A single-entry model and wait time for hip and knee replacement in eastern health region of Newfoundland and Labrador 2011–2019

Background A single-entry model in healthcare consolidates waiting lists through a central intake and allows patients to see the next available health care provider based on the prioritization. This study aimed to examine whether and to what extent the prioritization reduced wait times for hip and knee replacement surgeries. Method The survival regression method was used to estimate the effects of priority levels on wait times for consultation and surgery for hip and knee replacements. The sample data included patients who were referred to the Orthopedic Central Intake clinic at the Eastern Health region of Newfoundland and Labrador and had surgery of hip and knee replacements between 2011 and 2019. Result After adjusting for covariates, the hazard of having consultation booked was greater in patients with priority 1 and 2 than those in priority 3 when and at 90 days after the referral was made for both hip and knee replacements. Regarding wait time for surgery after the decision for surgery was made, while the hazard of having surgery was lower in priority 2 than in priority 3 when and indifferent at 182 days after the decision was made, it was not significantly different between priority 1 and priority 3 among hip replacement patients. Priority levels were not significantly related to the hazard of having surgery for a knee replacement after the decision for surgery was made. Overall, the hazard of having surgery after the referral was made by a primary care physician was greater for patients in high priority than those in low priority. Preferring a specific surgeon indicated at referral was found to delay consultation and it was not significantly related to the total wait time for surgery. Incomplete referral forms prolonged wait time for consultation and patients under age 65 had a longer total wait time than those aged 65 or above. Conclusion Patients with high priority could have a consultation booked earlier than those with low priority and prioritization in a single entrance model shortens the total wait time for surgery. However, the association between priority levels and wait for surgery after the decision for surgery was made has not well-established.

Transatlantic spread of highly pathogenic avian influenza H5N1 by wild birds from Europe to North America in 2021

Highly pathogenic avian influenza (HPAI) viruses of the A/Goose/Guangdong/1/1996 lineage (GsGd), which threaten the health of poultry, wildlife and humans, are spreading across Asia, Europe and Africa, but are currently absent from Oceania and the Americas. In December 2021, H5N1 HPAI viruses were detected in poultry and a free-living gull in St. John, Newfoundland and Labrador, Canada. Phylogenetic analysis showed that these viruses were most closely related to HPAI GsGd viruses circulating in northwestern Europe in spring 2021. Analysis of wild bird migration suggested that these viruses may have been carried across the Atlantic via Iceland, Greenland/Arctic or pelagic routes. The here documented incursion of HPAI GsGd viruses into North America raises concern for further virus spread across the Americas by wild bird migration.

The RADARSAT Constellation Mission Core Applications: First Results

The Canadian RADARSAT Constellation Mission (RCM) has passed its early operation phase with the performance evaluation being currently active. This evaluation aims to confirm that the innovative design of the mission’s synthetic aperture radar (SAR) meets the expectations of intended users. In this study, we provide an overview of initial results obtained for three high-priority applications; flood mapping, sea ice analysis, and wetland classification. In our study, the focus is on results obtained using not only linear polarization, but also the adopted Compact Polarimetric (CP) architecture in RCM. Our study shows a promising level of agreement between RCM and RADARSAT-2 performance in flood mapping using dual-polarized HH-HV SAR data over Red River, Manitoba, suggesting smooth continuity between the two satellite missions for operational flood mapping. Visual analysis of coincident RCM CP and RADARSAT-2 dual-polarized HH-HV SAR imagery over the Resolute Passage, Canadian Central Arctic, highlighted an improved contrast between sea ice classes in dry ice winter conditions. A statistical analysis using selected sea ice samples confirmed the increased contrast between thin and both rough and deformed ice in CP SAR. This finding is expected to enhance Canadian Ice Service’s (CIS) operational visual analysis of sea ice in RCM SAR imagery for ice chart production. Object-oriented classification of a wetland area in Newfoundland and Labrador by fusion of RCM dual-polarized VV-VH data and Sentinel-2 optical imagery revealed promising classification results, with an overall accuracy of 91.1% and a kappa coefficient of 0.87. Marsh presented the highest user’s and producer’s accuracies (87.77% and 82.08%, respectively) compared to fog, fen, and swamp.

The epidemiological impact of the Canadian COVID Alert App

We analyzed the effectiveness of the Canadian COVID Alert app on reducing COVID-19 infections and deaths due to the COVID-19 virus using two separate, but complementary approaches, were taken. First, we undertook a comparative study to assess how the adoption and usage of the COVID Alert app compared to those of similar apps deployed in other regions. Next, we used data from the COVID Alert server and a range of plausible parameter values to estimate the numbers of infections and deaths averted in Canada using a model that combines information on number of notifications, secondary attack rate, expected fraction of transmissions that could be prevented, quarantine effectiveness, and expected size of the full transmission chain in the absence of exposure notification. The comparative analysis revealed that the COVID Alert app had among the lowest adoption levels among apps that reported usage. Our model indicates that use of the COVID Alert app averted between 6,284 and 10,894 infections across the six Canadian provinces where app usage was highest during the March - July 2021 period. This range is equivalent to 1.6%-2.9% of the total recorded infections across Canada in that time. Using province-specific case fatality rates, 57-101 deaths were averted during the same period. The number of cases and deaths averted was greatest in Ontario, whereas the proportion of cases and death averted was greatest in Newfoundland and Labrador. App impact measures were reported so rarely and so inconsistently by other countries that the relative assessment of impact is inconclusive. While the nationwide rates are low, provinces with widespread adoption of the app showed high ratios of averted cases and deaths (upper bound was greater than 60% of averted cases). Our findings suggest that the COVID Alert app, when adopted at sufficient levels, can be an effective public health tool for combatting a pandemic such as COVID-19.

The biota of Canada: checklist of the centipedes of Canada (Myriapoda: Chilopoda)

The centipede fauna of Canada is reviewed based on information available in the literature and on examination of some material, and provincial and territorial distributions are provided. About 53 species are known from Canada, representing four orders: Scutigeromorpha (1), Scolopendromorpha (5), Geophilomorpha (19), and Lithobiomorpha (28). British Columbia has the most recorded species (23), followed by Ontario (17) and Newfoundland and Labrador (12). Arctogeophilus glacialis (Attems) and Alaskobius adlatus Chamberlin are newly reported from Canada (Northwest Territories), Schendyla nemorensis (Koch) is newly reported from Ontario, and Lithobius forficatus (Linnaeus) is recorded for the first time from New Brunswick and Prince Edward Island. Arctogeophilus melanonotus (Wood) is removed from the list of Canadian species.

Disability and Employment Policy in Canada: National Policy Variation for Working Age Individuals

This article analyses and compares disability policies for working-age individuals in Canada with a focus on the mode of policy provision and type of measure to determine the degree to which direct funding is used in this country. To consider policy diversity in this federal system, policies are compared using a mixed-methods approach. Using quantitative methods, federal, provincial and territorial policies are first compared using hierarchical cluster analysis. This provides evidence of three distinct clusters in Canada according to policy provision and measure type. In a second, qualitative analysis, the disability strategies of four provinces’ (British Columbia, Ontario, Newfoundland and Labrador and Quebec) are compared, to determine over arching policy orientations. Findings indicate that policy provision in Canada largely favours money over services. Furthermore, most provinces emphasize either health or integration measures over substantive measures. Despite these commonalities, significant variation persists across Canada. This extends to poverty and disability reduction strategies with two of the four provinces having a broader orientation while the other two provinces focus specifically on employment as a means of social inclusion. The article concludes with a discussion on the state of employment policies for individuals with a disability in Canada.

From a study of the Newfoundland and Labrador school food system:

In this perspective piece I reflect on the importance of considering the place of schools within broader systems for critical school food study and intervention. These reflections are based on my study of school food in Newfoundland and Labrador from a systems perspective which helped reveal to me how assumptions about school food tend to get in the way of deep understanding about the impact and sustainability of programs.

Canadian Federalism and the Political Economy of Energy and the Environment

These two books draw attention to the role of Canada's oil-producing provinces—“petro-provinces” for Angela Carter and “carbon provinces” for Douglas Macdonald—in the politics of energy, environment and climate change, but they do so in very different ways. Carter's volume examines the erosion of environmental protections in the oil-rich provinces of Alberta, Saskatchewan, and Newfoundland and Labrador, while Macdonald's focuses on the way interest-based conflicts rooted in regional energy political economies have driven federal/provincial dynamics around energy and climate policy. Both books are well written (not always a given in academic publishing), and they should interest anyone concerned with the politics of energy, environment and climate change in Canada.