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Gambling encompasses all activities that involve betting or wagering money. It is highly prevalent both in Canada and worldwide. While most individuals gamble without experiencing harm, some develop problem gambling, which is associated with serious psychological, relational and financial outcomes. Sexual and gender diversity (SGD) populations experience disproportionately high rates of mental health disorders, although little is known about their gambling trajectories. Knowledge in this regard is mainly based on cross-sectional studies, with no longitudinal evidence being available internationally. This gap in the literature restricts understanding of how problematic gambling emerges and evolves among SGD populations. It also limits the development of prevention and harm reduction strategies tailored to their realities.
This five-year longitudinal study will use a mixed-methods explanatory and sequential design in two phases. The first phase is a prospective cohort study. A self-report questionnaire will be administered online via a web panel to Canadian residents who are 18 years of age or older, self-identify as SGD and have gambled at least once in the previous 12 months (n=2500). This survey will be repeated annually over the course of three years to describe respondents’ gambling habits, model their trajectories and identify factors associated with problematic gambling. The second phase is a descriptive qualitative study. Semi-structured interviews will be conducted with respondents from phase 1 who present problematic gambling (n=40) to explore their experiences and lived realities.
This research project has been ethically and scientifically approved by the Research Ethics Committee and by the CIUSSS de l’Estrie—CHUS scientific evaluation committee on November 3, 2025 (reference number: 2026-6060 Trajectoires-JHA-LGBTQ). For all phases of the study, written or verbal consent will be obtained from each participant. A copy of the consent form and contact information will be sent to each participant.
Heatwaves are among the fastest-growing climate-related threats to human health, increasing in frequency, intensity and duration with climate change. Older adults are disproportionately affected, reflecting intersecting physiological, social and economic vulnerabilities. Beyond mortality, heatwaves drive substantial but often under-recognised morbidity, including emergency visits and hospitalisations for cardiovascular, respiratory, renal and metabolic conditions. Health administrative data provide valuable opportunities to improve understanding of these phenomena and for the quantification of their impacts. However, comparability is limited by heterogeneity in case definitions, that is, the criteria used to determine which health events are counted as cases: some studies only clinically diagnosed heat illness, while others also capture outcomes plausibly triggered or exacerbated by heat. It is further constrained by differences in International Classification of Diseases (ICD) versions, national adaptations, coding practices and adoption timelines across countries. No synthesis has yet mapped these heterogeneous approaches for older adults, despite their over-representation among those most affected by heat-health risks. This heterogeneity limits the ability to capture the true burden of disease and to inform adaptation planning.
We will conduct a scoping review to map how heat-related diagnoses among older adults are identified and measured in health administrative data. The review will follow the initial methodological framework of Arksey and O’Malley refined by Levac et al and adhere to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The search strategy will be developed with a public health librarian and applied to MEDLINE (Ovid), Embase and Web of Science. We will include peer-reviewed and grey literature published in English or French from 2010 onward. Two reviewers will independently screen titles, abstracts and full texts in Covidence, with disagreements resolved by consensus or a third reviewer. Data will be extracted using a standardised form to capture study characteristics, ICD codes, definitions of heat exposure and approaches to measurement. A descriptive and thematic analysis will be conducted, and findings will be presented narratively and in tables.
Ethical approval is not required for this review as it involves secondary analysis of published and publicly available data; for more information, contact University of Montreal’s Research Integrity department at plaintes-crr@umontreal.ca. Results will be published through a peer-reviewed publication, conference presentations and knowledge transfer activities with public health stakeholders in Québec. This review contributes to the MEDICCS (Modélisation économique des impacts des changements climatiques sur la santé) project and will support recommendations for improving the capture of heat-related morbidity in health administrative data.
Quality improvement is a well-known and commonly utilized approach to improving care and outcomes that is built on process improvement methods but not practice improvement methods. Because quality care includes both process and practice elements, process improvement alone cannot ensure quality outcomes will be achieved. This calls for a new approach.
To share an innovative, synergistic, and collaborative quality framework: Evidence-based Quality in Practice and Process: The EQUiPP Framework.
The EQUiPP Framework's intent is to provide structure for collaborative efforts to effectively identify best practices/processes, implement and sustain change, and improve outcomes. The framework provides guidance to decrease the frequency of implementing ineffective changes by deriving effective solutions … the first time, every time.
A team of experts used a consensus approach to develop the framework.
A precursor to this framework, the Practice and Process Improvement = Quality (PPQ) Model, was evaluated by individual expert review and a two-day beta test workshop. Feedback was obtained during the workshop when participants applied the model in activities reflecting real-world healthcare scenarios. When used in both DNP student work and real-world health systems, fundamental flaws were identified which resulted in the necessity to develop a different conceptualization. The framework described here is a new approach to improving quality care.
The EQUiPP Framework is a tool that provides the synergistic integration of both practice improvement (EBP) and process improvement methodologies to successfully implement and sustain best practices to achieve and sustain quality outcomes.
The EQUiPP Framework aligns EBP and process improvement, allowing clinicians and students to work collaboratively to identify and effectively, as well as efficiently, implement and sustain best practices to deliver quality outcomes.
Primary care nurses (PCNs) are the second largest workforce in primary care and play a critical role in facilitating access to coordinated care and reducing health disparities. There is renewed interest in team-based primary care as a solution for health workforce challenges. Some team models enable PCNs (ie, nurse practitioners, registered nurses, licensed/registered practical nurses) to leverage one another’s expertise to work to optimal scope; the extent to which this happens depends on multiple context-dependent factors. We will conduct an umbrella review to synthesise and compare international knowledge syntheses focused on scope of practice enactment (ie., roles and activities) of PCNs in primary care.
We will conduct the umbrella review according to the Joanna Briggs Institute methodology, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) guidelines, and using the Nursing Care Organization Framework as guidance. We will search a wide range of scientific electronic databases and grey literature sources, and consider articles published in English and French by the Organization for Economic Cooperation and Development and designated key partner countries for inclusion, with no publication date limits. Two independent reviewers will screen titles, abstracts and full-text articles, and any disagreements will be resolved through discussion or by a third reviewer. We will use the Risk of Bias Assessment Tool for Systematic Reviews to assess the quality and risk of bias in the included systematic and scoping reviews.
Results will be presented in a PRISMA Scoping Review flow diagram. We will synthesise data from included studies in a detailed literature review table and develop visual aids to communicate the shared and unique roles and activities of PCN scope of practice. We will disseminate the results of the review through peer-reviewed publications and conferences related to this field. Ethics approval is not required.
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