Recent Canadian efforts to develop population-level pregnancy intervention studies to mitigate effects of natural disasters and other tragedies.

The preconception, pregnancy and immediate postpartum and newborn periods are times for mothers and their offspring when they are especially vulnerable to major stressors - those that are sudden and unexpected and those that are chronic. Their adverse effects can transcend generations. Stressors can include natural disasters or political stressors such as conflict and/or migration. Considerable evidence has accumulated demonstrating the adverse effects of natural disasters on pregnancy outcomes and developmental trajectories. However, beyond tracking outcomes, the time has arrived for gathering more information related to identifying mechanisms, predicting risk and developing stress-reducing and resilience-building interventions to improve outcomes. Further, we need to learn how to encapsulate both the quantitative and qualitative information available and share it with communities and authorities to mitigate the adverse developmental effects of future disasters, conflicts and migrations. This article briefly reviews prenatal maternal stress and identifies three contemporary situations (wildfire in Fort McMurray, Alberta, Canada; hurricane Harvey in Houston, USA and transgenerational and migrant stress in Pforzheim, Germany) where current studies are being established by Canadian investigators to test an intervention. The experiences from these efforts are related along with attempts to involve communities in the studies and share the new knowledge to plan for future disasters or tragedies.

Evidence brief: expanding uptake of hospital-based tobacco-use cessation supports across Ontario

An assessment of what is is known about problems related to expanding the uptake of hospital-based tobacco-use cessation supports, options for addressing these problems, and key implementation considerations. The evidence brief was an input to a stakeholder dialogue on the topic of expanding the uptake of hospital-based tobacco-use cessation supports across Ontario.

Evidence brief: enhancing patient transitions from treatment in regional cancer centres to survivorship in the Hamilton Niagara Haldimand Brant community

Cancer can be seen as a chronic disease that requires long-term efforts to address the late effects of treatment and to maximize the health outcomes of survivors. Clinicians, experts and healthcare system leaders in the Hamilton Niagara Haldimand Brant region of Ontario, much like those working in other jurisdictions, are grappling with how best to plan and coordinate these long-term efforts. This evidence brief, and the stakeholder dialogue it was prepared to inform, were designed to support their actions. The hope is that the lessons learned from this demonstration area can inform developments in other regions across the province of Ontario and at the provincial level, in other provinces across Canada and at the national level, and in other countries.