On the Timing of Marriage and Childbearing: Family Formation Pathways Among Immigrants in Switzerland.

This paper examines childbearing in and outside of marriage as a manifestation of the Second Demographic Transition among immigrant populations in Switzerland. Based on full-population register data, we simultaneously analyse fertility and partnership changes at different stages of the migration process. Results from a multistate event history model show that most of the differences in family formation patterns between migrant groups and natives are in the sequencing of marriage and first birth among childless unmarried women. Out of wedlock family trajectories prove to be a common experience for European migrants, but a sustainable family pathway only among natives, as well as among immigrants from France, and Sub-Saharan Africa. Among married women, it is the risk of a third birth that marks the differences between groups; first and second birth rates are relatively similar across migrant groups. Distinguishing between the transition patterns of newly arrived immigrants and settled immigrants (characterised by various residence durations) support the disruption hypothesis among EU migrants and the interrelated life events hypothesis among non-EU groups. Family size and the partnership context of fertility highlight which family regime prevails in different population subgroups and the role that immigrants play in the Second Demographic Transition and family transformation in Europe.

Long-term changes in bat activity in Quebec suggest climatic responses and summer niche partitioning associated with white-nose syndrome.

In North America, the greatest and most sudden threat to hibernating bats is white-nose syndrome (WNS), which has caused massive declines in populations since 2006. Other determinants of bat dynamics, such as the climate, and the effect of reduction in the number of individuals sharing foraging space and summer roosting habitat may have an effect on population dynamics. We analyzed transect acoustic bat surveys conducted with ultrasonic detectors in 16 regions in Quebec, Canada, between 2000 and 2015. We used piecewise regression to describe changes in activity over time for each species and a meta-analytic approach to measure its association with the North Atlantic Oscillation (NAO). As expected, mouse-eared bat (Myotis spp.) activity sharply declined after the onset of WNS, down by 79% after 3 years. In contrast, big brown/silver-haired bat activity increased over the same period, possibly due to a release of competition. Hoary bats and red bats remained present, although their activity did not increase. Myotis activity was positively correlated with a one-year lag to the NAO index, associated with cold conditions in winter, but warm autumns. Big brown/silver-haired and hoary bats were also more active during NAO-positive years but without a lag. We conclude that combinations of threats may create rapid shifts in community compositions and that a more balanced research agenda that integrates a wider range of threats would help better understand and manage those changes.

Sweet's syndrome and fistulizing Crohn's disease: A case report.

Sweet's syndrome is a rare, acute febrile neutrophilic dermatosis sometimes associated with inflammatory diseases, infections, malignancies or the administration of pharmacotherapeutics. Very seldom, it occurs as an extraintestinal manifestation of Crohn's disease. We present a unique combined diagnosis of recurrent Sweet's syndrome associated with colovaginal fistulization, subsequently diagnosed as Crohn's disease.

Wait times for Mohs micrographic surgery in Ottawa, Ontario.

BACKGROUND: The Ministry of Health and Long-Term Care, in coordination with Cancer Care Ontario, records and analyzes wait times for cancer surgery in the province of Ontario. However, this strategy does not include wait times for skin cancer surgery. PURPOSE: The wait times and referral patterns of patients undergoing Mohs micrographic surgery at The Ottawa Hospital (TOH) were examined to better assess the adequacy of access to skin cancer treatment in Ontario. METHOD: The records of 101 Mohs surgeries (96 patients) consecutively performed at TOH between June 14, 2010, and October 19, 2010, were reviewed. The interval between the date the referral for Mohs surgery was first received and the date of surgery was calculated for each case. The specialty of the referring physician and the postal code of each patient treated were also recorded. RESULTS: The average wait time between the date of referral and the date of surgery was 122.6 days or 17.5 weeks (median 124 days, 17.7 weeks). Over 75% of patients waited over 12 weeks (84 days) for cancer surgery. All Mohs surgery patients treated at TOH resided within postal districts in eastern and northern Ontario. CONCLUSION: The current wait time for Mohs surgery in the Ottawa region is beyond the standard for cancer treatment. Improving access to care and incorporating Mohs surgery into the Ministry of Health and Long-Term Care's Wait Time Strategy might significantly improve this.

Renal transplantation using non-heart-beating donors: a potential solution to the organ donor shortage in Canada.

INTRODUCTION: There is a chronic shortage of cadaveric organ donors for renal transplantation, which might be solved by the use of non-heart-beating donors (patients who suffer cardiac arrest and whose kidneys are harvested subsequently when irreversible heart and respiratory function occur). We carried out a chart review to determine whether the renal transplantation rate would improve if a non-heart-beating donor program was introduced at a Canadian centre. METHODS: We reviewed the charts of all 1547 patients who died in the emergency department or intensive care unit of the Ottawa Hospital, a tertiary care centre serving 1.2 million people in eastern Ontario, between January 1999 and May 2001. The number of potential non-heart-beating donors was determined by the use of predefined criteria. The number of additional kidneys that could be obtained with a non-heart-beating donor program was estimated and compared to the actual number of kidneys procured from conventional brain-dead donors during the same period. The potential increase in the renal transplantation rate was calculated. RESULTS: There were 83 potential non-heart-beating donors during the 29-month study period. The mean (and standard deviation) age of the donors was 40.6 (13.1) years, and 20% were female. The mean serum creatinine value was 75 (29) micromol/L; 44.6% of donors died secondary to trauma. We estimated that the use of non-heart-beating donors would have provided 14 to 41 additional donors during the study period (12-34 kidneys/yr). The cadaveric renal transplantation rate would have increased between 30% and 87%. CONCLUSION: The cadaveric renal transplantation rate could improve significantly if non-heart-beating donors were used in Canadian hospitals.