.

Improving body functions through participation in community activities among young people with physical disabilities.

AIM: To examine the impact of engagement in a self-chosen community-based activity on three relevant body functions (motor, cognitive, and affective) as well as on the performance of the selected activity. METHOD: An individual-based interrupted time series design with multiple baselines was used. Seven young people (four males, three females) aged 15 to 25 years (median 18y; interquartile range 17-20y) with physical disabilities participated in an 8-week community activity of choice (e.g. swimming, playing piano). Change in three relevant body functions, underpinning the specific chosen activity, including motor (e.g. Functional Reach Test, Trunk Impairment Scale, dynamometers), cognitive and affective (Behavior Assessment System for Children), as well as activity performance (Canadian Occupational Performance Measure) were measured repeatedly, providing individual outcome trajectories. Linear and mixed-effects models were used. RESULTS: Significant improvements in at least one aspect of motor function (6 out of 6), cognition (3 out of 3), affect (5 out of 7), and performance (7 out of 7) were observed. Specifically, the intervention had a moderate to large effect on hyperactivity (1.45, 95% confidence interval [CI] 1.0-1.9) with a smaller effect on anxiety (0.21, 95% CI 0.10-0.32) and inadequacy (0.21, 95% CI 0.02-0.39). Concurrently, a notable effect size for activity performance (4.61, 95% CI 0.76-8.46) was observed. Average change across motor outcomes was substantial (3.7 SDs from baseline), yet non-significant. INTERPERTATION: Findings provide initial evidence of the benefits resulting from participation-based interventions, emphasizing the merit of meaningful 'real-life' young people-engaging therapy. WHAT THIS PAPER ADDS: Participation-based interventions can impact body-function level outcomes. Significant improvements in the performance of chosen activities were observed. Significant improvements were also seen in cognitive and affective body functions. Improvements in motor-related outcomes were substantial but not statistically significant.

Beyond stereotypes of cerebral palsy: Exploring the lived experiences of young Canadians.

BACKGROUND: Health for people with cerebral palsy (CP) must extend beyond physical impairments to include social, environmental, and psychological factors that are rarely captured by quantitative research alone. This qualitative study sought to explore the lived experience of young people with CP with their physical, mental, and emotional health in the context of a larger longitudinal Canadian study focusing on brain function, physical and mental health, and well-being. METHODS: An integrated research team (including people with CP or other impairments, clinicians, and researchers) was formed to study participant-identified research needs. A purposive sample of 16 people with CP (seven female), aged 17-29, Gross Motor Function Classification System (GMFCS) levels I-V, participated in three focus groups that were conceptualized and analysed using interpretive description methodology. RESULTS: This study reports the experiences of people with CP across GMFCS levels and identifies some consequences of growing up with the condition: physical and mental health issues, importance of meaningful participation, impact of the environment, and identity formation. Participants shared challenges related to accessibility, healthcare, social/environmental supports, relationships, and sustainable employment. DISCUSSION: Body structure and function challenges impact participation in activities of daily living, threatening participants' ability to form positive identities and live meaningful lives. People with CP desire to work but may require additional training, accommodation, and support to do so. Environmental conditions, including relationships, supportive people, and accessibility, shape participants' health, well-being, and social/civic engagement. This study confirms the need for improved care for adults with CP, including multidisciplinary adult health team(s) and community services.

Real-Time XANES Measurement of Se Reduction by Zerovalent Iron in a Flow-through Cell, and Accompanying Se Isotope Measurements.

An anoxic flow-through cell experiment was conducted to examine mechanisms controlling the real-time reduction of selenate (Se(VI)) by zerovalent iron (ZVI), which is commonly used in permeable reactive barriers to treat dissolved contaminants including Se(VI). Changes in selenium (Se) isotope composition were examined by increasing the influent Se concentration over time, thus changing the proportion of Se removed from solution. At the conclusion of the experiment, an anoxic Se-free solution was pumped through the cell to assess the stability of the reaction products. At all stages, X-ray absorption data were obtained from the solid phase and Se isotope data from the aqueous phase. Reduced Se in the form of adsorbed Se(IV), Fe2SeO4, Se(0), and iron selenides accumulated on the ZVI over time. A linear regression function was fit to the δ82/76Se values of the effluent, yielding an isotopic separation of 9.6‰. A Rayleigh curve was fit to the isotope data from the effluent samples collected during the rinse stage with an effective fractionation of 2.4‰. The results from this experiment can be used to elucidate the effect of multiple concurrent mechanisms on Se isotope behavior.

Dual Mechanism Conceptual Model for Cr Isotope Fractionation during Reduction by Zerovalent Iron under Saturated Flow Conditions.

Chromium isotope analysis is rapidly becoming a valuable complementary tool for tracking Cr(VI) treatment in groundwater. Evaluation of various treatment materials has demonstrated that the degree of isotope fractionation is a function of the reaction mechanism, where reduction of Cr(VI) to Cr(III) induces the largest fractionation. However, it has also been observed that uniform flow conditions can contribute complexity to isotope measurements. Here, laboratory batch and column experiments were conducted to assess Cr isotope fractionation during Cr(VI) reduction by zerovalent iron under both static and saturated flow conditions. Isotope measurements were accompanied by traditional aqueous geochemical measurements (pH, Eh, concentrations) and solid-phase analysis by scanning electron microscopy and X-ray absorption spectroscopy. Increasing δ(53)Cr values were associated with decreasing Cr(VI) concentrations, which indicates reduction; solid-phase analysis showed an accumulation of Cr(III) on the iron. Reactive transport modeling implemented a dual mechanism approach to simulate the fractionation observed in the experiments. The faster heterogeneous reaction pathway was associated with minimal fractionation (ε=-0.2‰), while the slower homogeneous pathway exhibited a greater degree of fractionation (ε=-0.9‰ for the batch experiment, and ε=-1.5‰ for the column experiment).

Reactive transport modeling of chromium isotope fractionation during Cr(VI) reduction.

Chromium isotope fractionation is indicative of mass-transfer processes, such as reduction of Cr(VI) to Cr(III) during groundwater remediation. Laboratory experiments comparing batch and column treatment of Cr(VI) using organic carbon suggest that the associated isotope fractionation may be influenced by solute-transport mechanisms. These batch and column experiments were simulated using the reactive transport model MIN3P to further evaluate the effects of Cr reduction and transport on isotope fractionation under saturated flow conditions. Simulation of the batch experiment provided a good fit to the experimental data, where a fractionation factor (α53) of 0.9965 was attributed to a single, dominant Cr(VI) removal mechanism. Calibration of the column simulations to the experimental results suggested the presence of a second, more rapid Cr(VI) removal mechanism with α53 = 0.9992. Results from this study demonstrate that the interpretation of Cr isotope fractionation during reduction can be complex, particularly where multiple removal mechanisms are evident. Reactive transport modeling of Cr isotope fractionation can provide a quantitative assessment of the contaminant removal mechanisms, thus improving the application of Cr isotope measurements as a tool to track Cr(VI) migration and attenuation in groundwater.

Chromium isotope fractionation during reduction of Cr(VI) under saturated flow conditions.

Chromium isotopes are potentially useful indicators of Cr(VI) reduction reactions in groundwater flow systems; however, the influence of transport on Cr isotope fractionation has not been fully examined. Laboratory batch and column experiments were conducted to evaluate isotopic fractionation of Cr during Cr(VI) reduction under both static and controlled flow conditions. Organic carbon was used to reduce Cr(VI) in simulated groundwater containing 20 mg L(-1) Cr(VI) in both batch and column experiments. Isotope measurements were performed on dissolved Cr on samples from the batch experiments, and on effluent and profile samples from the column experiment. Analysis of the residual solid-phase materials by scanning electron microscopy (SEM) and by X-ray absorption near edge structure (XANES) spectroscopy confirmed association of Cr(III) with organic carbon in the column solids. Decreases in dissolved Cr(VI) concentrations were coupled with increases in δ(53)Cr, indicating that Cr isotope enrichment occurred during reduction of Cr(VI). The δ(53)Cr data from the column experiment was fit by linear regression yielding a fractionation factor (α) of 0.9979, whereas the batch experiments exhibited Rayleigh-type isotope fractionation (α = 0.9965). The linear characteristic of the column δ(53)Cr data may reflect the contribution of transport on Cr isotope fractionation.