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\"Prior to the implementation of the Equal Opportunity Program in the 1960s, most New Brunswickers, many of them Francophone, lived with limited access to welfare, education, and health services. New Brunswick's social services framework was similar to that of nineteenth-century England, and many people experienced the patronizing attitudes inherent in these laws. New Brunswick Before Equal Opportunity examines the observations and experiences of New Brunswick's early social workers, who operated under this system, and illuminates how Premier Louis J. Robichaud's Equal Opportunity Program transformed the province's social services. Authors Laurel Lewey, Louis J. Richard and Linda Turner, describe more than a century of social work history, including the work of the earliest Acadian social workers. They also address the fact that the federal government did not take responsibility for social welfare of the Mi'kmaq and Maliseet people, planning for assimilation instead. Clan structures continued to be relied on while subsisting upon inadequate relief provisions.\"-- Provided by publisher.

While many older American cities struggle to remain vibrant, New Brunswick has transformed itself, adapting to new forms of commerce and a changing population, and enjoying a renaissance that has led many experts to cite this New Jersey city as a model for urban redevelopment. Featuring more than 100 remarkable photographs and many maps,New Brunswick, New Jerseyexplores the history of the city since the seventeenth century, with an emphasis on the dramatic changes of the past few decades. Using oral histories, archival materials, census data, and surveys, authors David Listokin, Dorothea Berkhout, and James W. Hughes illuminate the decision-making and planning process that led to New Brunswick's dramatic revitalization, describing the major redevelopment projects that demonstrate the city's success in capitalizing on funding opportunities. These projects include the momentous decision of Johnson & Johnson to build its world headquarters in the city, the growth of a theater district, the expansion of Rutgers University into the downtown area, and the destruction and rebuilding of public housing. But while the authors highlight the positive effects of the transformation, they also explore the often heated controversies about demolishing older neighborhoods and ask whether new building benefits residents. Shining a light on both the successes and failures in downtown revitalization, they underscore the lessons to be learned for national urban policy, highlighting the value of partnerships, unwavering commitment, and local leadership. Today, New Brunswick's skyline has been dramatically altered by new office buildings, residential towers, medical complexes, and popular cultural centers. This engaging volume explores the challenges facing urban America, while also providing a specific case study of a city's quest to raise its economic fortunes and retool its economy to changing needs.

Personal identification (ID) is a prerequisite to many financial and social services; however, many vulnerable residents do not have ID and lack the resources to acquire it. To assess the impact of ID inaccessibility in a local context, a study was conducted throughout New Brunswick, Canada. The study objective was to understand the implications of ID requirements and the barriers to acquiring it through the lens of consumers. This mixed-methods, observational study included surveys and interviews. The survey collected demographics, socioeconomic status (SES), financial behaviors and experiences, and barriers to accessing ID. The semi-structured interviews explored individual experiences. In order to address disparities in health and social outcomes, ID requirements and barriers to access need to be acknowledged and mitigated. A total of 142 surveys were completed. Many respondents reported difficulty obtaining or replacing a driver’s license (30.8%), a provincial photo ID (47.7%), or their birth certificate (39.4%), identifying cost (34.4%) and required documentation (28.1%) as the main barriers. Thematic analysis identified three main themes: the difficulty of living without ID, barriers to obtaining or replacing an ID, and an exploration of solutions. Current ID policies restrict access to community services such as banking, housing, and employment, which are intended to support individuals to improve their situation and gain autonomy. Policies and services are required to address this urgent issue.

During the COVID-19 pandemic, telehealth technologies were used in the primary health care setting in New Brunswick as a means to continue providing care to patients while following public health guidelines. This study aimed to measure these changes and examine if they improved timely access to primary care. A secondary goal was to identify which telehealth technologies were deemed sustainable by primary care providers. This was a comparative study on the use of telehealth technology before and during the COVID-19 pandemic. Between April 2020 and November 2020, 114 active primary care providers (family physicians or nurse practitioners) responded to the online survey. The findings illustrated an increase in the use of telehealth technologies. The use of phone consultations increased by 122%, from 43.9% pre-pandemic to 97.6% during the pandemic (p < 0.001). The use of virtual consultation (19.3% pre-pandemic vs. 41.2% during the pandemic, p < 0.001), emails and texts also increased during the pandemic. Whereas the more structural organizational tools (electronic medical charts and reservation systems) remained stable. However, those changes did not coincide with a significant improvement to timely access to care during the pandemic. Many participants (40.1%) wanted to keep phone consultations, and 21.9% of participants wanted to keep virtual consultations as part of their long-term practice. The observed increase in the use of telehealth technologies may be sustainable, but it has not significantly improved timely access to primary care in New Brunswick.

The effects of the COVID-19 pandemic have been more pronounced for socially disadvantaged populations. We sought to determine how access to SARS-CoV-2 testing and the likelihood of testing positive for COVID-19 were associated with demographic factors, socioeconomic status (SES) and social determinants of health (SDH) in three Canadian provinces. An observational population-based cross-sectional study was conducted for the provinces of Ontario, Manitoba and New Brunswick between March 1, 2020 and April 27, 2021, using provincial health administrative data. After excluding residents of long-term care homes, those without current provincial health insurance and those who were tested for COVID-19 out of province, records from provincial healthcare administrative databases were reviewed for 16,900,661 healthcare users. Data was modelled separately for each province in accordance to a prespecified protocol and follow-up consultations among provincial statisticians and collaborators. We employed univariate and multivariate regression models to examine determinants of testing and test results. After adjustment for other variables, female sex and urban residency were positively associated with testing, while female sex was negatively associated with test positivity. In New Brunswick and Ontario, individuals living in higher income areas were more likely to be tested, whereas in Manitoba higher income was negatively associated with both testing and positivity. High ethnocultural composition was associated with lower testing rates. Both high ethnocultural composition and high situational vulnerability increased the odds of testing positive for SARS-CoV-2. We observed that multiple demographic, income and SDH factors were associated with SARS-CoV-2 testing and test positivity. Barriers to healthcare access identified in this study specifically relate to COVID-19 testing but may reflect broader inequities for certain at-risk groups.

Political scientists have often assumed that communities severely divided by cleavages such as religion and ethnicity will also be unstable. The civil strife experienced by Northern Ireland seems to confirm this assumption. Yet other communities, no less divided than Northern Ireland, have maintained political stability in spite of serious tensions created by religious and ethnic differences. The Canadian province of New Brunswick is an example of such a community. In Search of Political Stability offers a detailed comparison of society and politics in New Brunswick and Northern Ireland. It reveals the fragmented nature of the two communities by comparing the distinctive cultures and separate social institutions of the major blocs, whether English or French, Protestant or Catholic. It documents the contrasting experiences of stability and instability by assessing the durability of each community's political institutions, the legitimacy and efficacy of their governments, and the prevalence or absence of civil strife. The search for the causes of stability and instability focuses on the nature of the social conflicts and the behaviour of the political elites. In New Brunswick major conflicts have cut across the division between the English and French blocs. In Northern Ireland conflicts have tended to reinforce the division between the Protestant and Catholic blocs. The effects of these differing patterns are consistent with the theory of crosscutting cleavages. An examination of the elite political cultures, including such specific elements as campaign strategies, cabinet formation, and civil service composition, shows a pattern of elite cooperation in New Brunswick and elite confrontation in Northern Ireland. These results are broadly consistent with Lijphart's theory of consociational democracy, although significant revisions are made to this theory.

Background Visitor restrictions to healthcare facilities were enacted throughout the course of the COVID-19 pandemic and changed over time. Further research on the consequences of restrictions, particularly in relation to palliative care and from multiple key stakeholder perspectives, is needed. We investigated the impact of COVID-19 visitor restrictions on family members of patients with a life limiting diagnosis or who received palliative care during the pandemic, and health care providers (HCPs) for patients with life limiting diagnoses within New Brunswick, Canada. Methods Semi-structured interviews were conducted with 12 family members and 11 HCPs. Reflexive thematic analysis was used to allow for the inductive generation of themes from the qualitative data, while investigating and comparing participants’ experiences. Results The analysis found that HCP and family member themes had a great deal of similarities. The themes developed for family members were: Visitor restrictions have negative impacts on palliative patients and their families ; Visitor restrictions impacted patient-family care decisions and timing; Family members had more positive experiences when a patient-centred approach to care was used; Exceptions need to be made when it comes to palliative care and visitation; COVID restrictions didn’t make sense; and, COVID led to healthcare providers being further overextended. HCP themes developed were: COVID restrictions and policies impacted satisfaction with work life ; The impact of not visiting on families was terrible; HCP had to figure out new ways of providing care; We believe that patients need their families; Patients are lonely and miss family; Weren’t always made clearly aware of the changes happening in hospital visitor restrictions; and, COVID restrictions led to people keeping loved ones at home . Conclusions Results unveiled dynamic relationships between HCPs and family members, whose perspectives on the impacts of visitor restrictions overlapped. Main findings emphasized the overall negative impacts of visitor restrictions and a clear need to enact policies with a particular focus on understanding the need for a flexible patient and family-centred approach and quality of life considerations. Clear and consistent communication with all stakeholders regarding policies is recommended, as well as consistent exceptions for patients with life-limiting diagnoses.

Objectives Long-haul truck drivers experience multiple challenges, including increased health risks. A large percentage of professional truck drivers (PTDs) suffer from numerous chronic physical health conditions such as obesity, hypertension, diabetes, heart disease, sleep disorders, etc.) as well as poor mental health and social challenges. Furthermore, this population experiences numerous barriers related to accessing health care services including primary care and resources to improve their health. PTDs living in rural and remote areas are at higher risk. The objective of this study is to understand the views of PTDs and the trucking industry on health and personalized healthcare interventions and services. Methods In-depth semi-structured interviews were conducted with twenty-six individuals with contextual knowledge and experience in the trucking ecosystem, to better understand the needs, expectations, and preferences of PTDs based in New Brunswick (Canada), related to their health (physical, mental, and social). Analysis of the audiotape recording was conducted using thematic content analysis. Results Three major themes emerged from the qualitative analysis describing PTDs’ health needs, existing health and preventive services, as well as recommendations for personalized healthcare interventions and services to be implemented: (1) “My life as a trucker!” Understanding needs and challenges, (2) “Taking care of myself, do you think it is easy while you’re on the road?” Describing drivers and motivators for better health, and (3) “Can you hear what we need?” Translating needs into recommendations for tailored health services and preventative services. Conclusion A highly demanding work environment and lack of timely access to integrated primary care negatively affect PTDs’ health. Results of this study shed light on how to tailor primary care to improve its responsiveness and adequacy to PTDs’ needs and realities. PTDs-sensitive integrated services, including multicomponent interventions (health education, coaching for lifestyle changes, and social support), are still lacking within the New Brunswick health system.

Accurate forecasting of claim frequency in automobile insurance is essential for insurers to assess risks effectively and establish appropriate pricing policies. Traditional methods typically rely on a Poisson distribution for modeling claim counts; however, this approach can be inadequate due to frequent zero-claim periods, leading to zero inflation in the data. Zero inflation occurs when more zeros are observed than expected under standard Poisson or negative binomial (NB) models. While machine learning (ML) techniques have been explored for predictive analytics in other contexts, their application to zero-inflated insurance data remains limited. This study investigates the utility of ML in improving forecast accuracy under conditions of zero-inflation, a data characteristic common in automobile insurance. The research involved a comparative evaluation of several models, including Poisson, NB, zero-inflated Poisson (ZIP), hurdle Poisson, zero-inflated negative binomial (ZINB), hurdle negative binomial, random forest (RF), support vector machine (SVM), and artificial neural network (ANN) on an insurance dataset. The performance of these models was assessed using mean absolute error. The results reveal that the SVM model outperforms others in predictive accuracy, particularly in handling zero-inflation, followed by the ZIP and ZINB models. In contrast, the traditional Poisson and NB models showed lower predictive capabilities. By addressing the challenge of zero-inflation in automobile claim data, this study offers insights into improving the accuracy of claim frequency predictions. Although this study is based on a single dataset, the findings provide valuable perspectives on enhancing prediction accuracy and improving risk management practices in the insurance industry.

In Canada, healthcare reforms typically aim to improve the quality of care and access while making healthcare systems more efficient. These reforms have led to a 2-level healthcare system consisting of provincial and regional health authorities (RHAs). RHAs are responsible for providing and administering health services within specific territories. One of the 2 language-based RHAs in New Brunswick (NB) operates in French-speaking rural minority communities. This study explored key factors affecting the retention of nurses and physicians within a RHA operating in a language minority context. This descriptive qualitative study explored how macro-level decisions are experienced on the frontlines. Data were collected through semi-structured interviews with 21 physicians and 37 registered nurses, as well as 2 focus groups involving 20 key informants in managerial roles. Thematic analysis was used to identify key themes. Three main factors emerged: organizational accountability and frustration, local autonomy and contextual responsiveness, and a culture of openness and perceived loss of control. These factors are associated with policy changes that affect operational settings and resource distribution within the RHA and influence the retention of nurses and physicians. Stakeholders in health system reforms, including governments and RHAs, must recognize that policy adjustments can have direct implications on everyday care. Participants expressed a growing disconnect from decision-making hierarchies and a perceived loss of control. Both are seen as barriers to delivering quality care. Ensuring adequate support and resources for implementing system-level changes is key to fostering professional engagement and enhancing job satisfaction.