Maria Mathews, PhD, Peer Reviewed Publications


2017-2024

2024

Idrees S, Young G, Dunne B, Antony D, Meredith L, Mathews M. The implementation of person-centred plans in the community-care sector: a qualitative study of organizations in Ontario, Canada. BMC Health Serv Res. 2024 May 29;24(1):680. doi: 10.1186/s12913-024-11089-7. PMID: 38811995.

Mathews M, Liu T, Ryan D, Hedden L, Lukewich J, Marshall EG, Buote R, Meredith L, Moritz LR, Spencer S, Asghari S, Brown JB, Freeman TR, Gill PS, Sibbald S. Practice- and System-Based Interventions to Reduce COVID-19 Transmission in Primary Care Settings: A Qualitative Study. Healthc Policy. 2023 Nov;19(2):63-78. doi: 10.12927/hcpol.2023.27232.

Mathews M, Hedden L, Lukewich J, Marshall EG, Meredith L, Moritz L, Ryan D, Spencer S, Brown JB, Gill PS, Wong EKW. Adapting care provision in family practice during the COVID-19 pandemic: a qualitative study exploring the impact of primary care reforms in four Canadian regions. BMC Prim Care. 2024 Apr 6;25(1):109. doi: 10.1186/s12875-024-02356-x. PMID: 38582824.

Morita LR, Buote R, McKay M, Meredith L, Ryan D, Spencer S, Vaughan C, Hedden L, Lukewich J, Mathews M, Shabnam A, Brown JB, Gill PS, Wong E, Marshall EG. Family physicians’ perspectives on collaboration challenges between primary care and specialist care during the COVID-19 pandemic in Canada: A qualitative study. SSM - Qualitative Research in Health. 2023 Dec 1;4:100338.

Premji K, Green ME, Glazier RH, Khan S, Schultz SE, Mathews M, Nastos S, Frymire E, Ryan BL. Characteristics of patients attached to near-retirement family physicians: a population-based serial cross-sectional study in Ontario, Canada. BMJ Open. 2023 Dec 7;13(12):e074120. doi: 10.1136/bmjopen-2023-074120.

Spencer S, Lukewich J, Marshall EG, Mathews M, Asghari S, Brown JB, Freeman TR, Gill P, Idrees S, McCracken RK, Ranade S, Slade S, Terry AL, Wickett J, Wong E, Buote R, Meredith L, Moritz L, Ryan D, Hedden L. “Family doctors are also people”: a qualitative analysis of how family physicians managed competing personal and professional responsibilities during the COVID-19 pandemic. Hum Resour Health, 2024 Mar 4; 22 (1): 18, Coauthor, DOI: 10.1186/s12960-024-00901-4.

2023

Curnew D, Lukewich J, Mathews M, Poitras ME, Romme K. JBI Evid Synth. Integration of primary care education into undergraduate nursing programs: a scoping review protocol. 2023 Mar 27. doi: 10.11124/JBIES-22-00312. Online ahead of print. PMID: 36974446.

Hedden L, Spencer S, Allin S, Contandriopoulos D, Gavin F, Grudniewicz A, Lavergne MR, Leaver C, Lexchin J, McKay M, Mathews M, McCracken RK, McGrail K, Palmer KS, Poitras ME, Rudoler D, Spithoff S, Vanstone M. For health or for profit? Understanding how private financing and for-profit delivery operate within Canadian healthcare (4H|4P): protocol for a multimethod knowledge mobilisation research project. BMJ Open. 2023 Aug 21;13(8):e077783. doi: 10.1136/bmjopen-2023-077783. PMID: 37604630 Free article.

Hedden, L., Spencer, S., Mathews, M., Marshall, E.G., Lukewich, J., Asghari, S., Brown, J.B., Gill, P.S., Freeman, T.R., McCracken, R.K., Ryan, B.L., Vaughan, C., Wong, E., Buote, R., Meredith, L., Moritz, L., Ryan, D., McKay, M., Schacter, G. “There’s nothing like a good crisis for innovation”: a qualitative study of family physicians’ experiences with virtual care during the COVID-19 pandemic. BMC Health Serv Res 23, 338 (2023).

Kaneko M, Ikeda T, Inoue M, Sugiyama K, Saito M, Ohta R, Cooray U, Vingilis E, Freeman TR, Mathews M. Development and validation of a rurality index for healthcare research in Japan: a modified Delphi study. BMJ Open. 2023 Jun 19;13(6):e068800. doi: 10.1136/bmjopen-2022-068800. PMID: 37336534.

Lukewich J, Mathews M, Poitras ME, Tranmer J, Martin-Misener R, Bryant-Lukosius D, Aubrey-Bassler K, Klassen T, Curnew D, Bulman D, Leamon T, Ryan D. Primary care nursing competencies in Canadian undergraduate nursing programs: A national cross-sectional survey. Nurse Educ Pract. 2023 Aug 3;71:103738. doi: 10.1016/j.nepr.2023.103738. Online ahead of print. PMID: 37549469.

Marshall EG, Cook M, Moritz L, Buote R, Mathews M, Breton M. "A Band-Aid Solution": Policy Maker and Primary Care Provider Perspectives on the Value of Attachment Incentives. Healthc Policy. 2023 May;18(4):106-119. doi: 10.12927/hcpol.2023.27090. PMID: 37486816 Free PMC article.

Marshall EG, Stock D, Buote R, Andrew MK, Breton M, Cossette B, Green ME, Isenor JE, Mathews M, MacKenzie A, Martin-Misener R, McDougall B, Mooney M, Moritz LR. Emergency department utilization and hospital admissions for ambulatory care sensitive conditions among people seeking a primary care provider during the COVID-19 pandemic. CMAJ Open. 2023 Jun 20;11(3):E527-E536. doi: 10.9778/cmajo.20220128. Print 2023 May-Jun. PMID: 37339790.

Mathews M, Bourgeault I, Ryan D. Perceptions of bias in the selection of international medical graduate residency applicants in Canada. Can Med Educ J. 2023 Apr 8;14(2):16-22. doi: 10.36834/cmej.73320. eCollection 2023 Apr.PMID: 37304630.

Mathews M, Meredith L, Ryan D, Hedden L, Lukewich J, Marshall EG, Moritz L, Spencer S, Xiao J, Brown JB, McKay M, Wong E, Gill P. An analysis of policies supporting the roles of family physicians in four regions in Canada during the COVID-19 pandemic. Healthc Manage Forum. 2023 Jun 16:8404704231183174. doi: 10.1177/08404704231183174. Online ahead of print. PMID: 37326140.

Mathews M, Richard L, Lam M, Gozdyra P, Green M. A Cross-Sectional Study of Community-Level Physician Retention and Diabetes Management in Rural Ontario. Can J Diabetes. 2023 Mar 27:S1499-2671(23)00059-X. doi: 10.1016/j.jcjd.2023.03.004. Online ahead of print. PMID: 36990272.

Mathews M, Ryan D, Hedden L, Lukewich J, Marshall EG, Asghari S, Terry AL, Buote R, Meredith L, Moritz L, Spencer S, Brown JB, Christian E, Freeman TR, Gill PS, Sibbald SL, Wong E. Family physicians' responses to personal protective equipment shortages in four regions in Canada: a qualitative study. BMC Prim Care. 2023 Feb 27;24(1):56. doi: 10.1186/s12875-022-01958-7.

Mathews M, Ryan D, Bourgeault I. "I wish I had known what I was getting into": a qualitative study exploring the experiences of Canadians who study medicine abroad. BMC Med Educ. 2023 May 24;23(1):376. doi: 10.1186/s12909-023-04367-1.PMID: 37226232.

Mathews M, Ryan D, Hedden L, Lukewich J, Marshall EG, Buote R, Meredith L, Moritz LR, Spencer S, Brown JB, Gill PS, Ryan BL, Wetmore SJ. Strengthening the integration of primary care in pandemic response plans: a qualitative interview study of Canadian family physicians. Br J Gen Pract. 2023 Apr 27;73(730): e348-e355. doi: 10.3399/BJGP.2022.0350. Print 2023 May. PMID: 37105750.

Mathews M, Ouédraogo AM, Lam M, Gozdyra P, Green M. A cross-sectional study of community-level physician retention and hospitalization in rural Ontario, Canada. J Rural Health. 2023 Jan;39(1):69-78. doi: 10.1111/jrh.12661. Epub 2022 Mar 15.

2022

Breton M, Marshall EG, Deslaurier V, Smithman M-A, Moritz LR, Buote RD, Morrison B, Christian EK, McKay M, Stringer K, Godard-Sebilotte C, Sourial N, Maberge M, MacKenzie A, Isenor JE, Duhoux A, Ashcroft R, Mathews M, Cossette B, Hudon C, McDougall B, Guénette L, Kirkwood R, Green ME.  COVID-19 – an opportunity to improve access to primary care through organizational innovations? A qualitative multiple case study in Quebec and Nova Scotia (Canada).  BMC Health Services Research 2022; 22:759 e1-18.

Isenor JE, Cossette B, Murphy AL, Breton M, Mathews M, Moritz LR, Buote R, McCarthy L, Woodill L, Morrison B, Guénette L, Marshall EG. Community pharmacists' expanding roles in supporting patients before and during COVID-19: An exploratory qualitative study. Int J Clin Pharm. 2022 Oct 26:1-15. doi: 10.1007/s11096-022-01430-7. Online ahead of print.

Lukewich J, Asghari S, Marshall EG, Mathews M, Swab M, Tranmer J, Bryant-Lukosius D, Martin-Misener R, Norful AA, Ryan D, Poitras ME. Effectiveness of registered nurses on system outcomes in primary care: a systematic review. BMC Health Serv Res. 2022 Apr 4;22(1):440. doi: 10.1186/s12913-022-07662-7.

Lukewich J, Martin-Misener R, Norful AA, Poitras ME, Bryant-Lukosius D, Asghari S, Marshall EG, Mathews M, Swab M, Ryan D, Tranmer J. Effectiveness of registered nurses on patient outcomes in primary care: a systematic review. BMC Health Serv Res. 2022 Jun 3;22(1):740. doi: 10.1186/s12913-022-07866-x.

Marshall EG, Breton M, Green M, Edwards L, Ayn C, Smithman MA, Ryan Carson S, Ashcroft R, Bayoumi I, Burge F, Deslauriers V, Lawson B, Mathews M, McPherson C, Moritz LR, Nesto S, Stock D, Wong ST, Andrew M. CUP study: protocol for a comparative analysis of centralised waitlist effectiveness, policies and innovations for connecting unattached patients to primary care providers. BMJ Open. 2022 Mar 7;12(3):e049686. doi: 10.1136/bmjopen-2021-049686.

Mathews M, Meredith L, Ryan D, Hedden L, Lukewich J, Marshall EG, Buote RD, Moritz L, Spencer S, Asghari A, Brown JB, Freeman TR, Gill PS, McCracken RK, McKay M, Ryan B, Sibbald SL, Wetmore S, Wong E. The roles of family physicians during a pandemic. Healthcare Management Forum 2022; (0):1-6.

Mathews M, Ouédraogo AM, Lam M, Gozdyra P, Green M. A cross-sectional study of community-level physician retention and hospitalization in rural Ontario, Canada. J Rural Health. 2022 Mar 15. doi: 10.1111/jrh.12661. Epub ahead of print.

Mathews M , Ryan D, Randall E, Marshall EG, Goldsmith LJ, Jones L, Lavergne MR, Snadden D, Scott I, Wong ST, Stringer K, Horrey K, Grudniewicz A. "At the mercy of some of the regulations": the impact of the residency match and return of service requirement on the early-career decisions of international medical graduates in Canada. Hum Resour Health. 2022 Feb 4;20(1):15. doi: 10.1186/s12960-022-00709-0.

Mathews M, Ryan D, Hedden L, Lukewich J, Marshall EG, Brown JB, Gill PS, McKay M, Wong E, Wetmore SJ, Buote R, Meredith L, Moritz L, Spencer S, Alexiadis M, Freeman TR, Letto A, Ryan BL, Sibbald SL, Terry AL. Family physician leadership during the COVID-19 pandemic: roles, functions and key supports. Leadersh Health Serv (Bradf Engl). 2022 Jul 27; (ahead-of-print). doi: 10.1108/LHS-03-2022-0030.

Mathews M, Spencer S, Hedden L, Lukewich J, Poitras ME, Marshall EG, Brown JB, Sibbald S, Norful AA. The impact of funding models on the integration of registered nurses in primary health care teams: protocol for a multi-phase mixed-methods study in Canada. BMC Prim Care. 2022 Nov 19;23(1):290. doi: 10.1186/s12875-022-01900-x.

McKay M, Lavergne MR, Lea AP, Le M, Grudniewicz A, Blackie D, Goldsmith LJ, Marshall EG, Mathews M, McCracken R, McGrail K, Wong S, Rudoler D. Government policies targeting primary care physician practice from 1998-2018 in three Canadian provinces: A jurisdictional scan. Health Policy. 2022 Mar 17:S0168-8510(22)00063-X. doi: 10.1016/j.healthpol.2022.03.006. Epub ahead of print.  

Ravichandiran N, Mathews M, Ryan BL. Utilization of healthcare by immigrants in Canada: a cross-sectional analysis of the Canadian Community Health Survey. BMC Prim Care. 2022 Apr 6;23(1):69. doi: 10.1186/s12875-022-01682-2.

Ryan BL, Brown JB, Freeman TR, Richard L, Stewart M, Meredith L, Choi YH, He JW, Cejic S, Thompson K, Reichert S, Shariff SZ, Booth R, Terry AL, Mathews M. Virtual family physician care during COVID-19: a mixed methods study using health administrative data and qualitative interviews. BMC Prim Care. 2022 Nov 25;23(1):300. doi: 10.1186/s12875-022-01902-9.

Spencer S; Hedden L; Vaughan C, Marshall EG, Lukewich J; Asghari S, Gill P, Buote RD, Meredith L, Moritz L, Ryan D, Mathews M.  “It was horrible for that community, but not for the way we had imagined”: A qualitative study of family physicians’ experiences working with communities experiencing marginalization during COVID-19. SSM Qual Res Health. 2022 Dec; 2:100176. doi: 10.1016/ j.ssmqr.2022.100176. Epub 2022 Sep 30.

Vaughan C, Lukewich J, Mathews M, Hedden L, Poitras ME, Asghari S, Swab M, Ryan D. Nursing contributions to virtual models of care in primary care: a scoping review protocol. BMJ Open. 2022 Sep 20; 12(9):e065779. doi: 10.1136/bmjopen-2022-065779.

Vaughan, C., Lukewich, J., Mathews, M., Marshall, E., Hedden, L., Spencer, S., Ryan, D., McCracken, R. K., Gill, P., Wetmore, S., Buote, R., Meredith, L., Moritz, L., Brown, J. B. (2022). Family physicians’ perspectives on the impact of COVID-19 on preventative care in primary care: Findings from a qualitative study. Family Practice, 2022 Oct 21; mac113. doi: 10.1093/fampra/cmac113. Online ahead of print.

Vo AT, Yi Y, Mathews M, Valcour J, Alexander M, Billard M. A single-entry model and wait time for hip and knee replacement in eastern health region of Newfoundland and Labrador 2011-2019. BMC Health Serv Res. 2022 Jan 16;22(1):82. doi: 10.1186/s12913-021-07451-8.  

2021

Kaneko M, Ohta R, Vingilis E, Mathews M, Freeman TR. Systematic scoping review of factors and measures of rurality: toward the development of a rurality index for health care research in Japan. BMC Health Serv Res. 2021 Jan 4;21(1):9. doi: 10.1186/s12913-020-06003-w. .

Longo CJ, Fitch MI, Loree JM, Carlson LE, Turner D, Cheung WY, Gopaul D, Ellis J, Ringash J, Mathews M, Wright J, Stevens C, D'Souza D, Urquhart R, Maity T, Balderrama F, Haddad E. Patient and family financial burden associated with cancer treatment in Canada: a national study. Support Care Cancer. 2021 Jun;29(6):3377-3386. doi: 10.1007/s00520-020-05907-x. Epub 2021 Jan 5. Erratum in: Support Care Cancer. 2021 Feb 15.

Lukewich J, Poitras M-E, Mathews M. Unseen, unheard…unvalued?  Advancing research on family practice nurses in Canada.  Practice Nursing.  2021 42(4): 158-162. doi.org/10.12968/pnur.2021.32.4.158.

Marshall E, Breton M, Cossette B, Isenor J, Mathews M, Ayn C, Smithman MA, Stock D, Frymire E, Edwards L, Green M. The PUPPY Study: Protocol for a Longitudinal Mixed Methods Study Exploring Problems Coordinating and Accessing Primary Care for Attached and Unattached Patients Exacerbated During the COVID-19 Pandemic Year. JMIR Res Protoc. 2021 Sep 9. doi: 10.2196/29984. Epub ahead of print.

Marshall EG, Breton M, Cossette B, Isenor J, Mathews M, Ayn C, Smithman MA, Stock D, Frymire E, Edwards L, Green M. Problems in Coordinating and Accessing Primary Care for Attached and Unattached Patients Exacerbated During the COVID-19 Pandemic Year (the PUPPY Study): Protocol for a Longitudinal Mixed Methods Study. JMIR Res Protoc. 2021 Oct 13;10(10):e29984. doi: 10.2196/29984.

Mathews M, Ryan D, Buote R, Parsons S, Lukewich J. Family Practice Nursing in Newfoundland and Labrador: Are Reported Roles Reflective of Professional Competencies for Registered Nurses in Primary Care? SAGE Open Nurs. 2021 Oct 29;7:23779608211053496. doi: 10.1177/23779608211053496.

Mathews M, Koudieh D, Yi Y, Hedden L, Marshall EG, Samarasena A, Barnum G, Bourgeault I. Retention of visa-trainee post-graduate residents in Canada: a retrospective cohort study. Hum Resour Health. 2021 Aug 17;19(1):98. doi: 10.1186/s12960-021-00638-4.

Mathews M, Spencer S, Hedden L, Marshall EG, Lukewich J, Meredith L, Ryan D, Buote R, Liu T, Volpe E, Gill PS, Ryan B, Schacter G, Wickett J, Freeman TR, Sibbald SL, Wong E, McKay M, McCracken R, Brown JB. Development of a primary care pandemic plan informed by in-depth policy analysis and interviews with family physicians across Canada during COVID-19: a qualitative case study protocol. BMJ Open. 2021 Jul 22;11(7):e048209. doi: 10.1136/bmjopen-2020-048209. 

Perrault-Sequeira L, Torti J, Appleton A, Mathews M, Goldszmidt M. Discharging the complex patient - changing our focus to patients' networks of care providers. BMC Health Serv Res. 2021 Sep 10;21(1):950. doi: 10.1186/s12913-021-06841-2.

2020

  • Lukewich J, Allard M, Ashley L, Aubrey-Bassler K, Bryant-Lukosius D, Klassen T, Magee T, Martin-Misener R, Mathews M, Poitras ME, Roussel J, Ryan D, Schofield R, Tranmer J, Valaitis R, Wong ST. National Competencies for Registered Nurses in Primary Care: A Delphi Study. West J Nurs Res. 2020 Jul 3:193945920935590. doi: 10.1177/0193945920935590. Epub ahead of print.
  • Lukewich J, Buote R, Asghari S, Aubrey-Bassler K, Knight J, Mathews M. Adults with diabetes mellitus in Newfoundland and Labrador: a population-based, cross-sectional analysis. CMAJ Open. 2020 Dec 18;8(4):E895-E901. doi: 10.9778/cmajo.20190233.

    Mathews M,
    Ryan D, Buote R, Parsons S, Lukewich J. A qualitative study exploring the influence of clinic funding on the integration of family practice nurses in Newfoundland and Labrador. Nurs Open. 2020 Jul;7(4):1067-1073. doi: 10.1002/nop2.477. Epub 2020 Apr 14.

    Nguyen HV, Bornstein S, Gamble JM, Mathews M, Bishop L, Mital S. Too young for Cannabis? Choice of minimum legal age for legalized non-medical Cannabis in Canada. BMC Public Health. 2020 May 14;20(1):557. doi: 10.1186/s12889-020-08639-z.

2019

Blundell L, Mathews M, Bowley C, Roebothan B. Determining Student Food Insecurity at Memorial University of Newfoundland. Can J Diet Pract Res. 2019 Mar 1;80(1):14-21. doi: 10.3148/cjdpr-2018-026. Epub 2018 Oct 3.

Kaneko M, Oishi A, Matsui Y, Miyachi J, Aoki T, Mathews M. Research evidence is essential for the development of family medicine as a discipline in the Japanese healthcare system. BJGP Open. 2019 Jul 23;3(2). pii: bjgpopen19X101650. doi: 10.3399/bjgpopen19X101650. 

Knight JC, Moineddin R, Mathews M, Aubrey-Bassler K. Effect of primary health care reforms in the province of Newfoundland and Labrador: Interrupted time-series analysis. Can Fam Physician. 2019 Jul;65(7):e296-e304.

Lavergne MR, Goldsmith LJ, Grudniewicz A, Rudoler D, Marshall EG, Ahuja M, Blackie D, Burge F, Gibson RJ, Glazier RH, Hawrylyshyn S, Hedden L, Hernandez-Lee J, Horrey K, Joyce M, Kiran T, MacKenzie A, Mathews M, McCracken R, McGrail K, McKay M, McPherson C, Mitra G, Sampalli T, Scott I, Snadden D, Murphy GT, Wong ST. Practice patterns among early-career primary care (ECPC) physicians and workforce planning implications: protocol for a mixed methods study. BMJ Open. 2019 Sep 24;9(9):e030477. doi: 10.1136/bmjopen-2019-030477.

 

2018

Maxwell E, Mathews M, Mulay S. The Impact of Access Barriers on Fertility Treatment Decision-Making: A Qualitative Study from the Perspective of Patients and Service Providers. J Obstet Gynaecol Can. 2018 Mar;40(3):334-341. doi: 10.1016/j.jogc.2017.08.025. Epub 2017 Oct 20. 

Maxwell E, Mathews M, Mulay S. More Than a Biological Condition:The Heteronormative Framing of Infertility. Can J Bioethics 2018; 1(2):63-66.  

Mathews M, Bourgeault I. Saudi visa trainees called home from Canada in diplomatic dispute. Lancet. 2018 Sept 8;392(10150):815-816. doi: 10.1016/S0140-6736(18)31950-0. Epub 2018 Aug 20. 

2017

Mathews M, Bulman D, Ryan D. The role of patient and physician advocacy in reducing wait times for cancer care: a qualitative analysis. CMAJ Open. 2017 Oct 17;5(4):E773-E778. doi: 10.9778/cmajo.20170039.

Mathews M, Kandar R, Slade S, Yi Y, Beardall S, Bourgeault I. Examination outcomes and work locations of international medical graduate family medicine residents in Canada. Can Fam Physician. 2017 Oct;63(10):776-783.

Knight JC, Mathews M, Aubrey-Bassler K. Relation between family physician retention and avoidable hospital admission in Newfoundland and Labrador: a population-based cross-sectional study. CMAJ Open. 2017 Oct 6;5(4):E746-E752. doi: 10.9778/cmajo.20170007.

Mathews M, Kandar R, Slade S, Yi Y, Beardall S, Bourgeault I. Realization of entry-to-practice milestones by Canadians who studied medicine abroad and other international medical graduates: a retrospective cohort study. CMAJ Open. 2017 Jun 19;5(2):E476-E482. doi: 10.9778/cmajo.20160144.

Mathews M, Kandar R, Slade S, Yi Y, Beardall S, Bourgeault I. Retention Patterns of Canadians Who Studied Medicine Abroad and Other International Medical Graduates. Healthc Policy. 2017 May;12(4):33-45.

Mathews M, Kandar R, Slade S, Yi Y, Beardall S, Bourgeault I, Buske L. Credentialing and retention of visa trainees in post-graduate medical education programs in Canada. Hum Resour Health. 2017 Jun 12;15(1):38. doi: 10.1186/s12960-017-0211-6.

Mathews M, Ryan D. Publicly Funded Medical Travel Subsidy Programs in Canada. Can Social Work Rev 2017 34(1): 123-139.

Asghari S, Kris Aubrey-Bassler K, Godwin M, Rourke J, Mathews M, Barnes P, Smallwood E, Lesperance S, Oandasan I, Garcha I, Walczak A, Bosco C, Nasmith G, Shea N, O’Reilly S, Hurley O, Pike A, Hurd J. Factors influencing choice to practice in rural and remote communities throughout a physician’s life cycle. Can J of Rural Medicine 2017 22(3): 92-99.

Mathews M, Ryan D, Samarasena A. Early-career work location of Memorial University medical graduates: Why the decline in rural practice? Can J Rural Med. 2017 Spring;22(2):54-61.

Mathews M, Ryan D, Power M. The Role of Nurse Practitioners in Long-Term Care Settings in Newfoundland and Labrador. Nurs Leadersh (Tor Ont). 2017;30(4):26-38. doi: 10.12927/cjnl.2017.25451.