Homelessness is a social condition increasing in frequency and severity across Canada. Interventions to end and prevent homelessness include effective case management in addition to an affordable housing provision. Little standardization exists for service providers to guide their decision making in developing and maintaining effective case management programs. The purpose of this 2-part article is to articulate dimensions of promising practice for case managers working in a "Housing First" context. Part 1 discusses research processes and findings and Part 2 articulates the 6 dimensions of quality.
Practice settings include community-based organizations that employ and support case managers whose primary role is moving people from homelessness into permanent supportive housing.
Six dimensions of promising practice are critically important to reducing barriers, improving sector collaboration, and ensuring that case managers have appropriate and effective training and support. Dimensions of promising practice are (1) collaboration and cooperation-a true team approach; (2) right matching of services-person-centered; (3) contextual case management-culture and flexibility; (4) the right kind of engagement-relationships and advocacy; (5) coordinated and well-managed system-ethics and communication; and (6) evaluation for success-support and training.
Effective, coordinated case management, in addition to permanent affordable housing has the potential to reduce a person's or family's homelessness permanently. Organizations and professionals working in this context have the opportunity to improve processes, reduce burnout, collaborate and standardize, and, most importantly, efficiently and permanently end someone's homelessness with the help of dimensions of quality for case management.
Permafrost carbon feedback (PCF) modeling has focused on gradual thaw of near-surface permafrost leading to enhanced carbon dioxide and methane emissions that accelerate global climate warming. These state-of-the-art land models have yet to incorporate deeper, abrupt thaw in the PCF. Here we use model data, supported by field observations, radiocarbon dating, and remote sensing, to show that methane and carbon dioxide emissions from abrupt thaw beneath thermokarst lakes will more than double radiative forcing from circumpolar permafrost-soil carbon fluxes this century. Abrupt thaw lake emissions are similar under moderate and high representative concentration pathways (RCP4.5 and RCP8.5), but their relative contribution to the PCF is much larger under the moderate warming scenario. Abrupt thaw accelerates mobilization of deeply frozen, ancient carbon, increasing 14C-depleted permafrost soil carbon emissions by ~125-190% compared to gradual thaw alone. These findings demonstrate the need to incorporate abrupt thaw processes in earth system models for more comprehensive projection of the PCF this century.
In Canada, cultural, physical and structural barriers to the poor's accessibility to health care persist. The economically disadvantaged are clearly identified as a national high-risk target group because of poorer health status and health behaviours than higher-income Canadians. A four-component model is proposed to describe the complex, multivariate nature of access to health care for the economically disadvantaged. The mutual effects of characteristics of access and poverty are outlined and strategies to facilitate improved access are delineated and exemplified. Education, comprehensive and personalized care, consumer participation, and environmental strategies, while not uniquely applicable to the needs of the poor, may collectively constitute a reasonable approach to removing barriers to access to care for this vulnerable group. Furthermore, these four strategies are consistent with premises of primary health care and health promotion. While the model encompasses many relevant variables, it is neither exclusive nor all-inclusive. Further research is required to assess the linkage between specific elements of these four components and to conduct monetary and human cost-benefit analyses of recommended approaches.
Recent research advocates the use of count models with random parameters as an alternative method for analyzing accident frequencies. In this paper a dataset composed of urban arterials in Vancouver, British Columbia, is considered where the 392 segments were clustered into 58 corridors. The main objective is to assess the corridor effects with alternate specifications. The proposed models were estimated in a Full Bayes context via Markov Chain Monte Carlo (MCMC) simulation and were compared in terms of their goodness of fit and inference. A variety of covariates were found to significantly influence accident frequencies. However, these covariates resulted in random parameters and thereby their effects on accident frequency were found to vary significantly across corridors. Further, a Poisson-lognormal (PLN) model with random parameters for each corridor provided the best fit. Apart from the improvement in goodness of fit, such an approach is useful in gaining new insights into how accident frequencies are influenced by the covariates, and in accounting for heterogeneity due to unobserved road geometrics, traffic characteristics, environmental factors and driver behavior. The inclusion of corridor effects in the mean function could also explain enough variation that some of the model covariates would be rendered non-significant and thereby affecting model inference.
Physician-researchers are bound by professional obligations stemming from both the role of the physician and the role of the researcher. Currently, the dominant models for understanding the relationship between physician-researchers' clinical duties and research duties fit into three categories: the similarity position, the difference position and the middle ground. The law may be said to offer a fourth "model" that is independent from these three categories.These models frame the expectations placed upon physician-researchers by colleagues, regulators, patients and research participants. This paper examines the extent to which the data from semi-structured interviews with 30 physician-researchers at three major pediatric hospitals in Canada reflect these traditional models. It seeks to determine the extent to which existing models align with the described lived experience of the pediatric physician-researchers interviewed.Ultimately, we find that although some physician-researchers make references to something like the weak version of the similarity position, the pediatric-researchers interviewed in this study did not describe their dual roles in a way that tightly mirrors any of the existing theoretical frameworks. We thus conclude that either physician-researchers are in need of better training regarding the nature of the accountability relationships that flow from their dual roles or that models setting out these roles and relationships must be altered to better reflect what we can reasonably expect of physician-researchers in a real-world environment.
This paper proposes a new method to distinguish structural from exchange mobility in status attainment models with interval endogenous variables. In order to measure structural mobility, the paper proposes to trace occupational and educational changes across generations using information provided by children about their fathers. The validity of the method is assessed by comparing the effects of father's socio-economic status and education on son's status and educational attainments, net of occupational upgrading and educational expansion, in five European countries: Britain, Denmark, Germany, Norway, and Spain, using data from the 2005 EU-SILC survey. The results show that the effect of father's on son's ISEI weakens greatly in all countries after considering occupational upgrading, and that much of father's influence over sons occurs by directing them towards occupations with good economic prospects. Useful extensions to the method are discussed in the conclusions.
Systematic conservation plans have only recently considered the dynamic nature of ecosystems. Methods have been developed to incorporate climate change, population dynamics, and uncertainty in reserve design, but few studies have examined how to account for natural disturbance. Considering natural disturbance in reserve design may be especially important for the world's remaining intact areas, which still experience active natural disturbance regimes. We developed a spatially explicit, dynamic simulation model, CONSERV, which simulates patch dynamics and fire, and used it to evaluate the efficacy of hypothetical reserve networks in northern Canada. We designed six networks based on conventional reserve design methods, with different conservation targets for woodland caribou habitat, high-quality wetlands, vegetation, water bodies, and relative connectedness. We input the six reserve networks into CONSERV and tracked the ability of each to maintain initial conservation targets through time under an active natural disturbance regime. None of the reserve networks maintained all initial targets, and some over-represented certain features, suggesting that both effectiveness and efficiency of reserve design could be improved through use of spatially explicit dynamic simulation during the planning process. Spatial simulation models of landscape dynamics are commonly used in natural resource management, but we provide the first illustration of their potential use for reserve design. Spatial simulation models could be used iteratively to evaluate competing reserve designs and select targets that have a higher likelihood of being maintained through time. Such models could be combined with dynamic planning techniques to develop a general theory for reserve design in an uncertain world.