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Ice-out and Freshet Fluxes of CO2 and CH4 Across the Air–water Interface of the Channel Network of a Great Arctic Delta, the Mackenzie

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2020-06-26
Abstract: 

Carbon dioxide (CO2) and methane (CH4) were monitored at five sites spanning the upstream–downstream extent of the Mackenzie Delta channel network during May 2010, capturing the historically under-sampled ice-out period that includes the rising freshet, peak water levels and the early falling freshet (flood recession). Unexpectedly, partial pressures of CO2 in the Mackenzie River were undersaturated during the rising freshet before water levels peaked, indicating net CO2 invasion at instantaneous CO2 flux rates (F-CO2) ranging from –112 to –258 mg-C m-2 d-1. Net CO2 invasion was also observed around the time of peak water levels at sites in the middle and outer delta. Following peak water levels, the Mackenzie River switched to saturation and net CO2 evasion (F-CO2 from 74 to 177 mg-C m-2 d-1). Although the Peel River (which flows into the west side of the Mackenzie Delta) was a strong emitter of CO2 (F-CO2 from 373 to 871 mg-C m-2 d-1), overall, the Mackenzie River and Delta were weak emitters of CO2 during the 2010 ice-out period. All sites were strong emitters of CH4 during ice-out, however, with the highest evasive fluxes observed in the outer delta when the extent of flooded delta landscape was greatest. Estimated aerial fluxes from Mackenzie Delta channel surfaces during May 2010 ranged from 2.1 to 4.8 Gg-C as CO2, and 186 to 433 Mg-C as CH4. These results provide critical information that can be used to refine gas flux estimates in high-latitude circumpolar river deltas during the relatively under-studied ice-out period.

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Article
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Street Masking: A Network-based Geographic Mask for Easily Protecting Geoprivacy

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2020-07-06
Abstract: 

Background

Geographic masks are techniques used to protect individual privacy in published maps but are highly under-utilized in research. This leads to continual violations of individual privacy, as sensitive health records are put at risk in unmasked maps. New approaches to geographic masking are required that foster accessibility and ease of use, such that they become more widely adopted. This article describes a new geographic masking method, called street masking, that reduces the burden on users of finding supplemental population data by instead automatically retrieving OpenStreetMap data and using the road network as a basis for masking. We compare it to donut geomasking, both with and without population density taken into account, to evaluate its efficacy against geographic masks that require slightly less and slightly more supplemental data. Our analysis is performed on synthetic data in three different Canadian cities.

Results

Street masking performs similarly to population-based donut geomasking with regard to privacy protection, achieving comparable k-anonymity values at similar median displacement distances. As expected, distance-based donut geomasking performs worst at privacy protection. Street masking also performs very well regarding information loss, achieving far better cluster preservation and landcover agreement than population-based donut geomasking. Distance-based donut geomasking performs similarly to street masking, though at the cost of reduced privacy protection.

Conclusion

Street masking competes with, if not out-performs population-based donut geomasking and does so without requiring any supplemental data from users. Moreover, unlike most other geographic masks, it significantly minimizes the risk of false attribution and inherently takes many geographic barriers into account. It is easily accessible for Python users and provides the foundation for interfaces to be built for non-coding users, such that privacy can be better protected in sensitive geospatial research.

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Article
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“I Cannot Say No When a Pregnant Woman Needs My Support to get to the Health Centre”: Involvement of Community Health Workers in Rwanda’s Maternal Health

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2020-06-09
Abstract: 

Background

In Rwanda, maternal community health workers (M-CHWs) are involved in the country’s overall health system. In maternal health, their role includes the provision of preventive and promotional health services at the community level. They provide services such as health education on maternal health wellbeing, advice and information on access and timely utilization of health facilities for prenatal, delivery and postpartum care. The contribution of M-CHWs in the health sector combined with other government initiatives led the country to achieving the fifth Millennium Development Goal (MDG) - target 5A- that aimed to improve maternal health through the reduction of maternal mortality ratio by 75% between 1990 and 2015). The objective of this study was to explore M-CHWs’ perceptions and experiences on access and provision of maternal health services.

Methods

We used a case study methodology, a qualitative research approach to explore M-CHWs’ experiences and perceptions on access and provision of maternal health services at the community level in Rwanda. For the period of June–August 2014, in-depth interviews were conducted with sixteen M-CHWs who had been providing maternal health services in the Eastern Province of Rwanda. Participants shared their experiences and perceptions on access and provision of maternal health service in their communities.

Results

The results of this research highlight the role of M-CHWs in promoting the use of health facilities for prenatal care and delivery and the ways they use to reach out to women. Several challenges prohibit M-CHWs to deliver adequate maternal health services and these are related to the poor resources settings in which they operate.

Conclusion

The results of this study highlight the experiences and perceptions of M-CHWs on the provision and access to maternal health services in their communities. The fact that M-CHWs are volunteers operating in limited resources settings with no formal training in maternal health and with considerable workloads translates into challenges regarding the quality and quantity of services they provide in their communities. Such challenges create an impact on M-CHWs service provision, satisfaction and retention. The voices of M-CHWs and the communities they serve are needed to explore areas that are specific to each community context that would contribute to making the M-CHW program sustainable to achieve equitable access to maternal health services.

Document type: 
Article
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Opportunities and Challenges in Providing Health Care for International Retirement Migrants: A Qualitative Case Study of Canadians Travelling To Yuma, Arizona

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2020-06-03
Abstract: 

Background

Increasing numbers of older individuals opt to spend extended time abroad each year for lifestyle, health, and financial reasons. This practice is known as international retirement migration, and it is particularly popular among retirees in Global North countries such as Canada. Despite the popularity of international retirement migration, very little is known about how and why health care is accessed while abroad, nor the opportunities and challenges posed for destination hospitals. In this article we focus on addressing the latter knowledge gap.

Methods

This qualitative case study is focused on the only hospital in Yuma, Arizona – a popular destination for Canadian retirement migrants in the United States. We conducted focus groups with workers at this hospital to explore their experiences of treating this transnational patient group. Twenty-seven people participated in three, 90-min focus groups: twelve nurses, six physicians, and nine administrators. Thematic analysis of the focus group transcripts was conducted using a triangulated approach.

Results

Participants identified three care environments: practice, transnational, and community. Each environment presents specific opportunities and challenges pertaining to treating Canadian retirement migrants. Important opportunities include the creation of a strong and diverse seasonal workforce in the hospital, new transnational paths of communication and information sharing for physicians and health administrators, and informal care networks that support formal health care services within and beyond the hospital. These opportunities are balanced out by billing, practical, administrative, and lifestyle-related challenges which add complexity to treating this group of transnational patients.

Conclusion

Canadians represent a significant group of patients treated in Yuma, Arizona. This is contrary to long-standing, existing research that depicts older Canadians as being reluctant to access care while in the United States. Significant overlaps exist between the opportunities and challenges in the practice, transnational and community environments. More research is needed to better understand if these findings are similar to other destinations popular with Canadian international retirement migrants or if they are unique to Yuma, Arizona.

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Article
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Maximizing the Potential of Trauma Registries in Low-Income and Middle-Income Countries

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2020-05-12
Abstract: 

Injury is a major global health issue, resulting in millions of deaths every year. For decades, trauma registries have been used in wealthier countries for injury surveillance and clinical governance, but their adoption has lagged in low-income and middle-income countries (LMICs). Paradoxically, LMICs face a disproportionately high burden of injury with few resources available to address this pandemic. Despite these resource constraints, several hospitals and regions in LMICs have managed to develop trauma registries to collect information related to the injury event, process of care, and outcome of the injured patient. While the implementation of these trauma registries is a positive step forward in addressing the injury burden in LMICs, numerous challenges still stand in the way of maximizing the potential of trauma registries to inform injury prevention, mitigation, and improve quality of trauma care. This paper outlines several of these challenges and identifies potential solutions that can be adopted to improve the functionality of trauma registries in resource-poor contexts. Increased recognition and support for trauma registry development and improvement in LMICs is critical to reducing the burden of injury in these settings.

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Article
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Cooperation, Proximity, and Social Innovation: Three Ingredients for Industrial Medium-Sized Towns’ Renewal?

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2020-04-04
Abstract: 

Over several decades, medium-sized industrial towns have suffered from a combination of economic and political processes: Deindustrialization, metropolization, and withdrawal of public services. After two decades in which they have been somewhat neglected (in favor of metropolises), there have recently been State and European public policies aimed at them. Medium-sized cities are not homogeneous and present several trajectories. Based on quantitative approach in France, we highlight the very diverse socio-economic dynamics of French medium-sized industrial towns. Thus, far from widespread decline or shrinking dynamics, some of these cities are experiencing an economic rebound. This is the case of Romans-sur-Isère, a medium-sized town located in the south-east of France. Focusing our qualitative analyze on this city, we try to understand this type of process. In this medium-sized town, former capital of the shoe industry, local stakeholders, private, and public try to support a productive renewal. The results of our case study highlight the role that cooperation, spatial and organizational proximity, and social innovation could play in the renewal of productive economy in medium-sized industrial towns. Even if the economic situation remains difficult for many medium-sized cities in France as in Europe, we argue that they could have a productive future making and ultimately take advantages of their “medium-sized” attributes.

Over several decades, medium-sized industrial towns have suffered from a combination of economic and political processes: Deindustrialization, metropolization, and withdrawal of public services. After two decades in which they have been somewhat neglected (in favor of metropolises), there have recently been State and European public policies aimed at them. Medium-sized cities are not homogeneous and present several trajectories. Based on quantitative approach in France, we highlight the very diverse socio-economic dynamics of French medium-sized industrial towns. Thus, far from widespread decline or shrinking dynamics, some of these cities are experiencing an economic rebound. This is the case of Romans-sur-Isère, a medium-sized town located in the south-east of France. Focusing our qualitative analyze on this city, we try to understand this type of process. In this medium-sized town, former capital of the shoe industry, local stakeholders, private, and public try to support a productive renewal. The results of our case study highlight the role that cooperation, spatial and organizational proximity, and social innovation could play in the renewal of productive economy in medium-sized industrial towns. Even if the economic situation remains difficult for many medium-sized cities in France as in Europe, we argue that they could have a productive future making and ultimately take advantages of their “medium-sized” attributes.

 

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Article
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What Medical Crowdfunding Campaigns Can Tell Us About Local Health System Gaps and Deficiencies: Exploratory Analysis of British Columbia, Canada

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2020-05-22
Abstract: 

Background: There are a range of perceived gaps and shortcomings in the publicly funded Canadian health system. These include wait times for care, lack of public insurance coverage for dental care and pharmaceuticals, and difficulties accessing specialist care. Medical crowdfunding is a response to these gaps where individuals raise funds from their social networks to address health-related needs.

Objective: This study aimed to investigate the potential of crowdfunding data to better understand what health-related needs individuals are using crowdfunding for, how these needs compare with the existing commentary on health system deficiencies, and the advantages and limitations of using crowdfunding campaigns to enhance or augment our understanding of perceived health system deficiencies.

 

Methods: Crowdfunding campaigns were scraped from the GoFundMe website. These campaigns were then limited to those originating in the metropolitan Vancouver region of two health authorities during 2018. These campaigns were then further limited to those raising funds to allow the treatment of a medical problem or related to needs arising from ill health. These campaigns were then reviewed to identify the underlying health issue and motivation for pursuing crowdfunding.

 

Results: We identified 423 campaigns for health-related needs. These campaigns requested CAD $8,715,806 (US $6,088,078) in funding and were pledged CAD $3,477,384 (US $2,428,987) from 27,773 donors. The most common underlying medical condition for campaign recipients was cancer, followed by traumatic injuries from collisions and brain injury and stroke. By far, the most common factor of motivation for crowdfunding was seeking financial support for wages lost because of illness (232/684, 33.9%). Some campaigns (65/684, 9.5%) sought help with purchasing medical equipment and supplies; 8.2% (56/684) sought to fund complementary, alternative, or unproven treatments including experimental interventions; 7.2% (49/684) sought financial support to cover travel-related costs, including in-province and out-of-province (49/684, 7.2%) travel; and 6.3% (43/684) campaigns sought help to pay for medication.

 

Conclusions: This analysis demonstrates the potential of crowdfunding data to present timely and context-specific user-created insights into the perceived health-related financial needs of some Canadians. Although the literature on perceived limitations of the Canadian health system focuses on wait times for care and limited access to specialist services, among other issues, these campaigners were much more motivated by gaps in the wider social system such as costs related to unpaid time off work and travel to access care. Our findings demonstrate spatial differences in the underlying medical problems, motivations for crowdfunding, and success using crowdfunding that warrants additional attention. These differences may support established concerns that medical crowdfunding is most commonly used by individuals from relatively privileged socioeconomic backgrounds. We encourage the development of new resources to harness the power of crowdfunding data as a supplementary source of information for Canadian health system stakeholders.

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Article
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Extirpation Despite Regulation? Environmental Assessment and Caribou

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2020-03-14
Abstract: 

Many caribou populations in Canada face extirpation despite dozens of provincial and federal legislative instruments designed to protect them. How are industrial developments that impact caribou justified and permitted despite governments' commitments to caribou protection? Toward an answer, this paper scrutinizes an approval process for major projects in Canada: environmental assessment (EA). We identify 65 EAs for major projects with potentially significant adverse impacts for caribou—all projects but one were approved. The results show that most projects were approved on the basis of proposed mitigation measures that promise to render adverse effects “insignificant”; yet mitigation effectiveness is largely unknown. Further, several projects were approved even though mitigation measures were insufficient, citing public or national interest. Finally, some projects' approval rested in part on scientific claims that the project area is already degraded or absent of caribou. Based on these findings, EA is failing caribou, acting as a means by which the state licenses major developments with potentially significant adverse effects for caribou, with a pretense of protection. The failure stems in part from a broader tension within the state that manifests in EA: a tension between the state's roles promoting economic growth and protecting against this growth's negative effects. Recognition of this tension needs to be more central to conservation biology.

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Article
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Where to Enhance Rural Palliative Care? Developing a Spatial Model to Identify Suitable Communities Most in Need of Service Enhancement

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2020-03-04
Abstract: 

Background  In Canada, access to palliative care is a growing concern, particularly in rural communities. These communities have constrained health care services and accessing local palliative care can be challenging. The Site Suitability Model (SSM) was developed to identify rural “candidate” communities with need for palliative care services and existing health service capacity that could be enhanced to support a secondary palliative care hub. The purpose of this study was to test the feasibility of implementing the SSM in Ontario by generating a ranked summary of rural “candidate” communities as potential secondary palliative care hubs.

Methods  Using Census data combined with community-level data, the SSM was applied to assess the suitability of 12 communities as rural secondary palliative care hubs. Scores from 0 to 1 were generated for four equally-weighted components: (1) population as the total population living within a 1-h drive of a candidate community; (2) isolation as travel time from that community to the nearest community with palliative care services; (3) vulnerability as community need based on a palliative care index score; and (4) community readiness as five dimensions of fit between a candidate community and a secondary palliative care hub. Component scores were summed for the SSM score and adjusted to range from 0 to 1.

Results  Population scores for the 12 communities ranged widely (0.19–1.00), as did isolation scores (0.16–0.94). Vulnerability scores ranged more narrowly (0.27–0.35), while community readiness scores ranged from 0.4–1.0. These component scores revealed information about each community’s particular strengths and weaknesses. Final SSM scores ranged from a low of 0.33 to a high of 0.76.

Conclusions  The SSM was readily implemented in Ontario. Final scores generated a ranked list based on the relative suitability of candidate communities to become secondary palliative care hubs. This list provides information for policy makers to make allocation decisions regarding rural palliative services. The calculation of each community’s scores also generates information for local policy makers about how best to provide these services within their communities. The multi-factorial structure of the model enables decision makers to adapt the relative weights of its components.

Document type: 
Article
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Multi-decadal Reduction in Glacier Velocities and Mechanisms Driving Deceleration at Polythermal White Glacier, Arctic Canada

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2017-02-27
Abstract: 

Annual and seasonal surface velocities measured continuously from 1960 to 1970 at White Glacier, a 14 km long polythermal valley glacier spanning ~100–1800 m a.s.l., provide the most comprehensive early record of ice dynamics in the Canadian Arctic. Through comparison with differential GPS-derived velocity data spanning 2012–16, we find reductions in mean annual velocity by 31 and 38% at lower elevations (600 and 400 m a.s.l.). These are associated with decreased internal ice deformation due to ice thinning and reduced basal motion likely due to increased hydraulic efficiency in recent years. At higher elevation (~850 m a.s.l.) there is no detectable change in annual velocity and the expected decrease in internal deformation rates due to ice thinning is offset by increased basal motion in both summer and winter, likely attributable to supraglacial melt accessing a still inefficient subglacial drainage system. Decreases in mass flux at lower elevations since the 1960s cannot explain the observed elevation loss of ~20 m, meaning that ice thinning along the glacier trunk is primarily a function of downwasting rather than changing ice dynamics. The current response of the glacier exemplifies steady thinning, velocity slowdown and upstream retreat of the ELA but, because the glacier has an unstable geometry with considerable mass in the 1300–1500 m elevation range, a retreat of the ELA to >1300 plausible within 25–40 years, could trigger runaway wastage.

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Article
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