Montreal Police Service

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BackgroundIn May 2024, a highly infectious pulmonary tuberculosis (TB) case (smear 3+, cavitary disease) was identified after a 7-week symptomatic period in a century-old Montréal prison wing with natural ventilation, housing ∼200 incarcerated persons and experiencing high resident turnover. The investigation aimed to assess the extent of TB transmission and identify spatial-temporal risk patterns in a correctional setting where environmental factors may amplify airborne spread.Methods571 individuals (538 incarcerated persons, 33 staff) were identified for screening using Toronto's Contact Screening Parameters Tool. For people in custody and staff, screening included symptom questionnaires and initial plus 8-week post-exposure tuberculin skin tests (TSTs). Those with TST contraindications or positive results were referred to a TB clinic. Outreach to released individuals varied by region (letters, calls, SMS).ResultsScreening participation reached 91% among staff (n = 33), ∼70% among incarcerated persons (n = 241), but <10% among those released (n = 297). Among contacts from low-incidence countries, TST positivity rose with exposure duration (7% for <10 days, 15% for 10-21 days, 19% for 22-64 days, 21% for ≥65 days). Among first-floor contacts housed with the index case, positivity declined with increasing distance from the index cell (<10m: 42%, 10-30m: 22%, >30m: 15%), while upper floors showed no gradient. Four secondary active TB cases, linked by MIRU-VNTR, were identified between July 2024 and March 2025, and 66 latent TB infection cases.ConclusionsThough proximity is a known TB risk factor, few investigations have documented clear distance-based gradients in correctional settings, supporting improving environmental measures such as ventilation in aging facilities. Challenges included invalid or missing contact information for contacts no longer incarcerated, low self-administered symptom screening completion, lack of on-site airborne isolation rooms.Key messages• A single infectious TB case in a correctional setting sparked a major outbreak, leading to 4 secondary active cases and 66 latent infections among 571 identified contacts.• Rare evidence of a distance-based transmission gradient highlights the importance of engineering controls such as ventilation to mitigate airborne disease transmission in high-risk congregate settings.

Background/Objectives: Healthcare workers (HCW) have increased the risk of occupational stress injuries and adverse mental health outcomes, which were exacerbated during the COVID-19 pandemic. Understanding HCW psychological distress patterns and help-seeking behaviors can inform responsive resource development that may mitigate negative outcomes in future crises. This paper provides insights on monthly trends in HCW distress and support utilization at a large Canadian hospital over a 14-month period. Methods: As part of a hospital-wide wellness initiative during COVID-19, the STEADY program emailed monthly confidential wellness assessments to hospital staff from April 2020 to May 2021. The assessments included screens for burnout, anxiety, depression and posttraumatic stress, types of support accessed, and demographic information. Repeated cross-sectional data were summarized as monthly proportions and examined alongside longitudinal COVID-19 data. Results: A total of 2498 wellness assessments were submitted (M = ~168 monthly, range: 17-945). Overall, 67% of assessments had at least one positive screen for distress. Average positive screens were 44% for anxiety, 29% for depression, 31% for posttraumatic stress, and 53% for burnout. Despite high distress, most respondents used informal supports (e.g., family/friends), highlighting limited formal support use. Conclusions: HCWs experienced sustained high levels of psychological distress during the COVID-19 pandemic, with burnout remaining a predominant and persistent concern. The limited use of formal support services may indicate barriers to accessing these types of supports. Our findings underscore the need for accessible and acceptable mental health supports for HCW during prolonged crises.

Objective This rapid review of systematic reviews aimed to synthesize the adoption factors of digital health technologies (DHTs). Methods A reference search was performed on MEDLINE, EMBASE, CINAHL, PsychInfo, PubMed, EBM Review, Web of Science, Scopus, PROSPERO and Google Scholar to search systematic reviews published in the last three years. Study selection was conducted following the PRISMA guidelines. The methodological quality of the included systematic reviews was assessed with the AMSTAR 2 tool. The identified adoption factors were classified using the Nonadoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) framework, in which the self-determination factors were integrated. Results Out of 4277 identified references, 45 systematic reviews were retained. The quality of most included systematic reviews, assessed by AMSTAR 2, was critically low. The most cited adoption factors included DHT’s ease of use, training for using DHT, adopters’ access to DHT and a high-speed internet connection, technical support, DHT’s customizability, the relevance and reliability of DHT data, the demand-side value of DHT (desirability), safety, cost-effectiveness, staff and patient competence, patient relatedness with others, organizational readiness, necessary changes in team routines, capacity for innovation, along with the political, economic, regulatory and sociocultural contexts. Integrating the findings of this rapid review, a DHT adoption checklist was elaborated. This checklist would aid future developers and implementers of DHT in successfully adopting the technology. Conclusions This review synthesized the DHT adoption factors using the NASSS framework and Self-Determination Theory. When developing or implementing a DHT, the micro-, meso- and macro-level adoption factors must be considered.

Les populations des environs de Paris au xviiie siècle confiaient-elles le règlement de leurs différends à la justice ou bien s’arrangeaient-elles seules devant un notaire ? Autrement dit, quels rapports existait-il entre la justice comme vertu et les tribunaux de première instance comme administration ?

L’économie canadienne constitue un cas paradigmatique d’exploitation intensive des ressources naturelles. Depuis plusieurs décennies, ce modèle est contesté par de nouveaux acteurs environnementaux qui peinent à changer les logiques de production. En s’appuyant sur des approches renouvelées de l’écologisation issues de la sociologie politique, ce papier propose d’analyser un mode d’écologisation alternatif à la contestation : l’implémentation d’innovations écologiques (ou éco-innovations). L’étude de ce processus est opérationnalisée dans deux études de cas issues de l’aquaculture canadienne. L’analyse du travail de construction et de promotion de deux éco-innovations permet de montrer les trajectoires d’une écologisation discrète entre science et industrie.

Abstract BackgroundMeta-analyses suggest that post-COVID-19 condition (PCC) mostly takes three clinical presentations: fatigue, cognitive and respiratory. We sought to estimate the prevalence of these presentations and the strength of their associations with potential risk/protective factors, activity limitations and healthcare utilization.MethodsFollow-up study by telephone re-interview, ≥5 months after initial interview, of a random sample of Montrealers aged 18 years or more, with a PCR-confirmed COVID-19 infection reported between July 18 and December 4, 2021. The re-interview covered age, sex, comorbidities, signs and symptoms (SS), activity limitations, healthcare utilization, perceived stigmatization and psychological distress.ResultsOf a sample of 2000 adults, 652 (39.1%) completed the questionnaire. Of 518 with only 1 acute episode of COVID-19, 32.2% met the WHO definition of PCC. Of these, 45.5% reported SS that fit the fatigue presentation, 24.6% the cognitive presentation and 16.8% the respiratory presentation. Neither age nor COVID-19 immunization was associated with PCC, compared to COVID-19 without PCC. However, being female (OR=2.28), hospitalization (OR=2.44) and intensive care (OR=3.21) for the acute COVID-19 episode were. Various activity limitations and types of healthcare utilization were also associated with PCC. All presentations were associated with serious psychological distress. The respiratory presentation was particularly associated with hospitalization for the acute episode (aOR=7.72) and was the only one associated with later hospitalization (aOR=23.6).InterpretationOur findings suggest that caring for patients with PCC requires adapted organizational models. If they favoured excellence in research, these models could help future studies meet the recommended methodological standards.

Fretting wear is a surface degradation process caused by oscillatory motion and contact slipping. During gross slip, high local stresses and plastic deformation in the surface and subsurface can lead to the creation of a nanosized grained structure called Tribologically Transformed Structure (TTS). The current paper studies the formation of TTS in an alpha-beta Ti-6Al-4V alloy under fretting loading while changing the contact pressure and the number of fretting cycles.Cross-sections of wear scars are observed after polishing and chemical etching. Above a threshold pressure of 300 MPa, TTS appears early in the contact (before 1000 cycles) along with two other structures: a Third Body Layer (TBL) made of compacted debris and a General Deformed Layer (GDL) which is the plastic zone under the TTS. TTS first appears as islands and merges in the middle of the contact after enough cycles. Below 200 MPa, only TBL and GDL are formed. At 200 MPa, only small, localized TTS is found. All structures have the same chemical compositions as the initial bulk material except for the nitrided TBL. TTS has a very high hardness compared to the bulk. TTS was carefully extracted using a Focused Ion Beam (FIB) and its microstructure was observed with a Transmission Electron Microscope (TEM). It shows extreme grain refinement and is composed of two alternated zones. The first zone I is composed of $\alpha$ grains with a size of 20 to 50 nm with crystallographic texture. Zone II comprises nanosized equiaxed grains whose sizes range from 5 to 20 nm without texture. The results made it possible to establish a scenario of the appearance of the TTS according to the conditions of contact pressure and number of fretting cycles.