Measles Outbreak with Unique Virus Genotyping, Ontario, Canada, 2015.

PubMed

Thomas, Shari; Hiebert, Joanne; Gubbay, Jonathan B; Gournis, Effie; Sharron, Jennifer; Severini, Alberto; Jiaravuthisan, Manisa; Shane, Amanda; Jaeger, Valerie; Crowcroft, Natasha S; Fediurek, Jill; Sander, Beate; Mazzulli, Tony; Schulz, Helene; Deeks, Shelley L

2017-07-01

The province of Ontario continues to experience measles virus transmissions despite the elimination of measles in Canada. We describe an unusual outbreak of measles in Ontario, Canada, in early 2015 that involved cases with a unique strain of virus and no known association among primary case-patients. A total of 18 cases of measles were reported from 4 public health units during the outbreak period (January 25-March 23, 2015); none of these cases occurred in persons who had recently traveled. Despite enhancements to case-patient interview methods and epidemiologic analyses, a source patient was not identified. However, the molecular epidemiologic analysis, which included extended sequencing, strongly suggested that all cases derived from a single importation of measles virus genotype D4. The use of timely genotype sequencing, rigorous epidemiologic investigation, and a better understanding of the gaps in surveillance are needed to maintain Ontario's measles elimination status.

Evaluating risk factors for endemic human Salmonella Enteritidis infections with different phage types in Ontario, Canada using multinomial logistic regression and a case-case study approach

PubMed Central

2012-01-01

Background Identifying risk factors for Salmonella Enteritidis (SE) infections in Ontario will assist public health authorities to design effective control and prevention programs to reduce the burden of SE infections. Our research objective was to identify risk factors for acquiring SE infections with various phage types (PT) in Ontario, Canada. We hypothesized that certain PTs (e.g., PT8 and PT13a) have specific risk factors for infection. Methods Our study included endemic SE cases with various PTs whose isolates were submitted to the Public Health Laboratory-Toronto from January 20th to August 12th, 2011. Cases were interviewed using a standardized questionnaire that included questions pertaining to demographics, travel history, clinical symptoms, contact with animals, and food exposures. A multinomial logistic regression method using the Generalized Linear Latent and Mixed Model procedure and a case-case study design were used to identify risk factors for acquiring SE infections with various PTs in Ontario, Canada. In the multinomial logistic regression model, the outcome variable had three categories representing human infections caused by SE PT8, PT13a, and all other SE PTs (i.e., non-PT8/non-PT13a) as a referent category to which the other two categories were compared. Results In the multivariable model, SE PT8 was positively associated with contact with dogs (OR=2.17, 95% CI 1.01-4.68) and negatively associated with pepper consumption (OR=0.35, 95% CI 0.13-0.94), after adjusting for age categories and gender, and using exposure periods and health regions as random effects to account for clustering. Conclusions Our study findings offer interesting hypotheses about the role of phage type-specific risk factors. Multinomial logistic regression analysis and the case-case study approach are novel methodologies to evaluate associations among SE infections with different PTs and various risk factors. PMID:23057531

Curricular Ethics in Early Childhood Education Programming: A Challenge to the Ontario Kindergarten Program

ERIC Educational Resources Information Center

Heydon, Rachel M.; Wang, Ping

2006-01-01

Through a case study of a key Canadian early childhood education program, The Kindergarten Program (Ontario Ministry of Education and Training, 1998a), we explore the relationship between curricular paradigms and early childhood education (ECE) models, and the opportunities that each creates for enacting ethical teaching and learning…

Constructing the 'Transitional Problem' for Young Disabled People Leaving School: Comparing Policy and Practice in Ontario and Scotland.

ERIC Educational Resources Information Center

Tisdall, E. K. M.

1997-01-01

Explores how the "transitional question" of young disabled people leaving school is constructed. Describes and evaluates D. L. Kirp's classification system of social problems as applied to the "transition question." Reports case studies from Ontario (Canada) and Scotland. Concludes that Kirp's classification system is not…

Educational Information System for Ontario. Final Report, March 1977-April 1978.

ERIC Educational Resources Information Center

Auster, Ethel; Lawton, Stephen B.

This final report describing the operation and research of the EISO project, which provides online bibliographic search services to educators of Ontario, briefly summarizes the first and second interim reports. In addition, it discusses users and the uses of EISO information by providing mini-case studies to illustrate quantitative data and…

Economic evaluation of meningococcal serogroup B childhood vaccination in Ontario, Canada.

PubMed

Tu, Hong Anh T; Deeks, Shelley L; Morris, Shaun K; Strifler, Lisa; Crowcroft, Natasha; Jamieson, Frances B; Kwong, Jeffrey C; Coyte, Peter C; Krahn, Murray; Sander, Beate

2014-09-22

Invasive Neisseria meningitidis serogroup B (MenB) disease is a low incidence but severe infection (mean annual incidence 0.19/100,000/year, case fatality 11%, major long-term sequelae 10%) in Ontario, Canada. This study assesses the cost-effectiveness of a novel MenB vaccine from the Ontario healthcare payer perspective. A Markov cohort model of invasive MenB disease based on high quality local data and data from the literature was developed. A 4-dose vaccination schedule, 97% coverage, 90% effectiveness, 66% strain coverage, 10-year duration of protection, and vaccine cost of C$75/dose were assumed. A hypothetical Ontario birth cohort (n=150,000) was simulated to estimate expected lifetime health outcomes, quality-adjusted life years (QALYs), and costs, discounted at 5%. A MenB infant vaccination program is expected to prevent 4.6 invasive MenB disease cases over the lifetime of an Ontario birth cohort, equivalent to 10 QALYs gained. The estimated program cost of C$46.6 million per cohort (including C$318,383 for treatment of vaccine-associated adverse events) were not offset by healthcare cost savings of C$150,522 from preventing MenB cases, resulting in an incremental cost of C$4.76 million per QALY gained. Sensitivity analyses showed the findings to be robust. An infant MenB vaccination program significantly exceeds commonly used cost-effectiveness thresholds and thus is unlikely to be considered economically attractive in Ontario and comparable jurisdictions. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

District Resource Capacity and the Effects of Educational Policy: The Case of Primary Class Size Reduction in Ontario

ERIC Educational Resources Information Center

Mascall, Blair; Leung, Joannie

2012-01-01

In a study of Ontario, Canada's province-wide Primary Class Size Reduction (PCS) Initiative, school districts' ability to direct and support schools was related to their experience with planning and monitoring, interest in innovation, and its human and fiscal resource base. Districts with greater "resource capacity" were able to…

An Exploration of the Implementation of Restorative Justice in an Ontario Public School

ERIC Educational Resources Information Center

Reimer, Kristin

2011-01-01

This qualitative case study explores the implementation of restorative justice within one Ontario Public School. Restorative justice is a philosophy and a process for dealing with harmful behaviour, viewing such behaviour as a violation of relationships, not rules. My research seeks to present how restorative justice has been implemented in one…

The antibiotic management of gonorrhoea in Ontario, Canada following multiple changes in guidelines: an interrupted time-series analysis.

PubMed

Dickson, Catherine; Taljaard, Monica; Friedman, Dara Spatz; Metz, Gila; Wong, Tom; Grimshaw, Jeremy M

2017-12-01

This study assessed adherence with first-line gonorrhoea treatment recommendations in Ontario, Canada, following recent guideline changes due to antibiotic resistance. We used interrupted times-series analyses to analyse treatment data for cases of uncomplicated gonorrhoea reported in Ontario, Canada, between January 2006 and May 2014. We assessed adherence with first-line treatment according to the guidelines in place at the time and the use of specific antibiotics over time. We used the introduction of new recommendations in the Canadian Guidelines for Sexually Transmitted Infections in 2008 and 2011 and the release of the province of Ontario's Guidelines for the Treatment and Management of Gonococcal Infections in Ontario in 2013 as interruptions in the time-series analysis. Overall, 34 287 gonorrhoea cases were reported between 1 January 2006 and 31 May 2014. Treatment data were available for 32 312 (94.2%). Our analysis included 32 272 (94.1%) cases without either a conjunctival or disseminated infection. Following the release of the 2011 recommendations, adherence with first-line recommendations immediately decreased to below 30%. Adherence slowly increased but did not reach baseline levels before the 2013 guidelines were released. Following release of the 2013 guidelines, adherence again decreased; adherence is slowly recovering but by May 2014, was only approximately 60%. Due to concerns about antibiotic resistance, gonorrhoea treatment guidelines need to be updated regularly and rapidly adopted in practice. Our study showed poor adherence following dissemination of updated guidelines. Over a year after the latest Ontario guidelines were released, 40% of patients did not receive first-line treatment, putting them at risk of treatment failure and potentially promoting further drug resistance. Greater attention should be devoted to dissemination and implementation of new guidelines. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Views from the Blackboard: Neoliberal Education Reforms and the Practice of Teaching in Ontario, Canada

ERIC Educational Resources Information Center

Carpenter, Sara; Weber, Nadya; Schugurensky, Daniel

2012-01-01

This article discusses findings from two case studies examining the impact of neoliberal education reform on the classroom practice of teachers and adult educators in Ontario, Canada. We asked educators to comment on the impacts of 20 years of policy shifts in their classrooms. Teachers in public schools and adult literacy programmes echoed each…

Inclusion on the Agenda in Four Different School Contexts in Canada (Ontario, Manitoba, New Brunswick and Quebec)

ERIC Educational Resources Information Center

Belanger, Nathalie; Gougeon, Nathalie A.

2009-01-01

Four case studies from four different Canadian provinces (Ontario, Manitoba, New Brunswick, and Quebec) are examined in order to better understand meanings given to an inclusive approach in education, as it is defined and experienced by the actors, practitioners, parents, and students. The data examined in this article come from a larger research…

A Tale of Two Policies: The Case of School Discipline in an Ontario School Board

ERIC Educational Resources Information Center

Milne, Emily; Aurini, Janice

2017-01-01

This study examines how staff working for one Ontario school board perceive two distinct approaches to school discipline policy: the Safe Schools Act (Bill 81) and Progressive Discipline and School Safety (Bill 212). The more centrally controlled and rigid Safe Schools Act was criticized by interviewees and cited for human rights violations.…

Under-reporting of pertussis in Ontario: A Canadian Immunization Research Network (CIRN) study using capture-recapture

PubMed Central

Crowcroft, Natasha S.; Johnson, Caitlin; Chen, Cynthia; Li, Ye; Marchand-Austin, Alex; Bolotin, Shelly; Schwartz, Kevin; Deeks, Shelley L.; Jamieson, Frances; Drews, Steven; Russell, Margaret L.; Svenson, Lawrence W.; Simmonds, Kimberley; Mahmud, Salaheddin M.; Kwong, Jeffrey C.

2018-01-01

Introduction Under-reporting of pertussis cases is a longstanding challenge. We estimated the true number of pertussis cases in Ontario using multiple data sources, and evaluated the completeness of each source. Methods We linked data from multiple sources for the period 2009 to 2015: public health reportable disease surveillance data, public health laboratory data, and health administrative data (hospitalizations, emergency department visits, and physician office visits). To estimate the total number of pertussis cases in Ontario, we used a three-source capture-recapture analysis stratified by age (infants, or aged one year and older) and adjusting for dependency between sources. We used the Bayesian Information Criterion to compare models. Results Using probable and confirmed reported cases, laboratory data, and combined hospitalizations/emergency department visits, the estimated total number of cases during the six-year period amongst infants was 924, compared with 545 unique observed cases from all sources. Using the same sources, the estimated total for those aged 1 year and older was 12,883, compared with 3,304 observed cases from all sources. Only 37% of infants and 11% for those aged 1 year and over admitted to hospital or seen in an emergency department for pertussis were reported to public health. Public health reporting sensitivity varied from 2% to 68% depending on age group and the combination of data sources included. Sensitivity of combined hospitalizations and emergency department visits varied from 37% to 49% and of laboratory data from 1% to 50%. Conclusions All data sources contribute cases and are complementary, suggesting that the incidence of pertussis is substantially higher than suggested by routine reports. The sensitivity of different data sources varies. Better case identification is required to improve pertussis control in Ontario. PMID:29718945

Bologna through Ontario Eyes: The Case of the Advanced Diploma in Architectural Technology

ERIC Educational Resources Information Center

Mitchell, Amy D.; Feltham, Mark; Trotter, Lane

2015-01-01

Inspired by Ontario's burgeoning interest in postsecondary student mobility, this article examines how elements of Europe's Bologna Process can help bridge the college--university divide of Ontario's postsecondary system. Via discourse analysis of relevant qualification frameworks and program standards, it argues that the current system…

Blastomycosis in northwestern Ontario, 2004 to 2014

PubMed Central

Dalcin, Daniel; Ahmed, Syed Zaki

2015-01-01

Blastomycosis is an invasive fungal disease caused by Blastomyces dermatitidis and the recently discovered Blastomyces gilchristii. The medical charts of 64 patients with confirmed cases of blastomycosis in northwestern Ontario during a 10-year period (2004 to 2014) were retrospectively reviewed. The number of patients diagnosed with blastomycosis in Ontario was observed to have increased substantially compared with before 1990, when blastomycosis was removed from the list of reportable diseases. Aboriginals were observed to be disproportionately represented in the patient population. Of the patients whose smoking status was known, 71.4% had a history of smoking. 59.4% of patients had underlying comorbidities and a higher comorbidity rate was observed among Aboriginal patients. The case-fatality rate from direct complications of blastomycosis disease was calculated to be 20.3%; this case-fatality rate is the highest ever to be reported in Canada and more than double that of previously published Canadian studies. The clinical characteristics of 64 patients diagnosed with blastomycosis are summarized. PMID:26600814

Factors That Are Important to Succession Planning: A Case Study of One Ontario College of Applied Arts and Technology

ERIC Educational Resources Information Center

Morrin, Arleen

2013-01-01

The Canadian population is aging; many are rapidly advancing towards the age of normal retirement (Miner, 2010). The demographics for Ontario colleges are similar; in 2009, 70 percent of administrators and faculty were baby boomers, and 40 percent of the workforce in the college sector was eligible for retirement (OCASA, 2009). In 2010, there were…

Increase in seroprevalence of canine leptospirosis and its risk factors, Ontario 1998-2006.

PubMed

Alton, Gillian D; Berke, Olaf; Reid-Smith, Richard; Ojkic, Davor; Prescott, John F

2009-07-01

Canine leptospirosis has been described as having re-emerged in North America around the mid-1990s, with a change in the epidemiology of the infecting serovars responsible for the disease emergence. A retrospective case-control study was conducted to examine the re-emergence of seroprevalent cases of canine leptospirosis in Ontario using serology submission records from 1406 dogs from January 1, 1998 to December 31, 2006. The data collected [results of the microscopic agglutination test (MAT), veterinary clinic postal code, age, sex, neutering status, and breed] were analyzed by multivariable logistic regression, generalized linear mixed modeling, and Cochran-Armitage test for trends in proportions. Dogs in urban areas appeared to be at significantly higher risk than dogs in rural areas for the entire study period [odds ratio (OR) = 1.6, confidence interval (CI) = 1.2-2.3], though this was not as marked as in other studies. Results indicated that canine leptospirosis in Ontario is a disease of all breeds and ages, regardless of gender. No geographic clustering was noted, but clustering of cases by clinic within geographic areas suggested differences in awareness or in diagnosis by veterinarians. A distinctive seasonal pattern of leptospirosis, with more cases occurring during the summer and fall, as found in previous studies, was also observed in this study. The temporal trend analysis was consistent with an increasing proportion or re-emergence of seroprevalent cases of canine leptospirosis since 1998, suggesting that the putative increase in canine leptospirosis has been genuine.

Metropolitan transportation management center : a case study : COMPASS : effectively managing traffic and incidents

DOT National Transportation Integrated Search

1999-10-01

The following case study provides a snapshot of the Downsview, Ontario transportation management center. It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts of Operation - A Cross Cutting ...

West Nile virus in Ontario, Canada: A twelve-year analysis of human case prevalence, mosquito surveillance, and climate data

PubMed Central

Kaur, Sukhdeep; Hunter, Fiona F.

2017-01-01

West Nile Virus (WNV) first arrived in Ontario, Canada in 2001 and has since spread throughout most of the province, causing disease in humans. The provincial government established a province-wide surveillance program to monitor WNV transmission throughout the 36 regional health units. Here we have acquired records of WNV human and mosquito surveillance from 2002 to 2013 to describe seasonal and geographic trends in WNV activity in southern Ontario. Additionally, we obtained climate data from seven municipalities to investigate how temperature and precipitation affect WNV transmission dynamics. We identified a strong quadratic relationship between the number of confirmed human cases and positive Culex mosquito pools recorded at the end of each year (R2 = 0.9783, p < 0.001). Using Spearman rank correlation tests, we identified that the minimum infection rate of Culex pipiens/restuans pools are the strongest predictor of human cases at a 1 week lag period. We also identified positive correlations between minimum infection rates, temperature, vector abundance, and cumulative precipitation. Global Moran’s I index indicates strong positive autocorrelation and clustering of positive Culex pool counts in southern Ontario. Local indicators of spatial association tests revealed a total of 44 high-high and 1 high-low trap locations (n = 680). In the current work we have identified when and where hot spots of WNV activity have occurred in southern Ontario. The municipalities surrounding the western shore of the Lake Ontario and Windsor-Essex County have the largest records of positive mosquitoes and human cases. We identified that positive mosquitoes are a strong indicator of human cases to follow in the coming weeks. An epidemic action threshold of cumulative positive Culex pools was established, allowing Ontario public health officials to predict an epidemic at epidemiological week 34 (rho = 0.90, p < 0.001). These data have the potential to contribute to more efficient larvicide programs and awareness campaigns for the public. PMID:28829827

Validation of an algorithm to identify children with biopsy-proven celiac disease from within health administrative data: An assessment of health services utilization patterns in Ontario, Canada

PubMed Central

Chan, Jason; Mack, David R.; Manuel, Douglas G.; Mojaverian, Nassim; de Nanassy, Joseph

2017-01-01

Importance Celiac disease (CD) is a common pediatric illness, and awareness of gluten-related disorders including CD is growing. Health administrative data represents a unique opportunity to conduct population-based surveillance of this chronic condition and assess the impact of caring for children with CD on the health system. Objective The objective of the study was to validate an algorithm based on health administrative data diagnostic codes to accurately identify children with biopsy-proven CD. We also evaluated trends over time in the use of health services related to CD by children in Ontario, Canada. Study design and setting We conducted a retrospective cohort study and validation study of population-based health administrative data in Ontario, Canada. All cases of biopsy-proven CD diagnosed 2005–2011 in Ottawa were identified through chart review from a large pediatric health care center, and linked to the Ontario health administrative data to serve as positive reference standard. All other children living within Ottawa served as the negative reference standard. Case-identifying algorithms based on outpatient physician visits with associated ICD-9 code for CD plus endoscopy billing code were constructed and tested. Sensitivity, specificity, PPV and NPV were tested for each algorithm (with 95% CI). Poisson regression, adjusting for sex and age at diagnosis, was used to explore the trend in outpatient visits associated with a CD diagnostic code from 1995–2011. Results The best algorithm to identify CD consisted of an endoscopy billing claim follow by 1 or more adult or pediatric gastroenterologist encounters after the endoscopic procedure. The sensitivity, specificity, PPV, and NPV for the algorithm were: 70.4% (95% CI 61.1–78.4%), >99.9% (95% CI >99.9->99.9%), 53.3% (95% CI 45.1–61.4%) and >99.9% (95% CI >99.9->99.9%) respectively. It identified 1289 suspected CD cases from Ontario-wide administrative data. There was a 9% annual increase in the use of this combination of CD-associated diagnostic codes in physician billing data (RR 1.09, 95% CI 1.07–1.10, P<0.001). Conclusions With its current structure and variables Ontario health administrative data is not suitable in identifying incident pediatric CD cases. The tested algorithms suffer from poor sensitivity and/or poor PPV, which increase the risk of case misclassification that could lead to biased estimation of CD incidence rate. This study reinforced the importance of validating the codes used to identify cohorts or outcomes when conducting research using health administrative data. PMID:28662204

Public involvement in the priority setting activities of a wait time management initiative: a qualitative case study.

PubMed

Bruni, Rebecca A; Laupacis, Andreas; Levinson, Wendy; Martin, Douglas K

2007-11-16

As no health system can afford to provide all possible services and treatments for the people it serves, each system must set priorities. Priority setting decision makers are increasingly involving the public in policy making. This study focuses on public engagement in a key priority setting context that plagues every health system around the world: wait list management. The purpose of this study is to describe and evaluate priority setting for the Ontario Wait Time Strategy, with special attention to public engagement. This study was conducted at the Ontario Wait Time Strategy in Ontario, Canada which is part of a Federal-Territorial-Provincial initiative to improve access and reduce wait times in five areas: cancer, cardiac, sight restoration, joint replacements, and diagnostic imaging. There were two sources of data: (1) over 25 documents (e.g. strategic planning reports, public updates), and (2) 28 one-on-one interviews with informants (e.g. OWTS participants, MOHLTC representatives, clinicians, patient advocates). Analysis used a modified thematic technique in three phases: open coding, axial coding, and evaluation. The Ontario Wait Time Strategy partially meets the four conditions of 'accountability for reasonableness'. The public was not directly involved in the priority setting activities of the Ontario Wait Time Strategy. Study participants identified both benefits (supporting the initiative, experts of the lived experience, a publicly funded system and sustainability of the healthcare system) and concerns (personal biases, lack of interest to be involved, time constraints, and level of technicality) for public involvement in the Ontario Wait Time Strategy. Additionally, the participants identified concern for the consequences (sustainability, cannibalism, and a class system) resulting from the Ontario Wait Times Strategy. We described and evaluated a wait time management initiative (the Ontario Wait Time Strategy) with special attention to public engagement, and provided a concrete plan to operationalize a strategy for improving public involvement in this, and other, wait time initiatives.

Public involvement in the priority setting activities of a wait time management initiative: a qualitative case study

PubMed Central

Bruni, Rebecca A; Laupacis, Andreas; Levinson, Wendy; Martin, Douglas K

2007-01-01

Background As no health system can afford to provide all possible services and treatments for the people it serves, each system must set priorities. Priority setting decision makers are increasingly involving the public in policy making. This study focuses on public engagement in a key priority setting context that plagues every health system around the world: wait list management. The purpose of this study is to describe and evaluate priority setting for the Ontario Wait Time Strategy, with special attention to public engagement. Methods This study was conducted at the Ontario Wait Time Strategy in Ontario, Canada which is part of a Federal-Territorial-Provincial initiative to improve access and reduce wait times in five areas: cancer, cardiac, sight restoration, joint replacements, and diagnostic imaging. There were two sources of data: (1) over 25 documents (e.g. strategic planning reports, public updates), and (2) 28 one-on-one interviews with informants (e.g. OWTS participants, MOHLTC representatives, clinicians, patient advocates). Analysis used a modified thematic technique in three phases: open coding, axial coding, and evaluation. Results The Ontario Wait Time Strategy partially meets the four conditions of 'accountability for reasonableness'. The public was not directly involved in the priority setting activities of the Ontario Wait Time Strategy. Study participants identified both benefits (supporting the initiative, experts of the lived experience, a publicly funded system and sustainability of the healthcare system) and concerns (personal biases, lack of interest to be involved, time constraints, and level of technicality) for public involvement in the Ontario Wait Time Strategy. Additionally, the participants identified concern for the consequences (sustainability, cannibalism, and a class system) resulting from the Ontario Wait Times Strategy. Conclusion We described and evaluated a wait time management initiative (the Ontario Wait Time Strategy) with special attention to public engagement, and provided a concrete plan to operationalize a strategy for improving public involvement in this, and other, wait time initiatives. PMID:18021393

Increase in seroprevalence of canine leptospirosis and its risk factors, Ontario 1998–2006

PubMed Central

Alton, Gillian D.; Berke, Olaf; Reid-Smith, Richard; Ojkic, Davor; Prescott, John F.

2009-01-01

Canine leptospirosis has been described as having re-emerged in North America around the mid-1990s, with a change in the epidemiology of the infecting serovars responsible for the disease emergence. A retrospective case-control study was conducted to examine the re-emergence of seroprevalent cases of canine leptospirosis in Ontario using serology submission records from 1406 dogs from January 1, 1998 to December 31, 2006. The data collected [results of the microscopic agglutination test (MAT), veterinary clinic postal code, age, sex, neutering status, and breed] were analyzed by multivariable logistic regression, generalized linear mixed modeling, and Cochran-Armitage test for trends in proportions. Dogs in urban areas appeared to be at significantly higher risk than dogs in rural areas for the entire study period [odds ratio (OR) = 1.6, confidence interval (CI) = 1.2–2.3], though this was not as marked as in other studies. Results indicated that canine leptospirosis in Ontario is a disease of all breeds and ages, regardless of gender. No geographic clustering was noted, but clustering of cases by clinic within geographic areas suggested differences in awareness or in diagnosis by veterinarians. A distinctive seasonal pattern of leptospirosis, with more cases occurring during the summer and fall, as found in previous studies, was also observed in this study. The temporal trend analysis was consistent with an increasing proportion or re-emergence of seroprevalent cases of canine leptospirosis since 1998, suggesting that the putative increase in canine leptospirosis has been genuine. PMID:19794888

Mandated Community Service in High School and Subsequent Civic Engagement: The Case of the "Double Cohort" in Ontario, Canada

ERIC Educational Resources Information Center

Henderson, Ailsa; Brown, Steven D.; Pancer, S. Mark; Ellis-Hale, Kimberly

2007-01-01

In 1999, the Ontario provincial government introduced into its high school curriculum a requirement that students complete 40 h of volunteer community service before graduation. At the same time, the high school curriculum was shortened from five years to four. Consequently, the 2003 graduating class of Ontario high school students contained two…

The Forces Shaping National Response(s) to Global Educational Regulatory Initiatives: The Case for Germany and Ontario

ERIC Educational Resources Information Center

Adam, Edmund G.

2017-01-01

This article argues that the stance toward global regulatory initiatives is influenced by the extent to which these regulatory initiatives threaten the comparative institutional advantages of the national economy. The cases through which this proposition is examined are the showpieces of Germany and Ontario: their system of vocational education…

Serving Alcohol at Home: What Do Most People Do? Findings from a 2001 Ontario Adult Survey

ERIC Educational Resources Information Center

Anglin, Lise; Giesbrecht, Norman; Ialomiteanu, Anca; Grand, Larry; Mann, Robert; McAllister, Janet

2004-01-01

In Ontario, some court cases have involved attempts to sue social hosts for damage caused by the behaviour of drunken guests. Such legal actions give rise to the question of risks and responsibilities accruing to social hosts who serve alcohol. Using a sample of 1395 male and female adult residents of Ontario, the authors present self-report…

A retrospective study on the etiological diagnoses of diarrhea in neonatal piglets in Ontario, Canada, between 2001 and 2010.

PubMed

Chan, Gloria; Farzan, Abdolvahab; DeLay, Josepha; McEwen, Beverly; Prescott, John F; Friendship, Robert M

2013-10-01

Laboratory surveillance data from the Animal Health Laboratory, University of Guelph, on the etiological diagnoses of neonatal diarrhea in piglets were analyzed to determine the relative importance and trends of different enteric pathogens in Ontario. A total of 237 cases, including live and dead 1- to 7-day-old piglets, were submitted for diagnosis of gastrointestinal illness between 2001 and 2010. The combined frequencies for cases of gastrointestinal illness involving Escherichia coli, Clostridium perfringens type A, rotavirus, and Clostridium difficile, either as single pathogens or a complex of pathogens, accounted for 56% of the total cases. In a total of 33% of cases of gastrointestinal illness, an etiological agent was not identified. The frequency of cases diagnosed with enterotoxigenic E. coli was decreased from 2007. Cases submitted in 2010 were more likely to be diagnosed with C. perfringens type A compared to cases submitted in 2002 to 2007 (P < 0.05). There was a significant trend for cases submitted in the winter to be diagnosed with C. perfringens type A, enterotoxigenic E. coli, rotavirus, and Cystoisospora suis (formerly Isospora suis) (P < 0.05). Enterotoxigenic E. coli was less likely diagnosed if C. difficile, C. perfringens, or rotavirus were detected (P < 0.05). Younger piglets were more likely to be diagnosed with C. perfringens type A (P < 0.05) and C. difficile (P < 0.05) than older piglets. This study shows that E. coli, C. perfringens type A, rotavirus, and C. difficile are enteric pathogens of concern for Ontario swine farrowing operations and further research is required to understand the reasons for the cases that are not diagnosed.

A retrospective study on the etiological diagnoses of diarrhea in neonatal piglets in Ontario, Canada, between 2001 and 2010

PubMed Central

Chan, Gloria; Farzan, Abdolvahab; DeLay, Josepha; McEwen, Beverly; Prescott, John F.; Friendship, Robert M.

2013-01-01

Laboratory surveillance data from the Animal Health Laboratory, University of Guelph, on the etiological diagnoses of neonatal diarrhea in piglets were analyzed to determine the relative importance and trends of different enteric pathogens in Ontario. A total of 237 cases, including live and dead 1- to 7-day-old piglets, were submitted for diagnosis of gastrointestinal illness between 2001 and 2010. The combined frequencies for cases of gastrointestinal illness involving Escherichia coli, Clostridium perfringens type A, rotavirus, and Clostridium difficile, either as single pathogens or a complex of pathogens, accounted for 56% of the total cases. In a total of 33% of cases of gastrointestinal illness, an etiological agent was not identified. The frequency of cases diagnosed with enterotoxigenic E. coli was decreased from 2007. Cases submitted in 2010 were more likely to be diagnosed with C. perfringens type A compared to cases submitted in 2002 to 2007 (P < 0.05). There was a significant trend for cases submitted in the winter to be diagnosed with C. perfringens type A, enterotoxigenic E. coli, rotavirus, and Cystoisospora suis (formerly Isospora suis) (P < 0.05). Enterotoxigenic E. coli was less likely diagnosed if C. difficile, C. perfringens, or rotavirus were detected (P < 0.05). Younger piglets were more likely to be diagnosed with C. perfringens type A (P < 0.05) and C. difficile (P < 0.05) than older piglets. This study shows that E. coli, C. perfringens type A, rotavirus, and C. difficile are enteric pathogens of concern for Ontario swine farrowing operations and further research is required to understand the reasons for the cases that are not diagnosed. PMID:24124267

Estrogen receptor status of breast cancer in Ontario

PubMed Central

McKeown-Eyssen, Gail E.; Rogers-Melamed, Iris; Clarke, E. Aileen

1985-01-01

Data from a number of studies of breast cancer have suggested that after the ages associated with the menopause the rates of estrogen-receptor-positive tumours increase with age, whereas the rates of estrogen-receptor-negative tumours do not. Previous investigators studied cases in specific treatment centres, so there was a possibility that the findings were influenced by differences in patterns of case referral by age. A review of all the cases of breast cancer diagnosed in Ontario women in 1981 and assayed for estrogen receptors, however, confirmed the earlier findings. The results showed that the incidence of estrogen-receptor-positive and estrogen-receptor-negative tumours increased at about the same rate before age 45, but thereafter an increase in incidence was seen only for estrogen-receptor-positive tumours. These differences in patterns of incidence suggest the possibility that the two types of tumour may have different etiologic factors. PMID:4063915

How underserviced rural communities approach physician recruitment: changes following the opening of a socially accountable medical school in northern Ontario.

PubMed

Mian, Oxana; Hogenbirk, John C; Warry, Wayne; Strasser, Roger P

2017-01-01

The Northern Ontario School of Medicine (NOSM) opened in 2005 with a social accountability mandate to address a long history of physician shortages in northern Ontario. The objective of this qualitative study was to understand the school's effect on recruitment of family physicians into medically underserviced rural communities of northern Ontario. We conducted a multiple case study of 8 small rural communities in northern Ontario that were considered medically underserviced by the provincial ministry of health and had successfully recruited NOSM-trained physicians. We interviewed 10 people responsible for physician recruitment in these communities. Interview transcripts were analyzed by means of an inductive and iterative thematic method. All 8 communities were NOSM medical education sites with populations of 1600-16 000. Positive changes, linked to collaboration with NOSM, included achieving a full complement of physicians in 5 communities with previous chronic shortages of 30%-50% of the physician supply, substantial reduction in recruitment expenditures, decreased reliance on locums and a shift from crisis management to long-term planning in recruitment activities. The magnitude of positive changes varied across communities, with individual leadership and communities' active engagement being key factors in successful physician recruitment. Locating medical education sites in underserviced rural communities in northern Ontario and engaging these communities in training rural physicians showed great potential to improve the ability of small rural communities to recruit family physicians and alleviate physician shortages in the region.

Putting policy into practice? Poverty and people with serious mental illness.

PubMed

Wilton, Robert

2004-01-01

This paper addresses the effects of chronic poverty on people with serious mental illness. More specifically, we are concerned with the extent to which welfare restructuring, by deepening the poverty facing people with serious mental illness, undermines the expressed intent of mental health policy to improve the quality of life (QOL) of this population. The province of Ontario in Canada forms the setting for the study. The paper first examines recent trends in mental health care and social assistance policy in Ontario. While income support is consistently recognized as a core element of mental health care, welfare restructuring has led to a significant decline in the real value of income supports received by people with serious mental illness. The paper then examines the implications of this trend for the QOL of residential care facility tenants in Hamilton, Ontario. Here, the case study is explicitly connected to QOL scholarship. In addition, the study is grounded in an analysis of the broader transformation of the welfare state in Ontario. Interview data suggest that tenants experience chronic poverty that has a deleterious impact on multiple life domains including basic needs, family, social relations, leisure and self-esteem. Implications for research and policy are discussed.

Retrospective Analysis of Hanging Deaths in Ontario.

PubMed

Tugaleva, Elena; Gorassini, Donald R; Shkrum, Michael J

2016-11-01

Hanging deaths from investigation standpoint are rarely problematic. Unusual circumstances can on occasion raise suspicion of foul play. Associated neck injuries are reported in the literature with variable frequency (from 0% to 76.8%). This study retrospectively analyzed 755 hanging deaths in Ontario (Canada) to evaluate the demographic features and circumstances of hanging fatalities, and the frequency of hanging-related neck injuries. A number of cases showed unusual/special circumstances (e.g., complex, double suicides, restraints). Among 632 cases with complete autopsies, hyoid and larynx fractures were present in 46 cases (7.3%) with the most common being isolated hyoid fractures. The incidence of cricoid fractures was 0.5% and cervical spine injuries, 1.1%. A higher incidence of neck injuries occurred among males, long drop hangings, and in cases with complete suspension. There was a tendency for the number of fractures to increase with increasing age and weight of the deceased. © 2016 American Academy of Forensic Sciences.

Patterns of initial management of node-negative breast cancer in two Canadian provinces

PubMed Central

Goel, V; Olivotto, I; Hislop, T G; Sawka, C; Coldman, A; Holowaty, E J

1997-01-01

OBJECTIVE: To describe the patterns of initial management of node-negative breast cancer in Ontario and British Columbia and to compare the characteristics of the patients and tumours and of the physicians and hospitals involved in management. DESIGN: Retrospective, population-based, cohort study. PARTICIPANTS: All 942 newly diagnosed cases of node-negative breast cancer in 1991 in British Columbia and a random sample of 938 newly diagnosed cases in Ontario in the same year. OUTCOME MEASURES: Number and proportion of patients with newly diagnosed node-negative breast cancer who received breast-conserving surgery (BCS) or mastectomy and who received radiation therapy after BCS. RESULTS: BCS was used in 413 cases (43.8%) in British Columbia and in 634 cases (67.6%) in Ontario (p < 0.001). After BCS, radiation therapy was received by 378 patients (91.5% of those who had undergone BCS) in British Columbia and 479 patients (75.6% of those who had undergone BCS) in Ontario (p < 0.001). In both provinces, lower patient age, smaller tumour size, a noncentral unifocal tumour, absence of extensive ductal carcinoma in situ and initial surgery by a surgeon with an academic affiliation were associated with greater use of BCS. Lower patient age and larger tumour size were associated with greater use of radiation therapy after BCS in both provinces. CONCLUSION: Patient, tumour and physician factors are associated with the choice of initial management of breast cancer in these two Canadian provinces. However, the differences in management between the two provinces are only partly explained by these factors. Other possible explanations, such as the presence of provincial guidelines, differences in the organization of the health care system or differences in patient preference, require further research. PMID:9006561

Practice patterns of post-radical prostatectomy incontinence surgery in Ontario

PubMed Central

Wallis, Christopher J.D.; Herschorn, Sender; Liu, Ying; Carr, Lesley K.; Kodama, Ronald T.; Klotz, Laurence H.; Saskin, Refik; Nam, Robert K.

2014-01-01

Introduction: We assess the practice patterns of artificial urinary sphincter (AUS) and urethral sling insertion after radical prostatectomy (RP) from a large population-based cohort. Methods: We examined 25 346 men in Ontario, Canada who underwent RP between 1993 and 2006. Using hospital and cancer registry data, we identified patients who subsequently underwent an incontinence procedure. We characterized the practice patterns of post-prostatectomy incontinence procedures across Ontario during the study interval. Results: A total of 703 (2.8%) men underwent subsequent insertion of an AUS and 282 (1.1%) underwent a urethral sling procedure (985 total incontinence procedures, 3.9%) over the study period. During the study period, 121 hospitals performed RP. Among them, 32 (26%) hospitals performed both RP and AUS/sling procedures, and 89 (74%) performed RP only. Four hospitals performed AUS/sling procedures but not RP. Of the 36 institutions that performed AUS/sling procedures, the median annual case volume was 0.29 (interquartile range: 0.083-0.75). Of all incontinence procedures, 56% were performed at 3 academic institutions. When examining observed rates of AUS/sling procedures compared with expected rates from the overall cohort, 15 of 32 hospitals (47%) performed significantly fewer incontinence procedures than expected given their RP case volume (p range: <0.0001–0.0390) and 5 (16%) performed significantly more (p range: <0.0001–0.038). Conclusions: A small number of academic institutions provide most of the surgical care for men with incontinence following RP in Ontario. Many centres that perform RP refer out to other centres to surgically manage their patients’ incontinence. PMID:25408805

Retrospective review of voluntary reports of nonsurgical paresthesia in dentistry.

PubMed

Gaffen, Andrew S; Haas, Daniel A

2009-10-01

Paresthesia is an adverse event that may be associated with the administration of local anesthetics in dentistry. The purpose of this retrospective study was to analyze cases of paresthesia associated with local anesthetic injection that were voluntarily reported to Ontario"s Professional Liability Program (PLP) from 1999 to 2008 inclusive, to see if the findings were consistent with those from 1973 to 1998 from this same source. All cases of nonsurgical paresthesia reported from 1999 to 2008 were reviewed; cases involving surgical procedures were excluded. Variables examined included patient age and gender, type and volume of local anesthetic, anatomic site of nerve injury, affected side and pain on injection or any other symptoms. During the study period, 182 PLP reports of paresthesia following nonsurgical procedures were made; all but 2 were associated with mandibular block injection. There was no significant gender predilection, but the lingual nerve was affected more than twice as frequently as the inferior alveolar nerve. During 2006-2008 alone, 64 cases of nonsurgical paresthesia were reported to PLP, a reported incidence of 1 in 609,000 injections. For the 2 local anesthetic drugs available in dental cartridges as 4% solutions, i.e., articaine and prilocaine, the frequencies of reporting of paresthesia were significantly greater than expected (chi2, exact binomial distribution; p < 0.01) based on their level of use by Ontario dentists. These data suggest that local anesthetic neurotoxicity may be at least partly involved in the development of postinjection paresthesia.

Clinical mastitis in dairy cattle in Ontario: frequency of occurrence and bacteriological isolates.

PubMed Central

Sargeant, J M; Scott, H M; Leslie, K E; Ireland, M J; Bashiri, A

1998-01-01

The objective of this study was to describe the frequency of occurrence of clinical mastitis in dairy herds in Ontario. The study group consisted of 65 dairy farms involved in a 2-year observational study, which included recording all clinical mastitis cases and milk sampling of quarters with clinical mastitis. Lactational incidence risks of 9.8% for abnormal milk only, 8.2% for abnormal milk with a hard or swollen udder, and 4.4% for abnormal milk plus systemic signs of illness related to mastitis were calculated for 2840 cows and heifers. Overall, 19.8% of cows experienced one or more cases of clinical mastitis during location. Teat injuries occurred in 2.1% of lactations. Standard bacteriology was performed on pretreatment milk samples from 834 cows with clinical mastitis. The bacteria isolated were Staphylococcus aureus (6.7%), Streptococcus agalactiae (0.7%), other Streptococcus spp. (14.1%), coliforms (17.2%), gram-positive bacilli (5.5%), Corynebacterium bovis (1.7%), and other Staphylococcus spp. (28.7%). There was no growth in 17.7% of samples, and 8.3% of samples were contaminated. Clinical mastitis is a common disease in dairy cows in Ontario; approximately 1 in 5 cow lactations have at lease one episode of clinical mastitis. There is, however, considerable variation in the incidence of clinical mastitis among farms. The majority of 1st cases of clinical mastitis occur early in lactation, and the risk of clinical mastitis increases with increasing parity. Environmental, contagious, and minor pathogens were all associated with cases of clinical mastitis. Images Figure 1. Figure 3. PMID:9442950

An outbreak of foodborne botulism in Ontario

PubMed Central

Loutfy, Mona R; Austin, John W; Blanchfield, Burke; Fong, Ignatius W

2003-01-01

Botulism is a rare paralytic illness resulting from a potent neurotoxin produced by Clostridium botulinum. Botulism in Canada is predominately due to C botulinum type E and affects mainly the First Nations and Inuit populations. The most recent outbreak of botulism in Ontario was in Ottawa in 1991 and was caused by C botulinum type A. We report an outbreak of foodborne type B botulism in Ontario, which implicated home-canned tomatoes. The outbreak was characterized by mild symptoms in two cases and moderately severe illness in one case. The investigation shows the importance of considering the diagnosis of botulism in patients presenting with cranial nerve and autonomic dysfunction, especially when combined with gastrointestinal complaints; it also highlights the importance of proper home canning technique. PMID:18159458

Dancing the Two-Step in Ontario's Long-term Care Sector: More Deterrence-oriented Regulation = Ownership and Management Consolidation.

PubMed

Daly, Tamara

2015-03-01

This paper explores shifts in public and private delivery over time through an analysis of Ontario's approach to LTC funding and regulation in relation to other jurisdictions in Canada and abroad. The case of Ontario's long-term care (LTC) policy evolution - from the 1940s until early 2013 -- shows how moving from compliance to deterrence oriented regulation can support consolidation of commercial providers' ownership and increase the likelihood of non-profit and public providers outsourcing their management.

Practice patterns in the management of patients with differentiated thyroid cancer in Ontario Canada 2000-2008

PubMed Central

2014-01-01

Background The extent of treatment for differentiated thyroid cancer remains controversial. The objective of this study was to describe the variations in practice prior to diagnosis and for the first year after diagnosis, including the investigations, the extent of surgery and the use of RAI 131, for all patients with thyroid cancer (TC) treated Jan 1 2000 to Dec 2008 across Ontario Canada. Method Population-based study of all patients who had a therapeutic surgical procedure for TC based on the data holdings of the Institute of Clinical Investigative Sciences (ICES) linking the Ontario Cancer Registry to the Ontario Health Insurance Plan and to the Canadian Institutes of Health Information. The analysis includes comparisons between health care utilization/geographic regions and between treating specialties. The study population was 12957 patients. Results There was a 112% increase in case detection over 9 years. Overall the initial (index) surgery was less-than-total thyroidectomy (LTT) in 37.6% and 63.4% of the patients who had total thyroidectomy (TT) as an index surgery went on to adjuvant RAI, however there was wide variation in all aspects of patient care across the province, between Local Health Networks and between surgical specialties. Conclusion In Ontario, there was wide variation for most aspects of the management of TC and, as the incidence of TC is increasing at least 7% per year in females, these data provide a foundation for future discussions, the provision of health care services and research. PMID:25055715

Radiographic abnormalities and the risk of lung cancer among workers exposed to silica dust in Ontario.

PubMed Central

Finkelstein, M M

1995-01-01

OBJECTIVE: To determine whether workers in Ontario who had been exposed to silica dust and who have radiographic abnormalities are at increased risk of lung cancer. DESIGN: Cohort and case-control studies of rates of death from lung cancer and cancer incidence rates; data were obtained from the Ontario Silicosis Surveillance Registry. Follow-up was through linkage to the Ontario mortality and cancer registries. SETTING: Ontario. PARTICIPANTS: A total of 523 workers with radiographic abnormalities and 1568 control subjects with normal radiographic findings who had been exposed to silica dust. Matching criteria were year of birth and the requirement that the control subject have a normal radiographic finding either later than or in the same year that the radiographic abnormality was identified in the silicosis subject. OUTCOME MEASURES: Standardized mortality ratios (SMRs), standardized incidence ratios (SIRs) and odds ratios for lung cancer. RESULTS: In the cohort analysis, with the Ontario population rates as reference, the all-cause SMR was 0.96 among the workers with radiographic abnormalities and 0.51 among the control subjects. The corresponding SIRs for lung cancer were 2.49 and 0.87 (p < 0.001). In the case-control analysis the workers with silicosis were more likely than the control subjects to have been smokers, but this difference likely accounted for only a small part of the difference in the incidence of lung cancer. The relative risk of lung cancer was elevated among the workers with silicosis from the foundry, mining and nonmetallic-minerals industries; however, the number of subjects was too small for a significant difference to be detected. Among the miners exposure to radon daughters did not affect the risk of lung cancer attributable to radiographic abnormalities. CONCLUSIONS: Radiographic abnormalities suggestive of exposure to silica dust are markers for increased risk of lung cancer. Physicians might thus wish to warn their patients with silica-associated radiographic abnormalities about the increased risk and to counsel those who smoke to stop. PMID:7804920

Organizational capacity and implementation change: a comparative case study of heart health promotion in Ontario public health agencies.

PubMed

Riley, Barbara L; Taylor, S Martin; Elliott, Susan J

2003-12-01

This paper reports the results of a comparative case study that examines factors influencing changes in implementation of heart health promotion activities in Ontario public health units. The study compared two cases that experienced large changes in implementation from 1994 to 1996, but in opposite directions. Multiple data sources were used, with an emphasis on secondary analyses of quantitative surveys of health units and other community agencies, and in-depth interviews of public health staff, collected as part of the Canadian Heart Health Initiative Ontario Project. Guided by social ecological and organizational theories, changes in implementation were explained by examining changes in (1) organizational predisposition to undertake heart health promotion activities, (2) organizational practices to undertake these activities, (3) other internal organizational factors and (4) external system factors. Findings show that in communities with diverse characteristics, implementation change was most strongly influenced by an interplay of changes in internal features of public health agencies; notably, leadership, structure and staff skills. Findings support a social ecological approach to health promotion by demonstrating the importance of the institutional context in the implementation change process, the interaction of individual (skills) and organizational (structure) levels in explaining implementation change, and community context in shaping the change process. Findings also reinforce the value of strengthening capacity within public health agencies and suggest further research on the implementation change process, especially in different systems and over longer periods of time.

Expanding the epidemiologic profile: risk factors for active tuberculosis in people immigrating to Ontario

PubMed Central

Wobeser, Wendy L.; Yuan, Lilian; Naus, Monika; Corey, Paul; Edelson, Jeff; Heywood, Neil; Holness, D. Linn

2000-01-01

Background Many people immigrating to Canada come from countries with a high burden of tuberculosis. The aim of this study was to develop a detailed epidemiologic profile of foreign-born people with tuberculosis living in Ontario. Methods In this population-based case-control study, cases of tuberculosis diagnosed in 1994-1995 were identified from the database of the Ontario Reportable Disease Information Service and were considered eligible for analysis if a record of landing (receipt of permission to establish residence in Canada) from the period 1986-1995 was found in the Citizenship and Immigration Canada (CIC) database, if the person was at least 11 years of age at the time their visa was issued, and if the person had not been diagnosed with tuberculosis before becoming legally landed in Canada. Control subjects, who met the same criteria as the case subjects but who did not have tuberculosis in 1994-1995, were identified from a CIC database for landed immigrants. Results A total of 1341 cases of tuberculosis in foreign-born people were reported in Ontario in 1994-1995. A record of landing was found in CIC databases for 1099 of these people, 224 of whom were not legally landed at the time of diagnosis. In total, 602 cases met the inclusion criteria. The 2 strongest determinants of risk among those who had become landed within the preceding 10 years were referral for medical surveillance by immigration officials (odds ratio [OR] 3.8, 95% confidence interval [CI] 2.6-6.0) and world region of origin (Somalia [OR 67.7, 95% CI 31.3-154.9], Vietnam [OR 25.0, 95% CI 12.5-50.0], the Philippines [OR 11.9, 95% CI 6.0-23.3], other sub-Saharan African countries [OR 11.6, 95% CI 5.7-23.2], India [OR 9.7, 95% CI 4.9-18.9], China [OR 6.1, 95% CI 3.1-12.1], other Asian countries [OR 4.7, 95% CI 2.4-9.1], the Middle East [OR 4.1, 95% CI 2.0-8.3], Latin America [OR 1.9, 95% CI 0.9-3.8), and the former socialist countries of Europe [OR 1.8, 95% CI 0.8-3.8]; the reference category was countries with established market economies). Low socioeconomic status was an independent risk factor. Interpretation The risk of tuberculosis in groups of people migrating to Ontario is highly variable and is influenced by several factors. Successful population-based tuberculosis prevention strategies will need to accommodate this variability. PMID:11033709

Consideration of the influence of place on access to employment for persons with serious mental illness in northeastern Ontario.

PubMed

Rebeiro Gruhl, K L; Kauppi, C; Montgomery, P; James, S

2012-01-01

Despite increasing attention to employment within the mental health sector, reports indicate that people with serious mental illness (SMI) continue to experience limited employment success in the province of Ontario, Canada. Research specifies that people with SMI who live in rural places are less likely than those living in urban centers to have access to satisfactory employment services or to become gainfully employed. The objective of this study was to examine access to employment from the perspectives of people with SMI, mental health and vocational service providers, and decision-makers, and to explore whether place influenced their access to work in northeastern Ontario. A qualitative case study using community-based participatory research methods was chosen to examine the experience of access to competitive employment in two northeastern Ontario communities. The cases selected for study were two geographic areas in northeastern Ontario which provided best-practice, mental health services to persons with SMI. Community-based site partners advertised and recruited participants, and a consumer advisory provided input on key stakeholders, questions, findings and the study action plan. The study findings were informed by individual and group interviews conducted with 46 individuals who resided in both rural and urban settings in the case communities, and feedback from 49 participants who attended town hall forums for presentation of study findings and development of an action plan. The qualitative data was supported by a secondary data source reporting on the employment outcomes of 4112 people with SMI who received disability income support and who resided in the case communities. Qualitative data were analyzed inductively, and categories and themes were developed. Findings were member checked with all informants and town hall participants in each case community. This article draws on the findings of a larger study and reports on the influence of place to the low employment success experienced by people with SMI who reside in the case communities; 91.3% of those receiving disability income support are unemployed, and rural residents experience higher levels of unemployment than those in urban places. Place was found to influence access to employment in five ways: by limited access to employment support services in rural places, and to recommended ratios in urban places; by the use of different models and practices that were inconsistent with best practices for people with SMI; by the lack of a plan for the implementation of employment services in the case communities; by limited use of the available, dedicated vocational resources for employment purposes; and by inadequate supports provided to persons with SMI who wish to enter the workforce. The results also underscore how people with SMI continue to be perceived negatively regarding their capacity for employment. Such stereotypical attitudes additionally contributed to employment marginalization of people with SMI from the workforce, especially in rural communities. The study highlights the influence of geography and human resources to the implementation of best practice employment services and supports for persons with SMI. Important policy implications include the need to consider place when implementing evidence-based practices in places where geography, distance and human health resources limit the communities' capacity to successfully do so. The study also underscores the need to build community capacity for supported employment, especially in rural places, in order to improve the participation of people with SMI in employment, and subsequently, to help shift the communities' thinking about their capacity for work.

Technology and tuberculosis control: the OUT-TB Web experience.

PubMed

Guthrie, Jennifer L; Alexander, David C; Marchand-Austin, Alex; Lam, Karen; Whelan, Michael; Lee, Brenda; Furness, Colin; Rea, Elizabeth; Stuart, Rebecca; Lechner, Julia; Varia, Monali; McLean, Jennifer; Jamieson, Frances B

2017-04-01

Develop a tool to disseminate integrated laboratory, clinical, and demographic case data necessary for improved contact tracing and outbreak detection of tuberculosis (TB). In 2007, the Public Health Ontario Laboratories implemented a universal genotyping program to monitor the spread of TB strains within Ontario. Ontario Universal Typing of TB (OUT-TB) Web utilizes geographic information system (GIS) technology with a relational database platform, allowing TB control staff to visualize genotyping matches and microbiological data within the context of relevant epidemiological and demographic data. OUT-TB Web is currently available to the 8 health units responsible for >85% of Ontario's TB cases and is a valuable tool for TB case investigation. Users identified key features to implement for application enhancements, including an e-mail alert function, customizable heat maps for visualizing TB and drug-resistant cases, socioeconomic map layers, a dashboard providing TB surveillance metrics, and a feature for animating the geographic spread of strains over time. OUT-TB Web has proven to be an award-winning application and a useful tool. Developed and enhanced using regular user feedback, future versions will include additional data sources, enhanced map and line-list filter capabilities, and development of a mobile app. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Who Will Put Humpty Together Again? Professional Liability under Canadian and Ontario Special Law.

ERIC Educational Resources Information Center

Wilson, Anne Keeton; Usher, Leila

1985-01-01

The authors question whether mandatory special education in Ontario is likely to result in increased litigation against school boards. Two areas of educational litigation, negligence claims and appeal hearings, are examined taking into consideration cases from Canada and the United States. (Author)

Influence of an independent quarterly audit on publicly reported vancomycin-resistant enterocococi bacteremia data in Ontario, Canada.

PubMed

Prematunge, Chatura; Policarpio, Michelle E; Johnstone, Jennie; Adomako, Kwaku; Nadolny, Emily; Lam, Freda; Li, Ye; Brown, Kevin A; Garber, Gary

2018-04-13

All Ontario hospitals are mandated to self-report vancomycin-resistant enterocococi (VRE) bacteremias to Ontario's Ministry of Health and Long-term Care for public reporting purposes. Independent quarterly audits of publicly reported VRE bacteremias between September 2013 and June 2015 were carried out by Public Health Ontario. VRE bacteremia case-reporting errors between January 2009 and August 2013 were identified by a single retrospective audit. Employing a quasiexperimental pre-post study design, the relative risk of VRE bacteremia reporting errors before and after quarterly audits were modeled using Poisson regression adjusting for hospital type, case counts reported to the Ministry of Health and Long-term Care, and autocorrelation via generalized estimating equation. Overall, 24.5% (126 out of 514) of VRE bacteremias were reported in error; 114 out of 367 (31%) VRE bacteremias reported before quarterly audits and 12 out of 147 (8.1%) reported after audits were found to be incorrect. In adjusted analysis, quarterly audits of VRE bacteremias were associated with significant reductions in reporting errors when compared with before quarterly auditing (relative risk, 0.17; 95% confidence interval, 0.05-0.63). Risk of reporting errors among community hospitals were greater than acute teaching hospitals of the region (relative risk, 4.39; 95% CI, 3.07-5.70). This study found independent quarterly audits of publicly reported VRE bacteremias to be associated with significant reductions in reporting errors. Public reporting systems should consider adopting routine data audits and hospital-targeted training to improve data accuracy. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Encephalitis, Ontario, Canada, 2002-2013.

PubMed

Parpia, Alyssa S; Li, Ye; Chen, Cynthia; Dhar, Badal; Crowcroft, Natasha S

2016-03-01

Encephalitis, a brain inflammation leading to severe illness and often death, is caused by >100 pathogens. To assess the incidence and trends of encephalitis in Ontario, Canada, we obtained data on 6,463 Ontario encephalitis hospitalizations from the hospital Discharge Abstract Database for April 2002-December 2013 and analyzed these data using multiple negative binomial regression. The estimated crude incidence of all-cause encephalitis in Ontario was ≈4.3 cases/100,000 persons/year. Incidence rates for infants <1 year of age and adults >65 years were 3.9 and 3.0 times that of adults 20-44 years of age, respectively. Incidence peaks during August-September in 2002 and 2012 resulted primarily from encephalitis of unknown cause and viral encephalitis. Encephalitis occurred more frequently in older age groups and less frequently in women in Ontario when compared to England, but despite differences in population, vector-borne diseases, climate, and geography, the epidemiology was overall remarkably similar in the two regions.

Using existing case-mix methods to fund trauma cases.

PubMed

Monakova, Julia; Blais, Irene; Botz, Charles; Chechulin, Yuriy; Picciano, Gino; Basinski, Antoni

2010-01-01

Policymakers frequently face the need to increase funding in isolated and frequently heterogeneous (clinically and in terms of resource consumption) patient subpopulations. This article presents a methodologic solution for testing the appropriateness of using existing grouping and weighting methodologies for funding subsets of patients in the scenario where a case-mix approach is preferable to a flat-rate based payment system. Using as an example the subpopulation of trauma cases of Ontario lead trauma hospitals, the statistical techniques of linear and nonlinear regression models, regression trees, and spline models were applied to examine the fit of the existing case-mix groups and reference weights for the trauma cases. The analyses demonstrated that for funding Ontario trauma cases, the existing case-mix systems can form the basis for rational and equitable hospital funding, decreasing the need to develop a different grouper for this subset of patients. This study confirmed that Injury Severity Score is a poor predictor of costs for trauma patients. Although our analysis used the Canadian case-mix classification system and cost weights, the demonstrated concept of using existing case-mix systems to develop funding rates for specific subsets of patient populations may be applicable internationally.

Impact of Concomitant Chemotherapy on Outcomes of Radiation Therapy for Head-and-Neck Cancer: A Population-Based Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gupta, Shlok; Kong, Weidong; Booth, Christopher M.

2014-01-01

Purpose: Clinical trials have shown that the addition of chemotherapy to radiation therapy (RT) improves survival in advanced head-and-neck cancer. The objective of this study was to describe the effectiveness of concomitant chemoradiation therapy (C-CRT) in routine practice. Methods and Materials: This was a population-based cohort study. Electronic records of treatment from all provincial cancer centers were linked to a population--based cancer registry to describe the adoption of C-CRT for head-and-neck cancer patients in Ontario, Canada. The study population was then divided into pre- and postadoption cohorts, and their outcomes were compared. Results: Between 1992 and 2008, 18,867 patients hadmore » diagnoses of head-and-neck cancer in Ontario, of whom 7866 (41.7%) were treated with primary RT. The proportion of primary RT cases that received C-CRT increased from 2.2% in the preadoption cohort (1992-1998) to 39.3% in the postadoption cohort (2003-2008). Five-year survival among all primary RT cases increased from 43.6% in the preadoption cohort to 51.8% in the postadoption cohort (P<.001). Over the same period, treatment-related hospital admissions increased significantly, but there was no significant increase in treatment-related deaths. Conclusions: C-CRT was widely adopted in Ontario after 2003, and its adoption was temporally associated with an improvement in survival.« less

The Effects of Discourses in Regional Contexts on the Development of Curriculum-Based Literacy Standards for Adolescents in Schooling: A Comparative Study of South Australia and Ontario

ERIC Educational Resources Information Center

Fenwick, Lisl

2017-01-01

This study analyses how discourses in regional contexts affect the development of curriculum-based literacy standards for adolescents in schooling. A comparative case-study research design enabled the influences of discourses at the regional level to be analysed. The case studies include the development of curricula to define a minimum literacy…

Canada's new medical school: The Northern Ontario School of Medicine: social accountability through distributed community engaged learning.

PubMed

Strasser, Roger P; Lanphear, Joel H; McCready, William G; Topps, Maureen H; Hunt, D Dan; Matte, Marie C

2009-10-01

Like many rural regions around the world, Northern Ontario has a chronic shortage of doctors. Recognizing that medical graduates who have grown up in a rural area are more likely to practice in the rural setting, the Government of Ontario, Canada, decided in 2001 to establish a new medical school in the region with a social accountability mandate to contribute to improving the health of the people and communities of Northern Ontario. The Northern Ontario School of Medicine (NOSM) is a joint initiative of Laurentian University and Lakehead University, which are located 700 miles apart. This paper outlines the development and implementation of NOSM, Canada's first new medical school in more than 30 years. NOSM is a rural distributed community-based medical school which actively seeks to recruit students into its MD program who come from Northern Ontario or from similar northern, rural, remote, Aboriginal, Francophone backgrounds. The holistic, cohesive curriculum for the MD program relies heavily on electronic communications to support distributed community engaged learning. In the classroom and in clinical settings, students explore cases from the perspective of physicians in Northern Ontario. Clinical education takes place in a wide range of community and health service settings, so that the students experience the diversity of communities and cultures in Northern Ontario. NOSM graduates will be skilled physicians ready and able to undertake postgraduate training anywhere, but with a special affinity for and comfort with pursuing postgraduate training and clinical practice in Northern Ontario.

A Survey of Hospital Ethics Structures in Ontario.

PubMed

Breslin, Jonathan

2017-01-01

In response to the growing recognition of the prevalence of ethical issues in clinical care, hospitals in Canada began forming ethics committees in the 1980s. Studies showed significant growth in the prevalence of ethics committees over the ensuing decade. Although the limited studies available suggest that ethics committees have become very prevalent in Canadian hospitals, hospital ethics services have evolved in recent years to include a wider range of structures. In some cases, these structures may work in conjunction with an ethics committee, but in other cases they may replace ethics committees. They include on-staff ethicists, external ethics consultants, "hub-and-spokes" structures and regional ethics programs. What is not known, however, is how prevalent these other structures are and whether ethics committees continue to function as the main delivery mechanism for ethics services in Canadian hospitals. This paper reports on the results of a survey of hospitals in Ontario to answer those questions.

Validation of algorithms to determine incidence of Hirschsprung disease in Ontario, Canada: a population-based study using health administrative data

PubMed Central

Nasr, Ahmed; Sullivan, Katrina J; Chan, Emily W; Wong, Coralie A; Benchimol, Eric I

2017-01-01

Objective Incidence rates of Hirschsprung disease (HD) vary by geographical region, yet no recent population-based estimate exists for Canada. The objective of our study was to validate and use health administrative data from Ontario, Canada to describe trends in incidence of HD between 1991 and 2013. Study design To identify children with HD we tested algorithms consisting of a combination of diagnostic, procedural, and intervention codes against the reference standard of abstracted clinical charts from a tertiary pediatric hospital. The algorithm with the highest positive predictive value (PPV) that could maintain high sensitivity was applied to health administrative data from April 31, 1991 to March 31, 2014 (fiscal years 1991–2013) to determine annual incidence. Temporal trends were evaluated using Poisson regression, controlling for sex as a covariate. Results The selected algorithm was highly sensitive (93.5%) and specific (>99.9%) with excellent predictive abilities (PPV 89.6% and negative predictive value >99.9%). Using the algorithm, a total of 679 patients diagnosed with HD were identified in Ontario between 1991 and 2013. The overall incidence during this time was 2.05 per 10,000 live births (or 1 in 4,868 live births). The incidence did not change significantly over time (odds ratio 0.998, 95% confidence interval 0.983–1.013, p = 0.80). Conclusion Ontario health administrative data can be used to accurately identify cases of HD and describe trends in incidence. There has not been a significant change in HD incidence over time in Ontario between 1991 and 2013. PMID:29180902

Serological studies on the infection of dogs in Ontario with Borrelia burgdorferi, the etiological agent of Lyme disease

PubMed Central

Artsob, Harvey; Barker, Ian K.; Fister, Richard; Sephton, Gregory; Dick, Daryl; Lynch, John A.; Key, Doug

1993-01-01

A serological study was undertaken to determine whether dogs in Ontario are being exposed to Borrelia burgdorferi, the etiological agent of Lyme disease. This study consisted of a survey of randomly selected dogs and testing of diagnostic submissions from candidate Lyme disease cases. The survey of 1,095 dogs, bled between January 1988 and August 1989, revealed a total of 65 (5.9%) enzyme-linked immunosorbent assay (ELISA) reactors, of which 22 had immuno-fluorescent antibody assay (IFA) titers ≥1:32. All but one of the IFA-positive and 10 of the ELISA-positive, IFA-negative sera were further tested by western blot. Eight western blot positive and three equivocal reactors were obtained. Three of the eight confirmed reactors had visited areas known to be endemic for Lyme disease, leaving five reactors that might have been infected in previously undocumented areas for B. burgdorferi activity in Ontario. Diagnostic submissions of sera from 223 dogs were received between August 1987 and February 1992. Test results revealed 21 (9.4%) IFA reactors, of which only six had significant titers (≥1:256) and were reactive by an immunodot Borrelia test. All six dogs had travelled to known Lyme endemic areas. Based on results obtained from this study, it seems likely that the agent of Lyme disease is not widespread in Ontario. PMID:17424284

Challenges in Interpretation of Diagnostic Test Results in a Mumps Outbreak in a Highly Vaccinated Population.

PubMed

Trotz-Williams, L A; Mercer, N J; Paphitis, K; Walters, J M; Wallace, D; Kristjanson, E; Gubbay, J; Mazzulli, T

2017-02-01

In spite of a greatly reduced incidence rate due to vaccination, mumps outbreaks continue to occur in several areas of the world, sometimes in vaccinated populations. This article describes an outbreak in a highly vaccinated population in southwestern Ontario, Canada, and the challenges encountered in interpreting the results of diagnostic tests used in the outbreak. During the outbreak, patients were interviewed and classified according to the outbreak case definition, and specimens were collected for diagnostic testing according to Ontario guidelines. Twenty-seven individuals were classified as confirmed cases (n = 19) or suspect cases (n = 8) according to the case definition, only 9 of which were laboratory-confirmed cases: 7 confirmed by reverse transcriptase PCR (RT-PCR) and 2 by IgM serology. All 19 confirmed cases represented patients who were associated with secondary schools in the local area and had been vaccinated against mumps with one (n = 2) or two (n = 17) doses of the measles-mumps-rubella (MMR) vaccine. This is the first published report of an outbreak of mumps in Ontario in which all confirmed cases had been vaccinated against the disease. It highlights the limitations of and difficulties in interpreting current mumps diagnostic tests when used in vaccinated individuals. Copyright © 2017 American Society for Microbiology.

Challenges in Interpretation of Diagnostic Test Results in a Mumps Outbreak in a Highly Vaccinated Population

PubMed Central

Mercer, N. J.; Paphitis, K.; Walters, J. M.; Wallace, D.; Kristjanson, E.; Gubbay, J.; Mazzulli, T.

2016-01-01

ABSTRACT In spite of a greatly reduced incidence rate due to vaccination, mumps outbreaks continue to occur in several areas of the world, sometimes in vaccinated populations. This article describes an outbreak in a highly vaccinated population in southwestern Ontario, Canada, and the challenges encountered in interpreting the results of diagnostic tests used in the outbreak. During the outbreak, patients were interviewed and classified according to the outbreak case definition, and specimens were collected for diagnostic testing according to Ontario guidelines. Twenty-seven individuals were classified as confirmed cases (n = 19) or suspect cases (n = 8) according to the case definition, only 9 of which were laboratory-confirmed cases: 7 confirmed by reverse transcriptase PCR (RT-PCR) and 2 by IgM serology. All 19 confirmed cases represented patients who were associated with secondary schools in the local area and had been vaccinated against mumps with one (n = 2) or two (n = 17) doses of the measles-mumps-rubella (MMR) vaccine. This is the first published report of an outbreak of mumps in Ontario in which all confirmed cases had been vaccinated against the disease. It highlights the limitations of and difficulties in interpreting current mumps diagnostic tests when used in vaccinated individuals. PMID:28003216

Risk selection and cost shifting in a prospective physician payment system: evidence from Ontario.

PubMed

Kantarevic, Jasmin; Kralj, Boris

2014-04-01

We study the risk-selection and cost-shifting behavior of physicians in a unique capitation payment model in Ontario, using the incentive to enroll and care for complex and vulnerable patients as a case study. This incentive, which is incremental to the regular capitation payment, ceases after the first year of patient enrollment and may therefore impact on the physician's decision to continue to enroll the patient. Furthermore, because the enrolled patients in Ontario can seek care from any provider, the enrolling physician may shift some treatment costs to other providers. Using longitudinal administrative data and a control group of physicians in the fee-for-service model who were eligible for the same incentive, we find no evidence of either patient 'dumping' or cost shifting. These results highlight the need to re-examine the conventional wisdom about risk selection for physician payment models that significantly deviate from the stylized capitation model. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Containing Pedagogical Complexity through the Assignment of Photography: Two Case Presentations

ERIC Educational Resources Information Center

Garrett, H. James; Matthews, Sara

2014-01-01

This article investigates the use of photography as a narrative approach to learning in the context of postsecondary education. Two cases are presented: a social studies methods course in a teacher education program in the South of the United States; and a senior undergraduate seminar on global violence at a university in southern Ontario, Canada.…

Examining What We Mean by "Collaboration" in Collaborative Action Research: A Cross-Case Analysis

ERIC Educational Resources Information Center

Bruce, Catherine D.; Flynn, Tara; Stagg-Peterson, Shelley

2011-01-01

The purpose of this paper is to report on the nature of collaboration in a multi-year, large-scale collaborative action research project in which a teachers' federation (in Ontario, Canada), university researchers and teachers partnered to investigate teacher-selected topics for inquiry. Over two years, 14 case studies were generated involving six…

Thyroid cancer incidence among Asian immigrants to Ontario, Canada: A population-based cohort study.

PubMed

Shah, Baiju R; Griffiths, Rebecca; Hall, Stephen F

2017-09-01

The highest rates of thyroid cancer are observed in Pacific Island nations as well as Australia and Asian countries bordering the Pacific. The objective of this study was to determine the risk for thyroid cancer among immigrants to Canada from Southeast and East Asia compared with immigrants from other regions and nonimmigrants. This was a population-based, longitudinal cohort study using health care administrative data to examine all residents of Ontario without pre-existing thyroid cancer. Individuals were followed from January 1997 or 5 years after they became eligible for health care coverage in Ontario, whichever came later. Patients were followed until March 2015 for incident-differentiated thyroid cancer, and then for recurrence. The study followed 14,659,733 individuals for a median of 17 years. Thyroid cancer incidence was 43.8 cases per 100,000 person-years among Southeast Asian immigrants, 28.6 cases per 100,000 person-years among East Asian immigrants, 21.5 cases per 100,000 person-years among other immigrants, and 14.5 cases per 100,000 person-years among nonimmigrants. Incidence was highest among immigrants from the Philippines (52.7 cases per 100,000 person-years), South Korea (33.5 cases per 100,000 person-years), and China (30.0 cases per 100,000 person-years). Adjusted hazard ratios for thyroid cancer compared with nonimmigrants were 2.66 (95% confidence interval, 2.48-2.84) for Southeast Asian immigrants, 1.87 (95% confidence interval, 1.75-2.00) for East Asian immigrants, and 1.51 (95% confidence interval, 1.45-1.57) for other immigrants. Immigrants were more likely to have papillary histology and stage I cancer. East Asian immigrants, but not Southeast Asian immigrants, had a lower risk of recurrence (hazard ratio, 0.73 [95% confidence interval, 0.57-0.94] and 1.01 [95% confidence interval, 0.81-1.26], respectively). Immigrants from Southeast and East Asia had markedly higher thyroid cancer incidence than nonimmigrants. At particularly elevated risk were immigrants from the Philippines, South Korea, and China. Cancer 2017;123:3320-5. © 2017 American Cancer Society. © 2017 American Cancer Society.

Case of disclosure of HIV status helps to clarify privacy law in Ontario.

PubMed

Lang, Renée

2008-07-01

A judge in the Ontario Superior Court of Justice has dismissed a breach of privacy suit on the basis that the plaintiff failed to prove that the disclosure of his HIV status had caused him harm. The judgment set out guidelines for how future claims of breach of privacy should be addressed.

Children in Need of Protection: Reporting Policies in Ontario School Boards

ERIC Educational Resources Information Center

Shewchuk, Samantha

2014-01-01

A clear, well defined policy can help empower school personnel to make informed decisions on how to handle cases of suspected child abuse. This article presents an analysis of (N = 64) school board child abuse reporting policies and procedures in Ontario and explored what training, resources, and support school boards state they will provide to…

Calculating the College-to-University Transfer Rate in Ontario

ERIC Educational Resources Information Center

Decock, Henry

2004-01-01

Measuring transfer is as varied as it is controversial, particularly in an era of increased accountability and in the case of Ontario Colleges, in a time of flux and change. American Community Colleges have been grappling with the definition of a transfer rate, continuing to fail on reaching a consensus. The importance of an acceptable transfer…

Encephalitis, Ontario, Canada, 2002–2013

PubMed Central

Parpia, Alyssa S.; Li, Ye; Chen, Cynthia; Dhar, Badal

2016-01-01

Encephalitis, a brain inflammation leading to severe illness and often death, is caused by >100 pathogens. To assess the incidence and trends of encephalitis in Ontario, Canada, we obtained data on 6,463 Ontario encephalitis hospitalizations from the hospital Discharge Abstract Database for April 2002–December 2013 and analyzed these data using multiple negative binomial regression. The estimated crude incidence of all-cause encephalitis in Ontario was ≈4.3 cases/100,000 persons/year. Incidence rates for infants <1 year of age and adults >65 years were 3.9 and 3.0 times that of adults 20–44 years of age, respectively. Incidence peaks during August–September in 2002 and 2012 resulted primarily from encephalitis of unknown cause and viral encephalitis. Encephalitis occurred more frequently in older age groups and less frequently in women in Ontario when compared to England, but despite differences in population, vector-borne diseases, climate, and geography, the epidemiology was overall remarkably similar in the two regions. PMID:26890626

Pediatric fire deaths in Ontario: retrospective study of behavioural, social, and environmental risk factors.

PubMed

Chen, Yingming Amy; Bridgman-Acker, Karen; Edwards, Jim; Lauwers, Albert Edward

2011-05-01

To identify the predictors of residential fire deaths in the Ontario pediatric population using systematically collected data from the Office of the Chief Coroner. Retrospective cohort study. Ontario. Children younger than 16 years of age who died in accidental residential fires in Ontario between January 1, 2001, and December 31, 2006. The study retrospectively reviewed the coroner's case files for 60 subjects who qualified according to the selection criteria. Reviewed documents included the coroner's investigation statements, autopsy reports, toxicology reports, fire marshal's reports, police reports, and Children's Aid Society (CAS) reports. Information on a range of demographic, behavioural, social, and environmental factors was collected. Statistical tests, including relative risk, relative risk confidence intervals, and χ(2) tests were performed to determine the correlation between factors of interest and to establish their significance. Thirty-nine fire events resulting in 60 deaths occurred between 2001 and 2006. Fire play and electrical failures were the top 2 causes of residential fires. More fires occurred during the night (midnight to 9 AM) than during the day (9 AM to midnight). Nighttime fires were most commonly due to electrical failures or unattended candles, whereas daytime fires were primarily caused by unsupervised fire play and stove fires. Smoke alarms were present at 32 of 39 fire events (82%), but overall alarm functionality was only 54%. Children from families with a history of CAS involvement were approximately 32 times more likely to die in fires. Risk factors for pediatric fire death in Ontario include smoke alarm functionality, fire play, fire escape behaviour, and CAS involvement. Efforts to prevent residential fire deaths should target these populations and risk factors, and primary care physicians should consider education around these issues as a primary preventive strategy for families with young children.

Coordination Mechanism in Fast Human Movements. Experimental and Modelling Studies. Volume 1.

DTIC Science & Technology

1983-09-01

Electrical Stimulation and the Treatment of Flaccid Hemiparesis : A Report on Three Case Studies", W. Kroll, P. Lagasse, and W. Kilmer. Proc. Conf...Canadian Soc. for Biomechanics (Human Locomotion 2), Kingston, Ontario, September 1982. 5. " Hemiparesis of the Upper Limb and Functional Electrical

The Movement of Teachers within Ontario School Boards

ERIC Educational Resources Information Center

Sibbald, Timothy

2017-01-01

This study examines teacher movement between secondary schools within the same school board using qualitative multiple case study. Interviews were conducted with each participant before moving, shortly after moving, and a period of time after moving schools. The coding of the interviews found evidence corroborating known themes of leadership,…

Lead in school drinking water: Canada can and should address this important ongoing exposure source.

PubMed

Barn, Prabjit; Kosatsky, Tom

2011-01-01

Reducing all preventable lead exposures in children should be a public health priority given that blood lead levels in children that were once considered "safe" have since been associated with important neuro-developmental deficits. Limited Canadian data indicate that school drinking water can be an important component of children's overall exposure to lead. Outside of Ontario, however, Canadian schools are not required to test for lead in water; in most of Canada, school testing is case by case, typically initiated by parental concerns. Provinces and territories are encouraged to follow Ontario's example by instituting a routine school water lead testing program in order to identify facilities where action can result in a decrease in students' exposure to lead. Testing and remediation frameworks developed by the US Environmental Protection Agency, Health Canada, and the province of Ontario provide direction to school boards and local and provincial/territorial health authorities.

An assessment of mumps vaccine effectiveness by dose during an outbreak in Canada.

PubMed

Deeks, Shelley L; Lim, Gillian H; Simpson, Mary Anne; Gagné, Louise; Gubbay, Jonathan; Kristjanson, Erik; Fung, Cecilia; Crowcroft, Natasha S

2011-06-14

This investigation was done to assess vaccine effectiveness of one and two doses of the measles, mumps and rubella (MMR) vaccine during an outbreak of mumps in Ontario. The level of coverage required to reach herd immunity and interrupt community transmission of mumps was also estimated. Information on confirmed cases of mumps was retrieved from Ontario's integrated Public Health Information System. Cases that occurred between Sept. 1, 2009, and June 10, 2010, were included. Selected health units supplied coverage data from the Ontario Immunization Record Information System. Vaccine effectiveness by dose was calculated using the screening method. The basic reproductive number (R(0)) represents the average number of new infections per case in a fully susceptible population, and R(0) values of between 4 and 10 were considered for varying levels of vaccine effectiveness. A total of 134 confirmed cases of mumps were identified. Information on receipt of MMR vaccine was available for 114 (85.1%) cases, of whom 63 (55.3%) reported having received only one dose of vaccine; 32 (28.1%) reported having received two doses. Vaccine effectiveness of one dose of the MMR vaccine ranged from 49.2% to 81.6%, whereas vaccine effectiveness of two doses ranged from 66.3% to 88.0%. If we assume vaccine effectiveness of 85% for two doses of the vaccine, vaccine coverage of 88.2% and 98.0% would be needed to interrupt community transmission of mumps if the corresponding reproductive values were four and six. Our estimates of vaccine effectiveness of one and two doses of mumps-containing vaccine were consistent with the estimates that have been reported in other outbreaks. Outbreaks occurring in Ontario and elsewhere serve as a warning against complacency over vaccination programs.

Food for Thought: An Analysis of Pro-Environmental Behaviours and Food Choices in Ontario Environmental Studies Programs

ERIC Educational Resources Information Center

Breunig, Mary

2013-01-01

In Canada, there exists a noteworthy educational initiative referred to as Environmental Studies Programs (ESPs). These secondary school programs are interdisciplinary, helping to link subject matter and encouraging student responsibility. This paper will present student reports from five case studies where I investigated how ESP participation…

Sustaining Leadership.

ERIC Educational Resources Information Center

Hargreaves, Andy; Fink, Dean

2003-01-01

Drawing on case studies of six urban and suburban secondary schools in Ontario, Canada, examines characteristics and role of school leaders in supporting and sustaining educational reform. Discusses three implications for developing sustainable leadership. For example, education systems should see leadership as a vertical system that extends for…

Association between cervical screening and prevention of invasive cervical cancer in Ontario: a population-based case-control study.

PubMed

Vicus, Danielle; Sutradhar, Rinku; Lu, Yan; Kupets, Rachel; Paszat, Lawrence

2015-01-01

The aim of this study was to estimate the effect of cervical screening in the prevention of invasive cervical cancer among age groups, using a population-based case-control study in the province of Ontario, Canada. Exposure was defined as cervical cytology history greater than 3 months before the diagnosis date of cervical cancer (index date). Cases were women who were diagnosed with cervical cancer between January 1, 1998, and December 31, 2008. Controls were women without a diagnosis of cervical cancer on, or before, December 31, 2008. Two controls were matched to each case on year of birth and income quintile, as of the index date. Conditional logistic regression was used to estimate the odds ratio for having been screened among those with cervical cancer. Cervical cancer screening performed between 3 and 36 months before the index date was protective against invasive cervical cancer in women aged 40 through 69 years. In women younger than 40 years, cervical cancer screening performed 3 to 36 months before the index date was not protective. Cervical screening is associated with a reduced risk for invasive cervical cancer among women older than 40 years. Cervical cancer resources should be focused on maximizing the risk reduction.

Prostate cancer risk and diet, recreational physical activity and cigarette smoking.

PubMed

Darlington, Gerarda Ann; Kreiger, Nancy; Lightfoot, Nancy; Purdham, James; Sass-Kortsak, Andrea

2007-01-01

Associations between prostate cancer and dietary factors, physical activity and smoking were assessed based on data from a population-based case-control study. The study was conducted among residents of northeastern Ontario. Cases were identified from the Ontario Cancer Registry and diagnosed between 1995 and 1998 at ages 50 to 84 years (N=752). Male controls were identified from telephone listings and were frequency matched to cases on age (N=1,613). Logistic regression analyses investigated history of diet, physical activity and smoking as potential risk factors. Tomato intake had a significant positive association with prostate cancer risk for highest versus lowest quartiles (OR=1.6; 95 percent CI: 1.2-2.0). Associations were observed for tomato or vegetable juices and ketchup (OR=1.5; 95 percent CI: 1.2-1.9; OR=1.2; 95 percent CI: 1.0-1.5, respectively). Neither other dietary variables nor smoking were associated with prostate cancer risk. Strenuous physical activity by men in their early 50s was associated with reduced risk (OR=0.8; 95 percent CI: 0.6-0.9). While the recreational physical activity association was consistent with results from previous studies, the tomato products association was not.

Health service utilisation for anogenital warts in Ontario, Canada prior to the human papillomavirus (HPV) vaccine programme introduction: a retrospective longitudinal population-based study.

PubMed

Guerra, Fiona M; Rosella, Laura C; Dunn, Sheila; Wilson, Sarah E; Chen, Cynthia; Deeks, Shelley L

2016-03-10

Trends in occurrence of anogenital warts (AGWs) can provide early evidence of human papillomavirus (HPV) vaccination programme impact on preventing HPV infection and HPV-induced lesions. The objective of this study was to provide a baseline of AGW epidemiology in Ontario prior to the introduction of the publicly-funded school-based HPV vaccination programme in September 2007. As a retrospective longitudinal population-based study, we used health administrative data as a proxy to estimate incident AGWs and total health service utilisation (HSU) for AGWs for all Ontario residents 15 years and older with valid health cards between 1 April 2003 and 31 March 2007. The outcome of interest was AGW healthcare utilisation identified using the International Classification of Diseases, 10th revision (ICD-10) diagnostic code for AGWs, as well as an algorithm for identifying AGW physician office visits in a database with a unique system of diagnostic and procedural codes. An AGW case was considered incident if preceded by 12 months without HSU for AGWs. Time trends by age group and sex were analysed. Between fiscal years 2003 and 2006, we identified 123,247 health service visits for AGWs by 51,436 Ontario residents 15 years and older. Incident AGWs peaked in females and males in the 21-23 year age group, at 3.74 per 1000 and 2.81 per 1000, respectively. HSU for AGWs peaked in females and males within the 21-23 year age group, at 9.34 per 1000 and 7.22 per 1000, respectively. To the best of our knowledge, this is the first population-based study of AGW incidence and HSU in Ontario. The sex and age distribution of individuals with incident and prevalent AGWs in Ontario was similar to that of other provinces before HPV vaccine programme implementation in Canada. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Traumatic brain injuries in the construction industry.

PubMed

Colantonio, Angela; McVittie, Doug; Lewko, John; Yin, Junlang

2009-10-01

This study analyses factors associated with work-related traumatic brain injury (TBI), specifically in the construction industry in Ontario, Canada. This cross-sectional study utilized data extracted from the Ontario Workplace Safety and Insurance Board (WSIB) records indicating concussion/intracranial injury that resulted in days off work in 2004-2005. Analyses of 218 TBI cases revealed that falls were the most common cause of injury, followed by being struck by or against an object. Mechanisms of injury and the temporal profile of injury also varied by age. For instance, a significantly higher proportion of injuries occurred in the mornings for young workers compared to older workers. The results of this study provide important information for prevention of TBI which suggest important age-specific strategies for workers in the construction industry.

Changing Visions of Excellence in Ontario School Policy: The Cases of "Living and Learning" and "For the Love of Learning"

ERIC Educational Resources Information Center

Bruno-Jofre, Rosa; Hills, George

2011-01-01

In this essay, Rosa Bruno-Jofre and George Hills examine two major Ontario policy documents: 1968's "Living and Learning" and 1994's "For the Love of Learning." The purpose is, first, to gain insight into the uses of the term "excellence" in the context of discourse about educational aims and evaluation, and, second,…

High incidence of diagnosis with syphilis co-infection among men who have sex with men in an HIV cohort in Ontario, Canada.

PubMed

Burchell, Ann N; Allen, Vanessa G; Gardner, Sandra L; Moravan, Veronika; Tan, Darrell H S; Grewal, Ramandip; Raboud, Janet; Bayoumi, Ahmed M; Kaul, Rupert; Mazzulli, Tony; McGee, Frank; Rourke, Sean B

2015-08-20

The re-emergence of syphilis among HIV-positive gay and other men who have sex with men (MSM) requires vigilance. We estimated incidence of and risk factors for first and subsequent syphilis diagnoses among MSM in HIV care in Ontario, Canada. We analyzed data from 2,280 MSM under follow-up from 2006 to 2010 in the Ontario HIV Treatment Network Cohort Study (OCS), a multi-site clinical cohort. We obtained syphilis serology results via record linkage with the provincial public health laboratory. Rates were calculated using Poisson regression. First syphilis diagnoses occurred at a rate of 2.0 per 100 person-years (95 % CI 1.7, 2.4; 121 cases) whereas the re-diagnosis rate was 7.5 per 100 person-years (95 % CI 6.3, 8.8; 136 cases). We observed higher rates over time and among men who were aged <30 years, receiving care in the two largest urban centers, or had a previous syphilis diagnosis. Syphilis diagnosis was less common among Indigenous men, men with higher CD4 cell counts, and, for first diagnoses only, among men with less than high school education. Compared to reported cases in the general male population, incidence of a new syphilis diagnosis was over 300 times greater among HIV-positive MSM but year-to-year changes reflected provincial trends. Re-diagnosis was common, suggesting treatment failure or re-infection. Novel syphilis control efforts are needed among HIV-positive MSM.

Intestinal toxemia botulism in 3 adults, Ontario, Canada, 2006-2008.

PubMed

Sheppard, Yolanda D; Middleton, Dean; Whitfield, Yvonne; Tyndel, Felix; Haider, Shariq; Spiegelman, Jamie; Swartz, Richard H; Nelder, Mark P; Baker, Stacey L; Landry, Lisa; Maceachern, Ross; Deamond, Sherri; Ross, Lorrie; Peters, Garth; Baird, Michelle; Rose, David; Sanders, Greg; Austin, John W

2012-01-01

Five cases of intestinal toxemia botulism in adults were identified within an 18-month period in or near Toronto, Ontario, Canada. We describe findings for 3 of the 5 case-patients. Clinical samples contained Clostridium botulinum spores and botulinum neurotoxins (types A and B) for extended periods (range 41-61 days), indicative of intestinal toxemia botulism. Patients' clinical signs improved with supportive care and administration of botulinum antitoxin. Peanut butter from the residence of 1 case-patient yielded C. botulinum type A, which corresponded with type A spores found in the patient's feces. The food and clinical isolates from this case-patient could not be distinguished by pulsed-field gel electrophoresis. Two of the case-patients had Crohn disease and had undergone previous bowel surgery, which may have contributed to infection with C. botulinum. These cases reinforce the view that an underlying gastrointestinal condition is a risk factor for adult intestinal toxemia botulism.

High Incidence of Invasive Group A Streptococcus Disease Caused by Strains of Uncommon emm Types in Thunder Bay, Ontario, Canada

PubMed Central

Athey, Taryn B. T.; Teatero, Sarah; Sieswerda, Lee E.; Gubbay, Jonathan B.; Marchand-Austin, Alex; Li, Aimin; Wasserscheid, Jessica; Dewar, Ken; McGeer, Allison; Williams, David

2015-01-01

An outbreak of type emm59 invasive group A Streptococcus (iGAS) disease was declared in 2008 in Thunder Bay District, Northwestern Ontario, 2 years after a countrywide emm59 epidemic was recognized in Canada. Despite a declining number of emm59 infections since 2010, numerous cases of iGAS disease continue to be reported in the area. We collected clinical information on all iGAS cases recorded in Thunder Bay District from 2008 to 2013. We also emm typed and sequenced the genomes of all available strains isolated from 2011 to 2013 from iGAS infections and from severe cases of soft tissue infections. We used whole-genome sequencing data to investigate the population structure of GAS strains of the most frequently isolated emm types. We report an increased incidence of iGAS in Thunder Bay compared to the metropolitan area of Toronto/Peel and the province of Ontario. Illicit drug use, alcohol abuse, homelessness, and hepatitis C infection were underlying diseases or conditions that might have predisposed patients to iGAS disease. Most cases were caused by clonal strains of skin or generalist emm types (i.e., emm82, emm87, emm101, emm4, emm83, and emm114) uncommonly seen in other areas of the province. We observed rapid waxing and waning of emm types causing disease and their replacement by other emm types associated with the same tissue tropisms. Thus, iGAS disease in Thunder Bay District predominantly affects a select population of disadvantaged persons and is caused by clonally related strains of a few skin and generalist emm types less commonly associated with iGAS in other areas of Ontario. PMID:26491184

High Incidence of Invasive Group A Streptococcus Disease Caused by Strains of Uncommon emm Types in Thunder Bay, Ontario, Canada.

PubMed

Athey, Taryn B T; Teatero, Sarah; Sieswerda, Lee E; Gubbay, Jonathan B; Marchand-Austin, Alex; Li, Aimin; Wasserscheid, Jessica; Dewar, Ken; McGeer, Allison; Williams, David; Fittipaldi, Nahuel

2016-01-01

An outbreak of type emm59 invasive group A Streptococcus (iGAS) disease was declared in 2008 in Thunder Bay District, Northwestern Ontario, 2 years after a countrywide emm59 epidemic was recognized in Canada. Despite a declining number of emm59 infections since 2010, numerous cases of iGAS disease continue to be reported in the area. We collected clinical information on all iGAS cases recorded in Thunder Bay District from 2008 to 2013. We also emm typed and sequenced the genomes of all available strains isolated from 2011 to 2013 from iGAS infections and from severe cases of soft tissue infections. We used whole-genome sequencing data to investigate the population structure of GAS strains of the most frequently isolated emm types. We report an increased incidence of iGAS in Thunder Bay compared to the metropolitan area of Toronto/Peel and the province of Ontario. Illicit drug use, alcohol abuse, homelessness, and hepatitis C infection were underlying diseases or conditions that might have predisposed patients to iGAS disease. Most cases were caused by clonal strains of skin or generalist emm types (i.e., emm82, emm87, emm101, emm4, emm83, and emm114) uncommonly seen in other areas of the province. We observed rapid waxing and waning of emm types causing disease and their replacement by other emm types associated with the same tissue tropisms. Thus, iGAS disease in Thunder Bay District predominantly affects a select population of disadvantaged persons and is caused by clonally related strains of a few skin and generalist emm types less commonly associated with iGAS in other areas of Ontario. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Moral codes of mothering and the introduction of welfare-to-work in Ontario.

PubMed

Gazso, Amber

2012-02-01

In this paper, I trace how the reform of social assistance in Ontario, especially the post-1990s enforcement of lone mothers' employability via welfare-to-work programs, parallels shifts in dominant moral codes of mothering, from "mother-carer" to "mother-worker." Additionally, I use this case as an entry point to consider the implications of public and policy allegiance to these moral codes for all mothers. The central argument I make is that the introduction of welfare-to-work programs in Ontario did not occur in a neoliberal state-sanctioned vacuum but also involved the circulation of ideas about moral mothering outside of policy into policy.

Working and Living in Northern vs Southern Ontario Is Associated with the Duration of Compensated Time off Work: A Retrospective Cohort Study.

PubMed

Senthanar, S; Kristman, V L; Hogg-Johnson, S

2015-07-01

Northern Ontario, Canada has a larger elder population, more resource-based employment, and limited access to physicians and specialists compared to southern Ontario. Given these important differences, it is possible that work disability rates will vary between the two Ontario jurisdictions. To determine the association between time lost due to workplace injuries and illnesses occurring in northern vs southern Ontario and work disability duration from 2006--2011. The study base included all lost-time claims approved by the Workplace Safety and Insurance Board in Ontario, Canada for workplace injury or illness compensation occurring between January 1, 2006 and December 31, 2011. All eligible participants had to be 18 years of age or older at the time of making the claim and participants were excluded if one of the three variables used to determine location (claimant home postal code, workplace geographical code, and WSIB firm location) were missing. Multivariable proportional hazards regression models were used to estimate hazard ratios and 95% confidence intervals adjusted for sex, age, occupation, part of body, and nature of injury relating Ontario geographical location to compensated time off work. A total of 156 453 lost-time claims were approved over the study period. Injured and ill workers from northern Ontario were 16% less likely to return to work than those from southern Ontario. Adjustment for potential confounding factors had no effect. The disability duration in northern Ontario is longer than that in southern Ontario. Future research should focus on assessing the relevant factors associated with this observation to identify opportunities for intervention.

Keeping Our Cultural and Linguistic Heritage Alive: A Canadian Literary Experience.

ERIC Educational Resources Information Center

Mylopoulos, Chryssafi

1992-01-01

Describes how multicultural library services have contributed to the promotion, support, and preservation of the cultural and linguistic identity of the community being served, using the Public Library of Scarborough in Ontario (Canada) as a case study. Observation reveals the importance of commitment, planning, and methodology. (SLD)

Behavioral Ecology of Subterranean Termites and Implications for Control

Treesearch

J. Kenneth Grace

1991-01-01

Subterranean termites are important structural pests in much of North America, and worldwide. Recent studies of eastern subterranean termite (Reticulitermes flavipes [Kollar]) colonies in Ontario, Canada, indicate that these colonies contain greater foraging populations and forage over larger territories than was previously thought to be the case....

Costs of cervical cancer treatment: population-based estimates from Ontario

PubMed Central

Pendrith, C.; Thind, A.; Zaric, G.S.; Sarma, S.

2016-01-01

Objectives The objectives of the present study were to estimate the overall and specific medical care costs associated with cervical cancer in the first 5 years after diagnosis in Ontario. Methods Incident cases of invasive cervical cancer during 2007–2010 were identified from the Ontario Cancer Registry and linked to administrative databases held at the Institute for Clinical Evaluative Sciences. Mean costs in 2010 Canadian dollars were estimated using the arithmetic mean and estimators that adjust for censored data. Results Mean age of the patients in the study cohort (779 cases) was 49.3 years. The mean overall medical care cost was $39,187 [standard error (se): $1,327] in the 1st year after diagnosis. Costs in year 1 ranged from $34,648 (se: $1,275) for those who survived at least 1 year to $69,142 (se: $4,818) for those who died from cervical cancer within 1 year. At 5 years after diagnosis, the mean overall unadjusted cost was $63,131 (se: $3,131), and the cost adjusted for censoring was $68,745 (se: $2,963). Inpatient hospitalizations and cancer-related care were the two largest components of cancer treatment costs. Conclusions We found that the estimated mean costs that did not account for censoring were consistently undervalued, highlighting the importance of estimates based on censoring-adjusted costs in cervical cancer. Our results are reliable for estimating the economic burden of cervical cancer and the cost-effectiveness of cervical cancer prevention strategies. PMID:27122978

Perspectives and Plans for Graduate Studies. 16. Biophysics 1974.

ERIC Educational Resources Information Center

Ontario Council on Graduate Studies, Toronto. Advisory Committee on Academic Planning.

In March, 1973, after a review of the Ontario universities' three-year plans, a provisional embargo was placed on doctoral work in biophysics. A full-scale assessment with outside consultants was not necessary in the case of a provisional embargo. Instead, the method used to remove the embargo was self-study by the discipline group leading to a…

Sense of Place and Health in Hamilton, Ontario: A Case Study

ERIC Educational Resources Information Center

Williams, Allison; Kitchen, Peter

2012-01-01

The concept of sense of place has received considerable attention by social scientists in recent years. Research has indicated that a person's sense of place is influenced by a number of factors including the built environment, socio-economic status (SES), well-being and health. Relatively few studies have examined sense of place at the…

Teaching for Transfer: Insights from Theory and Practices in Primary-Level French-Second-Language Classrooms

ERIC Educational Resources Information Center

Thomas, Reed; Mady, Callie

2014-01-01

This paper illustrates teaching for transfer across languages by synthesizing key insights from theory and previously published research alongside our case study data from primary-level teachers in core French-second-language (CF) classrooms in Ontario, Canada. Drawing on research that redefines language transfer as a resource, this study drew on…

Voices of Resilience from the Bottom Rungs: The Stories of Three Elementary Core French Teachers in Ontario

ERIC Educational Resources Information Center

Knouzi, Ibtissem; Mady, Callie

2014-01-01

This paper reports on a study that used activity theory (AT) as a framework to understand the dialogical relationship between three elementary Core French (CF) teachers' personal and professional experiences and their literacy teaching beliefs and practices. This study used a case study design collecting data from three different teachers in three…

Reported municipal costs from outdoor smoke-free by-laws-experience from Ontario, Canada

PubMed Central

2014-01-01

Background In 2006, enclosed public and workplaces in Ontario were made smoke-free by the Smoke-free Ontario Act (SFOA). Numerous area municipalities across the province have since developed local by-laws that are more restrictive than the SFOA and ban smoking in outdoor environments including parks, beaches, and patios. The current study measured reported costs associated with the implementation and enforcement of smoke-free outdoor municipal by-laws including materials and staffing costs. The study also assessed the number of warnings or tickets issued to smokers. Ontario communities with a by-law in force for at least 2 years were included in the sample (n = 42). The study was completed by 88% of area municipalities (n = 37). Municipal staff and managers completed a survey by telephone between June-September 2012. Findings No area municipality surveyed reported that they hired additional enforcement staff as a result of their community’s smoke-free by-law. Most municipalities (95%) posted signage to support awareness of their by-law; signs costs ranged from $40-$150/sign with most municipalities reporting signs were made in-house. Most communities reported actively enforcing the by-law; six communities reported they had issued tickets to people not in compliance with outdoor smoking restrictions. Conclusions The implementation, promotion, and enforcement of outdoor smoke-free by-laws have required municipal staff time and in most cases have promotional costs, but these have come from existing budgets and using existing staff. Outdoor smoke-free by-laws have not created significant burdens on municipal enforcement staff or on municipal budgets. PMID:24581326

Statistical Analysis of Regional Surface Water Quality in Southeastern Ontario.

ERIC Educational Resources Information Center

Bodo, Byron A.

1992-01-01

Historical records from Ontario's Provincial Water Quality Monitoring Network for rivers and streams were analyzed to assess the feasibility of mapping regional water quality patterns in southeastern Ontario, spanning the Precambrian Shield and the St. Lawrence Lowlands. The study served as a model for much of Ontario. (54 references) (Author/MDH)

Early detection of emerald ash borer infestation using multisourced data: a case study in the town of Oakville, Ontario, Canada

NASA Astrophysics Data System (ADS)

Zhang, Kongwen; Hu, Baoxin; Robinson, Justin

2014-01-01

The emerald ash borer (EAB) poses a significant economic and environmental threat to ash trees in southern Ontario, Canada, and the northern states of the USA. It is critical that effective technologies are urgently developed to detect, monitor, and control the spread of EAB. This paper presents a methodology using multisourced data to predict potential infestations of EAB in the town of Oakville, Ontario, Canada. The information combined in this study includes remotely sensed data, such as high spatial resolution aerial imagery, commercial ground and airborne hyperspectral data, and Google Earth imagery, in addition to nonremotely sensed data, such as archived paper maps and documents. This wide range of data provides extensive information that can be used for early detection of EAB, yet their effective employment and use remain a significant challenge. A prediction function was developed to estimate the EAB infestation states of individual ash trees using three major attributes: leaf chlorophyll content, tree crown spatial pattern, and prior knowledge. Comparison between these predicted values and a ground-based survey demonstrated an overall accuracy of 62.5%, with 22.5% omission and 18.5% commission errors.

The utility of measles and rubella IgM serology in an elimination setting, Ontario, Canada, 2009-2014.

PubMed

Bolotin, Shelly; Lim, Gillian; Dang, Vica; Crowcroft, Natasha; Gubbay, Jonathan; Mazzulli, Tony; Schabas, Richard

2017-01-01

In Canada, measles was eliminated in 1998 and rubella in 2000. Effective measles and rubella surveillance is vital in elimination settings, hinging on reliable laboratory methods. However, low-prevalence settings affect the predictive value of laboratory tests. We conducted an analysis to determine the performance of measles and rubella IgM testing in a jurisdiction where both infections are eliminated. 21,299 test results were extracted from the Public Health Ontario Laboratories database and 1,239 reports were extracted from the Ontario Integrated Public Health Information System (iPHIS) from 2008 and 2010 for measles and rubella, respectively, to 2014. Deterministic linkage resulted in 658 linked measles records (2009-2014) and 189 linked rubella records (2010-2014). Sixty-six iPHIS measles entries were classified as confirmed cases, of which 53 linked to laboratory data. Five iPHIS rubella entries were classified as confirmed, all linked to IgM results. The positive predictive value was 17.4% for measles and 3.6% for rubella. Sensitivity was 79.2% for measles and 100.0% for rubella. Specificity was 65.7% for measles and 25.8% for rubella. Our study confirms that a positive IgM alone does not confirm a measles case in elimination settings. This has important implications for countries that are working towards measles and rubella elimination.

A population-based study of the epidemiology of pancreatic cancer: a brief report

PubMed Central

Raju, R.S.; Coburn, N.; Liu, N.; Porter, J.M.; Seung, S.J.; Cheung, M.C.; Goyert, N.; Leighl, N.B.; Hoch, J.S.; Trudeau, M.E.; Evans, W.K.; Dainty, K.N.; Earle, C.C.; Mittmann, N.

2015-01-01

Objective Administrative data are used to describe the pancreatic cancer (pcc) population. The analysis examines demographic details, incidence, site, survival, and factors influencing mortality in a cohort of individuals diagnosed with pcc. Methods Incident cases of pcc diagnosed in Ontario between 1 January 2004 and 31 December 2011 were extracted from the Ontario Cancer Registry. They were linked by encrypted health card number to several administrative databases to obtain demographic and mortality information. Descriptive, bivariate, and survival analyses were conducted. Results During the period of interest, 9221 new cases of pcc (4548 in men, 4673 in women) were diagnosed, for an age-adjusted standardized annual incidence in the range of 8.6–9.5 per 100,000 population. Mean age at diagnosis was 70.3 ± 12.5 years (standard deviation). Five-year survival was 7.2% (12.8% for those <60 years of age and 3.6% for those >80 years of age). Survival varied by sex, older age, rural residence, lower income, site of involvement in the pancreas, and presence of comorbidity. Conclusions The mortality rate in pcc is exceptionally high. With an increasing incidence and a mortality positively associated with age, additional support will be needed for this highly fatal disease as demographics in Ontario continue to trend toward a higher proportion of older individuals. PMID:26715886

A population on the rise: The origin of deepwater sculpin in Lake Ontario

USGS Publications Warehouse

Welsh, Amy B.; Scribner, Kim T.; Stott, Wendylee; Walsh, Maureen

2017-01-01

Deepwater sculpin, Myoxocephalus thompsonii, were thought to have been extirpated from Lake Ontario. However, in recent years, abundance has increased and recruitment has been documented. There are two hypotheses concerning the origin of the current Lake Ontario deepwater sculpin population. First, individuals from the upper Great Lakes may have recolonized Lake Ontario. Alternatively, the Lake Ontario population may have not been extirpated, and the remnant population has recovered naturally. To test these hypotheses, eight microsatellite loci were used to analyze samples from the current Lake Ontario population, museum specimens from the historic Lake Ontario population, and current upper Great Lakes populations. The genetic data suggest that historically throughout the Great Lakes, deepwater sculpin exhibited low levels of spatial genetic structure. Approximate Bayesian Computation analyses support the hypothesis that the current Lake Ontario population is more closely related to populations in the upper Great Lakes than to the historic Lake Ontario samples, indicating that the current Lake Ontario population likely resulted from recolonization from the Upper Great Lakes. The current Lake Ontario population has reduced allelic diversity relative to upper Great Lakes populations, indicating a possible founder effect. This study demonstrates the role life history variation can play in recolonization success. The pelagic larval phase of the deepwater sculpin allowed recolonization of Lake Ontario via passive larval drift.

Creating a cultural analysis tool for the implementation of Ontario's civil mental health laws.

PubMed

Dhand, Ruby

2016-01-01

Ethno-racial people with mental health disabilities experience multiple inequities and differential outcomes when interacting with Ontario's civil mental health laws. Given the increasing multi-racial population in Ontario, there is a need to develop mechanisms to address these intersecting issues. Other countries that have created evaluative tools for mental health legislation include the United Kingdom and Australia. Australia's Rights Analysis Tool, the United Kingdom's Race Equality Impact Assessment, the Scottish Recovery Tool, and the World Health Organization's Mental Health and Human Rights checklist are examples of evaluative tools developed for mental health legislation. Such a tool does not exist in Canada, let alone in Ontario specifically. Thus, this study developed a Cultural Analysis Tool (CAT) consisting of specific and meaningful thematic questions that can be used by practitioners when addressing issues of culture and equity for ethno-racial people with mental health disabilities interacting with Ontario's civil mental health laws. It is hoped that the CAT, and the research underlying its development, will enable practitioners to critically question whether cultural and intersecting concerns are being appropriately addressed within an ethno-racial client's case and, furthermore, how equitable outcomes can be achieved. This article describes and analyzes the methodology, research and qualitative data used to develop the CAT. It then presents and examines the CAT itself. The qualitative data was drawn from thirty-five semi-structured interviews with seven members of each of the following groups: (1) ethno-racial people with mental health disabilities including in-patients and ex-patients, (2) lawyers who practice in the area of mental health law, (3) health care professionals including psychiatrists, nurses and social workers, (4) service providers such as front-line case workers at mental health agencies and (5) adjudicators, government advisors and academics. After an analysis of these data, the CAT's questions were refined through an expert review (involving the qualitative technique of member-checking) using three focus groups comprised of ethno-racial people with mental health disabilities, mental health lawyers and service providers and health care professionals. Copyright © 2016 Elsevier Ltd. All rights reserved.

Diagnostic and Treatment Patterns Among Children, Adolescents, and Young Adults with Thyroid Cancer in Ontario: 1992-2010.

PubMed

Pole, Jason D; Zuk, Aleksandra M; Wasserman, Jonathan D

2017-08-01

Thyroid carcinoma is rare in young children, with a sharp increase in incidence among adolescents and young adults between 15 and 29 years of age. The incidence of thyroid carcinoma is increasing worldwide. Limited prospective population-based data are available to describe diagnostic and treatment practices in this age group. This study undertook a population-based review of thyroid carcinoma among 0- to 29-year-old individuals in Ontario, Canada, utilizing linked administrative data to describe the demographic and care patterns over nearly two decades. Cases from the Ontario Cancer Registry were identified and linked to administrative data sources at the Institute for Clinical Evaluative Sciences. Cases diagnosed prior to a patient's 30th birthday between 1992 and 2010 were considered eligible. Billing records identified ultrasonography, fine-needle aspiration biopsy, radioiodine therapy, and surgical approach. A total of 2552 patients aged 0-29 years were diagnosed with thyroid carcinoma during the study period. There was a 2.1-fold increase in standardized incidence rate over the 19 years of this study. Thyroid carcinoma was diagnosed subsequent to a prior malignancy in 47/2552 patients at a median interval of 11.6 years after initial cancer diagnosis. Seventeen individuals developed a second malignancy after treatment for thyroid carcinoma. Most patients (90.44%) underwent preoperative ultrasound (ranging from 1 to 13 preoperative studies). Preoperative thyroid scintigraphy was used in 44% of patients, with a significant decline in usage over the study period. Fine-needle aspiration biopsy usage rose by 20% over the study period, although 26% of patients had no biopsy prior to surgery. Primary total thyroidectomy followed by two-stage thyroidectomy were the most frequently performed procedures, and 56% of patients received therapeutic radioiodine. This study establishes a foundation of diagnostic and practice patterns over nearly two decades. The study corroborates, in the Ontario population, the rising incidence of thyroid carcinoma in children and adolescents and young adults. Finally, it identifies the use of multiple preoperative ultrasound studies, low rates of thyroid biopsy, and thyroid scintigraphy as targets to improve efficiencies of care and to reduce unnecessary healthcare expenditures through education, standardization of diagnostic approach, and possibly regionalization of care.

Mortality experience of glass fibre workers.

PubMed Central

Shannon, H S; Hayes, M; Julian, J A; Muir, D C

1984-01-01

A historical prospective mortality study was conducted at an insulating wool plant in Ontario, Canada, on 2576 men who had worked for at least 90 days and were employed between 1955 and 1977. Eighty eight deaths were found in the 97.2% of men traced. Mortality was compared by the person-years method with that of the Ontario population. Measurements taken since 1977 show very low fibre concentrations. The overall standardised mortality ratio (SMR) was 78%, significantly below 100. Among plant only employees, seven deaths were attributed to lung cancer compared with 4.22 expected, a non-significant excess (SMR = 166; 95% confidence limits 67 to 342). No confirmed cases of mesothelioma were observed and no other disease was significantly increased in plant workers. PMID:6691934

Enabling the participation of marginalized populations: case studies from a health service organization in Ontario, Canada.

PubMed

Montesanti, Stephanie R; Abelson, Julia; Lavis, John N; Dunn, James R

2017-08-01

We examined efforts to engage marginalized populations in Ontario Community Health Centers (CHCs), which are primary health care organizations serving 74 high-risk communities. Qualitative case studies of community participation in four Ontario CHCs were carried out through key informant interviews with CHC staff to identify: (i) the approaches, strategies and methods used in participation initiatives aimed specifically at engaging marginalized populations in the planning of and decision making for health services; and (ii) the challenges and enablers for engaging these populations. The marginalized populations involved in the community participation initiatives studied included Low-German Speaking Mennonites in a rural town, newcomer immigrants and refugees in an urban downtown city, immigrant and francophone seniors in an inner city and refugee women in an inner city. Our analysis revealed that enabling the participation of marginalized populations requires CHCs to attend to the barriers experienced by marginalized populations that constrain their participation. Key informants outlined the features of a 'community development approach' that they rely on to address the barriers to marginalized peoples' involvement by strengthening their skills, abilities and leadership in capacity-building activities. The community development approach also shaped the participation methods that were used in the engagement process of CHCs. However, key informants also described the challenges of applying this approach, influenced by the cultural values of some groups, which shaped their willingness and motivation to participate. This study provides further insight into the approach, strategies and methods used in the engagement process to enable the participation of marginalized populations, which may be transferable to other health services settings. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Impact of Provincial Policies on University Research. A Comparative Study of Selected Canadian Provinces.

ERIC Educational Resources Information Center

Brochu, Mireille

This report reviews and compares the impact of university support policies in Ontario to those of Quebec, Alberta, and British Columbia and proposes a framework to regenerate the research infrastructure of Ontario universities. It identifies erosion in Ontario's comparative and competitive position within Canada though Ontario still performs about…

Research at Colleges in Ontario: Learning from the Past and Looking Towards the Future

ERIC Educational Resources Information Center

Holmes, Krista M.

2017-01-01

Research activities are a relatively new undertaking for Ontario colleges. The Government of Ontario enabled Ontario colleges to grant baccalaureate degrees in applied areas of study with the passing of the 2000 Postsecondary Education Choice and Excellence Act, and conduct applied research with the passing of the 2002 Colleges of Applied Arts and…

University Finance in Ontario. Research Monographs in Higher Education, Number 5.

ERIC Educational Resources Information Center

Lang, Daniel W.; House, Dawn; Young, Stacey; Jones, Glen A.

This study was an attempt to examine and discuss university finance issues in Ontario, Canada, within the broader context of higher education policy and to present data on trends and the impact of recent changes on Ontario universities. Multiple sources of data were used for the analyses. Higher education policy in Ontario has become increasingly…

Contextualizing Teacher Professionalism: Findings from a Cross-Case Analysis of Union Active Teachers

ERIC Educational Resources Information Center

Osmond-Johnson, Pamela

2016-01-01

This paper draws on data collected as part of a study of the discourses of teacher professionalism amongst union active teachers in the Canadian provinces of Alberta and Ontario. Interviews revealed a triad of influences on the professionalism discourses of participants: engagement in teacher associations, the larger policy environment, and…

Identifying the Potential Organizational Impact of an Educational Peer Review Program

ERIC Educational Resources Information Center

Toth, Kate E.; McKey, Colleen A.

2010-01-01

The literature on educational peer review (EPR) has focused on evaluating EPR's impact on faculty and/or student learning outcomes; no literature exists on the potential organizational impact. A qualitative (case study) research design explored perceptions of 17 faculty and 10 administrators within a school of nursing in an Ontario university…

A Framework To Explore Lifelong Learning: The Case of the Civic Education of Civics Teachers.

ERIC Educational Resources Information Center

Schugurensky, Daniel; Myers, John P.

2003-01-01

Fifteen Ontario social studies teachers who taught a revised civics course reflected on their own civics learning experiences. Most had some elementary-secondary exposure; teacher training emphasized methods over content. The most powerful influence was family socialization; political participation also contributed to development of knowledge and…

An Explanatory Model of Teacher Movement within Ontario School Boards

ERIC Educational Resources Information Center

Sibbald, Timothy M.

2017-01-01

Teacher movement within school boards is examined using multiple case study. Emergent themes achieved theoretical saturation and are consistent with the research literature. In this paper, the relationships between the themes are used to develop a substantive theoretical model of teacher movement within school boards. The model uses a two-phase…

Standards Collection Development and Management in an Academic Library: A Case Study at the University of Western Ontario Libraries

ERIC Educational Resources Information Center

Dunn, Linda K.; Xie, Shiyi

2017-01-01

How can academic libraries ensure their standards collections meet the teaching and research needs of science and engineering faculties? Nowadays, most academic libraries face financial constraints that greatly impact collection development. This article documents an academic library's experience with standards collections and the investigation…

Leadership & Spirit: Rejuvenating an Organization from the Bottom Up.

ERIC Educational Resources Information Center

Dance, Terry

Using a case study which documents the creation of the Access and Program Development Division at George Brown College, a large urban community college in Ontario, Canada, this paper explores the nature of leadership in educational management. Introductory material argues that leadership in management should be defined as a performing art rather…

Linking mechanistic toxicology to population models in forecasting recovery from chemical stress: A case study from Jackfish Bay, Ontario, Canada

EPA Science Inventory

A Beneficial Use Impairment (BUI) common at Great Lakes Areas of Concern (AOCs) is loss of fish and wildlife populations. Consequently, recovery of populations after stressor mitigation serves as a basis for evaluating remediation success. We describe a framework that can be a...

Deadwood Didn't Kill Itself: A Pathology of Failing Schools.

ERIC Educational Resources Information Center

Fink, Dean

1999-01-01

During the 1990s, the school has become the center of blame. Policymakers seem more interested in identifying failing schools than celebrating successes. This paper uses case-study research on a once-innovative Ontario high school to show that "deadwood" schools do not kill themselves, but need outsiders' help. (42 references) (MLH)

Evaluation of a Research Mentorship Program in Community Care

ERIC Educational Resources Information Center

Ploeg, Jenny; de Witt, Lorna; Hutchison, Brian; Hayward, Lynda; Grayson, Kim

2008-01-01

This article describes the results of a qualitative case study evaluating a research mentorship program in community care settings in Ontario, Canada. The purpose of the program was to build evaluation and research capacity among staff of community care agencies through a mentorship program. Data were collected through in-depth, semi-structured…

Black Resistance in High School: Forging a Separatist Culture.

ERIC Educational Resources Information Center

Solomon, R. Patrick

This book is an ethnographic case study of the school experience of West Indian children in a high school in Toronto (Ontario, Canada), which focuses on how minorities fail to achieve upward social mobility through education. Chapter 1, "Black Cultural Forms in Schools," reviews theories of resistance and cultural inversion in the…

Shifting Perspectives and Practices: Teacher Candidates' Experiences of an Aboriginal Infusion in Mainstream Teacher Education

ERIC Educational Resources Information Center

Blimkie, Melissa; Vetter, Diane; Haig-Brown, Celia

2014-01-01

This exploratory case study shares teacher candidates' perspectives and experiences of an Aboriginal infusion at York University's Faculty of Education field site in Barrie, Ontario. For this initiative, Aboriginal content and pedagogies were infused throughout placements and courses of the mainstream teacher education program. Teacher candidates…

An ecological study of cancer incidence in Port Hope, Ontario from 1992 to 2007.

PubMed

Chen, Jing; Moir, Deborah; Lane, Rachel; Thompson, Patsy

2013-03-01

A plant processing radium and uranium ores has been operating in the town of Port Hope since 1932. Given the nuclear industry located in the community and ongoing public health concerns, cancer incidence rates in Port Hope were studied for a recent 16 year period (1992-2007) for continued periodic cancer incidence surveillance of the community. The cancer incidence in the local community for all cancers combined was similar to the Ontario population, health regions with similar socio-economic characteristics in Ontario and in Canada, and the Canadian population. No statistically significant differences in childhood cancer, leukaemia or other radiosensitive cancer incidence were observed, with the exception of statistically significant elevated lung cancer incidence among women. However, the statistical significance was reduced or disappeared when the comparison was made to populations with similar socio-economic characteristics. These findings are consistent with previous ecological, case-control and cohort studies conducted in Port Hope, environmental assessments, and epidemiological studies conducted elsewhere on populations living around similar facilities or exposed to similar environmental contaminants. Although the current study covered an extended period of time, the power to detect risk at the sub-regional level of analysis was limited since the Port Hope population is small (16,500). The study nevertheless indicated that large differences in cancer incidence are not occurring in Port Hope compared to other similar communities and the general population.

Tourism climatology for camping: a case study of two Ontario parks (Canada)

NASA Astrophysics Data System (ADS)

Hewer, Micah J.; Scott, Daniel; Gough, William A.

2015-08-01

Climate and weather act as central motivators for the travel decisions of tourists. Due to their seasonality, these factors determine the availability and quality of certain outdoor recreational activities. Park visitation in Ontario, Canada, has been identified as a weather sensitive tourism and recreation activity. This study used a survey-based approach to identify and compare stated weather preferences and thresholds, as well as weather-related decision-making for campers at two provincial parks in Ontario, Canada. The two parks were selected for differing physical and environmental characteristics (forested lake versus coastal beach). Statistically significant differences were detected between the two parks in relation to the importance of weather and weather-based decision-making. Specific temperatures that were considered ideal and thresholds that were too cool and too warm were identified for both parks, both during the day and the night. Heavy rain and strong winds were the most influential factors in weather-related decision-making and on-site behavioural adaptations. Beach campers placed greater importance on the absence of rain and the presence of comfortable temperatures compared to forest campers. In addition, beach campers were more likely to leave the park early due to incremental weather changes. The results of this study suggest that beach campers are more sensitive to weather than forest campers.

Accessibility to Ontario Universities.

ERIC Educational Resources Information Center

Davis, Christine K.

Accessibility to a college education in Ontario, Canada, was assessed by studying the pattern of acceptances and rejections of various choices made by unregistered college applicants. Study concerns included: total offers to programs of choice from any college and from an Ontario college only; offers by institution type and program type for first…

Windsor, Ontario Exposure Assessment Study: Design and Methods Validation of Personal, Indoor and Outdoor Air Pollution Monitoring

EPA Science Inventory

The Windsor, Ontario Exposure Assessment Study evaluated the contribution of ambient air pollutants to personal and indoor exposures of adults and asthmatic children living in Windsor, Ontario, Canada. In addition, the role of personal, indoor, and outdoor air pollution exposures...

Report of a Study of Ontario Medical School Admissions Policies and Practices, 1975.

ERIC Educational Resources Information Center

Council of Ontario Universities, Toronto.

Presented are the results of a study of admissions policies and practices in the five Ontario schools of medicine. The study consists of a review of published information and a detailed examination of 1975 statistics from the Ontario Medical School Application Service, supplemented by a series of interviews with medical school admissions officers,…

Use of diagnostic imaging in the emergency department for cervical spine injuries in Kingston, Ontario.

PubMed

Pickett, William; Kukaswadia, Atif; Thompson, Wendy; Frechette, Mylene; McFaull, Steven; Dowdall, Hilary; Brison, Robert J

2014-01-01

This study assessed the use and clinical yield of diagnostic imaging (radiography, computed tomography, and medical resonance imaging) ordered to assist in the diagnosis of acute neck injuries presenting to emergency departments (EDs) in Kingston, Ontario, from 2002-2003 to 2009-2010. Acute neck injury cases were identified using records from the Kingston sites of the Canadian National Ambulatory Care Reporting System. Use of radiography was analyzed over time and related to proportions of cases diagnosed with clinically significant cervical spine injuries. A total of 4,712 neck injury cases were identified. Proportions of cases referred for diagnostic imaging to the neck varied significantly over time, from 30.4% in 2002-2003 to 37.6% in 2009-2010 (ptrend  =  0.02). The percentage of total cases that were positive for clinically significant cervical spine injury ("clinical yield") also varied from a low of 5.8% in 2005-2006 to 9.2% in 2008-2009 (ptrend  =  0.04), although the clinical yield of neck-imaged cases did not increase across the study years (ptrend  =  0.23). Increased clinical yield was not observed in association with higher neck imaging rates whether that yield was expressed as a percentage of total cases positive for clinically significant injury (p  =  0.29) or as a percentage of neck-imaged cases that were positive (p  =  0.77). We observed increases in the use of diagnostic images over time, reflecting a need to reinforce an existing clinical decision rule for cervical spine radiography. Temporal increases in the clinical yield for total cases may suggest a changing case mix or more judicious use of advanced types of diagnostic imaging.

Ontario pharmacists' crisis over Bill 16: A missed opportunity?

PubMed

Rosenthal, Meagen; Austin, Zubin; Tsuyuki, Ross T

2012-01-01

In 2010, the Ontario government brought forward Bill 16, which, among other things, removed pharmacists' professional allowances. While many would disagree with this unilateral action by the Ontario government, it also could have served as a crisis for change towards patient-centred care. We sought to examine the response of the pharmacy profession in Ontario to this crisis as it relates to the vision outlined in the Blueprint for Pharmacy. We systematically examined publicly available responses to Schedule 5 of Ontario's Bill 16 during the period from April to June 16, 2010. A rapid textual analysis of the data using tag or word clouds and a qualitative content analysis were performed on all of the data collected. The rapid textual analysis revealed that the most frequently used terms were "pharmacist," "pharmacy" and "professional allowances"; the least used were "layoffs," "service cuts" and "patient care." Content analysis revealed 4 themes: the desire to maintain the status quo of practice, a focus on the business of pharmacy, pharmacy stakeholders' perceptions of government's attitude towards the profession and changes to patient services. It is notable that patient care was almost completely absent from the discussion, a reflection that our profession has not embraced patient-centred care. This also represents a missed opportunity - a crisis that could have been used to move the profession towards the Blueprint's vision. We thought that the Blueprint had already achieved this consensus, but the Ontario experience has shown that this may not be the case.

Using participatory epidemiology to assess factors contributing to common enteric pathogens in Ontario: results from a workshop held at the Ontario Veterinary College, University of Guelph, Ontario

PubMed Central

2014-01-01

Background Common enteric pathogens that cause gastrointestinal illness are transmitted to humans through food, water or direct contact. This poses a significant concern to public health as enteric pathogens can cause disease in a large number of people, and cost a substantial amount to treat and prevent. In order to gain a better understanding of the occurrence of enteric disease in Ontario, this study explored public health professionals’ perceptions of major contributing factors for common enteric pathogens. Methods A case study was conducted as part of a two week training workshop in Participatory Epidemiology held at the Ontario Veterinary College, University of Guelph, in May 2013. Eight semi-structured interviews and four focus groups were conducted with representatives from the Public Health Agency of Canada, the University of Guelph, and three health regions in Southern Ontario. Written notes and pictures captured the qualitative information provided. Results were then analyzed using the mixed methods techniques of triangulation, convergence, and paradox. Results A total of fifty factors that contribute to enteric disease were identified across all interviews and focus groups. These contributing factors were grouped into key themes (travel, food handling, industry (farm-to-fork), water, geography, demographics, and behaviours) and were categorized as either a risk factor or susceptibility factor. Informants emphasized the complex relationships between the identified factors, and highlighted why these complexities make it difficult to determine where and how a person most likely acquired an enteric pathogen. Workshop participants observed differences in the type and quality of information collected during interviews and focus groups; we hypothesize that this may be attributed to the dynamics between group members (i.e. focus group discussions) as opposed to one-on-one interviews. Conclusions The information gathered will serve as a starting point to further explore contributing factors for common enteric pathogens. The identified complexities would be best explored by conducting additional surveillance, as well as interviews and focus groups with a more diverse group of stakeholders. This type of qualitative study can enhance knowledge of enteric pathogen surveillance and contribute to the development of resources and initiatives to holistically address the occurrence of gastrointestinal illness. PMID:24767430

Mortality among patients with hypertension from 1995 to 2005: a population-based study

PubMed Central

Tu, Karen; Chen, Zhongliang; Lipscombe, Lorraine L.

2008-01-01

Background We have reported that the prevalence of diagnosed hypertension increased by 60% from 1995 to 2005 in Ontario. In the present study, we asked whether this increase is explained by a decrease in the mortality rate. Methods We performed a population-based cohort study using linked administrative data for Ontario, a Canadian province with over 12 million residents. We identified prevalent cases of hypertension using a validated case-definition algorithm for hypertension, and we examined trends in mortality from 1995 to 2005 among adults aged 20 years and older with hypertension. Results The age-and sex-adjusted mortality among patients with hypertension decreased from 11.3 per 1000 people in 1995 to 9.6 per 1000 in 2005 (p < 0.001), which is a relative reduction of 15.5%. We found that the relative decrease in age-adjusted mortality was higher among men than among women (–22.2% v. –7.3%, p < 0.001). Interpretation Mortality rates among patients with hypertension have decreased. Along with an increasing incidence, decreased mortality rates may contribute to the increased prevalence of diagnosed hypertension. Sex-related discrepancies in the reduction of mortality warrant further investigation. PMID:18490639

Mortality among patients with hypertension from 1995 to 2005: a population-based study.

PubMed

Tu, Karen; Chen, Zhongliang; Lipscombe, Lorraine L

2008-05-20

We have reported that the prevalence of diagnosed hypertension increased by 60% from 1995 to 2005 in Ontario. In the present study, we asked whether this increase is explained by a decrease in the mortality rate. We performed a population-based cohort study using linked administrative data for Ontario, a Canadian province with over 12 million residents. We identified prevalent cases of hypertension using a validated case-definition algorithm for hypertension, and we examined trends in mortality from 1995 to 2005 among adults aged 20 years and older with hypertension. The age- and sex-adjusted mortality among patients with hypertension decreased from 11.3 per 1000 people in 1995 to 9.6 per 1000 in 2005 (p < 0.001), which is a relative reduction of 15.5%. We found that the relative decrease in age-adjusted mortality was higher among men than among women (-22.2% v. -7.3%, p < 0.001). Mortality rates among patients with hypertension have decreased. Along with an increasing incidence, decreased mortality rates may contribute to the increased prevalence of diagnosed hypertension. Sex-related discrepancies in the reduction of mortality warrant further investigation.

Effectiveness of the Revised Ontario School Record System.

ERIC Educational Resources Information Center

Humphreys, Edward H.; Elwood, Bryan C.

Results of a study conducted for the Ministry of Education (Ontario) and designed to evaluate the effectiveness of the Ontario School Record System (OSR) as revised in 1973 are reported in this paper. In order to evaluate the OSR's effectiveness, the study team examined educators', parents and students' perceived needs for student information,…

Pediatric fire deaths in Ontario

PubMed Central

Chen, Yingming Amy; Bridgman-Acker, Karen; Edwards, Jim; Lauwers, Albert Edward

2011-01-01

Abstract Objective To identify the predictors of residential fire deaths in the Ontario pediatric population using systematically collected data from the Office of the Chief Coroner. Design Retrospective cohort study. Setting Ontario. Participants Children younger than 16 years of age who died in accidental residential fires in Ontario between January 1, 2001, and December 31, 2006. Main outcome measures The study retrospectively reviewed the coroner’s case files for 60 subjects who qualified according to the selection criteria. Reviewed documents included the coroner’s investigation statements, autopsy reports, toxicology reports, fire marshal’s reports, police reports, and Children’s Aid Society (CAS) reports. Information on a range of demographic, behavioural, social, and environmental factors was collected. Statistical tests, including relative risk, relative risk confidence intervals, and χ2 tests were performed to determine the correlation between factors of interest and to establish their significance. Results Thirty-nine fire events resulting in 60 deaths occurred between 2001 and 2006. Fire play and electrical failures were the top 2 causes of residential fires. More fires occurred during the night (midnight to 9 am) than during the day (9 am to midnight). Nighttime fires were most commonly due to electrical failures or unattended candles, whereas daytime fires were primarily caused by unsupervised fire play and stove fires. Smoke alarms were present at 32 of 39 fire events (82%), but overall alarm functionality was only 54%. Children from families with a history of CAS involvement were approximately 32 times more likely to die in fires. Conclusion Risk factors for pediatric fire death in Ontario include smoke alarm functionality, fire play, fire escape behaviour, and CAS involvement. Efforts to prevent residential fire deaths should target these populations and risk factors, and primary care physicians should consider education around these issues as a primary preventive strategy for families with young children. PMID:21571705

Consumption of Lake Ontario Sport Fish and the Incidence of Colorectal Cancer in the New York State Angler Cohort Study (NYSACS)

PubMed Central

Callahan, Catherine L.; Vena, John E.; Green, Joseph; Swanson, Mya; Mu, Lina; Bonner, Matthew R.

2017-01-01

Fish consumption is hypothesized to reduce the risk of colorectal cancer. Nonetheless, consuming sport fish from the Great Lakes increases exposure to certain persistent organic pollutants, namely polychlorinated biphenyls (PCBs) and organochlorine insecticides, which may increase the risk of cancer. Evidence that exposure to persistent organic pollutants is associated with colorectal cancer is sparse. We examined colorectal cancer incidence in the New York State Angler Cohort Study (NYSACS), a prospective cohort of 17,110 anglers and spouses aged 18 to 40 years at enrollment. In 1991, participants completed a mailed self-administered questionnaire that ascertained the number of years that fish from Lake Ontario were consumed, as well as potential confounders. Forty-one histologically confirmed first primary incident colorectal cancers diagnosed as of December 31, 2008 were identified via the New York State Cancer Registry. Vital status was ascertained by linkage with the Social Security Administration Death File. Rate ratios (RR) and 95% confidence intervals (CI) were calculated with Poisson regression, adjusting for age, pack-years of smoking, and sex. Compared with never consumers, colorectal cancer incidence was statistically non-significantly lower among consumers of Lake Ontario sport fish (RR = 0.66; 95% CI: 0.35; 1.24). Incidence of colon cancer was lower among Lake Ontario fish consumers (RR = 0.45, 95%CI: 0.20; 1.00). We did not observe any evidence of effect measure modification by sex or age. Although consumption of Lake Ontario sport fish may have an inverse association with colorectal cancer risk, inferences are complicated by a small number of cases and a lack of information regarding potential confounders including other dietary factors. However, our results do not provide support for the hypothesis that consumption of contaminated sport fish increases the risk of colorectal cancer. PMID:28040638

Risk of colorectal cancer among immigrants to Ontario, Canada.

PubMed

Paszat, Lawrence; Sutradhar, Rinku; Liu, Ying; Baxter, Nancy N; Tinmouth, Jill; Rabeneck, Linda

2017-07-06

The risk of colorectal cancer (CRC) varies around the world and between females and males. We aimed to compare the risk of CRC among immigrants to Ontario, Canada, to its general population. We used an exposure-control matched design. We identified persons in the Immigration, Refugees and Citizenship Canada Permanent Resident Database with first eligibility for the Ontario Health Insurance Plan between July 1, 1991 and June 30, 2008 at age 40 years or older, and matched five controls by year of birth and sex on the immigrant's first eligibility date. We identified CRC from the Ontario Cancer Registry between the index date and December 31, 2014. All analyses were stratified by sex. We calculated crude and relative rates of CRC. We estimated risk of CRC over time by the Kaplan-Meier method and compared immigrants to controls in age and sex stratified strata using log-rank tests. We modeled the hazard of CRC using Cox proportional hazards regression, accounting for within-cluster correlation by a robust sandwich variance estimation approach, and assessed an interaction with time since eligibility. Among females, 1877 cases of CRC were observed among 209,843 immigrants, and 16,517 cases among 1,049,215 controls; the crude relative rate among female immigrants was 0.623. Among males, 1956 cases of CRC were observed among 191,792 immigrants and 18,329 cases among 958,960 controls; the crude relative rate among male immigrants was 0.582.. Comparing immigrants to controls in all age and sex stratified strata, the log rank test p < 0.0001 except for females aged > = 75 years at index, where p = 0.01. The age-adjusted hazard ratio (HR) for CRC among female immigrants was 0.63 (95% CI 0.59, 0.67) during the first 10 years, and 0.66 (95% CI 0.59, 0.74) thereafter. Among male immigrants the age-adjusted HR = 0.55 (95% CI 0.52, 0.59) during the first 10 years and increased to 0.63 (95% CI 0.57, 0.71) thereafter. The adjusted HR > = 1 only among immigrants born in Europe and Central Asia. The risk of CRC among immigrants to Ontario relative to controls varies by origin and over time since immigration.

Once the Beat Gets Going It Really Grooves: Informal Music Learning as Experienced by Two Irish Traditional Musicians

ERIC Educational Resources Information Center

Waldron, Janice

2007-01-01

The purpose of this ethnographic case study was to discover the manner in which two Irish musicians, Loretto Reid and Brian Taheny, taught/and or transmitted traditional music at the Celtic College Summer School in Goderich, Ontario. Two central questions, each followed by several sub-questions, served to focus the study: "How did you learn…

Reading the Urban Landscape: The Case of a Campus Tour at York University, Toronto, Ontario, Canada

ERIC Educational Resources Information Center

Bardekjian, Adrina; Classens, Michael; Sandberg, L. Anders

2012-01-01

This paper presents a campus tour assignment in a first-year undergraduate environmental studies course at York University, Toronto, Canada. As a pedagogical tool, the assignment enables students to interrogate the dominant narratives of a university's immediate physical spaces and to apply broader theoretical and practical concepts to their…

"Great Chorus of Protest": A Case Study of Conflict over the 1909 Eaton's Readers

ERIC Educational Resources Information Center

Clark, Penney

2009-01-01

This article examines the controversy that ensued when the Education Department of the province of Ontario, Canada, granted the tender to publish elementary school readers to the T. Eaton Company, a department store, in 1909. This decision eliminated an important source of income for retail booksellers, who could not compete with the consumer…

Challenging Fundraising, Challenging Inequity: Contextual Constraints on Advocacy Groups' Policy Influence

ERIC Educational Resources Information Center

Winton, Sue

2018-01-01

School fundraising is known to reproduce inequities in schools, yet it remains common practice in Ontario, Canada; findings from a critical policy analysis of an advocacy group's efforts to change fundraising policy help explain why this is the case. Adopting a discursive understanding of policy, the study used rhetorical analysis to identify how…

Implementing the General Education Development (GED) Program in First Nations Communities: Struggles for Power

ERIC Educational Resources Information Center

Shields, Tracy Jill; Melville, Wayne

2015-01-01

This paper describes an ethnographic case study of eleven First Nations adult learners in a Northern Ontario community attempting to earn secondary school equivalency through the General Education Development (GED) program. The paper maintains a focus on the power differentials at work in both the learners' prior educational endeavours and their…

Epidemiology of multiple sclerosis in London and Middlesex County, Ontario, Canada.

PubMed

Hader, W J; Elliot, M; Ebers, G C

1988-04-01

A case-controlled epidemiologic study of multiple sclerosis (MS) was carried out in London, Ontario, and its surrounding Middlesex County for the period 1974-1983. The prevalence rates for clinically definite/probable MS on January 1, 1984 were 94/100,000 for the city and 91/100,000 for the county. The estimated annual incidence rate for the decade 1974-83 was 3.4/100,000. The female-to-male sex ratio was 2.5:1. A familial history of MS was recorded in 14.4% of close relatives and a total of 17% when distant relatives are included. The MS group is predominantly of British (70%) and European (23%) origin. The urban-rural residence pattern analysis indicates no significant regional influence on the risk of developing MS.

Resurgence of leptospirosis in dogs in Ontario: recent findings

PubMed Central

Prescott, John F.; McEwen, Beverly; Taylor, Judith; Woods, J. Paul; Abrams-Ogg, Anthony; Wilcock, Brian

2002-01-01

A marked increase in leptospirosis in dogs was observed in 2000, part of an increasing trend observed in previous years in Ontario. The highest frequency of seropositive cases occurred from September to December 2000, with the peak in November. Large breed dogs were particularly affected. Clinical and clinicopathological data for 31 dogs admitted between 1998 and 2000 to the Ontario Veterinary College Veterinary Teaching Hospital were analyzed. Major clinical presenting features were acute onset of anorexia, depression, fever, and vomiting. Ninety percent of dogs, on admission, showed biochemical evidence of injury to several organs, notably combinations in the order of kidney, muscle, pancreas, and liver. Almost all dogs showed increased serum urea and creatinine levels, and the majority had increased total creatine kinase, bilirubin, alkaline phosphatase, and leukocytosis with neutrophilia. One-third were thrombocytopenic. Of dogs with liver-related abnormalities, most had evidence of cholestasis, with or without hepatocellular damage. Based on serologic studies, in the year 2000, the major serovar involved was autumnalis, but bratislava, grippotyphosa, and pomona were also implicated. The microscopic agglutination test often gave a confusing pattern of reactivities to the serovars that were tested. The high reactivity to serovar autumnalis may represent an erroneous or “paradoxical” reaction typical of early leptospiral serology. The year 2000 was the warmest in Ontario in each of the 4 fall months (September–December) of the previous decade, as well as being the third wettest in the fall period in the last decade. The increase in canine leptospirosis, therefore, may, in part, reflect climate change. The number of positive cases declined in 2001 by about one-third of those in 2000, but the number of submissions of sera for diagnosis increased markedly over previous years. Further work is required to isolate and to identify definitively serovars involved in resurgent canine leptospirosis and the common sources for dogs. PMID:12561690

Money left on the table: generic drug prices in Canada.

PubMed

Law, Michael R

2013-02-01

Generic drugs are a major cost-saving opportunity for patients and drug plans. While almost every province has reduced generic drug prices, we have no information on whether these new prices are internationally competitive. Therefore, I compared Canadian prices to those in two other countries. I used 2009 data from the IMS Brogan Canadian CompuScript and PharmaStat databases and studied the 100 most frequently dispensed generic products in Ontario, which has Canada's lowest generic prices. I compared these prices to those in public drug programs in the United States and New Zealand that use tendering. Using these alternative prices, I calculated the potential savings in Ontario. Of the top 100 generic products, 82 were listed on an international formulary. In 90% of cases, generic products were less expensive in other countries. If Ontario had obtained the lowest comparator price for these products, the annual public sector and overall drug expenditure savings would have been $129 million and $245 million, respectively. Further, the province could have publicly paid for all these generic drugs - both public and private - and saved $87 million compared to current public sector expenditures. Even after recent reforms, generic drug prices in Canada remain high by international standards. I found that if Ontario had obtained commonly used generic drugs at international best prices, the province could have publicly paid for all generic drugs and lowered annual expenditures by nearly a quarter-billion dollars. Copyright © 2013 Longwoods Publishing.

Money Left on the Table: Generic Drug Prices in Canada

PubMed Central

Law, Michael R.

2013-01-01

Background: Generic drugs are a major cost-saving opportunity for patients and drug plans. While almost every province has reduced generic drug prices, we have no information on whether these new prices are internationally competitive. Therefore, I compared Canadian prices to those in two other countries. Methods: I used 2009 data from the IMS Brogan Canadian CompuScript and PharmaStat databases and studied the 100 most frequently dispensed generic products in Ontario, which has Canada's lowest generic prices. I compared these prices to those in public drug programs in the United States and New Zealand that use tendering. Using these alternative prices, I calculated the potential savings in Ontario. Results: Of the top 100 generic products, 82 were listed on an international formulary. In 90% of cases, generic products were less expensive in other countries. If Ontario had obtained the lowest comparator price for these products, the annual public sector and overall drug expenditure savings would have been $129 million and $245 million, respectively. Further, the province could have publicly paid for all these generic drugs – both public and private – and saved $87 million compared to current public sector expenditures. Discussion: Even after recent reforms, generic drug prices in Canada remain high by international standards. I found that if Ontario had obtained commonly used generic drugs at international best prices, the province could have publicly paid for all generic drugs and lowered annual expenditures by nearly a quarter-billion dollars. PMID:23968624

The effect of the Ontario Bariatric Network on health services utilization after bariatric surgery: a retrospective cohort study

PubMed Central

Elnahas, Ahmad; Jackson, Timothy D.; Okrainec, Allan; Austin, Peter C.; Bell, Chaim M.; Urbach, David R.

2016-01-01

Background: In 2009, the Ontario Bariatric Network was established to address the exploding demand by Ontario residents for bariatric surgery services outside Canada. We compared the use of postoperative hospital services between out-of-country surgery recipients and patients within the Ontario Bariatric Network. Methods: We conducted a population-based, comparative study using administrative data held at the Institute for Clinical Evaluative Sciences. We included Ontario residents who underwent bariatric surgery between 2007 and 2012 either outside the country or at one of the Ontario Bariatric Network's designated centres of excellence. The primary outcome was use of hospital services in Ontario within 1 year after surgery. Results: A total of 4852 patients received bariatric surgery out of country, and 5179 patients underwent surgery through the Ontario Bariatric Network. After adjustment, surgery at a network centre was associated with a significantly lower utilization rate of postoperative hospital services than surgery out of country (rate ratio 0.90, 95% confidence interval [CI] 0.84 to 0.97). No statistically significant differences were found with respect to time in critical care or mortality. However, the physician assessment and reoperation rates were significantly higher among patients who received surgery at a network centre than among those who had bariatric surgery out of country (rate ratio 4.10, 95% CI 3.69 to 4.56, and rate ratio 1.84, 95% CI 1.34 to 2.53, respectively). Interpretation: The implementation of a comprehensive, multidisciplinary provincial program to replace outsourcing of bariatric surgical services was associated with less use of postoperative hospital services by Ontario residents undergoing bariatric surgery. Future research should include an economic evaluation to determine the costs and benefits of the Ontario Bariatric Network. PMID:27730113

Ontario pharmacists' crisis over Bill 16: A missed opportunity?

PubMed Central

Rosenthal, Meagen; Austin, Zubin; Tsuyuki, Ross T.

2012-01-01

Introduction: In 2010, the Ontario government brought forward Bill 16, which, among other things, removed pharmacists' professional allowances. While many would disagree with this unilateral action by the Ontario government, it also could have served as a crisis for change towards patient-centred care. We sought to examine the response of the pharmacy profession in Ontario to this crisis as it relates to the vision outlined in the Blueprint for Pharmacy. Methods: We systematically examined publicly available responses to Schedule 5 of Ontario's Bill 16 during the period from April to June 16, 2010. A rapid textual analysis of the data using tag or word clouds and a qualitative content analysis were performed on all of the data collected. Results: The rapid textual analysis revealed that the most frequently used terms were “pharmacist,” “pharmacy” and “professional allowances”; the least used were “layoffs,” “service cuts” and “patient care.” Content analysis revealed 4 themes: the desire to maintain the status quo of practice, a focus on the business of pharmacy, pharmacy stakeholders' perceptions of government's attitude towards the profession and changes to patient services. Discussion: It is notable that patient care was almost completely absent from the discussion, a reflection that our profession has not embraced patient-centred care. This also represents a missed opportunity — a crisis that could have been used to move the profession towards the Blueprint's vision. We thought that the Blueprint had already achieved this consensus, but the Ontario experience has shown that this may not be the case. PMID:23509486

The law and ethics in relation to dentists treating HIV-positive patients: two recent court cases.

PubMed

Graham, P E; Miller, N M; Harel-Raviv, M

1995-06-01

Two recent Canadian judgements regarding the application of human rights legislation to dentistry and HIV-seropositive patients are summarized and discussed. In the Ontario case of Jerome v. DeMarco, the Ontario Human Rights tribunal found that seropositivity constitutes a "handicap" under human rights legislation. However, the tribunal dismissed the claim by a seropositive patient that he had been illegally discriminated against by a dentist who, on learning the patient was seropositive, delayed treating him until the end of the day. This decision served as a precedent in the lengthy Quebec small claims court judgment of Hamel v. Malaxos. In this case, the dentist was held to have violated Quebec human rights legislation by trying to refer an HIV-seropositive patient to a hospital treatment centre rather than performing the appropriate dental treatment himself. Court judgments regarding this problem are reported and discussed.

Suicide by Fatal Pentobarbital Intoxication in Ontario, Canada, from 2012 to 2015.

PubMed

Solbeck, Patricia; Snowdon, Victoria; Rajagopalan, Ashwyn; Jhirad, Reuven

2018-05-24

A fatal concentration of pentobarbital found in a coroner's case where the history had not indicated use of this drug prompted a review of fatalities in Ontario from 2012 to 2015. Coroner's case files, including police and toxicology reports, were reviewed in twenty deaths, in which pentobarbital was identified as the primary cause of death. In all of the deaths (11 females, 9 males), the blood concentration of pentobarbital was greater than 10 mg/L. There were three to eight deaths per year and each was classified as suicide. In 11 cases, there was clear evidence that the drug was purchased over the internet from Mexico or China and imported into Canada. In four cases, it appears that the pentobarbital was labeled as a different, innocuous chemical to facilitate crossing the border without scrutiny. The findings underscore the value of a thorough scene investigation, including details of evidence that may be considered unrelated. © 2018 American Academy of Forensic Sciences.

Administrator and Teachers' Perceptions of School Success in a Publicly Funded Catholic School in Ontario, Canada

ERIC Educational Resources Information Center

Pollock, Katina

2013-01-01

School success is a complex and abstract notion. Asking questions about what is meant by school success is important, since the ways in which educators and administrators define school success tends to guide their practice, and may have implications for current and future policy initiatives. This qualitative case study explores how one publicly…

Canadian experiences in development of critical loads for sulphur and nitrogen

Treesearch

Shaun Watmough; Julian Aherne; Paul Arp; Ian DeMerchant; Rock Ouimet

2006-01-01

Critical loads are a broad-scale modelling approach designed to assess the potential risk of pollutants to ecosystems. A description of the methodology for estimating critical loads (sulphur and nitrogen) for acid deposition (CL(A)) for upland forests in eastern Canada is presented, using a case study in central Ontario. In eastern Canada, CL(A) have been calculated...

Broadening Educational Practice to Include Translanguaging: An Outcome of Educator Inquiry into Multilingual Students' Learning Needs

ERIC Educational Resources Information Center

Van Viegen Stille, Saskia; Bethke, Robin; Bradley-Brown, Jackie; Giberson, Janet; Hall, Gillian

2016-01-01

This paper reports research findings relating to a recent initiative to build capacity and support professional learning among educators to meet the needs of English language learners in Ontario schools. Drawing on data from case studies of educator teams in 16 school districts, the paper explores whether and how collaborative inquiry promoted…

System Alignment and Consensus Discourses in Reforms: "School Effectiveness Frameworks and Instructional Rounds." Philosophical Responses with Oakeshott, Mouffe and Rancière

ERIC Educational Resources Information Center

Stickney, Jeff

2015-01-01

In this commentary 26-year Ontario district teacher, Jeff Stickney, begins by surveying balanced approaches to large- and small-scale education reforms: contrasting linear alignment with more complex ecological models, drawing on recent work by Andy Hargreaves (2008; Hargreaves & Shirley, 2012). Next, through a brief case study of School…

A Case Study on Environmental Perspectives of Boulderers and Access Issues at the Niagara Glen Nature Reserve

ERIC Educational Resources Information Center

Thompson, Jeremy; Davidson, Justin; Hutson, Garrett

2008-01-01

Currently, there are concerns about access restrictions to bouldering, a form of rock climbing, and other outdoor activities practiced at the Niagara Glen Nature Reserve located near Niagara Falls, Ontario, Canada. The Niagara Parks Commission is currently in the process of exploring ways to balance protection of the natural area with sustainable…

Bayridge Secondary School: A Case Study of the Planning and Implementation of Educational Change.

ERIC Educational Resources Information Center

Eastabrook, Glen; And Others

This is an account of the planning and implementation processes of a new secondary school (Bayridge Secondary School), located in a suburban area of a medium-sized city in Ontario, Canada. This report traces the planning and development of the school's goals, which included involvement of the entire school community, from 1970 through 1974. The…

Ontario appellate court overturns judgment for plaintiffs infected through tainted blood.

PubMed

Elliott, Richard

2002-03-01

On 29 November 2001, the Ontario Court of Appeal issued a lengthy decision overturning a lower-court judgment in favour of three hemophiliacs infected with HIV in 1985 through contaminated blood-factor concentrate. The joint decision in the three cases of Robb, Rintoul, and Farrow is the latest decision in litigation dating back to 1992. The plaintiffs alleged negligence by the Canadian Red Cross Society and the Canadian government for delays in introducing heat-treated concentrate after the risks posed by unheated product were known.

Direct medical costs of motorcycle crashes in Ontario

PubMed Central

Pincus, Daniel; Wasserstein, David; Nathens, Avery B.; Bai, Yu Qing; Redelmeier, Donald A.; Wodchis, Walter P.

2017-01-01

BACKGROUND: There is no reliable estimate of costs incurred by motorcycle crashes. Our objective was to calculate the direct costs of all publicly funded medical care provided to individuals after motorcycle crashes compared with automobile crashes. METHODS: We conducted a population-based, matched cohort study of adults in Ontario who presented to hospital because of a motorcycle or automobile crash from 2007 through 2013. For each case, we identified 1 control absent a motor vehicle crash during the study period. Direct costs for each case and control were estimated in 2013 Canadian dollars from the payer perspective using methodology that links health care use to individuals over time. We calculated costs attributable to motorcycle and automobile crashes within 2 years using a difference-in-differences approach. RESULTS: We identified 26 831 patients injured in motorcycle crashes and 281 826 injured in automobile crashes. Mean costs attributable to motorcycle and automobile crashes were $5825 and $2995, respectively (p < 0.001). The rate of injury was triple for motorcycle crashes compared with automobile crashes (2194 injured annually/100 000 registered motorcycles v. 718 injured annually/100 000 registered automobiles; incidence rate ratio [IRR] 3.1, 95% confidence interval [CI] 2.8 to 3.3, p < 0.001). Severe injuries, defined as those with an Abbreviated Injury Scale ≥ 3, were 10 times greater (125 severe injuries annually/100 000 registered motorcycles v. 12 severe injuries annually/100 000 registered automobiles; IRR 10.4, 95% CI 8.3 to 13.1, p < 0.001). INTERPRETATION: Considering both the attributable cost and higher rate of injury, we found that each registered motorcycle in Ontario costs the public health care system 6 times the amount of each registered automobile. Medical costs may provide an additional incentive to improve motorcycle safety. PMID:29158454

Nurse case management: negotiating care together within a developing relationship.

PubMed

Yamashita, Mineko; Forchuk, Cheryl; Mound, Bronwyn

2005-01-01

TOPIC/PROBLEM: The purpose of this study was to explicate the process of nurse case management involving clients afflicted with chronic mental illness. Grounded theory was the method of choice. Interviews were conducted with nurses in inpatient, transitional, and community settings in four cities in southern Ontario, Canada. Negotiating care together within a developing relationship emerged as the basic social process. "Building a trusting relationship" was identified as the foundation of case management. Salient differences were found between the three settings, yet the basic social process was consistent across settings. This underscores the therapeutic relationship as the basis for nurse psychiatric case management.

Milestones on the social accountability journey: Family medicine practice locations of Northern Ontario School of Medicine graduates.

PubMed

Hogenbirk, John C; Timony, Patrick E; French, Margaret G; Strasser, Roger; Pong, Raymond W; Cervin, Catherine; Graves, Lisa

2016-03-01

To assess the effect of different levels of exposure to the Northern Ontario School of Medicine's (NOSM's) distributed medical education programs in northern Ontario on FPs' practice locations. Cross-sectional design using longitudinal survey and administrative data. Canada. All 131 Canadian medical graduates who completed FP training in 2011 to 2013 and who completed their undergraduate (UG) medical degree or postgraduate (PG) residency training or both at NOSM. Exposure to NOSM's medical education program at the UG (n = 49) or PG (n = 31) level or both (n = 51). Primary practice location in September of 2014. Approximately 16% (21 of 129) of FPs were practising in rural northern Ontario, 45% (58 of 129) in urban northern Ontario, and 5% (7 of 129) in rural southern Ontario. Logistic regression found that more rural Canadian background years predicted rural practice in northern Ontario or Ontario, with odds ratios of 1.16 and 1.12, respectively. Northern Canadian background, sex, marital status, and having children did not predict practice location. Completing both UG and PG training at NOSM predicted practising in rural and northern Ontario locations with odds ratios of 4.06 to 48.62. Approximately 61% (79 of 129) of Canadian medical graduate FPs who complete at least some of their training at NOSM practise in northern Ontario. Slightly more than a quarter (21 of 79) of these FPs practise in rural northern Ontario. The FPs with more years of rural background or those with greater exposure to NOSM's medical education programs had higher odds of practising in rural northern Ontario. This study shows that NOSM is on the road to reaching one of its social accountability milestones.

Prevalence, Recurrence, and Incidence of Current Depressive Symptoms among People Living with HIV in Ontario, Canada: Results from the Ontario HIV Treatment Network Cohort Study.

PubMed

Choi, Stephanie K Y; Boyle, Eleanor; Cairney, John; Collins, Evan J; Gardner, Sandra; Bacon, Jean; Rourke, Sean B

2016-01-01

Current studies of depression among people living with HIV focus on describing its point prevalence. Given the fluctuating nature of depression and its profound impacts on clinical and quality-of-life outcomes, this study aimed to examine the prevalence, recurrence and incidence of current depressive symptoms and its underlying catalysts longitudinally and systematically among these individuals. We conducted a prospective cohort study between October 1, 2007 and December 31, 2012 using longitudinal linked data sources. Current depressive symptoms was identified using the Centre for Epidemiologic Studies Depression Scale or the Kessler Psychological Distress Scale, first at baseline and again during follow-up interviews. Multivariable regressions were used to characterize the three outcomes. Of the 3,816 HIV-positive participants, the point prevalence of depressive symptoms was estimated at 28%. Of the 957 participants who were identified with depressive symptoms at baseline and who had at least two years of follow-up, 43% had a recurrent episode. The cumulative incidence among 1,745 previously depressive symptoms free participants (at or prior to baseline) was 14%. During the five-year follow-up, our multivariable models showed that participants with greater risk of recurrent cases were more likely to feel worried about their housing situation. Participants at risk of developing incident cases were also likely to be younger, gay or bisexual, and unable to afford housing-related expenses. Depressive symptoms are prevalent and likely to recur among people living with HIV. Our results support the direction of Ontario's HIV/AIDS Strategy to 2026, which addresses medical concerns associated with HIV (such as depression) and the social drivers of health in order to enhance the overall well-being of people living with or at risk of HIV. Our findings reinforce the importance of providing effective mental health care and demonstrate the need for long-term support and routine management of depression, particularly for individuals at high risk.

Development and Use of Performance Appraisal of Certificated Education Staff in Ontario School Boards. Volume IV: Non-Technical Report. Professionalism in Schools Series.

ERIC Educational Resources Information Center

Lawton, S. B.; And Others

This report, the fourth and final volume of a series, examines in a summary fashion the results from a massive study of performance appraisal policies and procedures currently used in Ontario school boards. The study, a two-year undertaking, focused on appraisal practices for certified educational personnel in Ontario: teachers, principals,…

Paediatric meningococcaemia in northwestern Ontario, Canada: a case for publicly funded meningococcal B vaccination

PubMed Central

Tsang, Raymond S. W.; Ulanova, Marina

2016-01-01

Introduction: Neisseria meningitidis serogroup B is an important infectious agent in developed countries, including Canada. Infants are particularly susceptible to infection with serogroup B because of immature immune systems, pathogen virulence factors and changing serogroup dynamics in the post-vaccination era. Currently, the Ontario provincial government does not include serogroup B in its routine publicly funded meningococcal vaccination program. Case Presentation: A formerly well 14-month-old male presented to a tertiary hospital emergency department with fever, minor respiratory problems, diffuse purpuric rash, distended abdomen, tachycardia, and history of one episode of vomiting and melena each. Meningococcaemia was immediately suspected, and he was treated with ceftriaxone, cefotaxime and vancomycin before transfer to a different acute care facility within 12 h. N. meningitidis serogroup B, sensitive to ceftriaxone and penicillin, was identified in his blood. The patient developed gangrene of the lower legs and underwent bilateral below-knee amputation 8 days post-admission. Conclusion: This instance of meningococcaemia with extensive sequelae is an example of the various serious outcomes of meningococcal infection. It provides persuasive reason for routine publicly funded vaccination against N. meningitidis serogroup B in Ontario. PMID:28348748

Examining Competition in Ontario's Higher Education Market

ERIC Educational Resources Information Center

Farhan, Bayan Yousef

2017-01-01

Financial challenges have forced many publicly funded academic institutions in Ontario to adopt a corporate model and to use market tools to compete in the higher education market and maintain their enrolment and revenue levels. This study has analyzed how competition affects publicly funded universities in Ontario. Competition was examined by…

Meanings of Success and Successful Leadership in Ontario, Canada, in Neo-Liberal Times

ERIC Educational Resources Information Center

Winton, Sue; Pollock, Katina

2016-01-01

The provincial government of Ontario, Canada, has committed itself to raising student achievement, closing achievement gaps, and increasing the public's confidence in public education. It has introduced many policies, including the Ontario Leadership Strategy (OLS), to support these goals. Our study examined how teachers, administrators, support…

Ontario Kindergarten Teachers' Social Media Discussions about Full Day Kindergarten

ERIC Educational Resources Information Center

Lynch, Meghan

2014-01-01

This exploratory netnographic study describes how a sample of Ontario kindergarten teachers perceive the new Ontario Full Day Kindergarten (FDK) curriculum. Discussions from teacher message boards, the comment sections of online news articles, and interviews with kindergarten teachers were analyzed and coded using a qualitative approach. Analysis…

Translating Research into Practice: Establishing a Network of Climate Change Practitioners in Ontario, Canada

NASA Astrophysics Data System (ADS)

Milner, G. A.

2017-12-01

Climate research and information continues to emerge at a rapid pace from the academic and scientific community. Decisions being made today by planners, engineers and staff across the Province of Ontario rely on science and information to plan and build our systems for the long term. Of course, as scientific information evolves continuously to produce lessons learned and new evidence, on the ground decisions often become entrenched in outdated information and need updating. Given this, bridging the gap between research to policy, and research to practice is of critical importance as the Province of Ontario upgrades its infrastructure, plans for long term growth in population within the Great Lakes Basin, and manages its natural systems and resources responsibly. The Ontario Climate Consortium (OCC) is an interdisciplinary network of academics and practitioners established in 2011 in the province that works to mobilize climate research findings towards building capacity, inspiring climate action, and training end-users with the latest science. The OCC has collaborated with more than 39 organizations throughout Ontario and across Canada, including government agencies at all levels (local, provincial and federal), non-profit organizations and private sector companies. This presentation will describe the foundations of climate action in Ontario, Canada including the landscape of climate adaptation practitioners from both public and private organizations. Furthermore, this presentation will feature lessons learned from the OCC network, including: 1) What comprises effective partnerships to undertake climate change adaptation planning for cities; 2) How to build the foundation for capacity at agencies with limited resources or expertise in the climate change field; and 3) How to successfully mobilize complex climate data for end-users to produce usable tools (through a case study research project). The latter will present findings from a two-year research project undertaken with OCC and the City of Vaughan, just northwest of Toronto, which examined vulnerability and risks of climate change to the city's stormwater infrastructure system and produced key tools and information for managers to begin building climate resilience into their planning and operations.

Do case-generic measures of queue performance for bypass surgery accurately reflect the waiting-list experiences of those most urgent?

PubMed

Burstein, Jason; Lee, Douglas S; Alter, David A

2006-02-01

Queue performance is typically assessed using generic measures, which capture the queue in aggregate. The objective of this study was to examine whether case-generic measures of queue performance appropriately reflected the waiting-list experiences of those patients with greatest disease severity. We examined the queue for isolated coronary artery bypass grafting (CABG) in Ontario between April 1993 and March 2000 using data obtained from the Cardiac Care Network. Our primary measure of queue performance was the proportion of patients who received their bypass surgery within their recommended maximum waiting times (%RMWTs) in any given month. We compared case-generic measures of queue performance to case-specific measures of queue performance stratified by urgency level. The queue was largely comprised of elective cases ranging from 73% (1993) to 57%(1999). Urgent patients comprised the minority of the queue ranging from 14% (1993) to 20% (1999). Case-generic month-to-month variations in the percentage of cases completed within RMWTs (an aggregated waiting list measure encompassing the characteristics of all patients in the queue) closely resembled the experiences of elective patients (R2 = 0.81), but conversely, bore little relationship to the waiting-list experiences of those most urgent (R2 = 0.15). Case-generic measures of queue performance for bypass surgery in Ontario were not reflective of the waiting-list experiences of those most urgent. Our results reinforce the concept that urgency-specific waiting list monitoring systems are required to best evaluate and appropriately respond to fluctuations in queue performance.

Factors affecting recruitment and retention of rehabilitation professionals in Northern Ontario, Canada: a cross-sectional study.

PubMed

Winn, C S; Chisholm, B A; Hummelbrunner, J A

2014-01-01

Historically, Northern Ontario, Canada, has been an underserviced area for health care, including the rehabilitation professions of occupational therapy, physiotherapy, speech-language pathology and audiology. The Rehabilitation Studies and Northern Studies Stream programs were created in the 1990s to improve the recruitment and retention of rehabilitation professionals to Northern Ontario. However, no recent research has been conducted examining the factors that lead to rehabilitation professionals relocating to and remaining in the region. A cross-sectional survey of rehabilitation professionals living and working in Northern Ontario was administered in 2009. Information collected included demographics and a rating of the personal and professional factors that had an impact on an individual's decision to continue living and working in Northern Ontario. A total of 345 individuals completed the survey (response rate 57%). Multiple personal and professional factors were closely linked to recruitment and retention with differences noted between those individuals originally from Northern Ontario and those who were not. Rural or remote education experiences and rural/remote origin were identified as important recruitment factors while job satisfaction and lifestyle options were important factors for retention of rehabilitation professionals to rural and remote areas of practice. This study has provided updated information specific to the recruitment and retention of rehabilitation professionals in Northern Ontario, Canada. These findings support previous work examining health professions worldwide and have clear implications for educational programs, funding agencies, and health human resource planning in underserviced areas.

Review of Ice-Control Methods at Lock 8, Welland Canal, Port Colborne, Ontario

DTIC Science & Technology

2016-05-01

ER D C/ CR RE L SR -1 6- 1 Review of Ice-Control Methods at Lock 8, Welland Canal, Port Colborne, Ontario Co ld R eg io ns R es ea rc... Lock 8, Welland Canal, Port Colborne, Ontario Robert B. Haehnel U.S. Army Engineer Research and Development Center (ERDC) Cold Regions Research and...CRREL and the St. Lawrence Seaway Management Corporation C-15-CRL-15, “ Lock 8 Ice Management Study, Lake Erie Port Colborne, Ontario, Canada

Prion protein genotypes of sheep as determined from 3343 samples submitted from Ontario and other provinces of Canada from 2005 to 2012

PubMed Central

Cameron, Colin; Bell-Rogers, Patricia; McDowall, Rebeccah; Rebelo, Ana R.; Cai, Hugh Y.

2014-01-01

This study analyzed sheep prion protein (PrP) genotypes of samples submitted from Ontario and other provinces of Canada to the Animal Health Laboratory at the University of Guelph, Guelph, Ontario, between 2005 and 2012. In Ontario, the proportion of scrapie-resistant sheep increased from 2005 to 2012 as evidenced by an increase in the ARR haplotype. When Canadian provinces (Alberta, Ontario, Quebec, and Nova Scotia) were compared from 2008 to 2012, a high proportion of scrapie-resistant sheep was found in all the provinces. The proportions of resistant sheep were lower in Alberta and Quebec than in Ontario and Nova Scotia. Alberta had higher proportions of susceptible sheep and a higher frequency of VRQ alleles, and Quebec had a higher frequency of the ARQ allele. PMID:25355994

Dementia in Ontario: Prevalence and Health Services Utilization

ERIC Educational Resources Information Center

Tranmer, J. E.; Croxford, R.; Coyte, P. C.

2003-01-01

To understand the impact of ongoing reform of mental health and dementia care in Ontario, an examination of prevalence and health services utilization rates is needed. However, there exists a gap in current prevalence and health services research specific to dementia care in Ontario. The objective of this study was to address these concerns using…

Pedagogical over Punitive: The Academic Integrity Websites of Ontario Universities

ERIC Educational Resources Information Center

Griffith, Jane

2013-01-01

This study is a snapshot of how Ontario universities are currently promoting academic integrity (AI) online. Rather than concentrating on policies, this paper uses a semiotic methodology to consider how the websites of Ontario's publicly funded universities present AI through language and image. The paper begins by surveying each website and…

Endometrial cancer and meat consumption: a case-cohort study.

PubMed

van Lonkhuijzen, Luc; Kirsh, Victoria A; Kreiger, Nancy; Rohan, Thomas E

2011-07-01

Diet plays an important role in the etiology of certain cancers, but there is limited evidence with regard to the association between diet and risk of endometrial cancer. Few prospective studies have investigated meat intake as a potential determinant of endometrial cancer risk. The objective of this study was to examine the association between endometrial cancer risk and total meat, red meat, processed meat, fish, and poultry intake. We conducted a case-cohort analysis within the Canadian Study of Diet, Lifestyle, and Health, a prospective cohort of 73 909 adults (39 614 women). Participants were recruited from 1992 to 1999, predominantly from three Canadian universities. We conducted a linkage with the Ontario Cancer Registry for the years 1992-2007 for the female cohort members, who resided in Ontario at the time of enrollment (n=26 024), to yield data on cancer incidence. The analytic sample was comprised of 107 incident cases and 1830 subcohort members, the latter being an age-stratified sample of the full cohort. A nonsignificant increase in the risk of endometrial cancer was associated with increased consumption of red meat [hazard ratio (HR)=1.62, 95% confidence intervals (CI)=0.86-3.08, for high vs. low intake; P trend=0.13)], processed meat (HR=1.45, 95% CI=0.80-2.61, for high vs. low intake; P trend=0.058), and all meat combined (HR=1.50, 95% CI=0.78-2.89, for high vs. low intake; P trend=0.14). No clear patterns were noted for poultry or fish. The results of this study, although based on a limited number of cases, suggest that relatively high meat intake may be associated with increased risk of endometrial cancer.

An assessment of mumps vaccine effectiveness by dose during an outbreak in Canada

PubMed Central

Deeks, Shelley L.; Lim, Gillian H.; Simpson, Mary Anne; Gagné, Louise; Gubbay, Jonathan; Kristjanson, Erik; Fung, Cecilia; Crowcroft, Natasha S.

2011-01-01

Background This investigation was done to assess vaccine effectiveness of one and two doses of the measles, mumps and rubella (MMR) vaccine during an outbreak of mumps in Ontario. The level of coverage required to reach herd immunity and interrupt community transmission of mumps was also estimated. Methods Information on confirmed cases of mumps was retrieved from Ontario’s integrated Public Health Information System. Cases that occurred between Sept. 1, 2009, and June 10, 2010, were included. Selected health units supplied coverage data from the Ontario Immunization Record Information System. Vaccine effectiveness by dose was calculated using the screening method. The basic reproductive number (R0) represents the average number of new infections per case in a fully susceptile population, and R0 values of between 4 and 10 were considered for varying levels of vaccine effectiveness. Results A total of 134 confirmed cases of mumps were identified. Information on receipt of MMR vaccine was available for 114 (85.1%) cases, of whom 63 (55.3%) reported having received only one dose of vaccine; 32 (28.1%) reported having received two doses. Vaccine effectiveness of one dose of the MMR vaccine ranged from 49.2% to 81.6%, whereas vaccine effectiveness of two doses ranged from 66.3% to 88.0%. If we assume vaccine effectiveness of 85% for two doses of the vaccine, vaccine coverage of 88.2% and 98.0% would be needed to interrupt community transmission of mumps if the corresponding reproductive values were four and six. Interpretation Our estimates of vaccine effectiveness of one and two doses of mumps-containing vaccine were consistent with the estimates that have been reported in other outbreaks. Outbreaks occurring in Ontario and elsewhere serve as a warning against complacency over vaccination programs. PMID:21576295

Nuggets of Wisdom: Salmonella Enteritidis Outbreaks and the Case for New Rules on Uncooked Frozen Processed Chicken.

PubMed

Hobbs, J Leigh; Warshawsky, Bryna; Maki, Anne; Zittermann, Sandra; Murphy, Allana; Majury, Anna; Middleton, Dean

2017-04-01

In 2014 and 2015, three Canadian Salmonella serotype Enteritidis outbreak investigations implicated uncooked, frozen, processed chicken products produced at the same establishment, namely establishment A. In November 2014, a sustained increase in the number of reported domestically acquired Salmonella Enteritidis cases in Ontario led to the first outbreak investigation, which implicated uncooked, frozen, processed chicken products produced at establishment A. In June 2015, the identification of pulsed-field gel electrophoresis patterns that had not been previously reported in Canada led to a national Salmonella Enteritidis investigation. Of 51 cases reported nationally, 35 were from Ontario. Uncooked, frozen, processed chicken products produced at establishment A were identified as the source of the outbreak, and public health action was taken as a result of this second investigation. In September 2015, a sustained increase in the number of domestically acquired Salmonella Enteritidis PT13a cases in Ontario led to a third outbreak investigation, which identified a total of 36 PT13a cases. Uncooked, frozen, processed chicken products produced at establishment A were again identified as the source of the outbreak. Outbreaks have been linked to uncooked, frozen, processed chicken products since the late 1990s. Information collected during the three outbreak investigations, and from other jurisdictions, suggests that the breaded and prebrowned appearance of the product, as well as factors related to product packaging and marketing, result in consumer misperception that this raw product is cooked. This misperception may result in mishandling and improper cooking. The three outbreaks described in this article highlight the potential ongoing risks to consumers from these products and support interventions to prevent contamination at the source level and infection at the consumer level.

Differences in access to services in rural emergency departments of Quebec and Ontario.

PubMed

Fleet, Richard; Pelletier, Christina; Marcoux, Jérémie; Maltais-Giguère, Julie; Archambault, Patrick; Audette, Louis David; Plant, Jeff; Bégin, François; Tounkara, Fatoumata Korika; Poitras, Julien

2015-01-01

Rural emergency departments (EDs) are important safety nets for the 20% of Canadians who live there. A serious problem in access to health care services in these regions has emerged. However, there are considerable geographic disparities in access to trauma center in Canada. The main objective of this project was to compare access to local 24/7 support services in rural EDs in Quebec and Ontario as well as distances to Levels 1 and 2 trauma centers. Rural EDs were identified through the Canadian Healthcare Association's Guide to Canadian Healthcare Facilities. We selected hospitals with 24/7 ED physician coverage and hospitalization beds that were located in rural communities. There were 26 rural EDs in Quebec and 62 in Ontario meeting these criteria. Data were collected from ministries of health, local health authorities, and ED statistics. Fisher's exact test, the t-test or Wilcoxon-Mann-Whitney test, were performed to compare rural EDs of Quebec and Ontario. All selected EDs of Quebec and Ontario agreed to participate in the study. The number of EDs visits was higher in Quebec than in Ontario (19 322 ± 6 275 vs 13 446 ± 8 056, p = 0.0013). There were no significant differences between Quebec and Ontario's local population and small town population density. Quebec's EDs have better access to advance imaging services such as CT scanner (77% vs 15%, p < .0001) and most the consultant support and ICU (92% vs 31%, p < .0001). Finally, more than 40% of rural EDs in Quebec and Ontario are more than 300 km away from Levels 1 and 2 trauma centers. Considering that Canada has a Universal health care system, the discrepancies between Quebec and Ontario in access to support services are intriguing. A nationwide study is justified to address this issue.

Impact of diabetes on healthcare costs in a population-based cohort: a cost analysis.

PubMed

Rosella, L C; Lebenbaum, M; Fitzpatrick, T; O'Reilly, D; Wang, J; Booth, G L; Stukel, T A; Wodchis, W P

2016-03-01

To estimate the healthcare costs attributable to diabetes in Ontario, Canada using a propensity-matched control design and health administrative data from the perspective of a single-payer healthcare system. Incident diabetes cases among adults in Ontario were identified from the Ontario Diabetes Database between 2004 and 2012 and matched 1:3 to control subjects without diabetes identified in health administrative databases on the basis of sociodemographics and propensity score. Using a comprehensive source of administrative databases, direct per-person costs (Canadian dollars 2012) were calculated. A cost analysis was performed to calculate the attributable costs of diabetes; i.e. the difference of costs between patients with diabetes and control subjects without diabetes. The study sample included 699 042 incident diabetes cases. The costs attributable to diabetes were greatest in the year after diagnosis [C$3,785 (95% CI 3708, 3862) per person for women and C$3,826 (95% CI 3751, 3901) for men], increasing substantially for older age groups and patients who died during follow-up. After accounting for baseline comorbidities, attributable costs were primarily incurred through inpatient acute hospitalizations, physician visits and prescription medications and assistive devices. The excess healthcare costs attributable to diabetes are substantial and pose a significant clinical and public health challenge. This burden is an important consideration for decision-makers, particularly given increasing concern over the sustainability of the healthcare system, aging population structure and increasing prevalence of diabetic risk factors, such as obesity. © 2015 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

Institutional Motivations and Barriers to the Construction of Green Buildings on Campus: A Case Study of the University of Waterloo, Ontario

ERIC Educational Resources Information Center

Richardson, Gregory R. A.; Lynes, Jennifer K.

2007-01-01

Purpose: To explore the barriers and motivations to the construction of green buildings at the University of Waterloo (UW) by documenting and analysing the UW building process. Design/methodology/approach: The authors conducted 13 semi-structured in-depth interviews with key UW individuals as well as analyzing numerous internal reports in order to…

More than Nickels and Dimes: The Health Benefits of a Community-Based Lifelong Learning Programme for Older Adults

ERIC Educational Resources Information Center

Narushima, Miya

2008-01-01

In Canada, as in many countries, public continuing education of the non-vocational general interest type for people in post-work languishes on the margins of political discourse. This case study of one such traditional program for seniors run by a school board in Ontario explores the experiences of older adults and the meanings they attach to…

Cost-effectiveness analysis of a system-based approach for managing neonatal jaundice and preventing kernicterus in Ontario

PubMed Central

Xie, Bin; da Silva, Orlando; Zaric, Greg

2012-01-01

OBJECTIVE: To evaluate the incremental cost-effectiveness of a system-based approach for the management of neonatal jaundice and the prevention of kernicterus in term and late-preterm (≥35 weeks) infants, compared with the traditional practice based on visual inspection and selected bilirubin testing. STUDY DESIGN: Two hypothetical cohorts of 150,000 term and late-preterm neonates were used to compare the costs and outcomes associated with the use of a system-based or traditional practice approach. Data for the evaluation were obtained from the case costing centre at a large teaching hospital in Ontario, supplemented by data from the literature. RESULTS: The per child cost for the system-based approach cohort was $176, compared with $173 in the traditional practice cohort. The higher cost associated with the system-based cohort reflects increased costs for predischarge screening and treatment and increased postdischarge follow-up visits. These costs are partially offset by reduced costs from fewer emergency room visits, hospital readmissions and kernicterus cases. Compared with the traditional approach, the cost to prevent one kernicterus case using the system-based approach was $570,496, the cost per life year gained was $26,279, and the cost per quality-adjusted life year gained was $65,698. CONCLUSION: The cost to prevent one kernicterus case using the system-based approach is much lower than previously reported in the literature. PMID:23277747

Just regionalisation: rehabilitating care for people with disabilities and chronic illnesses.

PubMed

Secker, Barbara; Goldenberg, Maya J; Gibson, Barbara E; Wagner, Frank; Parke, Bob; Breslin, Jonathan; Thompson, Alison; Lear, Jonathan R; Singer, Peter A

2006-08-29

Regionalised models of health care delivery have important implications for people with disabilities and chronic illnesses yet the ethical issues surrounding disability and regionalisation have not yet been explored. Although there is ethics-related research into disability and chronic illness, studies of regionalisation experiences, and research directed at improving health systems for these patient populations, to our knowledge these streams of research have not been brought together. Using the Canadian province of Ontario as a case study, we address this gap by examining the ethics of regionalisation and the implications for people with disabilities and chronic illnesses. The critical success factors we provide have broad applicability for guiding and/or evaluating new and existing regionalised health care strategies. Ontario is in the process of implementing fourteen Local Health Integration Networks (LHINs). The implementation of the LHINs provides a rare opportunity to address systematically the unmet diverse care needs of people with disabilities and chronic illnesses. The core of this paper provides a series of composite case vignettes illustrating integration opportunities relevant to these populations, namely: (i) rehabilitation and services for people with disabilities; (ii) chronic illness and cancer care; (iii) senior's health; (iv) community support services; (v) children's health; (vi) health promotion; and (vii) mental health and addiction services. For each vignette, we interpret the governing principles developed by the LHINs - equitable access based on patient need, preserving patient choice, responsiveness to local population health needs, shared accountability and patient-centred care - and describe how they apply. We then offer critical success factors to guide the LHINs in upholding these principles in response to the needs of people with disabilities and chronic illnesses. This paper aims to bridge an important gap in the literature by examining the ethics of a new regionalisation strategy with a focus on the implications for people with disabilities and chronic illnesses across multiple sites of care. While Ontario is used as a case study to contextualize our discussion, the issues we identify, the ethical principles we apply, and the critical success factors we provide have broader applicability for guiding and evaluating the development of - or revisions to - a regionalised health care strategy.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mackillop, William J., E-mail: william.mackillop@krcc.on.ca; Department of Public Health Sciences, Queen's University, Kingston, Ontario; Department of Oncology, Queen's University, Kingston, Ontario

Purpose: Palliative radiation therapy (PRT) benefits many patients with incurable cancer, but the overall need for PRT is unknown. Our primary objective was to estimate the appropriate rate of use of PRT in Ontario. Methods and Materials: The Ontario Cancer Registry identified patients who died of cancer in Ontario between 2006 and 2010. Comprehensive RT records were linked to the registry. Multivariate analysis identified social and health system-related factors affecting the use of PRT, enabling us to define a benchmark population of patients with unimpeded access to PRT. The proportion of cases treated at any time (PRT{sub lifetime}), the proportionmore » of cases treated in the last 2 years of life (PRT{sub 2y}), and number of courses of PRT per thousand cancer deaths were measured in the benchmark population. These benchmarks were standardized to the characteristics of the overall population, and province-wide PRT rates were then compared to benchmarks. Results: Cases diagnosed at hospitals with no RT on-site and residents of poorer communities and those who lived farther from an RT center, were significantly less likely than others to receive PRT. However, availability of RT at the diagnosing hospital was the dominant factor. Neither socioeconomic status nor distance from home to nearest RT center had a significant effect on the use of PRT in patients diagnosed at a hospital with RT facilities. The benchmark population therefore consisted of patients diagnosed at a hospital with RT facilities. The standardized benchmark for PRT{sub lifetime} was 33.9%, and the corresponding province-wide rate was 28.5%. The standardized benchmark for PRT{sub 2y} was 32.4%, and the corresponding province-wide rate was 27.0%. The standardized benchmark for the number of courses of PRT per thousand cancer deaths was 652, and the corresponding province-wide rate was 542. Conclusions: Approximately one-third of patients who die of cancer in Ontario need PRT, but many of them are never treated.« less

The Ontario Cancer Research Ethics Board: a central REB that works

PubMed Central

Chaddah, M.R.

2008-01-01

The Ontario Cancer Research Ethics Board (ocreb) has made its mark within Ontario as a successful, centralized, oncology-specific research ethics board. As such, ocreb has proven invaluable to principal investigators, sponsors, and study participants given its ability to reduce duplication during the submission process, to provide the highest quality of review, to shorten study start-up time, and to implement more efficient methods of reporting serious adverse events. PMID:18317585

Halogenated Flame Retardants in Predator and Prey Fish From the Laurentian Great Lakes: Age-Dependent Accumulation and Trophic Transfer.

PubMed

Su, Guanyong; Letcher, Robert J; McGoldrick, Daryl J; Backus, Sean M

2017-08-01

The identification, persistence, accumulation and trophic transfer of 25 polybrominated diphenyl ether (PBDE) congeners, 23 non-PBDE halogenated flame retardants (NPHFRs), 4 polybrominated-diphenoxybenzenes (PB-DiPhOBzs) and 6 methoxylated (MeO-) PB-DiPhOBzs were investigated in predator and prey fish collected in 2010 from sites in the North American Great Lakes of Ontario (n = 26) and Erie (n = 39). Regardless of locations or species, 20 PBDEs and 12 NPHFRs were quantifiable in at least one of the 65 analyzed samples, and polybrominated-1,4-diphenoxybenzenes (PB-DiPhOBzs) and MeO-PB-DiPhOBzs were not detectable in any of analyzed samples. Among the FRs, the greatest concentrations were the ∑PBDE, ranging from 1.06 (Rainbow Smelt, Lake Erie) to 162 (Lake Trout, Lake Ontario) ng/g wet weight (ww), which was followed by mean HBCDD concentrations ranging ND to 17.3 (Lake Trout, Lake Ontario) ng/g ww. The remaining FRs were generally not detectable or at sub-ppb levels. In most of cases, FR concentrations in samples from Lake Ontario were greater than those from Lake Erie. Strong and significant positive linear relationships occurred between log-normalized FR concentrations (ww or lipid weight (lw)) and ages of the top predator Lake Trout (n = 16, from Lake Ontario), and the estimated FR doubling ages (T 2 ) were 2.9-6.4 years. For Walleye from Lake Erie, significantly positive linear relationships were also observed for some FRs, but the linear relationships generally became negative after FR concentrations were normalized with lipid weight. This study provides novel information on FR accumulation in aquatic organisms, and for the first time, significant positive linear relationships are reported between log-normalized FR concentrations (lw or ww) and ages of Lake Trout from the Great Lakes.

Searching for Signs of Life in Ontario Universities: An Innovative Method for Evaluating Biodiversity Integration within University Curricula

ERIC Educational Resources Information Center

McCallum, Jenn; Elliott, Paul; McIntosh, Terese

2017-01-01

This study investigates the degree to which biodiversity concepts are included within university curricula in Ontario and provides a baseline for tracking this. A keyword search of undergraduate and graduate academic calendars from six Ontario universities was conducted. A list of 28 relevant keywords was developed, and university program…

A community outbreak of travel-acquired measles, Ontario 2009

PubMed Central

Armstrong, J; Arajs, A; Bailey, N; Wang, HL

2014-01-01

Background Canada has held elimination status for measles since 1998; however, imported cases continue to occur. Objective To describe the public health response to an imported measles case in the Waterloo Region of Ontario in May 2009. Results Contacts and exposures were traced, and cases were quickly investigated to identify the source. Through routine reporting mechanisms it was found that the index case had likely been exposed while on holiday in Disney World to a laboratory-confirmed measles case in a nine year old unimmunized boy from the United Kingdom (UK). Canada’s National Microbiology Laboratory confirmed that the index case had the same D4 measles strain as the UK case and the strain that had been circulating in the UK. In total, one probable case and six confirmed cases were reported. The median age of confirmed cases was 14.5 years (mean age 17 years, range 6 to 39 years). Five confirmed cases (83%) were female. One confirmed case (17%) was hospitalized; no deaths were associated with the outbreak. Conclusion This outbreak highlights the importance of collaboration with clinical care, the laboratory and public health at all levels of government to investigate and control a measles outbreak. Global travel and sustained local transmission may continue to pose a challenge with respect to the eradication of measles in developed countries. PMID:29769848

A Follow-Up Study of People in Ontario Completing Level 3 of the Language Instruction for Newcomers to Canada (LINC) Program. Report to the Ontario Region LINC Advisory Committee.

ERIC Educational Resources Information Center

Hart, Doug; Cumming, Alister

The report details results of a survey of students who had completed Level 3 of the Ontario (Canada) Language Instruction fore Newcomers to Canada (LINC) program. The initial followup study included 103 native speakers of Arabic, 208 speakers of Cantonese, 198 of Polish, 40 of Somali, 155 of Spanish, and 196 of Tamil. Ten from each group except…

Study of LANDSAT-D thematic mapper performance as applied to hydrocarbon exploration. [Southern Ontario, Lawton, Oklahoma; Owl Creek, Wyoming; Washington, D.C.; and Death Valley California

NASA Technical Reports Server (NTRS)

Everett, J. R. (Principal Investigator)

1983-01-01

Improved delineation of known oil and gas fields in southern Ontario and a spectacularly high amount of structural information on the Owl Creek, Wyoming scene were obtained from analysis of TM data. The use of hue, saturation, and value image processing techniques on a Death Valley, California scene permitted direct comparison of TM processed imagery with existing 1:250,000 scale geological maps of the area and revealed small outcrops of Tertiary volcanic material overlying Paleozoic sections. Analysis of TM data over Lawton, Oklahoma suggests that the reducing chemical environment associated with hydrocarbon seepage change ferric iron to soluble ferrous iron, allowing it to be leached. Results of the band selection algorithm show a suprising consistency, with the 1,4,5 combination selected as optimal in most cases.

Primary care physician referral patterns in Ontario, Canada: a descriptive analysis of self-reported referral data.

PubMed

Liddy, Clare; Arbab-Tafti, Sadaf; Moroz, Isabella; Keely, Erin

2017-08-22

In many countries, the referral-consultation process faces a number of challenges from inefficiencies and rising demand, resulting in excessive wait times for many specialties. We collected referral data from a sample of family doctors across the province of Ontario, Canada as part of a larger program of research. The purpose of this study is to describe referral patterns from primary care to specialist and allied health services from the primary care perspective. We conducted a prospective study of patient referral data submitted by primary care providers (PCP) from 20 clinics across Ontario between June 2014 and January 2016. Monthly referral volumes expressed as a total number of referrals to all medical and allied health professionals per month. For each referral, we also collected data on the specialty type, reason for referral, and whether the referral was for a procedure. PCPs submitted a median of 26 referrals per month (interquartile range 11.5 to 31.8). Of 9509 referrals eligible for analysis, 97.8% were directed to medical professionals and 2.2% to allied health professionals. 55% of medical referrals were directed to non-surgical specialties and 44.8% to surgical specialties. Medical referrals were for procedures in 30.8% of cases and non-procedural in 40.9%. Gastroenterology received the largest share (11.2%) of medical referrals, of which 62.3% were for colonoscopies. Psychology received the largest share (28.3%) of referrals to allied health professionals. We described patterns of patient referral from primary care to specialist and allied health services for 30 PCPs in 20 clinics across Ontario. Gastroenterology received the largest share of referrals, nearly two-thirds of which were for colonoscopies. Future studies should explore the use of virtual care to help manage non-procedural referrals and examine the impact that procedural referrals have on wait times for gastroenterology.

Presumptions respecting mental competence.

PubMed

Madigan, K V; Checkland, D; Silberfeld, M

1994-04-01

This paper addresses the role(s) played by presumptions regarding mental competence in the context of clinical assessment of decision-making capacity. In particular, the issue of whether or not the usual common law presumption of competence is appropriate and applicable in cases of reassessment of persons previously found incompetent is discussed. Arguments can be made for either retaining a presumption of competence or adopting a presumption of incompetence in reassessment cases. In addressing the issue and the arguments, the authors conclude that the question is really a public policy issue which requires legislative resolution. In writing this paper, the authors have drawn on their joint clinical experience at the Baycrest Competency Clinic. Though the authors' jurisdiction is the province of Ontario, their intent is to raise awareness and to prompt consideration of this issue both inside and outside Ontario.

An investigation of exudative epidermitis (greasy pig disease) and antimicrobial resistance patterns of Staphylococcus hyicus and Staphylococcus aureus isolated from clinical cases

PubMed Central

Park, Jeonghwa; Friendship, Robert M.; Poljak, Zvonimir; Weese, J. Scott; Dewey, Cate E.

2013-01-01

Exudative epidermitis (EE) is a common skin disease of young pigs, caused mainly by Staphylococcus hyicus. Increased prevalence of EE and poor response to treatment are reported. Common strategies used by Ontario pork producers to treat pigs with EE were determined using a survey. Injection of penicillin G was reported as the most common parenteral antibiotic choice. Antimicrobial resistance patterns of S. hyicus and Staphylococcus aureus isolated from clinical cases (30 herds with samples from approximately 6 pigs per farm) showed that 97% of S. hyicus isolates were resistant to penicillin G and ampicillin; 71% of these isolates were resistant to ceftiofur. Similar resistance was noted among S. aureus isolates. Antimicrobial resistance has become a problem in the treatment of EE in Ontario. PMID:23904636

Evaluating the implementation of health and safety innovations under a regulatory context: a collective case study of Ontario's safer needle regulation.

PubMed

Chambers, Andrea; Mustard, Cameron A; Breslin, Curtis; Holness, Linn; Nichol, Kathryn

2013-01-22

Implementation effectiveness models have identified important factors that can promote the successful implementation of an innovation; however, these models have been examined within contexts where innovations are adopted voluntarily and often ignore the socio-political and environmental context. In the field of occupational health and safety, there are circumstances where organizations must adopt innovations to comply with a regulatory standard. Examining how the external environment can facilitate or challenge an organization's change process may add to our understanding of implementation effectiveness. The objective of this study is to describe implementation facilitators and barriers in the context of a regulation designed to promote the uptake of safer engineered medical devices in healthcare. The proposed study will focus on Ontario's safer needle regulation (2007) which requires healthcare organizations to transition to the use of safer engineered medical devices for the prevention of needlestick injuries. A collective case study design will be used to learn from the experiences of three acute care hospitals in the province of Ontario, Canada. Interviews with management and front-line healthcare workers and analysis of supporting documents will be used to describe the implementation experience and examine issues associated with the integration of these devices. The data collection and analysis process will be influenced by a conceptual framework that draws from implementation science and the occupational health and safety literature. The focus of this study in addition to the methodology creates a unique opportunity to contribute to the field of implementation science. First, the study will explore implementation experiences under circumstances where regulatory pressures are influencing the organization's change process. Second, the timing of this study provides an opportunity to focus on issues that arise during later stages of implementation, a phase during the implementation cycle that has been understudied. This study also provides the opportunity to examine the relevance and utility of current implementation science models in the field of occupational health where the adoption of an innovation is meant to enhance the health and safety of workers. Previous work has tended to focus almost exclusively on innovations that are designed to enhance an organization's productivity or competitive advantage.

Access Opportunities and Issues for Students with Disabilities at One Ontario College

ERIC Educational Resources Information Center

Kernohan, Lori

2008-01-01

The pilot research project reported on here was conducted between October 2005 and March 2006 on one campus of one of Ontario's 24 colleges. The college is located in an urban centre in southern Ontario. The main focus of this pilot study was the exploration of issues of accessibility and accommodation for students with disabilities as they engage…

A case-control study of Nocardia mastitis in Nova Scotia dairy herds

PubMed Central

Ferns, Lyn; Dohoo, Ian; Donald, Alan

1991-01-01

A case-control study was conducted to identify herd production, housing, and hygienic and therapeutic factors associated with a diagnosis of Nocardia mastitis in dairy herds in Nova Scotia. The data were collected by on-farm interviews with owners of 54 case and 54 control herds. Logistic regression was used to study risk factors. The use of dry cow products containing neomycin, including two specific dry cow products, was strongly associated with a diagnosis of Nocardia mastitis in a herd. Other factors which increased the risk of Nocardia mastitis were higher levels of production, larger herd size, and a large percentage of cows treated with dry cow products. These results are compared to results from a similar study carried out in Ontario. PMID:17423896

Sensitization of a child to cyanobacteria after recreational swimming in a lake

EPA Science Inventory

We report a case of an 11 year-old white female who developed an allergic reaction after swimming in Lake Ontario, Canada. Specific IgE reactivity to various species of cyanobacteria extracts was found to be increased in the patient’s serum. This case emphasizes the importance of...

How is unemployment among people with mental illness conceptualized within social policy? A case study of the Ontario Disability Support Program.

PubMed

Gewurtz, Rebecca E; Cott, Cheryl; Rush, Brian; Kirsh, Bonnie

2015-01-01

Government policy shapes and is shaped by society's views of important social issues such as employment among people with disabilities. This article explores how unemployment among people with mental illness has been understood and characterized within social policy. Drawing on a qualitative case study that explored the construction and implementation of policy reform within the employment support branch of the Ontario Disability Support Program, this paper examines assumptions about unemployment among people with mental illness that underlie social policy and their impact on employment services and supports. The most prominent messages that emerged from the data focused on unemployment among people with mental illness as a function of personal responsibility, limitations and a lack of motivation. Although there was awareness of the role of social and systemic factors, these issues were given less weight, especially when describing employment support practices. There is a lack of sufficient attention to complex and deeply-rooted social and systemic inequalities within social policy and employment services. There is a need to expand conceptualizations of unemployment among people with mental illness within social policy, and develop interventions that address complex social factors and systemic constraints that can limit employment opportunities.

Future changes of temperature and heat waves in Ontario, Canada

NASA Astrophysics Data System (ADS)

Li, Zhong; Huang, Guohe; Huang, Wendy; Lin, Qianguo; Liao, Renfei; Fan, Yurui

2018-05-01

Apparent changes in the temperature patterns in recent years brought many challenges to the province of Ontario, Canada. As the need for adapting to climate change challenges increases, the development of reliable climate projections becomes a crucial task. In this study, a regional climate modeling system, Providing Regional Climates for Impacts Studies (PRECIS), is used to simulate the temperature patterns in Ontario. Three PRECIS runs with a resolution of 25 km × 25 km are carried out to simulate the present (1961-1990) temperature variations. There is a good match between the simulated and observed data, which validates the performance of PRECIS in reproducing temperature changes in Ontario. Future changes of daily maximum, mean, and minimum temperatures during the period 2071-2100 are then projected under the IPCC SRES A2 and B2 emission scenarios using PRECIS. Spatial variations of annual mean temperature, mean diurnal range, and temperature seasonality are generated. Furthermore, heat waves defined based on the exceedance of local climatology and their temporal and spatial characteristics are analyzed. The results indicate that the highest temperature and the most intensive heat waves are most likely to occur at the Toronto-Windsor corridor in Southern Ontario. The Northern Ontario, in spite of the relatively low projected temperature, would be under the risk of long-lasting heat waves, and thus needs effective measures to enhance its climate resilience in the future. This study can assist the decision makers in better understanding the future temperature changes in Ontario and provide decision support for mitigating heat-related loss.

How Can Data Drive Policy and Practice in Child Welfare? Making the Link in Canada.

PubMed

Fallon, Barbara; Filippelli, Joanne; Black, Tara; Trocmé, Nico; Esposito, Tonino

2017-10-14

Formal university-child welfare partnerships offer a unique opportunity to begin to fill the gaps in the child welfare knowledge base and link child welfare services to the realities of practice. With resources from a knowledge mobilization grant, a formal partnership was developed between the University of Toronto, clinicians, policy analysts, and researchers from child welfare agencies across Ontario. The key objectives of the grant included: (1) enhancing the capacity of service providers to access and analyze child welfare data to inform service and policy decisions; (2) integrating clinical expertise in service and policy decisions; and (3) developing a joint research agenda addressing high-priority knowledge gaps. This partnership was an opportunity to advance the evidence base with respect to service provision in Ontario and to create a culture of knowledge and evidence that would eventually support more complex research initiatives. Administrative data was analyzed for this partnership through the Ontario Child Abuse and Neglect Data System (OCANDS)-the first child welfare data system in Ontario to track child welfare-involved children and their families. Child welfare agencies identified recurrence as an important priority and agency-driven analyses were subsequently conducted on OCANDS generated recurrence Service Performance Indicators (SPI's). Using an urgent versus chronic investigative taxonomy for analyses, findings revealed that the majority of cases did not recur within 12 months and cases identified as chronic needs are more likely to return to the attention of child welfare authorities. One of the key outcomes of the partnership - helping agencies to understand their administrative data is described, as are considerations for next steps for future partnerships and research.

How Can Data Drive Policy and Practice in Child Welfare? Making the Link in Canada

PubMed Central

Filippelli, Joanne; Black, Tara; Trocmé, Nico; Esposito, Tonino

2017-01-01

Formal university–child welfare partnerships offer a unique opportunity to begin to fill the gaps in the child welfare knowledge base and link child welfare services to the realities of practice. With resources from a knowledge mobilization grant, a formal partnership was developed between the University of Toronto, clinicians, policy analysts, and researchers from child welfare agencies across Ontario. The key objectives of the grant included: (1) enhancing the capacity of service providers to access and analyze child welfare data to inform service and policy decisions; (2) integrating clinical expertise in service and policy decisions; and (3) developing a joint research agenda addressing high-priority knowledge gaps. This partnership was an opportunity to advance the evidence base with respect to service provision in Ontario and to create a culture of knowledge and evidence that would eventually support more complex research initiatives. Administrative data was analyzed for this partnership through the Ontario Child Abuse and Neglect Data System (OCANDS)—the first child welfare data system in Ontario to track child welfare-involved children and their families. Child welfare agencies identified recurrence as an important priority and agency-driven analyses were subsequently conducted on OCANDS generated recurrence Service Performance Indicators (SPI’s). Using an urgent versus chronic investigative taxonomy for analyses, findings revealed that the majority of cases did not recur within 12 months and cases identified as chronic needs are more likely to return to the attention of child welfare authorities. One of the key outcomes of the partnership — helping agencies to understand their administrative data is described, as are considerations for next steps for future partnerships and research. PMID:29036894

Les caracteristiques des apprenantes et des apprenants ages de 15 a 18 ans dans le systeme d'education en langue francaise en Ontario (The Characteristics of Female and Male Students Aged 15 to 18 Years in the French Language Educational System in Ontario).

ERIC Educational Resources Information Center

Herry, Yves; Levesque, Denis

A study undertaken to create a profile of 15- to 18-year-old students in minority French language schools in Ontario is reported. The first chapter describes the study's methodology, which included review of education ministry documents and other research, and interviews with students and educators. The second chapter summarizes research findings…

Overview of surgery for oral cavity cancer in Ontario.

PubMed

Eskander, Antoine; Irish, Jonathan; Gullane, Patrick; Gilbert, Ralph; de Almeida, John R; Freeman, Jeremy; Giuliani, Meredith; Urbach, David R; Goldstein, David P

2016-07-01

The pupose of this study was to describe variations in incidence and resection rates of patients with oral cavity squamous cell carcinoma (SCC) in Ontario. All oral cavity SCCs in Ontario between 2003 and 2010 were identified from the Ontario Cancer Registry. Incidence and resection rates along with variations in care were compared by sociodemographic factors and Ontario health regions. The 8-year incidence rates for oral cavity SCC was 21.3 per 100,000 with variations by sex, age group, neighborhood income, and community size. Seventy-four percent of patients underwent an oral cavity cancer resection, of which 91% were at a regional head and neck cancer center. Variations in resection rates existed by region of residence and treatment. Oral cavity cancer incidence rates vary by sex, age, neighborhood income, community size, and health region. Resection rates vary by age and health region. Oral cavity cancer care is highly regionalized in Ontario. © 2015 Wiley Periodicals, Inc. Head Neck 38: 1113-1118, 2016. © 2015 Wiley Periodicals, Inc.

Utilization and Short-Term Outcomes of Primary Total Hip and Knee Arthroplasty in the United States and Canada: An Analysis of New York and Ontario Administrative Data.

PubMed

Cram, Peter; Landon, Bruce E; Matelski, John; Ling, Vicki; Stukel, Therese A; Paterson, J Michael; Gandhi, Rajiv; Hawker, Gillian A; Ravi, Bheeshma

2018-04-01

Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are common and effective surgical procedures. This study sought to compare utilization and short-term outcomes of primary TKA and THA in adjacent regions of Canada and the United States. The study was designed as a retrospective cohort study of patients who underwent primary TKA or THA, comparing administrative data from New York and Ontario in 2012-2013. Demographic features of the TKA and THA patients, per capita utilization rates, and short-term outcomes were compared between the jurisdictions. A higher percentage of New York hospitals performed TKA compared to Ontario hospitals (75.7% versus 42.1%; P < 0.001), and the mean annual procedural volume for TKAs was lower in New York hospitals (mean 179 versus 327 in Ontario hospitals; P < 0.001). After direct standardization, utilization was significantly lower in New York compared to Ontario, both for TKA (16.1 TKAs versus 21.4 TKAs per 10,000 population per year; P < 0.001) and for THA (10.5 THAs versus 11.5 THAs per 10,000 population per year; P < 0.001). For those who underwent TKA, the length of stay in Ontario hospitals was significantly longer (mean 3.7 days versus 3.4 days in New York hospitals; P < 0.001). A smaller percentage of New York patients were discharged directly home (46.2% versus 90.9% of Ontario patients; P < 0.001), but 30-day and 90-day readmission rates were higher in New York compared to Ontario (30-day rates, 4.6% versus 3.9% [P < 0.001]; 90-day rates, 8.4% versus 6.7% [P < 0.001]). For the THA cohorts, the results with regard to length of stay, discharge disposition, and readmission rates were similar to those for TKA. Ontario has higher utilization of total joint arthroplasty than New York but has a smaller percentage of hospitals performing these procedures. Patients are more likely to be discharged home and less likely to be readmitted in Ontario. Our results suggest areas where each jurisdiction could improve. © 2017, American College of Rheumatology.

Estimating cancer risk in relation to tritium exposure from routine operation of a nuclear-generating station in Pickering, Ontario.

PubMed

Wanigaratne, S; Holowaty, E; Jiang, H; Norwood, T A; Pietrusiak, M A; Brown, P

2013-09-01

Evidence suggests that current levels of tritium emissions from CANDU reactors in Canada are not related to adverse health effects. However, these studies lack tritium-specific dose data and have small numbers of cases. The purpose of our study was to determine whether tritium emitted from a nuclear-generating station during routine operation is associated with risk of cancer in Pickering, Ontario. A retrospective cohort was formed through linkage of Pickering and north Oshawa residents (1985) to incident cancer cases (1985-2005). We examined all sites combined, leukemia, lung, thyroid and childhood cancers (6-19 years) for males and females as well as female breast cancer. Tritium estimates were based on an atmospheric dispersion model, incorporating characteristics of annual tritium emissions and meteorology. Tritium concentration estimates were assigned to each cohort member based on exact location of residence. Person-years analysis was used to determine whether observed cancer cases were higher than expected. Cox proportional hazards regression was used to determine whether tritium was associated with radiation-sensitive cancers in Pickering. Person-years analysis showed female childhood cancer cases to be significantly higher than expected (standardized incidence ratio [SIR] = 1.99, 95% confidence interval [CI]: 1.08-3.38). The issue of multiple comparisons is the most likely explanation for this finding. Cox models revealed that female lung cancer was significantly higher in Pickering versus north Oshawa (HR = 2.34, 95% CI: 1.23-4.46) and that tritium was not associated with increased risk. The improved methodology used in this study adds to our understanding of cancer risks associated with low-dose tritium exposure. Tritium estimates were not associated with increased risk of radiationsensitive cancers in Pickering.

Lake Ontario Shore Protection Study: Literature Review Report.

DTIC Science & Technology

1979-07-01

Rochester Region - Extracted from IJC, May 1976 31 Recreational Facilities and Lake Ontario State Parkway Expressways - Existing and Proposed...Throughout Areas of the Lake Ontario Western and Central Basins and the Genesee and Oswego River Basins - Extracted from the Genesee/Finger Lakes Regional...Planning Board, Nov. 1972 32 Recreational Facilities of the Rochester to St. Lawrence Region - Extracted from IJC, May 1976 33 Aquatic Vegetation

Preliminary Report of Alcohol and Other Drug Use among Ontario Students in 1983, and Trends since 1977.

ERIC Educational Resources Information Center

Smart, Reginald G.; And Others

Since 1977, alcohol and drug use among Ontario students has been studied every 2 years. To examine the patterns of alcohol and other drug use among Ontario students in 1983, a randomized sample of 5,835 students, representing grades 5, 7, 9, 11, and 13, from four geographical regions, completed an anonymous questionnaire. An analysis of the…

Kidney Disease Among Registered Métis Citizens of Ontario: A Population-Based Cohort Study

PubMed Central

Hayward, Jade S.; McArthur, Eric; Nash, Danielle M.; Sontrop, Jessica M.; Russell, Storm J.; Khan, Saba; Walker, Jennifer D.; Nesrallah, Gihad E.; Sood, Manish M.; Garg, Amit X.

2017-01-01

Background: Indigenous peoples in Canada have higher rates of kidney disease than non-Indigenous Canadians. However, little is known about the risk of kidney disease specifically in the Métis population in Canada. Objective: To compare the prevalence of chronic kidney disease and incidence of acute kidney injury and end-stage kidney disease among registered Métis citizens in Ontario and a matched sample from the general Ontario population. Design: Population-based, retrospective cohort study using data from the Métis Nation of Ontario’s Citizenship Registry and administrative databases. Setting: Ontario, Canada; 2003-2013. Patients: Ontario residents ≥18 years. Measurements: Prevalence of chronic kidney disease and incidence of acute kidney injury and end-stage kidney disease. Secondary outcomes among patients hospitalized with acute kidney injury included non-recovery of kidney function and mortality within 1 year of discharge. Methods: Database codes and laboratory values were used to determine study outcomes. Métis citizens were matched (1:4) to Ontario residents on age, sex, and area of residence. The analysis included 12 229 registered Métis citizens and 48 916 adults from the general population. Results: We found the prevalence of chronic kidney disease was slightly higher among Métis citizens compared with the general population (3.1% vs 2.6%, P = 0.002). The incidence of acute kidney injury was 1.2 per 1000 person-years in both Métis citizens and the general population (P = 0.54). Of those hospitalized with acute kidney injury, outcomes were similar among Métis citizens and the general population except 1-year mortality, which was higher for Métis citizens (24.5% vs 15.3%, P = 0.03). The incidence of end-stage kidney disease did not differ between groups (<3.0 per 10 000 person-years, P = 0.73). Limitations: The Métis Nation of Ontario Citizenship Registry only captures about 20% of Métis people in Ontario. Administrative health care codes used to identify kidney disease are highly specific but have low sensitivity. Conclusions: Rates of kidney disease were similar or slightly higher for Métis citizens in Ontario compared with the matched general population. PMID:28491337

Patterns of use for brand-name versus generic oral bisphosphonate drugs in Ontario over a 13-year period: a descriptive study.

PubMed

Fraser, Lisa-Ann; Albaum, Jordan M; Tadrous, Mina; Burden, Andrea M; Shariff, Salimah Z; Cadarette, Suzanne M

2015-01-01

Bisphosphonates are the first-line therapy for the treatment of osteoporosis. In the province of Ontario, the Ontario Drug Benefit Program funds medications for patients aged 65 years and older. The Ontario Drug Benefit Program has a generic substitution policy that requires lower-cost generic drugs to be dispensed when they are available. However, there is controversy surrounding the efficacy and tolerability of generic bisphosphonates. The objective of this study was to describe patterns in the use of brand-name versus generic formulations when dispensing oral bisphosphonate over a 13-year period. We identified all osteoporotic preparations for alendronate and risedronate that were dispensed through the Ontario Drug Benefit Program from 2001 to 2014. We stratified our sample into community-dwelling residents and residents in long-term care facilities. The number of prescriptions dispensed per month were plotted to illustrate trends over time. We found a rapid switch from brand-name to generic bisphosphonate equivalents immediately after the generic became available on the Ontario Drug Benefit formulary, with generics accounting for > 88% of dispensed drug within 2 months. We also observed a reduction in the number of generic drugs dispensed each time a new brand-name alternative (e.g., monthly risedronate, weekly alendronate plus vitamin D) was introduced to the formulary. The dispensing trends were similar in the community and long-term care settings. The Ontario Drug Benefit Program generic substitution policy resulted in rapid uptake of generic oral bisphosphonates among seniors in Ontario. However, there was a switch away from generic medications to new brand-name alternatives whenever they were introduced to the formulary. Therefore, some patients continued to use brand-name bisphosphonate despite the availability of generic options.

Association between allergies, asthma, and breast cancer risk among women in Ontario, Canada.

PubMed

Lowcock, Elizabeth C; Cotterchio, Michelle; Ahmad, Noor

2013-05-01

To investigate the association between allergies, asthma, and breast cancer risk in a large, population-based case-control study. Breast cancer cases (n = 3,101) were identified using the Ontario Cancer Registry and population controls (n = 3,471) through random digit dialing. Self-reported histories of allergies, hay fever, and asthma were collected by questionnaire. Logistic regression was used to assess associations between breast cancer risk and history of allergy/hay fever and asthma, with 16 possible confounders examined. Analyses were stratified by menopausal status. A history of allergies or hay fever was associated with a small reduction in breast cancer risk [age-adjusted odds ratio (AOR) = 0.86, 95 % confidence interval (CI) 0.77-0.96] and did not differ by menopausal status. Asthma was not associated with breast cancer risk overall; however, among premenopausal women, asthma was associated with a reduced risk of breast cancer (AOR = 0.72, 95 % CI 0.54-0.97). A history of allergies may be associated with a modest reduction in breast cancer risk. Asthma does not appear to be associated with breast cancer risk overall; however, asthma may be associated with reduced breast cancer risk among premenopausal women.

Distribution of, and risk factors associated with, sheep carcass condemnations due to Cysticercus ovis infection on Canadian sheep farms.

PubMed

DeWolf, Bradley D; Peregrine, Andrew S; Jones-Bitton, Andria; Jansen, Jocelyn T; Mactavish, Jennifer; Menzies, Paula I

2012-12-21

Cysticercus ovis, the intermediate stage of a canine tapeworm, Taenia ovis, produces cystic lesions in the skeletal and cardiac muscle of sheep which, if numerous, will result in the condemnation of an entire carcass. In 2007 and 2008, the number of carcass condemnations due to C. ovis rose dramatically across Canada, suggesting that the prevalence of this infection on sheep farms was increasing. Trace-back of 237 carcasses condemned at Ontario provincially inspected abattoirs, between March 2009 and March 2011, revealed they originated from 133 farms across Canada. A case-control study was performed (n=40 cases, 56 controls) to identify farm-level risk factors associated with carcass condemnations due to C. ovis. Participating farms, located in Alberta, Saskatchewan, Manitoba and Ontario, were asked to answer a short questionnaire which collected information about each farm's geographic location and management practices. A multivariable logistic regression model revealed that farm dogs scavenging deadstock (OR=4.04; 95% CI: 1.16-14.04) and failing to dispose of deadstock (OR=11.78; 95% CI: 2.93-47.40) were significantly associated with condemnations (p ≤ 0.05). Copyright © 2012 Elsevier B.V. All rights reserved.

An Assessment of the Expected Cost-Effectiveness of Quadrivalent Influenza Vaccines in Ontario, Canada Using a Static Model.

PubMed

Chit, Ayman; Roiz, Julie; Aballea, Samuel

2015-01-01

Ontario, Canada, immunizes against influenza using a trivalent inactivated influenza vaccine (IIV3) under a Universal Influenza Immunization Program (UIIP). The UIIP offers IIV3 free-of-charge to all Ontarians over 6 months of age. A newly approved quadrivalent inactivated influenza vaccine (IIV4) offers wider protection against influenza B disease. We explored the expected cost-utility and budget impact of replacing IIV3 with IIV4, within the context of Ontario's UIIP, using a probabilistic and static cost-utility model. Wherever possible, epidemiological and cost data were obtained from Ontario sources. Canadian or U.S. sources were used when Ontario data were not available. Vaccine efficacy for IIV3 was obtained from the literature. IIV4 efficacy was derived from meta-analysis of strain-specific vaccine efficacy. Conservatively, herd protection was not considered. In the base case, we used IIV3 and IIV4 prices of $5.5/dose and $7/dose, respectively. We conducted a sensitivity analysis on the price of IIV4, as well as standard univariate and multivariate statistical uncertainty analyses. Over a typical influenza season, relative to IIV3, IIV4 is expected to avert an additional 2,516 influenza cases, 1,683 influenza-associated medical visits, 27 influenza-associated hospitalizations, and 5 influenza-associated deaths. From a societal perspective, IIV4 would generate 76 more Quality Adjusted Life Years (QALYs) and a net societal budget impact of $4,784,112. The incremental cost effectiveness ratio for this comparison was $63,773/QALY. IIV4 remains cost-effective up to a 53% price premium over IIV3. A probabilistic sensitivity analysis showed that IIV4 was cost-effective with a probability of 65% for a threshold of $100,000/QALY gained. IIV4 is expected to achieve reductions in influenza-related morbidity and mortality compared to IIV3. Despite not accounting for herd protection, IIV4 is still expected to be a cost-effective alternative to IIV3 up to a price premium of 53%. Our conclusions were robust in the face of sensitivity analyses.

Laparoscopic Colorectal Surgery in the Emergency Setting: Trends in the Province of Ontario.

PubMed

Musselman, Reilly P; Gomes, Tara; Chan, Beverley P; Auer, Rebecca C; Moloo, Husein; Mamdani, Muhammad; Al-Omran, Mohammed; Al-Obeed, Omar; Boushey, Robin P

2015-10-01

The purpose of this study was to examine the adoption trends of emergency laparoscopic colorectal surgery in the province of Ontario. We conducted a retrospective time-series analysis examining rates of emergency colorectal surgery among 10.5 million adults in Ontario, Canada from April 1, 2002 to December 31, 2009. We linked administrative claims databases and the Ontario Cancer Registry to assess procedure rates over time. Procedure trends were assessed using time-series analysis. Over the 8-year period, 29,676 emergency colorectal procedures were identified. A total of 2582 (8.7%) were performed laparoscopically and 27,094 (91.3%) were open. Open and laparoscopic patients were similar with respect age, sex, and Charlson Comorbidity Index. The proportion of surgery for benign (63.8% of open cases vs. 65.6% laparoscopic, standardized difference=0.04) and malignant disease (36.2% open vs. 34.4% laparoscopic, standardized difference=0.04) was equal between groups. The percentage of emergency colorectal surgery performed laparoscopically increased from 5.7% in 2002 to 12.0% in 2009 (P<0.01). The use of laparoscopy increased for both benign and malignant disease. Statistically significant upward trends in laparoscopic surgery were seen for inflammatory bowel disease (P<0.01), obstruction (P<0.01), and colon cancer (P<0.01). From 2002 to 2009, annual procedure rates increased at a greater rate in nonacademic centers (P<0.01). Laparoscopic emergency colorectal surgery has increased significantly between 2002 and 2009 for both benign and malignant disease and for a wide range of diagnoses. This was driven in part by steadily rising usage of laparoscopy in nonacademic centers.

Association between positive corneal rim cultures and microbiology screening protocols in Ontario.

PubMed

Sharma, Rahul A; Park, John S Y; Wang, Yao; Zhang, Tinghua; Sharpen, Linda; Dixon, William; Mather, Rookaya

2018-06-01

(i) To assess the rate of positive microbiological cultures of corneas prepared by the Eye Bank of Canada (Ontario Division) between January 1, 2012, and December 31, 2013; (ii) to review the microbiology protocols at the 5 major transplant centres in Ontario; and (iii) to assess the incidence of endophthalmitis during the study period. Retrospective chart review. A total of 4186 consecutive cultured corneal tissues prepared by the Eye Bank from January 1, 2012, to December 31, 2013. Rates of culture-positive cornea rims and incidence of postkeratoplasty endophthalmitis at 5 surgical centres in Ontario were determined, and the protocols used to culture rims at each site were concurrently reviewed. Culture results were analyzed via logistic regression for positive cultures. The rate of positive cultures at each sites were as follows: centre A, 3.74%; centre B, 3.26%; centre C, 0.51%; centre D, 0.48%; and centre E, 0.04%. Centres A, B, and D were noted to have significantly higher positive rates than centre E. In comparing microbiology protocols, longer incubation period (11 days) was 12 times more likely to be associated with higher positive culture rates than shorter period (4-5 days). Six-month follow-up of all keratoplasties revealed zero reported cases of endophthalmitis. A literature review regarding the predictive value of routine culturing reveals conflicting data. Our findings suggest that differences in the microbiology protocols directly influence the rates of positive rim cultures. Without a standardized protocol, it is not possible to evaluate the predictive value of routine corneal rim culturing in predicting postkeratoplasty endophthalmitis. Copyright © 2018. Published by Elsevier Inc.

Trimethoprim-sulfamethoxazole induced hyperkalaemia in elderly patients receiving spironolactone: nested case-control study.

PubMed

Antoniou, Tony; Gomes, Tara; Mamdani, Muhammad M; Yao, Zhan; Hellings, Chelsea; Garg, Amit X; Weir, Matthew A; Juurlink, David N

2011-09-12

To characterise the risk of admission to hospital for hyperkalaemia in elderly patients treated with trimethoprim-sulfamethoxazole in combination with spironolactone. Population based nested case-control study. Ontario, Canada, from 1 April 1992 to 1 March 2010. Cases were residents of Ontario aged 66 years or above receiving chronic treatment with spironolactone and admitted to hospital with hyperkalaemia within 14 days of receiving a prescription for either trimethoprim-sulfamethoxazole, amoxicillin, norfloxacin, or nitrofurantoin. Up to four controls for each case were identified from the same cohort, matched on age, sex, and presence or absence of chronic kidney disease and diabetes, and required to have received one of the study antibiotics within 14 days before the case's index date. Odds ratio for association between admission to hospital with hyperkalaemia and receipt of a study antibiotic in the preceding 14 days, adjusted for conditions and drugs that may influence risk of hyperkalaemia. During the 18 year study period, 6903 admissions for hyperkalaemia were identified, 306 of which occurred within 14 days of antibiotic use. Of these, 248 (81%) cases were matched to 783 controls. 10.8% (17,859/165,754) of spironolactone users received at least one prescription for trimethoprim-sulfamethoxazole. Compared with amoxicillin, prescription of trimethoprim-sulfamethoxazole was associated with a marked increase in the risk of admission to hospital for hyperkalaemia (adjusted odds ratio 12.4, 95% confidence interval 7.1 to 21.6). The population attributable fraction was 59.7%, suggesting that approximately 60% of all cases of hyperkalaemia in older patients taking spironolactone and treated with an antibiotic for a urinary tract infection could be avoided if trimethoprim-sulfamethoxazole was not prescribed. Treatment with nitrofurantoin was also associated with an increase in the risk of hyperkalaemia (adjusted odds ratio 2.4, 1.3 to 4.6), but no such risk was found with norfloxacin (adjusted odds ratio 1.6, 0.8 to 3.4) Among older patients receiving spironolactone, treatment with trimethoprim-sulfamethoxazole was associated with a major increase in the risk of admission to hospital for hyperkalaemia. This drug combination should be avoided when possible.

Association between the 2008-09 seasonal influenza vaccine and pandemic H1N1 illness during Spring-Summer 2009: four observational studies from Canada.

PubMed

Skowronski, Danuta M; De Serres, Gaston; Crowcroft, Natasha S; Janjua, Naveed Z; Boulianne, Nicole; Hottes, Travis S; Rosella, Laura C; Dickinson, James A; Gilca, Rodica; Sethi, Pam; Ouhoummane, Najwa; Willison, Donald J; Rouleau, Isabelle; Petric, Martin; Fonseca, Kevin; Drews, Steven J; Rebbapragada, Anuradha; Charest, Hugues; Hamelin, Marie-Eve; Boivin, Guy; Gardy, Jennifer L; Li, Yan; Kwindt, Trijntje L; Patrick, David M; Brunham, Robert C

2010-04-06

In late spring 2009, concern was raised in Canada that prior vaccination with the 2008-09 trivalent inactivated influenza vaccine (TIV) was associated with increased risk of pandemic influenza A (H1N1) (pH1N1) illness. Several epidemiologic investigations were conducted through the summer to assess this putative association. (1) test-negative case-control design based on Canada's sentinel vaccine effectiveness monitoring system in British Columbia, Alberta, Ontario, and Quebec; (2) conventional case-control design using population controls in Quebec; (3) test-negative case-control design in Ontario; and (4) prospective household transmission (cohort) study in Quebec. Logistic regression was used to estimate odds ratios for TIV effect on community- or hospital-based laboratory-confirmed seasonal or pH1N1 influenza cases compared to controls with restriction, stratification, and adjustment for covariates including combinations of age, sex, comorbidity, timeliness of medical visit, prior physician visits, and/or health care worker (HCW) status. For the prospective study risk ratios were computed. Based on the sentinel study of 672 cases and 857 controls, 2008-09 TIV was associated with statistically significant protection against seasonal influenza (odds ratio 0.44, 95% CI 0.33-0.59). In contrast, estimates from the sentinel and three other observational studies, involving a total of 1,226 laboratory-confirmed pH1N1 cases and 1,505 controls, indicated that prior receipt of 2008-09 TIV was associated with increased risk of medically attended pH1N1 illness during the spring-summer 2009, with estimated risk or odds ratios ranging from 1.4 to 2.5. Risk of pH1N1 hospitalization was not further increased among vaccinated people when comparing hospitalized to community cases. Prior receipt of 2008-09 TIV was associated with increased risk of medically attended pH1N1 illness during the spring-summer 2009 in Canada. The occurrence of bias (selection, information) or confounding cannot be ruled out. Further experimental and epidemiological assessment is warranted. Possible biological mechanisms and immunoepidemiologic implications are considered.

The first case of porcine epidemic diarrhea in Canada.

PubMed

Ojkic, Davor; Hazlett, Murray; Fairles, Jim; Marom, Anna; Slavic, Durda; Maxie, Grant; Alexandersen, Soren; Pasick, John; Alsop, Janet; Burlatschenko, Sue

2015-02-01

In January, 2014, increased mortality was reported in piglets with acute diarrhea on an Ontario farm. Villus atrophy in affected piglets was confined to the small intestine. Samples of colon content were PCR-positive for porcine epidemic diarrhea virus (PEDV). Other laboratory tests did not detect significant pathogens, confirming this was the first case of PED in Canada.

Cost effectiveness of EML4-ALK fusion testing and first-line crizotinib treatment for patients with advanced ALK-positive non-small-cell lung cancer.

PubMed

Djalalov, Sandjar; Beca, Jaclyn; Hoch, Jeffrey S; Krahn, Murray; Tsao, Ming-Sound; Cutz, Jean-Claude; Leighl, Natasha B

2014-04-01

ALK-targeted therapy with crizotinib offers significant improvement in clinical outcomes for the treatment of EML4-ALK fusion-positive non-small-cell lung cancer (NSCLC). We estimated the cost effectiveness of EML4-ALK fusion testing in combination with targeted first-line crizotinib treatment in Ontario. A cost-effectiveness analysis was conducted using a Markov model from the Canadian Public health (Ontario) perspective and a lifetime horizon in patients with stage IV NSCLC with nonsquamous histology. Transition probabilities and mortality rates were calculated from the Ontario Cancer Registry and Cancer Care Ontario New Drug Funding Program (CCO NDFP). Costs were obtained from the Ontario Case Costing Initiative, CCO NDFP, University Health Network, and literature. Molecular testing with first-line targeted crizotinib treatment in the population with advanced nonsquamous NSCLC resulted in a gain of 0.011 quality-adjusted life-years (QALYs) compared with standard care. The incremental cost was Canadian $2,725 per patient, and the incremental cost-effectiveness ratio (ICER) was $255,970 per QALY gained. Among patients with known EML4-ALK-positive advanced NSCLC, first-line crizotinib therapy provided 0.379 additional QALYs, cost an additional $95,043 compared with standard care, and produced an ICER of $250,632 per QALY gained. The major driver of cost effectiveness was drug price. EML4-ALK fusion testing in stage IV nonsquamous NSCLC with crizotinib treatment for ALK-positive patients is not cost effective in the setting of high drug costs and a low biomarker frequency in the population.

Knowledge diffusion in social work: a new approach to bridging the gap.

PubMed

Herie, Marilyn; Martin, Garth W

2002-01-01

The continuing gap between research and practice has long been a problem in social work. A great deal of the empirical practice literature has emphasized practice evaluation (usually in the form of single-case methodologies) at the expense of research dissemination and utilization. An alternative focus for social work researchers can be found in the extensive theoretical and research literature on knowledge diffusion, technology transfer, and social marketing. Knowledge diffusion and social marketing theory is explored in terms of its relevance to social work education and practice, including a consideration of issues of culture and power. The authors present an integrated dissemination model for social work and use a case example to illustrate the practical application of the model. The OPTIONS (OutPatient Treatment In ONtario Services) project is an example of the effective dissemination of two research-based addiction treatment modalities to nearly 1,000 direct practice clinicians in Ontario, Canada.

Calcium and vitamin D and risk of colorectal cancer: results from a large population-based case-control study in Newfoundland and Labrador and Ontario.

PubMed

Sun, Zhuoyu; Wang, Peizhong Peter; Roebothan, Barbara; Cotterchio, Michelle; Green, Roger; Buehler, Sharon; Zhao, Jinhui; Squires, Josh; Zhao, Jing; Zhu, Yun; Dicks, Elizabeth; Campbell, Peter T; Mclaughlin, John R; Parfrey, Patrick S

2011-01-01

Previous epidemiological studies have been suggestive but inconclusive in demonstrating inverse associations of calcium, vitamin D, dairy product intakes with risk of colorectal cancer (CRC). We conducted a large population-based comparison of such associations in Newfoundland and Labrador (NL) and Ontario (ON). A case control study design was used. Colorectal cancer cases were new CRC patients aged 20-74 years. Controls were a sex and age-group matched random sample of the population in each province. 1760 cases and 2481 controls from NL and ON were analyzed. Information on dietary intake and lifestyle was collected using self-administered food frequency and personal history questionnaires. Controls reported higher mean daily intakes of total calcium and total vitamin D than cases in both provinces. In ON, significant reduced CRC risk was associated with intakes of total calcium (OR of highest vs. lowest quintiles was 0.57, 95% CI 0.42-0.77, p(trend) = 0.03), total vitamin D (OR = 0.73, 95% CI 0.54-1.00), dietary calcium (OR = 0.76, 95% CI 0.60-0.97), dietary vitamin D (OR = 0.77, 95% CI 0.61-0.99), total dairy products and milk (OR = 0.78, 95% CI 0.60-1.00), calcium-containing supplements use (OR = 0.76). In NL, the inverse associations of calcium, vitamin D with CRC risk were most pronounced among calcium- or vitamin D-containing supplement users (OR = 0.67, 0.68, respectively). Results of this study add to the evidence that total calcium, dietary calcium, total vitamin D, dietary vitamin D, calcium- or vitamin D-containing supplement use may reduce the risk of CRC. The inverse associations of CRC risk with intakes of total dairy products and milk may be largely due to calcium and vitamin D.

Residential Knowledge of Native Tree Species: A Case Study of Residents in Four Southern Ontario Municipalities

NASA Astrophysics Data System (ADS)

Almas, Andrew D.; Conway, Tenley M.

2017-01-01

In the past decade, municipalities across North America have increased investment in their urban forests in an effort to maintain and enhance the numerous benefits provided by them. Some municipalities have now drafted long-term urban forest management plans that emphasize the planting of native trees, to improve ecological integrity, and participation of residents, since the majority of urban trees are typically located on residential property. Yet it is unclear if residents are familiar with native trees or municipalities' urban forest management goals. Through a case study of southern Ontario municipalities, we administered a survey exploring residents' ability to correctly label common tree species as native or non-native, as well as their knowledge of urban forest management plans to test four hypotheses: 1) residents in municipalities with an urban forest management plans will be more knowledgeable about the native status of common street trees; 2) residents who have lived in the area longer will have greater knowledge; 3) knowledge level will be correlated with education level, ethnicity, and income; and 4) residents' knowledge will be related to having planted trees on their property. Our results indicate that residents are better able to identify common native trees than correctly determine which trees are non-native, although knowledge levels are generally low. Knowledge was significantly related to length of residency and tree planting experience, supporting hypotheses 2 and 4. These results highlight the importance of experience and local knowledge acquisition in relation to basic knowledge about urban trees, and also point to the failures of resident outreach within the case study municipalities.

Residential Knowledge of Native Tree Species: A Case Study of Residents in Four Southern Ontario Municipalities.

PubMed

Almas, Andrew D; Conway, Tenley M

2017-01-01

In the past decade, municipalities across North America have increased investment in their urban forests in an effort to maintain and enhance the numerous benefits provided by them. Some municipalities have now drafted long-term urban forest management plans that emphasize the planting of native trees, to improve ecological integrity, and participation of residents, since the majority of urban trees are typically located on residential property. Yet it is unclear if residents are familiar with native trees or municipalities' urban forest management goals. Through a case study of southern Ontario municipalities, we administered a survey exploring residents' ability to correctly label common tree species as native or non-native, as well as their knowledge of urban forest management plans to test four hypotheses: 1) residents in municipalities with an urban forest management plans will be more knowledgeable about the native status of common street trees; 2) residents who have lived in the area longer will have greater knowledge; 3) knowledge level will be correlated with education level, ethnicity, and income; and 4) residents' knowledge will be related to having planted trees on their property. Our results indicate that residents are better able to identify common native trees than correctly determine which trees are non-native, although knowledge levels are generally low. Knowledge was significantly related to length of residency and tree planting experience, supporting hypotheses 2 and 4. These results highlight the importance of experience and local knowledge acquisition in relation to basic knowledge about urban trees, and also point to the failures of resident outreach within the case study municipalities.

The national trajectory project of individuals found not criminally responsible on account of mental disorder in Canada. Part 4: criminal recidivism.

PubMed

Charette, Yanick; Crocker, Anne G; Seto, Michael C; Salem, Leila; Nicholls, Tonia L; Caulet, Malijai

2015-03-01

To examine criminal recidivism rates of a large sample of people found not criminally responsible on account of mental disorder (NCRMD) in Canada's 3 most populous provinces, British Columbia, Ontario, and Quebec. Public concern about the dangerousness of people found NCRMD has been fed by media attention on high-profile cases. However, little research is available on the rate of reoffending among people found NCRMD across Canadian provinces. Using data from the National Trajectory Project, this study examined 1800 men and women in British Columbia (n = 222), Ontario (n = 484), and Quebec (n = 1094) who were found NCRMD between May 2000 and April 2005 and followed until December 2008. Recidivism was relatively low after 3 years (17%). There were interprovincial differences after controlling for number of prior criminal offences, diagnosis, seriousness of the index offence, and supervision by the review boards. British Columbia (10%) and Ontario (9%) were similar, whereas Quebec had almost twice the recidivism (22%). People who had committed severe violent index offences were less likely to reoffend than those who had committed less severe offences. People from the sample were less likely to reoffend when under the purview of review boards, across all 3 provinces. The results of this study, along with other research on processing differences, suggest systemic differences in the trajectories and outcomes of persons found NCRMD need to be better understood to guide national policies and practices.

The National Trajectory Project of Individuals Found Not Criminally Responsible on Account of Mental Disorder in Canada. Part 4: Criminal Recidivism

PubMed Central

Charette, Yanick; Crocker, Anne G; Seto, Michael C; Salem, Leila; Nicholls, Tonia L; Caulet, Malijai

2015-01-01

Objective: To examine criminal recidivism rates of a large sample of people found not criminally responsible on account of mental disorder (NCRMD) in Canada’s 3 most populous provinces, British Columbia, Ontario, and Quebec. Public concern about the dangerousness of people found NCRMD has been fed by media attention on high-profile cases. However, little research is available on the rate of reoffending among people found NCRMD across Canadian provinces. Method: Using data from the National Trajectory Project, this study examined 1800 men and women in British Columbia (n = 222), Ontario (n = 484), and Quebec (n = 1094) who were found NCRMD between May 2000 and April 2005 and followed until December 2008. Results: Recidivism was relatively low after 3 years (17%). There were interprovincial differences after controlling for number of prior criminal offences, diagnosis, seriousness of the index offence, and supervision by the review boards. British Columbia (10%) and Ontario (9%) were similar, whereas Quebec had almost twice the recidivism (22%). People who had committed severe violent index offences were less likely to reoffend than those who had committed less severe offences. People from the sample were less likely to reoffend when under the purview of review boards, across all 3 provinces. Conclusion: The results of this study, along with other research on processing differences, suggest systemic differences in the trajectories and outcomes of persons found NCRMD need to be better understood to guide national policies and practices. PMID:25886688

Contributed Papers Workshop. Proceedings of a Western New York/Ontario Chapter of the Association of College and Research Libraries (ACRL) Workshop (Buffalo, New York, September 26, 1988).

ERIC Educational Resources Information Center

Association of Coll. and Research Libraries. Western New York/Ontario Chapter.

The eight papers in this collection were presented at an Association of College and Research Libraries workshop held in September 1988 in Buffalo, New York. The papers are as follows: (1) "Making Real Changes: Course Integrated Instruction and Its Impact, a Case Study" (Joan Ormondroyd); (2) "Dual Function Positions: A View from the Trenches" (Amy…

A Study of Burnout in International and Country of Origin Teachers

NASA Astrophysics Data System (ADS)

Coulter, Mary Ann; Abney, Paul C.

2009-01-01

The study examined the extent to which burnout levels of teachers working in international schools differed from the burnout level of teachers working in their country of origin. All participants of the study were Canadian citizens who were educated in Canada, held Ontario College of Teachers certification and were teaching credit courses in high schools offering the Ontario curriculum under the auspice of the Ontario Ministry of Education. All teachers completed the Burnout Test Form 1 - Revised (Jerabeck, Burnout Test Form 1 - Revised, 2001) online. The study found that international teachers had a statistically lower level of burnout than teachers working in their country of origin.

Numerical simulation of tides in Ontario Lacus

NASA Astrophysics Data System (ADS)

Vincent, David; Karatekin, Ozgür

2015-04-01

Hydrocarbons liquid filled lakes has been recently detected on Titan's surface. Most of these lakes are located in the northern latitudes but there is a substantial lake in the southern latitudes: Ontario Lacus. This lake gets our attention because of possible shoreline changes suggested by Cassini flybys over Ontario Lacus between September 2005 (T7) et January 2010 (T65). The shoreline changes could be due to evaporation-precipitation processes but could also be a consequence of tides. Previous studies showed that the maximal tidal amplitudes of Ontario Lacus would be about 0.2m (for an uniform bathymetry of 20m). In this study we simulate tidal amplitude and currents with SLIM (Second-generation Louvain-la-Neuve Ice-ocean Model, http://sites.uclouvain.be/slim/ ) which resolves 2D shallow water equation on an unstructured mesh. Unstructured mesh prevents problems like mesh discontinuities at poles and allows higher accuracy at some place like coast or straits without drastically increasing computing costs. The tide generating force modeled in this work is the gradient of tidal potential due to titan's obliquity and titan's orbital eccentricity around Saturn (other contribution such as sun tide generating force are unheeded). The uncertain input parameters such as the wind direction and amplitude, bottom friction and thermo-physical properties of hydrocarbons liquids are varied within their expected ranges. SAR data analysis can result in different bathymetry according to the method. We proceed simulations for different bathymetries: tidal amplitudes doesn't change but this is not the case for tidal currents. Using a recent bathymetry deduced from most recent RADAR/SAR observations and a finer mesh, the peak-to peak tidal amplitudes are calculated to be up to 0.6 m. which is more than a factor two larger than the previous results. The maximal offshore tidal currents magnitude is about 0.06 m/s.

Temporal trends in the association between socioeconomic status and cancer survival in Ontario: a population-based retrospective study

PubMed Central

Dabbikeh, Andrew; Peng, Yingwei; Mackillop, William J.; Booth, Christopher M.; Zhang-Salomons, Jina

2017-01-01

Background: Cancer survival is known to be associated with socioeconomic status. The income gap between the richer and poorer segments of the population has widened over the last 20 years in Canada. The purpose of this study was to investigate temporal trends in disparities in cancer-specific survival related to socioeconomic status in Ontario. Methods: There were 920 334 cancer cases between 1993 and 2009 in the Ontario Cancer Registry. We linked median household income from the Canadian census to the registry. We calculated 5-year cancer-specific survival rates for all cancers combined and for specific cancer sites by socioeconomic status quintile and year of diagnosis, and modelled time to death using Cox regression. Results: Between 1993 and 2009, for all cancers combined, the hazard of death decreased by 3.1% (hazard ratio [HR] 0.969 [95% confidence interval (CI) 0.967-0.971]) per year in the richest quintile and by 1.2% (HR 0.988 [95% CI 0.987-0.990]) per year in the poorest quintile. The corresponding values for breast cancer were 4.3% (HR 0.957 [95% CI 0.951-0.964]) and 2.0% (HR 0.980 [95% CI 0.975-0.986]); for lung cancer, 1.4% (HR 0.986 [95% CI 0.982-0.990]) and 0.3% (HR 0.997 [95% CI 0.995-1.000]); for colorectal cancer, 3.7% (HR 0.963 [95% CI 0.958-0.968]) and 1.8% (HR 0.982 [95% CI 0.978-0.985]); and for head and neck cancer, 3.1% (HR 0.969 [95% CI 0.958-0.979]) and 1.0% (HR 0.990 [95% CI 0.983-0.996]). Interpretation: Between 1993 and 2009, cancer-specific survival in Ontario improved more among patients from affluent communities than among those from poorer communities. This phenomenon cannot be explained by increased disparity in income. PMID:28877916

Angler specialization among salmon and trout anglers on Lake Ontario

Treesearch

Chad P. Dawson

1995-01-01

The angler specialization concept was studied using the expectancy model of motivation. An exploratory study of' Lake Ontario salmon and trout anglers was conducted to test the relationships between the variables of the expectancy model of motivation and actual angling participation.

Management of infectious diseases in remote northwestern Ontario with telemedicine videoconference consultations.

PubMed

Mashru, Jai; Kirlew, Michael; Saginur, Raphael; Schreiber, Yoko S

2017-01-01

Northwestern Ontario in Canada provides a unique clinical challenge for providing optimal medical care. It is a large geographic area (385,000 km 2 ) and is home to 32 remote First Nations communities, most without road access. These communities suffer a heavy burden of infectious disease and specialist consultations are difficult to obtain. The Division of Infectious Diseases at the Ottawa Hospital and the Sioux Lookout Meno Ya Win Health Centre established a telemedicine-based infectious disease consultation service in July 2014. We describe the implementation of this service, types of cases seen and patient satisfaction, as well as some of the challenges encountered. Information on visits was prospectively collected through an administrative database, and patient satisfaction surveys were administered after each initial consultation. During our first year of operation, 191 teleconsultations occurred: 76 initial consultations, 82 follow-up appointments and 33 case conferences. The scope of cases has been broad, mostly involving musculoskeletal infections (26%), followed by skin and soft tissue infections (23%). HCV, acute rheumatic fever, and respiratory infections (including pulmonary tuberculosis) were other diagnoses. Patient satisfaction has been very high and 28 telemedicine patient visits have occurred in their remote home communities, minimizing travel. The infectious disease consulting service and local clinicians have succeeded in addressing needs for care in infectious diseases in northwestern Ontario, where important gaps in service to First Nations' communities continue to exist. Regular scheduled available access to an infectious disease specialist is a well-received advancement of care in this remote region of Canada.

Geographic Accessibility of Community Pharmacies in Ontario

PubMed Central

Law, Michael R.; Dijkstra, Anna; Douillard, Jay A.; Morgan, Steven G.

2011-01-01

Background: Proximity is an important component of access to healthcare services. Recent changes in generic pricing in Ontario have caused speculation about pharmacy closures. However, there is little information on the current geographic accessibility of pharmacies. Therefore, we studied geographic access to pharmacies and modelled the impact of possible closures. Methods: We used location data on the 3,352 accredited community pharmacies from the Ontario College of Pharmacists and population estimates at the census dissemination block level. Using network analysis, we determined the share of Ontario's population who reside in a census dissemination block within three road travel distances of a community pharmacy: 800 m (walking), 2 km and 5 km (driving). We then simulated the effects on these measures of 10% to 50% reductions in the number of community pharmacies in Ontario. Results: Approximately 63.6% of the Ontario population reside in a dissemination block located within walking distance of one or more pharmacies; 84.6% and 90.7% reside within 2-km and 5-km driving distances, respectively. Randomly removing 30% of Ontario's community pharmacies reduces these estimates to 56.0%, 81.4% and 89.0% for each distance, respectively; a 50% reduction results in 48.3%, 77.1% and 87.2%, respectively. Conclusions: Pharmacies are geographically accessible for a majority of the Ontario population. Moreover, it appears that modest closures would have only a small impact on geographic access to pharmacies. However, closures may have other impacts on access, such as cost, waiting time and reduced patient choice. PMID:22294990

Construction fatality due to electrical contact in Ontario, Canada, 1997-2007.

PubMed

Kim, Hwan; Lewko, John; Garritano, Enzo; Sharma, Bhanu; Moody, Joel; Colantonio, Angela

2016-06-27

Electrical contact is a leading cause of occupational fatality in the construction industry. However, research on the factors that contribute to electricity-related fatality in construction is limited. To characterize, using an adapted Haddon's Matrix, the factors that contribute to electricity-related occupational fatalities in the construction industry in Ontario, Canada. Coroner's data on occupational electricity-related fatalities between 1997-2007 in the construction industry were acquired from the Ontario Ministry of Labour. Using an adapted Haddon's Matrix, we characterized worker, agent, and environmental characteristics of electricity-related occupational fatalities in the province through a narrative text analysis. Electrical contact was responsible for 15% of all occupational fatalities among construction workers in Ontario. Factors associated with said occupational fatalities included direct contact with electrical sources, lower voltage sources, and working outdoors. This study provides a profile of electricity-related occupational fatalities among construction workers in Ontario, and can be used to inform safety regulations.

Ontario Secondary School Program Innovations and Student A Report to the Ontario Study of the Relevance of Education and the Issue of Dropouts. Student Retention and Transition Series.

ERIC Educational Resources Information Center

Stamp, Robert M.

The time period between the early 1920s and the early 1970s witnessed increases in high school retention rates within Ontario's publicly-supported education system. These increases are attributed both to program changes within the system and to societal factors external to that system. Retention rates increased slowly during the 1920s, as minor…

Parting at the crossroads: the emergence of education for psychiatric nursing in three Canadian provinces, 1909-1955.

PubMed

Tipliski, Veryl Margaret

2004-01-01

Early in the 20th century, nursing emerged as an essential part of psychiatry's attempt to provide scientific care for insanity. Throughout Canada psychiatric nursing is a specialty of general or registered nursing. In Western Canada, however, it is also a separate and distinct profession known as registered psychiatric nursing (RPN). To further the study of nursing history, this paper examines the emergence and early development of mental hospital nursing in Canada, tracing the changing patterns of nurse training from 1909, when Ontario's asylum training school movement was established, to 1955, when education for psychiatric nursing split along the Manitoba-Ontario border into two models. Through case studies in three provinces (Ontario, Manitoba and Saskatchewan), this study examines the question of how Canadian psychiatric nursing developed into two entirely different models. During the 20th century, and interplay of social, political and economic factors emerged which shaped the development of psychiatric nursing and influenced the evolution of the two models. In addition, there were forces within nursing itself, including the effects of specific strategic decisions taken by nursing's leaders and the continuing role of nurses' resistance to the authority expressed by those within the medical profession. The development of psychiatric nursing is best understood by focusing on the point where psychiatry's authority intersected with the gendered limitations of nursing's leaders. This struggle represented a contest for control over education for mental hospital nursing. This paper argues that the turning point in the battle for control of Canadian education for psychiatric nursing occurred when nurse leaders refused to allow the specialty of psychiatric nursing to be taken over by an expanding psychiatric monopoly. The distinct psychiatric-controlled Western Canadian-style apprenticeship training was halted at the Manitoba-Ontario border. That nursing leaders persevered in the struggle to gain authority for psychiatric nursing education was a significant contribution to the development of Canadian nursing education and the psychiatric nursing specialty. Remnants of the themes found in the study endure to the present as organized nursing continues to struggle with issues around autonomy and authority over education and practice.

Quantifying the impact of community quarantine on SARS transmission in Ontario: estimation of secondary case count difference and number needed to quarantine.

PubMed

Bondy, Susan J; Russell, Margaret L; Laflèche, Julie Ml; Rea, Elizabeth

2009-12-24

Community quarantine is controversial, and the decision to use and prepare for it should be informed by specific quantitative evidence of benefit. Case-study reports on 2002-2004 SARS outbreaks have discussed the role of quarantine in the community in transmission. However, this literature has not yielded quantitative estimates of the reduction in secondary cases attributable to quarantine as would be seen in other areas of health policy and cost-effectiveness analysis. Using data from the 2003 Ontario, Canada, SARS outbreak, two novel expressions for the impact of quarantine are presented. Secondary Case Count Difference (SCCD) reflects reduction in the average number of transmissions arising from a SARS case in quarantine, relative to not in quarantine, at onset of symptoms. SCCD was estimated using Poisson and negative binomial regression models (with identity link function) comparing the number of secondary cases to each index case for quarantine relative to non-quarantined index cases. The inverse of this statistic is proposed as the number needed to quarantine (NNQ) to prevent one additional secondary transmission. Our estimated SCCD was 0.133 fewer secondary cases per quarantined versus non-quarantined index case; and a NNQ of 7.5 exposed individuals to be placed in community quarantine to prevent one additional case of transmission in the community. This analysis suggests quarantine can be an effective preventive measure, although these estimates lack statistical precision. Relative to other health policy areas, literature on quarantine tends to lack in quantitative expressions of effectiveness, or agreement on how best to report differences in outcomes attributable to control measure. We hope to further this discussion through presentation of means to calculate and express the impact of population control measures. The study of quarantine effectiveness presents several methodological and statistical challenges. Further research and discussion are needed to understand the costs and benefits of enacting quarantine, and this includes a discussion of how quantitative benefit should be communicated to decision-makers and the public, and evaluated.

Quantifying the impact of community quarantine on SARS transmission in Ontario: estimation of secondary case count difference and number needed to quarantine

PubMed Central

2009-01-01

Background Community quarantine is controversial, and the decision to use and prepare for it should be informed by specific quantitative evidence of benefit. Case-study reports on 2002-2004 SARS outbreaks have discussed the role of quarantine in the community in transmission. However, this literature has not yielded quantitative estimates of the reduction in secondary cases attributable to quarantine as would be seen in other areas of health policy and cost-effectiveness analysis. Methods Using data from the 2003 Ontario, Canada, SARS outbreak, two novel expressions for the impact of quarantine are presented. Secondary Case Count Difference (SCCD) reflects reduction in the average number of transmissions arising from a SARS case in quarantine, relative to not in quarantine, at onset of symptoms. SCCD was estimated using Poisson and negative binomial regression models (with identity link function) comparing the number of secondary cases to each index case for quarantine relative to non-quarantined index cases. The inverse of this statistic is proposed as the number needed to quarantine (NNQ) to prevent one additional secondary transmission. Results Our estimated SCCD was 0.133 fewer secondary cases per quarantined versus non-quarantined index case; and a NNQ of 7.5 exposed individuals to be placed in community quarantine to prevent one additional case of transmission in the community. This analysis suggests quarantine can be an effective preventive measure, although these estimates lack statistical precision. Conclusions Relative to other health policy areas, literature on quarantine tends to lack in quantitative expressions of effectiveness, or agreement on how best to report differences in outcomes attributable to control measure. We hope to further this discussion through presentation of means to calculate and express the impact of population control measures. The study of quarantine effectiveness presents several methodological and statistical challenges. Further research and discussion are needed to understand the costs and benefits of enacting quarantine, and this includes a discussion of how quantitative benefit should be communicated to decision-makers and the public, and evaluated. PMID:20034405

Estimating the burden of lung cancer and the efficiency of home radon mitigation systems in some Canadian provinces.

PubMed

Al-Arydah, Mo'tassem

2018-06-01

Lung cancer (LC) is the leading cause of death of cancer in Canada in both men and women, and indoor radon is the second leading cause of LC after tobacco smoking. The Population Attributable Risk (PAR) is used to assess radon exposure risk. In this work we estimate the burden of LC in some Canadian provinces. We use the PAR to identify the radon levels responsible for most LC cases. Finally, we use the PAR function of the two variables, radon action and target levels, to search for a possible optimal mitigation program. The LC burden for Ontario, Alberta, Manitoba, Quebec and British Columbia was estimated using provincial radon and mortality data. Then the PAR and LC cases for these provinces were estimated over the period 2006-2009 at different given indoor radon exposure levels. Finally, the PAR function when radon action levels and radon target levels are variables was analyzed. The highest burden of LC in 2006-2009 was in Ontario and Quebec. During the period 2006-2009, 6% of houses in Ontario, 9% of houses in Alberta, 19% of houses in Manitoba, 7% of houses in Quebec, and 5% of houses in British Columbia had radon levels higher than 200 Bq/m 3 and were responsible about 913, 211, 260, 972, and 258 lives, respectively. Radon mitigation programs could have prevented these LC cases. The BEIR VI assumption for the United States (US) population, 95% of LC deaths in men and 90% of LC deaths in women are Ever-Smokers (ES), can be applied to the Canadian population. The PAR is a linear function in the target radon value with an estimated slope of 0.0001 for Ontario, Alberta, Quebec and British Columbia, and 0.0004 for Manitoba. The PAR is almost a square root function in the radon action level. The PAR is sensitive to changes in the radon mitigation program and as such, any improvement is a worthwhile investment. Copyright © 2018 Elsevier B.V. All rights reserved.

Optimal selection of markers for validation or replication from genome-wide association studies.

PubMed

Greenwood, Celia M T; Rangrej, Jagadish; Sun, Lei

2007-07-01

With reductions in genotyping costs and the fast pace of improvements in genotyping technology, it is not uncommon for the individuals in a single study to undergo genotyping using several different platforms, where each platform may contain different numbers of markers selected via different criteria. For example, a set of cases and controls may be genotyped at markers in a small set of carefully selected candidate genes, and shortly thereafter, the same cases and controls may be used for a genome-wide single nucleotide polymorphism (SNP) association study. After such initial investigations, often, a subset of "interesting" markers is selected for validation or replication. Specifically, by validation, we refer to the investigation of associations between the selected subset of markers and the disease in independent data. However, it is not obvious how to choose the best set of markers for this validation. There may be a prior expectation that some sets of genotyping data are more likely to contain real associations. For example, it may be more likely for markers in plausible candidate genes to show disease associations than markers in a genome-wide scan. Hence, it would be desirable to select proportionally more markers from the candidate gene set. When a fixed number of markers are selected for validation, we propose an approach for identifying an optimal marker-selection configuration by basing the approach on minimizing the stratified false discovery rate. We illustrate this approach using a case-control study of colorectal cancer from Ontario, Canada, and we show that this approach leads to substantial reductions in the estimated false discovery rates in the Ontario dataset for the selected markers, as well as reductions in the expected false discovery rates for the proposed validation dataset. Copyright 2007 Wiley-Liss, Inc.

How do community pharmacists make decisions? Results of an exploratory qualitative study in Ontario.

PubMed

Gregory, Paul A M; Whyte, Brenna; Austin, Zubin

2016-03-01

As the complexity of pharmacy practice increases, pharmacists are required to make more decisions under ambiguous or information-deficient conditions. There is scant literature examining how pharmacists make decisions and what factors or values influence their choices. The objective of this exploratory research was to characterize decision-making patterns in the clinical setting of community pharmacists in Ontario. The think-aloud decision-making method was used for this study. Community pharmacists with 3 or more years' experience were presented with 2 clinical case studies dealing with challenging situations and were asked to verbally reason through their decision-making process while being probed by an interviewer for clarification, justification and further explication. Verbatim transcripts were analyzed using a protocol analysis method. A total of 12 pharmacists participated in this study. Participants experienced cognitive dissonance in attempting to reconcile their desire for a clear and confrontation-free conclusion to the case discussion and the reality of the challenge presented within each case. Strategies for resolving this cognitive dissonance included strong emphasis on the educational (rather than decision-making) role of the pharmacist, the value of strong interpersonal relationships as a way to avoid conflict and achieve desired outcomes, the desire to seek external advice or defer to others' authority to avoid making a decision and the use of strict interpretations of rules to avoid ambiguity and contextual interpretation. This research was neither representative nor generalizable but was indicative of patterns of decisional avoidance and fear of assuming responsibility for outcomes that warrant further investigation. The think-aloud method functioned effectively in this context and provided insights into pharmacists' decision-making patterns in the clinical setting. Can Pharm J (Ott) 2016;149:90-98.

The first case of porcine epidemic diarrhea in Canada

PubMed Central

Ojkic, Davor; Hazlett, Murray; Fairles, Jim; Marom, Anna; Slavic, Durda; Maxie, Grant; Alexandersen, Soren; Pasick, John; Alsop, Janet; Burlatschenko, Sue

2015-01-01

In January, 2014, increased mortality was reported in piglets with acute diarrhea on an Ontario farm. Villus atrophy in affected piglets was confined to the small intestine. Samples of colon content were PCR-positive for porcine epidemic diarrhea virus (PEDV). Other laboratory tests did not detect significant pathogens, confirming this was the first case of PED in Canada. PMID:25694663

Trimethoprim-sulfamethoxazole induced hyperkalaemia in elderly patients receiving spironolactone: nested case-control study

PubMed Central

Gomes, Tara; Mamdani, Muhammad M; Yao, Zhan; Hellings, Chelsea; Garg, Amit X; Weir, Matthew A; Juurlink, David N

2011-01-01

Objectives To characterise the risk of admission to hospital for hyperkalaemia in elderly patients treated with trimethoprim-sulfamethoxazole in combination with spironolactone. Design Population based nested case-control study. Setting Ontario, Canada, from 1 April 1992 to 1 March 2010. Participants Cases were residents of Ontario aged 66 years or above receiving chronic treatment with spironolactone and admitted to hospital with hyperkalaemia within 14 days of receiving a prescription for either trimethoprim-sulfamethoxazole, amoxicillin, norfloxacin, or nitrofurantoin. Up to four controls for each case were identified from the same cohort, matched on age, sex, and presence or absence of chronic kidney disease and diabetes, and required to have received one of the study antibiotics within 14 days before the case’s index date. Main outcome measures Odds ratio for association between admission to hospital with hyperkalaemia and receipt of a study antibiotic in the preceding 14 days, adjusted for conditions and drugs that may influence risk of hyperkalaemia. Results During the 18 year study period, 6903 admissions for hyperkalaemia were identified, 306 of which occurred within 14 days of antibiotic use. Of these, 248 (81%) cases were matched to 783 controls. 10.8% (17 859/165 754) of spironolactone users received at least one prescription for trimethoprim-sulfamethoxazole. Compared with amoxicillin, prescription of trimethoprim-sulfamethoxazole was associated with a marked increase in the risk of admission to hospital for hyperkalaemia (adjusted odds ratio 12.4, 95% confidence interval 7.1 to 21.6). The population attributable fraction was 59.7%, suggesting that approximately 60% of all cases of hyperkalaemia in older patients taking spironolactone and treated with an antibiotic for a urinary tract infection could be avoided if trimethoprim-sulfamethoxazole was not prescribed. Treatment with nitrofurantoin was also associated with an increase in the risk of hyperkalaemia (adjusted odds ratio 2.4, 1.3 to 4.6), but no such risk was found with norfloxacin (adjusted odds ratio 1.6, 0.8 to 3.4) Conclusions Among older patients receiving spironolactone, treatment with trimethoprim-sulfamethoxazole was associated with a major increase in the risk of admission to hospital for hyperkalaemia. This drug combination should be avoided when possible. PMID:21911446

Farmers' Use of Publications. Report of a Survey of Ontario Farmers' Receipt and Use of Three Technical Publications of the Ontario Department of Agriculture and Food.

ERIC Educational Resources Information Center

Blackburn, Donald J.

A survey was conducted to determine the extent of Ontario farmers' receipt, use and perception of three publications of the Ontario Department of Agriculture and Food--"Field Crop Recommendations for Ontario,""Guide to Chemical Weed Control" and "Dairy Husbandry in Ontario." A questionnaire was mailed in May 1969 to a…

The School System of Ontario with Special Reference to the Rural Schools. Bulletin, 1915, No. 32. Whole Number 659

ERIC Educational Resources Information Center

Foght, Harold W.

1915-01-01

This bulletin is the result of a study made in the Province of Ontario during the fall of 1914. The purpose of the investigation was, more than anything else, to seek some fair basis for comparison of the Schools of Old Ontario--wedged in as it is between New York and Michigan--and the States across the border. Chief attention is to rural life and…

Adolescent Tobacco and Cannabis Use: Young Adult Outcomes from the Ontario Child Health Study

ERIC Educational Resources Information Center

Georgiades, Katholiki; Boyle, Michael H.

2007-01-01

Background: This study examines the longitudinal associations between adolescent tobacco and cannabis use and young adult functioning. Methods: Data for analysis come from the Ontario Child Health Study (OCHS), a prospective study of child health, psychiatric disorder and adolescent substance use in a general population sample that began in 1983,…

Teaching Prejudice: A Content Analysis of Social Studies Textbooks Authorized for Use in Ontario.

ERIC Educational Resources Information Center

McDiarmid, Garnet; Pratt, David

This report of a study, undertaken at the request of the Ontario Human Rights Commission, details: 1) precedents and historical backgrounds in textbook analysis; 2) the methodology of the present study; and, 3) recommendations based on the findings. Groups selected for study were: Jews, immigrants, Moslems, Negroes, and American Indians. The…

Differences in Access to Services in Rural Emergency Departments of Quebec and Ontario

PubMed Central

Archambault, Patrick; Audette, Louis David; Plant, Jeff; Bégin, François; Poitras, Julien

2015-01-01

Introduction Rural emergency departments (EDs) are important safety nets for the 20% of Canadians who live there. A serious problem in access to health care services in these regions has emerged. However, there are considerable geographic disparities in access to trauma center in Canada. The main objective of this project was to compare access to local 24/7 support services in rural EDs in Quebec and Ontario as well as distances to Levels 1 and 2 trauma centers. Materials and Methods Rural EDs were identified through the Canadian Healthcare Association's Guide to Canadian Healthcare Facilities. We selected hospitals with 24/7 ED physician coverage and hospitalization beds that were located in rural communities. There were 26 rural EDs in Quebec and 62 in Ontario meeting these criteria. Data were collected from ministries of health, local health authorities, and ED statistics. Fisher’s exact test, the t-test or Wilcoxon-Mann-Whitney test, were performed to compare rural EDs of Quebec and Ontario. Results All selected EDs of Quebec and Ontario agreed to participate in the study. The number of EDs visits was higher in Quebec than in Ontario (19 322 ± 6 275 vs 13 446 ± 8 056, p = 0.0013). There were no significant differences between Quebec and Ontario’s local population and small town population density. Quebec’s EDs have better access to advance imaging services such as CT scanner (77% vs 15%, p < .0001) and most the consultant support and ICU (92% vs 31%, p < .0001). Finally, more than 40% of rural EDs in Quebec and Ontario are more than 300 km away from Levels 1 and 2 trauma centers. Conclusions Considering that Canada has a Universal health care system, the discrepancies between Quebec and Ontario in access to support services are intriguing. A nationwide study is justified to address this issue. PMID:25874948

Identification and survival outcomes of a cohort of patients with cancer of unknown primary in Ontario, Canada.

PubMed

Kim, Chong S; Hannouf, Malek B; Sarma, Sisira; Rodrigues, George B; Rogan, Peter K; Mahmud, Salaheddin M; Winquist, Eric; Brackstone, Muriel; Zaric, Gregory S

2015-11-01

Cancer of unknown primary origin (CUP) is defined by the presence of pathologically identified metastatic disease without clinical or radiological evidence of a primary tumour. Our objective was to identify incident cases of CUP in Ontario, Canada, and determine the influence of histology and sites of metastases on overall survival (OS). We used the Ontario Cancer Registry (OCR) and the Same-Day Surgery and Discharge Abstract Database (SDS/DAD) to identify patients diagnosed with CUP in Ontario between 1 January 2000, and 31 December 2005. Patient diagnostic information, including histology and survival data, was obtained from the OCR. We cross-validated CUP diagnosis and obtained additional information about metastasis through data linkage with the SDS/DAD database. OS was assessed using Cox regression models adjusting for histology and sites of metastases. We identified 3564 patients diagnosed with CUP. Patients without histologically confirmed disease (n = 1821) had a one-year OS of 10.9%, whereas patients with confirmed histology (n = 1743) had a one-year OS of 15.6%. The most common metastatic sites were in the respiratory or digestive systems (n = 1603), and the most common histology was adenocarcinoma (n = 939). Three-year survival rates were 3.5%, 5.3%, 41.6% and 3.6% among adenocarcinoma, unspecified carcinoma, squamous cell carcinoma and undifferentiated histology, respectively. Three-year survival rates were 40%, 2.4%, 8.0% and 4.6% among patients with metastases localised to lymph nodes, the respiratory or digestive systems, other specified sites, and unspecified sites, respectively. CUP patients in Ontario have a poor prognosis. Some subgroups may have better survival rates, such as patients with metastases localised to lymph nodes and patients with squamous cell histology.

The case for a cause-effect linkage between environmental contamination and development in eggs of the common snapping turtle (Chelydra S. serpentina) from Ontario, Canada

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bishop, C.A.; Brooks, R.J.; Carey, J.H.

1991-08-01

Concentrations of polychlorinated biphenyls (PCBs), dibenzo-p-dioxins, and dibenzofurans, organochlorine pesticides, and their metabolites were measured in eggs of the common snapping turtle (Chelydra s.serpentina) collected from four wetlands on the shorelines of Lakes Ontario, and Erie, and one control location in central Ontario, Canada. Snapping turtle eggs from these sites were also artificially incubated to determine hatching success, and incidence of deformities in embryo and hatchling turtles. The hypothesis that elevated incidences of egg death and/or deformities of hatchling turtles would occur in populations with high concentrations of organochlorine contaminants in eggs was tested. The results were elevated using epidemiologicalmore » criteria. Unhatched eggs and deformities occurred at significantly higher rates in eggs from Lake Ontario wetlands. Two of three sites from Lake Ontario had substantially higher levels of PCBs, dioxins, and furans compared to eggs from Lake Erie and the control site. It could not be shown that contamination of eggs preceded the occurrence of poor development of eggs, although excellent hatching success and low numbers of deformities in eggs from the control site were considered representative of development in healthy eggs. The statistical association between contaminant levels in eggs and poor development of these eggs supported the hypothesis that eggs from sites with the greatest contamination had the highest rates of abnormalities. PCBs were the most strongly associated chemicals, although possible effects due to the presence of other chemicals in eggs was a confounding factor. The deformities and rates of unhatched eggs were similar to those occurring in other vertebrates collected from highly contaminated areas of the Great Lakes. 54 references.« less

Sexual difference in mercury concentrations of lake trout (Salvelinus namaycush) from Lake Ontario

USGS Publications Warehouse

Madenjian, C.P.; Keir, M.J.; Whittle, D.M.

2011-01-01

We determined total mercury (Hg) concentrations in 50 female lake trout (Salvelinus namaycush) and 69 male lake trout from Lake Ontario (Ontario, Canada and New York, United States). Results showed that, on average, males were 8% higher in Hg concentration than females in Lake Ontario. We also used bioenergetics modeling to determine whether a sexual difference in gross growth efficiency (GGE) could explain the observed sexual difference in Hg concentrations. According to the bioenergetics modeling results, male GGE was about 3% higher than female GGE, on average. Although the bioenergetics modeling could not explain the higher Hg concentrations exhibited by the males, a sexual difference in GGE remained a plausible explanation for the sexual difference in Hg concentrations of the lake trout. In an earlier study, male lake trout from Lake Ontario were found to be 22% higher in polychlorinated biphenyl (PCB) concentration than females from Lake Ontario. Thus, although males were higher in both Hg and PCB concentrations, the degree of the sexual difference in concentration varied between the two contaminants. Further research on sexual differences in Hg excretion rates and Hg direct uptake rates may be needed to resolve the disparity in results between the two contaminants.

Transforming Ontario's Apprenticeship Training System: Supplying the Tradespersons Needed for Sustained Growth--A Proposal from Ontario's Colleges

ERIC Educational Resources Information Center

Colleges Ontario, 2009

2009-01-01

Ontario's colleges share the provincial government's belief that apprenticeship must play a greater role in addressing skills shortages and contributing to innovative, high-performance workplaces that enhance Ontario's competitiveness. Given the severity of the economic downturn, Ontario faces an immediate, serious challenge as apprenticeship…

Comparing health system performance assessment and management approaches in the Netherlands and Ontario, Canada

PubMed Central

Tawfik-Shukor, Ali R; Klazinga, Niek S; Arah, Onyebuchi A

2007-01-01

Background Given the proliferation and the growing complexity of performance measurement initiatives in many health systems, the Netherlands and Ontario, Canada expressed interests in cross-national comparisons in an effort to promote knowledge transfer and best practise. To support this cross-national learning, a study was undertaken to compare health system performance approaches in The Netherlands with Ontario, Canada. Methods We explored the performance assessment framework and system of each constituency, the embeddedness of performance data in management and policy processes, and the interrelationships between the frameworks. Methods used included analysing governmental strategic planning and policy documents, literature and internet searches, comparative descriptive tables, and schematics. Data collection and analysis took place in Ontario and The Netherlands. A workshop to validate and discuss the findings was conducted in Toronto, adding important insights to the study. Results Both Ontario and The Netherlands conceive health system performance within supportive frameworks. However they differ in their assessment approaches. Ontario's Scorecard links performance measurement with strategy, aimed at health system integration. The Dutch Health Care Performance Report (Zorgbalans) does not explicitly link performance with strategy, and focuses on the technical quality of healthcare by measuring dimensions of quality, access, and cost against healthcare needs. A backbone 'five diamond' framework maps both frameworks and articulates the interrelations and overlap between their goals, themes, dimensions and indicators. The workshop yielded more contextual insights and further validated the comparative values of each constituency's performance assessment system. Conclusion To compare the health system performance approaches between The Netherlands and Ontario, Canada, several important conceptual and contextual issues must be addressed, before even attempting any future content comparisons and benchmarking. Such issues would lend relevant interpretational credibility to international comparative assessments of the two health systems. PMID:17319947

School Boards and the Political Fact. A Report on Ontario Institute for Studies in Education/Ontario School Trustees' Council Conference, "The Politics of Education: Some Main Themes and Issues" (Toronto, Ontario, May 28-30, 1972).

ERIC Educational Resources Information Center

Cistone, Peter J., Ed.

This monograph presents papers by ten experts on such problems as the dynamic tension between the Province and local school districts, the size and inflexibility of the circle of elites who influence policymaking in education, and whether or not participation in policymaking should be broadened. The papers included are (1) Peter J. Cistone,…

Perspectives and Plans for Graduate Studies. 4. Geography 1973.

ERIC Educational Resources Information Center

Ontario Council on Graduate Studies, Toronto. Advisory Committee on Academic Planning.

This report is one of a series of disciplinary planning studies carried out by the Advisory Committee on Academic Planning of the Council of Ontario Universities. The emphasis of the report is on forward planning, and it is hoped that it will help ensure the more ordered growth and development of graduate studies in Ontario's Universities. This…

Exploring experiences of the food environment among immigrants living in the Region of Waterloo, Ontario.

PubMed

Rodriguez, Paulina I; Dean, Jennifer; Kirkpatrick, Sharon; Berbary, Lisbeth; Scott, Steffanie

2016-06-09

This exploratory study aimed to shed light on the role of the food environment in shaping food access among immigrants living in the Region of Waterloo, Ontario. In this qualitative case study, in-depth interviews aided by photovoice were conducted with nine immigrants, and key informant (KI) interviews were conducted with nine community stakeholders (e.g., settlement workers, planners) who held expert knowledge of the local context with respect to both the food system and experiences of immigrants in interacting with this system. In this paper, we focus specifically on insights related to the food environment, applying the Analysis Grid for Environments Linked to Obesity Framework to assess economic, physical, socio-cultural and political aspects. Economic features of the food environment, including food prices and differential costs of different types of food, emerged as factors related to food access. However, interactions with the food environment were shaped by broader economic factors, such as limited employment opportunities and low income. Most immigrants felt that they had good geographic access to food, though KIs expressed concerns about the types of outlet and food that were most accessible. Immigrants discussed social networks and cultural food practices, whereas KIs discussed political issues related to supporting food security in the Region. This exploratory case study is consistent with prior research in highlighting the economic constraints within which food access exists but suggests that there may be a need to further dissect food environments.

Waiting Lists for Radiation Therapy: A Case Study

PubMed Central

2001-01-01

Background Why waiting lists arise and how to address them remains unclear, and an improved understanding of these waiting list "dynamics" could lead to better management. The purpose of this study is to understand how the current shortage in radiation therapy in Ontario developed; the implications of prolonged waits; who is held accountable for managing such delays; and short, intermediate, and long-term solutions. Methods A case study of the radiation therapy shortage in 1998-99 at Princess Margaret Hospital, Toronto, Ontario, Canada. Relevant documents were collected; semi-structured, face-to-face interviews with ten administrators, health care workers, and patients were conducted, audio-taped and transcribed; and relevant meetings were observed. Results The radiation therapy shortage arose from a complex interplay of factors including: rising cancer incidence rates; broadening indications for radiation therapy; human resources management issues; government funding decisions; and responsiveness to previous planning recommendations. Implications of delays include poorer cancer control rates; patient suffering; and strained doctor-patient relationships. An incompatible relationship exists between moral responsibility, borne by government, and legal liability, borne by physicians. Short-term solutions include re-referral to centers with available resources; long-term solutions include training and recruiting health care workers, improving workload standards, increasing compensation, and making changes to the funding formula. Conclusion Human resource planning plays a critical role in the causes and solutions of waiting lists. Waiting lists have harsh implications for patients. Accountability relationships require realignment. PMID:11319944

Descriptive study of enteric zoonoses in Ontario, Canada, from 2010 - 2012.

PubMed

Whitfield, Yvonne; Johnson, Karen; Hobbs, Leigh; Middleton, Dean; Dhar, Badal; Vrbova, Linda

2017-02-21

Contact with animals and their environment has long been recognized as an important source of enteric zoonoses. However, there are limited data available on the burden of illness associated with specific types of animals in Canada. This study describes the overall burden of enteric zoonoses in Ontario, Canada from 2010 to 2012. Confirmed cases of seven enteric zoonotic diseases (campylobacteriosis, cryptosporidiosis, giardiasis, listeriosis, salmonellosis, verotoxin-producing E. coli (VTEC) infection, and yersiniosis) with episode dates from 2010 to 2012 were extracted from the integrated Public Health Information System (iPHIS). Reported exposures were categorized as animal contact, foodborne, waterborne and 'other', with animal contact grouped into nine sub-categories based on the type of animal or transmission setting. Overall incidence rates and proportions by animal exposure categories, age and sex-specific incidence rates and hospitalization and death proportions were calculated and sex proportions compared. Our study found that approximately 26% of the enteric pathogens assessed during the 2010 to 2012 period reported contact with animals and their environments as the mode of transmission. Of enteric disease cases reporting animal contact, farm exposures were reported for 51.3%, dog or cat exposures for 26.3%, and reptile or amphibian exposures for 8.9%. Contact with animals was reported more frequently during the period 2010 to 2012 in comparison to the period 1997 to 2003 when 6% or less of enteric cases were associated with animal contact. Public health professionals, stakeholders associated with animals and their related industries (e.g., pet treats, mobile zoos, abattoirs), and the public should recognize that animal contact is an important source of enteric illnesses in order to take measures to reduce the burden of illness from animal sources.

Natural rubber latex-related occupational asthma: association with interventions and glove changes over time.

PubMed

Liss, G M; Tarlo, S M

2001-10-01

Exposure to natural rubber latex (NRL) has been recognized as a cause of occupational asthma (OA), especially among health care workers (HCWs) associated with use of gloves. Little or no population-based data are available which chart the changes over time in the number of cases of OA as this problem was increasingly recognized and then interventions instituted. We obtained the numbers of allowed asthma claims with exposure to latex by year in the province of Ontario, Canada from the Ontario Workplace Safety and Insurance Board; details of the cases from the largest teaching hospital were reviewed. Interventions included: (1) in 1996, the Board recommended in its focus for accommodation of sensitized workers, the reduction of aerosols of latex proteins and that hospital facilities use powder-free, low-protein or nonlatex gloves; and (2) hospitals instituted latex policies and glove changes at various dates. For example, at the largest teaching hospital, interventions included education and voluntary medical surveillance in 1994; substitution of low protein, "powder-free" NRL gloves for non-sterile powdered gloves in 1995; and replacement of powdered sterile NRL gloves by lower protein, "powder-free" NRL gloves in 1997. Through 1999, there were 60 allowed claims for asthma in Ontario with exposure to latex; of these 49 (82%) were among HCWs. The number of claims among HCWs changed from 0 to 2 per year up to 1990; increased to 7 to 11 per year between 1991-1994; and declined to 3 per year in 1995-1996 and 1 to 2 per year in 1997-1999. Of the ten institutions having two or more OA latex claims, all claims occurred in 1996 or earlier at 8 (80%). At the largest hospital, there were five accepted claims with year of diagnosis in 1993 (1 case), 1994 (3 cases), and 1995 (1 case). These findings suggest that, despite the effect of increasing recognition, the introduction of gloves with reduced powder and/or protein, as well as other interventions have been associated temporally with declines in the number of cases of latex OA. Copyright 2001 Wiley-Liss, Inc.

Economic Evaluation of Community-Based HIV Prevention Programs in Ontario: Evidence of Effectiveness in Reducing HIV Infections and Health Care Costs.

PubMed

Choi, Stephanie K Y; Holtgrave, David R; Bacon, Jean; Kennedy, Rick; Lush, Joanne; McGee, Frank; Tomlinson, George A; Rourke, Sean B

2016-06-01

Investments in community-based HIV prevention programs in Ontario over the past two and a half decades are assumed to have had an impact on the HIV epidemic, but they have never been systematically evaluated. To help close this knowledge gap, we conducted a macro-level evaluation of investment in Ontario HIV prevention programs from the payer perspective. Our results showed that, from 1987 to 2011, province-wide community-based programs helped to avert a total of 16,672 HIV infections, saving Ontario's health care system approximately $6.5 billion Canadian dollars (range 4.8-7.5B). We also showed that these community-based HIV programs were cost-saving: from 2005 to 2011, every dollar invested in these programs saved about $5. This study is an important first step in understanding the impact of investing in community-based HIV prevention programs in Ontario and recognizing the impact that these programs have had in reducing HIV infections and health care costs.

The Efficacy of Key Performance Indicators in Ontario Universities as Perceived by Key Informants

ERIC Educational Resources Information Center

Chan, Vivian

2015-01-01

The Ontario Ministry of Education and Training's Task Force on University Accountability first proposed key performance indicators (KPIs) for colleges and universities in Ontario in the early 1990s. The three main KPIs for Ontario universities are the rates of (1) graduation, (2) employment, and (3) Ontario Student Assistance Program loan default.…

Association of Colleges of Applied Arts and Technology of Ontario 2002 Environmental Scan.

ERIC Educational Resources Information Center

Association of Colleges of Applied Arts and Technology of Ontario, Toronto.

This environmental scan is designed to assist Ontario's colleges in their strategic planning processes. Ontario's colleges have supported a 35% increase in enrollment, with a 40% decrease in funding, over the last ten years, while operating costs have risen. In addition, Ontario eliminated the secondary school Ontario Academic Courses (OACs),…

Inclusion of persons with mental illness in patient-centred medical homes: cross-sectional findings from Ontario, Canada.

PubMed

Steele, Leah S; Durbin, Anna; Sibley, Lyn M; Glazier, Richard

2013-01-01

In Ontario, Canada, the patient-centred medical home is a model of primary care delivery that includes 3 model types of interest for this study: enhanced fee-for-service, blended capitation, and team-based blended capitation. All 3 models involve rostering of patients and have similar practice requirements but differ in method of physician reimbursement, with the blended capitation models incorporating adjustments for age and sex, but not case mix, of rostered patients. We evaluated the extent to which persons with mental illness were included in physicians' total practices (as rostered and non-rostered patients) and were included on physicians' rosters across types of medical homes in Ontario. Using population-based administrative data, we considered 3 groups of patients: those with psychotic or bipolar diagnoses, those with other mental health diagnoses, and those with no mental health diagnoses. We modelled the prevalence of mental health diagnoses and the proportion of patients with such diagnoses who were rostered across the 3 medical home model types, controlling for demographic characteristics and case mix. Compared with enhanced fee-for-service practices, and relative to patients without mental illness, the proportions of patients with psychosis or bipolar disorders were not different in blended capitation and team-based blended capitation practices (rate ratio [RR] 0.91, 95% confidence interval [CI] 0.82-1.01; RR 1.06, 95% CI 0.96-1.17, respectively). However, there were fewer patients with other mental illnesses (RR 0.94, 95% CI 0.90-0.99; RR 0.89, 95% CI 0.85-0.94, respectively). Compared with expected proportions, practices based on both capitation models were significantly less likely than enhanced fee-for-service practices to roster patients with psychosis or bipolar disorders (for blended capitation, RR 0.92, 95% CI 0.90-0.93; for team-based capitation, RR 0.92, 95% CI 0.88-0.93) and also patients with other mental illnesses (for blended capitation, RR 0.94, 95% CI 0.92-0.95; for team-based capitation, RR 0.93, 95% CI 0.92-0.94). Persons with mental illness were under-represented in the rosters of Ontario's capitation-based medical homes. These findings suggest a need to direct attention to the incentive structure for including patients with mental illness.

Association between the 2008–09 Seasonal Influenza Vaccine and Pandemic H1N1 Illness during Spring–Summer 2009: Four Observational Studies from Canada

PubMed Central

Skowronski, Danuta M.; De Serres, Gaston; Crowcroft, Natasha S.; Janjua, Naveed Z.; Boulianne, Nicole; Hottes, Travis S.; Rosella, Laura C.; Dickinson, James A.; Gilca, Rodica; Sethi, Pam; Ouhoummane, Najwa; Willison, Donald J.; Rouleau, Isabelle; Petric, Martin; Fonseca, Kevin; Drews, Steven J.; Rebbapragada, Anuradha; Charest, Hugues; Hamelin, Marie-Ève; Boivin, Guy; Gardy, Jennifer L.; Li, Yan; Kwindt, Trijntje L.; Patrick, David M.; Brunham, Robert C.

2010-01-01

Background In late spring 2009, concern was raised in Canada that prior vaccination with the 2008–09 trivalent inactivated influenza vaccine (TIV) was associated with increased risk of pandemic influenza A (H1N1) (pH1N1) illness. Several epidemiologic investigations were conducted through the summer to assess this putative association. Methods and Findings Studies included: (1) test-negative case-control design based on Canada's sentinel vaccine effectiveness monitoring system in British Columbia, Alberta, Ontario, and Quebec; (2) conventional case-control design using population controls in Quebec; (3) test-negative case-control design in Ontario; and (4) prospective household transmission (cohort) study in Quebec. Logistic regression was used to estimate odds ratios for TIV effect on community- or hospital-based laboratory-confirmed seasonal or pH1N1 influenza cases compared to controls with restriction, stratification, and adjustment for covariates including combinations of age, sex, comorbidity, timeliness of medical visit, prior physician visits, and/or health care worker (HCW) status. For the prospective study risk ratios were computed. Based on the sentinel study of 672 cases and 857 controls, 2008–09 TIV was associated with statistically significant protection against seasonal influenza (odds ratio 0.44, 95% CI 0.33–0.59). In contrast, estimates from the sentinel and three other observational studies, involving a total of 1,226 laboratory-confirmed pH1N1 cases and 1,505 controls, indicated that prior receipt of 2008–09 TIV was associated with increased risk of medically attended pH1N1 illness during the spring–summer 2009, with estimated risk or odds ratios ranging from 1.4 to 2.5. Risk of pH1N1 hospitalization was not further increased among vaccinated people when comparing hospitalized to community cases. Conclusions Prior receipt of 2008–09 TIV was associated with increased risk of medically attended pH1N1 illness during the spring–summer 2009 in Canada. The occurrence of bias (selection, information) or confounding cannot be ruled out. Further experimental and epidemiological assessment is warranted. Possible biological mechanisms and immunoepidemiologic implications are considered. Please see later in the article for the Editors' Summary PMID:20386731

Intravascular Ultrasound to Guide Percutaneous Coronary Interventions

PubMed Central

2006-01-01

Executive Summary Objective The objective of this health technology policy assessment was to determine the effectiveness and cost-effectiveness of using intravascular ultrasound (IVUS) as an adjunctive imaging tool to coronary angiography for guiding percutaneous coronary interventions. Background Intravascular Ultrasound Intravascular ultrasound is a procedure that uses high frequency sound waves to acquire 3-dimensional images from the lumen of a blood vessel. The equipment for performing IVUS consists of a percutaneous transducer catheter and a console for reconstructing images. IVUS has been used to study the structure of the arterial wall and nature of atherosclerotic plaques, and obtain measurements of the vessel lumen. Its role in guiding stent placement is also being investigated. IVUS is presently not an insured health service in Ontario. Clinical Need Coronary artery disease accounts for approximately 55% of cardiovascular deaths, the leading cause of death in Canada. In Ontario, the annual mortality rate due to ischemic heart disease was 141.8 per 100,000 population between 1995 and 1997. Percutaneous coronary intervention (PCI), a less invasive approach to treating coronary artery disease, is used more frequently than coronary bypass surgery in Ontario. The number of percutaneous coronary intervention procedures funded by the Ontario Ministry of Health and Long-term Care is expected to increase from approximately 17, 780 in 2004/2005 to 22,355 in 2006/2007 (an increase of 26%), with about 95% requiring the placement of one or more stents. Restenosis following percutaneous coronary interventions involving bare metal stents occurs in 15% to 30% of the cases, mainly because of smooth muscle proliferation and migration, and production of extracellular matrix. In-stent restenosis has been linked to suboptimal stent expansion and inadequate lesion coverage, while stent thrombosis has been attributed to incomplete stent-to-vessel wall apposition. Since coronary angiography (the imaging tool used to guide stent placement) has been shown to be inaccurate in assessing optimal stent placement, and IVUS can provide better views of the vessel lumen, the clinical utility of IVUS as an imaging tool adjunctive to coronary angiography in coronary intervention procedures has been explored in clinical studies. Method A systematic review was conducted to answer the following questions: What are the procedure-related complications associated with IVUS? Does IVUS used in conjunction with angiography to guide percutaneous interventions improve patient outcomes compared to angiographic guidance without IVUS? Who would benefit most in terms of clinical outcomes from the use of IVUS adjunctive to coronary angiography in guiding PCIs? What is the effectiveness of IVUS guidance in the context of drug-eluting stents? What is the cost-effectiveness ratio and budget impact of adjunctive IVUS in PCIs in Ontario? A systematic search of databases OVID MEDLINE, EMBASE, MEDLINE In-Process & Other Non-Indexed Citations, The Cochrane Library, and the International Agency for Health Technology Assessment (INAHTA) database for the period beginning in May 2001 until the day of the search, November 4, 2005 yielded 2 systematic reviews, 1 meta-analysis, 6 randomized controlled trials, and 2 non-randomized studies on left main coronary arteries. The quality of the studies ranged from moderate to high. These reports were combined with reports from a previous systematic review for analysis. In addition to qualitative synthesis, pooled analyses of data from randomized controlled studies using a random effect model in the Cochrane Review Manager 4.2 software were conducted when possible. Findings of Literature Review & Analysis Safety Intravascular ultrasound appears to be a safe tool when used in coronary interventions. Periprocedural complications associated with the use of IVUS in coronary interventions ranged from 0.5% in the largest study to 4%. Coronary rupture was reported in 1 study (1/54). Other complications included prolonged spasms of the artery after stenting, dissection, and femoral aneurysm. Effectiveness Based on pooled analyses of data from randomized controlled studies, the use of intravascular ultrasound adjunctive to coronary intervention in percutaneous coronary interventions using bare metal stents yielded the following findings: For lesions predominantly at low risk of restenosis: There were no significant differences in preintervention angiographic minimal lumen diameter between the IVUS-guided and angiography-guided groups. IVUS guidance resulted in a significantly larger mean postintervention angiographic minimal lumen diameter (weighted mean difference of 0.11 mm, P = .0003) compared to angiographic guidance alone. The benefit in angiographic minimal lumen diameter from IVUS guidance was not maintained at 6-month follow-up, when no significant difference in angiographic minimal lumen diameter could be detected between the two arms (weighted mean difference 0.08, P = .13). There were no statistically significant differences in angiographic binary restenosis rates between IVUS-guidance and no IVUS guidance (Odds ratio [OR] 0.87 in favour of IVUS, 95% Confidence Interval [CI] [0.64–1.18], P = 0.37). IVUS guidance resulted in a reduction in the odds of target lesion revascularization (repeat percutaneous coronary intervention or coronary bypass graft) compared to angiographic guidance alone. The reduction was statistically significant at a follow-up period of 6 months to 1 year, and at a follow-up period of 18 month to 2 years (OR 0.52 in favour of IVUS, 95% CI [0.33–0.81], P = .004). Total revascularization rate (either target lesion or target vessel revascularization) was significantly lower for IVUS-guided patients at 18 months to 2.5 years after intervention (OR 0.43 in favour of IVUS, 95% CI [0.29–0.63], p < .0001). There were no statistically significant differences in the odds of death (OR 1.36 in favour of no IVUS, P =0.65) or myocardial infarction (OR 0.95 in favour of IVUS, P = 0.93) between IVUS-guidance and angiographic guidance alone at up to 2.5 years of follow-up The odds of having a major cardiac event (defined as death, myocardial infarction, and target lesion or target vessel revascularization) were significantly lower for patients with IVUS guidance compared to angiographic guidance alone during follow-up periods of up to 2.5 years (OR 0.53, 95% CI [0.36–0.78], P = 0.001). Since there were no significant reductions in the odds of death or myocardial infarction, the reduction in the odds of combined events reflected mainly the reduction in revascularization rates. For lesions at High Risk of Restenosis: There is evidence from one small, randomized controlled trial (n=150) that IVUS-guided percutaneous coronary intervention in long de novo lesions (>20 mm) of native coronary arteries resulted in statistically significant larger minimal lumen Diameter, and statistically significant lower 6-month angiographic binary restenosis rate. Target vessel revascularization rate and the rate of combined events were also significantly reduced at 12 months. A small subgroup analysis of a randomized controlled trial reported no benefit in clinical or angiographic outcomes for IVUS-guided percutaneous coronary interventions in patients with diabetes compared to those guided by angiography. However, due to the nature and size of the analysis, no firm conclusions could be reached. Based on 2 small, prospective, non-randomized controlled studies, IVUS guidance in percutaneous coronary interventions of left main coronary lesions using bare metal stents or drug-eluting stents did not result in any benefits in angiographic or clinical outcomes. These findings need to be confirmed. Interventions Using Drug-Eluting Stents There is presently no evidence on whether the addition of IVUS guidance during the implantation of drug-eluting stents would reduce incomplete stent apposition, or improve the angiographic or clinical outcomes of patients. Ontario-Based Economic Analysis Cost-effectiveness analysis showed that PCIs using IVUS guidance would likely be less costly and more effective than PCIs without IVUS guidance. The upfront cost of adjunctive use of IVUS in PCIs ranged from $1.56 million at 6% uptake to $13.04 million at 50% uptake. Taking into consideration cost avoidance from reduction in revascularization associated with the use of IVUS, a net saving of $0.63 million to $5.2 million is expected. However, since it is uncertain whether the reduction in revascularization rate resulting from the use of IVUS can be generalized to clinical settings in Ontario, further analysis on the budget impact and cost-effectiveness need to be conducted once Ontario-specific revascularization rates are verified. Factors to be Considered in the Ontario Context Applicability of Findings to Ontario The interim analysis of an Ontario field evaluation that compared drug-eluting stents to bare metal stents showed that the revascularization rates in low-risk patients with bare metal stents were much lower in Ontario compared to rates reported in randomized controlled trials (7.2% vs >17 %). Even though IVUS is presently not routinely used in the stenting of low-risk patients in Ontario, the revascularization rates in these patients in Ontario were shown to be lower than those reported for the IVUS groups reported in published studies. Based on this information and previous findings from the Ontario field evaluation on stenting, it is uncertain whether the reduction in revascularization rates from IVUS guidance can be generalized to Ontario. In light of the above findings, it is advisable to validate the reported benefits of IVUS guidance in percutaneous coronary interventions involving bare metal stents in the Ontario context. Licensing Status As of January 16, 2006, Health Canada has licensed 10 intravascular ultrasound imaging systems/catheters for transluminal intervention procedures, most as class 4 medical devices. Current Funding IVUS is presently not an insured procedure under the Ontario Health Insurance Plan and there are no professional fees for this procedure. All costs related to the use of IVUS are covered within hospitals’ global budgets. A single use IVUS catheter costs approximately $900CDN and the procedure adds approximately 20 minutes to 30 minutes to a percutaneous coronary intervention procedure. Diffusion According to an expert consultant, current use of IVUS in coronary interventions in Ontario is probably limited to high-risk cases such as interventions in long lesions, small vessels, and bifurcated lesions for which images from coronary angiography are indeterminate. It was estimated that IVUS is being used in about 6% of all percutaneous coronary interventions at a large Ontario cardiac centre. Expert Opinion IVUS greatly enhances the cardiac interventionists’ ability to visualize and assess high-risk lesions such as long lesions, narrow lesions, and bifurcated lesions that may have indeterminate angiographic images. Information from IVUS in these cases facilitates the choice of the most appropriate approach for the intervention. Conclusion The use of adjunctive IVUS in PCIs using bare metal stents in lesions predominantly at low risk for restenosis had no significant impact on survival, myocardial infarction, or angiographic restenosis rates up to 2.5 years after intervention. The use of IVUS adjunctive to coronary angiography in percutaneous coronary interventions using bare metal stents in lesions predominantly at low risk for restenosis significantly reduced the target lesion and target vessel revascularization at a follow-up period of 18 months to 2.5 years. One small study suggests that adjunctive IVUS in PCIs using bare metal stents in long lesions (>20 mm) significantly improved the 6-month angiographic restenosis rate and one-year target lesion revascularization rate. These results need to be confirmed with large randomized controlled trials. Based on information from the Ontario field evaluation on stenting, it is uncertain whether the reduction in revascularization rate resulting from the use of IVUS in the placement of bare metal stents can be generalized to clinical settings in Ontario. There is presently insufficient evidence available to determine the impact of adjunctive IVUS in percutaneous interventions in high-risk lesions (other than long lesions) or in PCIs using drug-eluting stents. PMID:23074482

A Comparative Study of Compensation of Faculty and Senior Administrative Personnel in Ontario Universities.

ERIC Educational Resources Information Center

Hayman, Brian; And Others

A study was undertaken to compare the compensation (salary, benefits and perquisites) of faculty and senior administrative personnel in Ontario universities with that of professionals in the private and public sectors. For senior, non-academic administrative personnel, the major findings were that: compensation practice across the 13 universities…

Children's Perceptions of the Northern Fruit and Vegetable Program in Ontario, Canada

ERIC Educational Resources Information Center

He, Meizi; Beynon, Charlene E.; Gritke, Jennifer L.; Henderson, Michelle L.; Kurtz, Joanne M.; Sangster Bouck, Michelle; St. Onge, Renee L.; van Zandvoort, Melissa M.; Chevrier-Lamoureux, Renee D.; Warren, Claire Y.

2012-01-01

Objective: This study examined students' perceptions of and suggestions for the Northern Fruit and Vegetable Program, a free, school-based fruit and vegetable snack program implemented in elementary schools in 2 regions of northern Ontario, Canada. Methods: This was a qualitative study involving 18 focus groups with students in 11 elementary…

Low-pathogenic avian influenza virus A/turkey/Ontario/6213/1966 (H5N1) is the progenitor of highly pathogenic A/turkey/Ontario/7732/1966 (H5N9)

PubMed Central

Ping, Jihui; Selman, Mohammed; Tyler, Shaun; Forbes, Nicole; Keleta, Liya

2012-01-01

The first confirmed outbreak of highly pathogenic avian influenza (HPAI) virus infections in North America was caused by A/turkey/Ontario/7732/1966 (H5N9); however, the phylogeny of this virus is largely unknown. This study performed genomic sequence analysis of 11 avian influenza isolates from 1956 to 1979 for comparison with A/turkey/Ontario/7732/1966 (H5N9). Phylogenetic and genetic analyses included these viruses in combination with all known full-genome sequences of avian viruses isolated before 1981. It was shown that a low-pathogenic avian influenza virus, A/turkey/Ontario/6213/1966 (H5N1), that had been isolated 3 months previously, was the closest known genetic relative with six genome segments of common lineage encoding the polymerase subunits PB2, PB1 and PA, nucleoprotein (NP), haemagglutinin (HA) and non-structural (NS) proteins. The lineages of these genome segments included reassortment with other North American turkey viruses that were all rooted in North American wild waterfowl with the HA gene originating from the H5N2 serotype. The phylogenies demonstrated adaptation from North American wild birds to turkeys with the possible involvement of domestic waterfowl. The turkey isolate, A/turkey/Wisconsin/1968 (H5N9), was the second most closely related poultry isolate to A/turkey/Ontario/7732/1966 (H5N9), possessing five common lineage genome segments (PB2, PB1, PA, HA and neuraminidase). The A/turkey/Ontario/6213/1966 (H5N1) virus was more virulent than A/turkey/Wisconsin/68 (H5N9) for chicken embryos and mice, indicating a greater biological similarity to A/turkey/Ontario/7732/1966 (H5N9). Thus, A/turkey/Ontario/6213/1966 (H5N1) was identified as the closest known ancestral relative of HPAI A/turkey/Ontario/7732/1966 (H5N9), which will serve as a useful reference virus for characterizing the early genetic and biological properties associated with the emergence of pathogenic avian influenza strains. PMID:22592261

Inequalities in Sport and Physical Activity Programs in Ontario Schools.

ERIC Educational Resources Information Center

Macintosh, Donald

1981-01-01

Two recent studies of interschool sports and physical education in Ontario secondary schools examine the issues of differences in interschool sports participation as a reflection of socioeconomic background, gender of the participants, degree of participation, and school size.

Literacy and Health Project. Phase One. Making the World Healthier and Safer for People Who Can't Read = Projet alphabetisation et sante: Premiere etape. Rendre le milieu plus sain et sans danger pour les personnes qui ne savent pas lire.

ERIC Educational Resources Information Center

Ontario Public Health Association, Toronto.

The Literacy and Health Project was set up to determine how reading and health problems were connected. A research phase documented the relationship between literacy and health. Information was collected from community organizations, literature review, three case studies in Ontario, and key informant interviews. The consultation process involved…

Hospitals' response to the buckle-up baby legislation in Ontario.

PubMed Central

Lawee, D; Stoughton, W V

1986-01-01

Drivers in Ontario are legally responsible to ensure that infants and toddlers are restrained in a child safety seat or by a lap belt. In 1982 the minister of health sent a memorandum to all medical officers of health and the administrators and medical directors of all public hospitals in Ontario, urging them to encourage and assist parents in protecting their newborn children with safety seats. In 1983 the Toronto General Hospital established the Cooperative Hospital Infant Restraint Program (CHIRP) to study the feasibility of a "loaner" program for hospitals in metropolitan Toronto. The authors describe CHIRP and its objectives. They also report the results of a questionnaire they sent in 1984 to all Ontario hospitals that had a newborn or pediatric service to assess their response to the minister's memorandum. PMID:3768820

"A midwife at every confinement": Midwifery and Medicalized Childbirth in Ontario and Britain, 1920-1950.

PubMed

Cross, Gwenith Siobhan

2014-01-01

This paper compares midwifery in Ontario and Britain in the first half of the 20th century. British midwives improved maternal and infant health and welfare by making childbirth a cooperative, medically managed event in conjunction with physicians. British midwives thus participated in, and contributed to, developments in obstetrics. In contrast, Ontario physicians worked to exclude midwives from participation in the modernization of birth management, relying on a narrower concept of "medicalization" defined as physician dominance. This study challenges the medical profession's assumptions that the exclusion of midwifery in Ontario was necessary to the medicalization of childbirth. The British alternative, where midwives were seen as partners rather than obstacles, illustrates that medicalization in the interest of infant and maternal safety could be integrated with the work of midwives.

Establishment of Ochlerotatus japonicus (Diptera: Culicidae) in Ontario, Canada.

PubMed

Thielman, Aynsley; Hunter, Fiona F

2006-03-01

Ochlerotatus (Finlaya) japonicus (Theobold) is newly established in Ontario, Canada. It was first discovered in 2001 during the province-wide West Nile virus mosquito surveillance program implemented by the Ontario Ministry of Health and Long Term Care. Although the numbers of adults trapped in CDC light traps were low in 2001 and 2002, they increased during the 2003 and 2004 surveillance seasons. Oc. japonicus larvae also have been collected in large numbers in the Niagara Peninsula in a variety of natural and artificial containers. The number of health units with records for Oc. japonicus has increased over the 4 yr of surveillance, illustrating the ability of this species to rapidly extend its range. As a potential arboviral bridge vector, its establishment in Ontario requires further study and should be considered a public health concern.

Global Citizenship

ERIC Educational Resources Information Center

Osiadacz, Evelina

2018-01-01

This article draws attention to the keyword "global citizenship" through an analysis of the ambiguity of expectations of teachers from the Ontario curriculum documents. Particular reference is drawn to the citizenship education framework, an addition to the 2013 revision of "Ontario Curriculum: Social Studies, Grades 1 to 6;…

Spatial-temporal epidemiology of human Salmonella Enteritidis infections with major phage types (PTs 1, 4, 5b, 8, 13, and 13a) in Ontario, Canada, 2008-2009.

PubMed

Varga, Csaba; Pearl, David L; McEwen, Scott A; Sargeant, Jan M; Pollari, Frank; Guerin, Michele T

2015-12-17

In Ontario and Canada, the incidence of human Salmonella enterica serotype Enteritidis (S. Enteritidis) infections have increased steadily during the last decade. Our study evaluated the spatial and temporal epidemiology of the major phage types (PTs) of S. Enteritidis infections to aid public health practitioners design effective prevention and control programs. Data on S. Enteritidis infections between January 1, 2008 and December 31, 2009 were obtained from Ontario's disease surveillance system. Salmonella Enteritidis infections with major phage types were classified by their annual health region-level incidence rates (IRs), monthly IRs, clinical symptoms, and exposure settings. A scan statistic was employed to detect retrospective phage type-specific spatial, temporal, and space-time clusters of S. Enteritidis infections. Space-time cluster cases' exposure settings were evaluated to identify common exposures. 1,336 cases were available for analysis. The six most frequently reported S. Enteritidis PTs were 8 (n = 398), 13a (n = 218), 13 (n = 198), 1 (n = 132), 5b (n = 83), and 4 (n = 76). Reported rates of S. Enteritidis infections with major phage types varied by health region and month. International travel and unknown exposure settings were the most frequently reported settings for PT 5b, 4, and 1 cases, whereas unknown exposure setting, private home, food premise, and international travel were the most frequently reported settings for PT 8, 13, and 13a cases. Diarrhea, abdominal pain, and fever were the most commonly reported clinical symptoms. A number of phage type-specific spatial, temporal, and space-time clusters were identified. Space-time clusters of PTs 1, 4, and 5b occurred mainly during the winter and spring months in the North West, North East, Eastern, Central East, and Central West regions. Space-time clusters of PTs 13 and 13a occurred at different times of the year in the Toronto region. Space-time clusters of PT 8 occurred at different times of the year in the North West and South West regions. Phage type-specific differences in exposure settings, and spatial-temporal clustering of S. Enteritidis infections were demonstrated that might guide public health surveillance of disease outbreaks. Our study methodology could be applied to other foodborne disease surveillance data to detect retrospective high disease rate clusters, which could aid public health authorities in developing effective prevention and control programs.

Integrating dental data in missing persons and unidentified remains investigations: the RESOLVE INITIATIVE and DIP3.

PubMed

Kogon, S; Arnold, J; Wood, R; Merner, L

2010-04-15

DIP3, a computerized aid to assist in dental identification, was integrated into the RESOLVE INITIATIVE, a joint endeavour by the Ontario Provincial Police and the Office of the Chief Coroner for Ontario, to resolve cases of missing persons (MP) and unidentified remains (UNID). Dental data, from the UNID, collected by the coroner and the dental records of MP, provided by investigating police, are streamed separately for input into a dedicated computer program. All dental management is provided by forensic dentists. The advantage of having experienced dentists managing this data is explained. A description of the RESOLVE INITIATIVE and DIP3, including the method used for record transmission is provided. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Arthritis and osteomyelitis associated with Enterococcus cecorum infection in broiler and broiler breeder chickens in Ontario, Canada.

PubMed

Stalker, Margaret J; Brash, Marina L; Weisz, Alexandru; Ouckama, Rachel M; Slavic, Durda

2010-07-01

In August 2008, an Ontario broiler chicken flock experienced an outbreak of lameness in 4-week-old birds, with morbidity reaching 7% by day 3. Necropsy examination and histopathology revealed arthritis of the hock, stifle, and coxofemoral joints, and femoral and vertebral osteomyelitis. Enterococcus cecorum was isolated from the lesions and identified by 16S ribosomal RNA sequencing. In October 2008, a second case of E. cecorum osteomyelitis involved a flock of 9-week-old broiler breeder chickens, with 2% of the male birds showing reluctance to walk. Necropsy examination revealed osteomyelitis and abscessation of the body of the caudal thoracic vertebra in affected birds, with impingement on the overlying spinal cord.

Seroprevalence of bovine viral diarrhea virus neutralizing antibodies in finisher hogs in Ontario swine herds and targeted diagnostic testing of 2 suspect herds

PubMed Central

O’Sullivan, Terri; Friendship, Robert; Carman, Susy; Pearl, David L.; McEwen, Beverly; Dewey, Catherine

2011-01-01

A pilot study was initiated to determine the seroprevalence of bovine viral diarrhea virus (BVDV) neutralizing antibodies in finisher hogs in Ontario swine herds, including 2 swine herds with clinical syndromes suspicious of BVDV. No herds were positive for BVDV antibodies by virus neutralization. The 2 swine herds with clinical disease suggestive of pestivirus infection were also negative for antibodies to BVDV in indirect fluorescent antibody assays. Prevalence of BVDV in Ontario swine farms is negligible. PMID:22654141

Sensitivity of GRACE-derived estimates of groundwater-level changes in southern Ontario, Canada

NASA Astrophysics Data System (ADS)

Hachborn, Ellen; Berg, Aaron; Levison, Jana; Ambadan, Jaison Thomas

2017-12-01

Amidst changing climates, understanding the world's water resources is of increasing importance. In Ontario, Canada, low water conditions are currently assessed using only precipitation and watershed-based stream gauges by the Conservation Authorities in Ontario and the Ministry of Natural Resources and Forestry. Regional groundwater-storage changes in Ontario are not currently measured using satellite data by research institutes. In this study, contributions from the Gravity Recovery and Climate Experiment (GRACE) data are compared to a hydrogeological database covering southern Ontario from 2003 to 2013, to determine the suitability of GRACE total water storage estimates for monitoring groundwater storage in this location. Terrestrial water storage data from GRACE were used to determine monthly groundwater storage (GWS) anomaly values. GWS values were also determined by multiplying groundwater-level elevations (from the Provincial Groundwater Monitoring Network wells) by specific yield. Comparisons of GRACE-derived GWS to well-based GWS data determined that GRACE is sufficiently sensitive to obtain a meaningful signal in southern Ontario. Results show that GWS values produced by GRACE are useful for identifying regional changes in groundwater storage in areas with limited available hydrogeological characterization data. Results also indicate that GRACE may have an ability to forecast changes in groundwater storage, which will become useful when monitoring climate shifts in the near future.

Built environment interventions aimed at improving physical activity levels in rural Ontario health units: a descriptive qualitative study.

PubMed

Coghill, Cara-Lee; Valaitis, Ruta K; Eyles, John D

2015-05-03

Few studies to date have explored the relationship between the built environment and physical activity specifically in rural settings. The Ontario Public Health Standards policies mandate that health units in Ontario address the built environment; however, it is unclear how public health practitioners are integrating the built environment into public health interventions aimed at improving physical activity in chronic disease prevention programs. This descriptive qualitative study explored interventions that have or are being implemented which address the built environment specifically related to physical activity in rural Ontario health units, and the impact of these interventions. Data were collected through twelve in-depth semi-structured interviews with rural public health practitioners and managers representing 12 of 13 health units serving rural communities. Key themes were identified using qualitative content analysis. Themes that emerged regarding the types of interventions that health units are employing included: Engagement with policy work at a municipal level; building and working with community partners, committees and coalitions; gathering and providing evidence; developing and implementing programs; and social marketing and awareness raising. Evaluation of interventions to date has been limited. Public health interventions, and their evaluations, are complex. Health units who serve large rural populations in Ontario are engaging in numerous activities to address physical activity levels. There is a need to further evaluate the impact of these interventions on population health.

Matching the Grade 8 TIMSS Item Pool to the Ontario Curriculum.

ERIC Educational Resources Information Center

Lawson, Alexandra; Bordignon, Catherine; Nagy, Philip

2002-01-01

Studied the match between the Ontario (Canada) eighth grade curriculum for 1997 and the item pool of the Third International Mathematics and Science Study (TIMSS) and analyzed the matching process itself. Findings show that the 1997 curriculum is a better match to the TIMSS item pool, achieving the better match by enlarging the curriculum and…

Publicly-Reported Indicators of School System Success: A Comparative Study of Three Canadian Provinces

ERIC Educational Resources Information Center

Hauseman, D. Cameron

2015-01-01

This comparative study paper seeks to investigate the nature of reported measures of school success currently reported in Ontario with two other Canadian jurisdictions with similar school systems and student populations (Alberta and British Columbia). As education in Ontario, Alberta and British Columbia is, for the most part, a government…

Building evaluation capacity in Ontario's public health units: promising practices and strategies.

PubMed

Bourgeois, I; Simmons, L; Buetti, D

2018-06-01

This article presents the findings of a project focusing on building evaluation capacity in 10 Ontario public health units. The study sought to identify effective strategies that lead to increased evaluation capacity in the participating organizations. This study used a qualitative, multiple case research design. An action research methodology was used to design customized evaluation capacity building (ECB) strategies for each participating organization, based on its specific context and needs. This methodological approach also enabled monitoring and assessment of each strategy, based on a common set of reporting templates. A multiple case study was used to analyze the findings from the 10 participating organizations and derive higher level findings. The main findings of the study show that most of the strategies used to increase evaluation capacity in public health units are promising, especially those focusing on developing the knowledge, skills, and attitudes of health unit staff and managers. Facilitators to ECB strategies were the engagement of all staff members, the support of leadership, and the existence of organizational tools and infrastructure to support evaluation. It is also essential to recognize that ECB takes time and resources to be successful. The design and implementation of ECB strategies should be based on organizational needs. These can be assessed using a standardized instrument, as well as interviews and staff surveys. The implementation of a multicomponent approach (i.e. several strategies implemented simultaneously) is also linked to better ECB outcomes in organizations. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The Haldimand Agreement: A Continuing Covenant.

ERIC Educational Resources Information Center

Simon, Michael P. P.

1983-01-01

Puts forth the case for the inherent sovereign right of the Iroquois to extensive tracts of land on the banks of the Grand River in Ontario, Canada, granted by the Haldimand agreement of 1784 to Iroquois siding with the British at the time of the American Revolution. (JHZ)

Barriers to Differentiation: Applying Organizational Studies to Ontario Higher Education

ERIC Educational Resources Information Center

Milian, Roger Pizarro; Davies, Scott; Zarifa, David

2016-01-01

Ontario's Ministry of Training, Colleges and Universities is currently attempting to increase institutional differentiation within that province's postsecondary education system. We contend that such policies aimed to trigger organizational change are likely to generate unanticipated responses. Using insights from the field of organizational…

Research and knowledge in Ontario tobacco control networks.

PubMed

Bickford, Julia J; Kothari, Anita R

2008-01-01

This study sought to better understand the role of research knowledge in Ontario tobacco control networks by asking: 1) How is research managed; 2) How is research evaluated; and 3) How is research utilized? This is a secondary analysis of a qualitative study based on individual semistructured interviews with 29 participants between January and May 2006. These participants were purposefully sampled from across four Ministries in the provincial government (n = 7), non-government (n = 15), and public health organizations (n = 7). Interviews were transcribed verbatim and coded and analyzed using QSR N7 qualitative software. This study received ethics approval from The University of Western Ontario Health Research Ethics Board. There exists a dissonance between the preference for peer-reviewed, unbiased, non-partisan knowledge to support claims and the need for fast, "real-time" information on which to base tobacco-related policy decisions. Second, there is a great deal of tacit knowledge held by experts within the Ontario tobacco control community. The networks among government, non-government, and public health organizations are the structures through which tacit knowledge is exchanged. These networks are dynamic, fluid and shifting. There exists a gap in the production and utilization of research knowledge for tobacco control policy. Tacit knowledge held by experts in Ontario tobacco control networks is an integral means of managing and evaluating research knowledge. Finally, this study builds on Weiss's concept of tactical model of evidence use by highlighting the utilization of research to enhance one's credibility.

Effect of human papillomavirus (HPV) vaccination on clinical indicators of sexual behaviour among adolescent girls: the Ontario Grade 8 HPV Vaccine Cohort Study.

PubMed

Smith, Leah M; Kaufman, Jay S; Strumpf, Erin C; Lévesque, Linda E

2015-02-03

Suboptimal human papillomavirus (HPV) vaccine coverage in some jurisdictions is partly attributed to fears that vaccination may increase risky sexual behaviour. We assessed the effect of HPV vaccination on clinical indicators of sexual behaviour among adolescent girls in Ontario. Using Ontario's administrative health databases, we identified a population-based cohort of girls in grade 8 in the 2 years before (2005/06 and 2006/07) and after (2007/08 and 2008/09) implementation of Ontario's grade 8 HPV vaccination program. For each girl, we then obtained data on vaccine receipt in grades 8 and 9 and data on indicators of sexual behaviour (pregnancy and non-HPV-related sexually transmitted infections) in grades 10-12. Using a quasi-experimental method known as regression discontinuity, we estimated, for each outcome, the risk difference (RD) and relative risk (RR) attributable to vaccination and to program eligibility. The cohort comprised 260 493 girls, of whom 131 781 were ineligible for the program and 128 712 were eligible. We identified 15 441 (5.9%) cases of pregnancy and sexually transmitted infection and found no evidence that vaccination increased the risk of this composite outcome: RD per 1000 girls -0.61 (95% confidence interval [CI] -10.71 to 9.49) and RR 0.96 (95% CI 0.81 to 1.14). Similarly, we found no discernible effect of program eligibility: RD per 1000 girls -0.25 (95% CI -4.35 to 3.85) and RR 0.99 (95% CI 0.93 to 1.06). The findings were similar when outcomes were assessed separately. We present strong evidence that HPV vaccination does not have any significant effect on clinical indicators of sexual behaviour among adolescent girls. These results suggest that concerns over increased promiscuity following HPV vaccination are unwarranted and should not deter from vaccinating at a young age. © 2015 Canadian Medical Association or its licensors.

Risk and protective factors associated with intentional self-harm among older community-residing home care clients in Ontario, Canada.

PubMed

Neufeld, Eva; Hirdes, John P; Perlman, Christopher M; Rabinowitz, Terry

2015-10-01

We aim to concurrently examine risk and protective factors associated with intentional self-harm among community-residing older adults receiving home care services in Ontario, Canada. Administrative health data from the home care sector were linked to hospital administrative data to carry out the analyses. Home care data are collected in Ontario using the Resident Assessment Instrument-Home Care (RAI-HC), an assessment tool that identifies strengths, preferences and needs of long-stay home care clients. The sample included Ontario home care clients aged 60 years or older assessed with the RAI-HC between 2007 and 2010 (N = 222,149). Multivariable analyses were performed using SAS. Hospital records of intentional self-harm (ISH) were present in 9.3 cases per 1000 home care clients. Risks of ISH included younger age (60-74 years; OR = 3.14, CI: 2.75-3.59), psychiatric diagnosis (OR = 2.29, CI: 2.06-2.54), alcohol use and dependence (OR = 1.69, CI: 1.34-2.14), psychotropic medication (OR = 1.94, CI: 1.75-2.15) and depressive symptoms (OR = 1.58, CI: 1.40-1.78). Protective effects were found for marital status and positive social relationships, yet these effects were more pronounced for men. Cognitive performance measures showed the odds of ISH 1.86 times higher for older adults with moderate to severe cognitive impairment. This study based on provincial data points to tangible areas for preventative assessment by frontline home care professionals. Of interest were the risk and protective factors that differed by sex. As demand for home care in Canada is expected to increase, these findings may inform home care professionals' appraisal and approach to suicide prevention among community-residing older adults. Copyright © 2015 John Wiley & Sons, Ltd.

Deep structure beneath Lake Ontario: Crustal-scale Grenville subdivisions

USGS Publications Warehouse

Forsyth, D. A.; Milkereit, B.; Zelt, Colin A.; White, D. J.; Easton, R. M.; Hutchinson, Deborah R.

1994-01-01

Lake Ontario marine seismic data reveal major Grenville crustal subdivisions beneath central and southern Lake Ontario separated by interpreted shear zones that extend to the lower crust. A shear zone bounded transition between the Elzevir and Frontenac terranes exposed north of Lake Ontario is linked to a seismically defined shear zone beneath central Lake Ontario by prominent aeromagnetic and gravity anomalies, easterly dipping wide-angle reflections, and fractures in Paleozoic strata. We suggest the central Lake Ontario zone represents crustal-scale deformation along an Elzevir–Frontenac boundary zone that extends from outcrop to the south shore of Lake Ontario.Seismic images from Lake Ontario and the exposed western Central Metasedimentary Belt are dominated by crustal-scale shear zones and reflection geometries featuring arcuate reflections truncated at their bases by apparent east-dipping linear reflections. The images show that zones analogous to the interpreted Grenville Front Tectonic Zone are also present within the Central Metasedimentary Belt and support models of northwest-directed crustal shortening for Grenvillian deep crustal deformation beneath most of southeastern Ontario.A Precambrian basement high, the Iroquoian high, is defined by a thinning of generally horizontal Paleozoic strata over a crestal area above the basement shear zone beneath central Lake Ontario. The Iroquoian high helps explain the peninsular extension into Lake Ontario forming Prince Edward County, the occurrence of Precambrian inlier outcrops in Prince Edward County, and Paleozoic fractures forming the Clarendon–Linden structure in New York.

Native Studies in Colleges and Universities: A Guide to Courses in Native Studies Offered in Ontario Beyond the Secondary School Level.

ERIC Educational Resources Information Center

Ontario Ministry of Colleges and Universities, Toronto.

Intended to provide general information about educational opportunities in Ontario beyond high school, this publication concentrates on post-secondary courses that may be of particular interest to Native people and non-Natives who wish to improve their appreciation of Native society and cultures. Courses of study described are offered by Ontario…

Morphological Observations of Pratylenchus penetrans from Celery and Strawberry in Southern Ontario

PubMed Central

Townshend, J. L.

1991-01-01

Pratylenchus penetrans was obtained from Premier strawberry in Norfolk County and the Niagara Peninsula and from celery in the latter area. Host affected the dimensions of P. penetrans to a greater extent than geographical area in Ontario. Adults of P. penetrans from southern Ontario tended to be smaller than those reported elsewhere. The presence of three lip annules was consistent in the seven populations studied, although in some specimens one of the annules did not entirely encompass the head. Crenations around the tail tip of females of P. penetrans was common in the populations studied. Not all of the morphological characters were proportional in size to length of the females of P. penetrans. PMID:19283114

"Strengthening" Ontario Universities: A Neoliberal Reconstruction of Higher Education

ERIC Educational Resources Information Center

Rigas, Bob; Kuchapski, Renée

2016-01-01

This paper reviews neoliberalism as an ideology that has influenced higher education generally and Ontario higher education in particular. It includes a discourse analysis of "Strengthening Ontario's Centres of Creativity, Innovation and Knowledge" (Ontario Ministry of Training, Colleges, and Universities, 2012), a government discussion…

Vertebral Augmentation Involving Vertebroplasty or Kyphoplasty for Cancer-Related Vertebral Compression Fractures: An Economic Analysis.

PubMed

2016-01-01

Untreated vertebral compression fractures can have serious clinical consequences and impose a considerable impact on patients' quality of life and on caregivers. Since non-surgical management of these fractures has limited effectiveness, vertebral augmentation procedures are gaining acceptance in clinical practice for pain control and fracture stabilization. The objective of this analysis was to determine the cost-effectiveness and budgetary impact of kyphoplasty or vertebroplasty compared with non-surgical management for the treatment of vertebral compression fractures in patients with cancer. We performed a systematic review of health economic studies to identify relevant studies that compare the cost-effectiveness of kyphoplasty or vertebroplasty with non-surgical management for the treatment of vertebral compression fractures in adults with cancer. We also performed a primary cost-effectiveness analysis to assess the clinical benefits and costs of kyphoplasty or vertebroplasty compared with non-surgical management in the same population. We developed a Markov model to forecast benefits and harms of treatments, and corresponding quality-adjusted life years and costs. Clinical data and utility data were derived from published sources, while costing data were derived using Ontario administrative sources. We performed sensitivity analyses to examine the robustness of the results. In addition, a 1-year budget impact analysis was performed using data from Ontario administrative sources. Two scenarios were explored: (a) an increase in the total number of vertebral augmentation procedures performed among patients with cancer in Ontario, maintaining the current proportion of kyphoplasty versus vertebroplasty; and (b) no increase in the total number of vertebral augmentation procedures performed among patients with cancer in Ontario but an increase in the proportion of kyphoplasties versus vertebroplasties. The base case considered each of kyphoplasty and vertebroplasty versus non-surgical management. Kyphoplasty and vertebroplasty were associated with an incremental cost-effectiveness ratio of $33,471 and $17,870, respectively, per quality-adjusted life-year gained. The budgetary impact of funding vertebral augmentation procedures for the treatment of vertebral compression fractures in adults with cancer in Ontario was estimated at about $2.5 million in fiscal year 2014/15. More widespread use of vertebral augmentation procedures raised total expenditures under a number of scenarios, with costs increasing by $67,302 to $913,386. Our findings suggest that the use of kyphoplasty or vertebroplasty in the management of vertebral compression fractures in patients with cancer may be a cost-effective strategy at commonly accepted willingness-to-pay thresholds. Nonetheless, more widespread use of kyphoplasty (and vertebroplasty to a lesser extent) would likely be associated with net increases in health care costs.

Active shoreline of Ontario Lacus, Titan: A morphological study of the lake and its surroundings

USGS Publications Warehouse

Wall, S.; Hayes, A.; Bristow, C.; Lorenz, R.; Stofan, E.; Lunine, J.; Le, Gall A.; Janssen, M.; Lopes, R.; Wye, L.; Soderblom, L.; Paillou, P.; Aharonson, O.; Zebker, H.; Farr, Tom; Mitri, Giuseppe; Kirk, R.; Mitchell, Ken; Notarnicola, C.; Casarano, D.; Ventura, B.

2010-01-01

Of more than 400 filled lakes now identified on Titan, the first and largest reported in the southern latitudes is Ontario Lacus, which is dark in both infrared and microwave. Here we describe recent observations including synthetic aperture radar (SAR) images by Cassini's radar instrument (??= 2 cm) and show morphological evidence for active material transport and erosion. Ontario Lacus lies in a shallow depression, with greater relief on the southwestern shore and a gently sloping, possibly wave-generated beach to the northeast. The lake has a closed internal drainage system fed by Earth-like rivers, deltas and alluvial fans. Evidence for active shoreline processes, including the wave-modified lakefront and deltaic deposition, indicates that Ontario is a dynamic feature undergoing typical terrestrial forms of littoral modification. Copyright ?? 2010 by the American Geophysical Union.

Pathology and diagnosis of avian bornavirus infection in wild Canada geese (Branta canadensis), trumpeter swans (Cygnus buccinator) and mute swans (Cygnus olor) in Canada: a retrospective study.

PubMed

Delnatte, Pauline; Ojkic, Davor; Delay, Josepha; Campbell, Doug; Crawshaw, Graham; Smith, Dale A

2013-04-01

Nine hundred and fifty-five pathology cases collected in Ontario between 1992 and 2011 from wild free-ranging Canada geese, trumpeter swans and mute swans were retrospectively evaluated for the pathology associated with avian bornavirus (ABV) infection. Cases were selected based on the presence of upper gastrointestinal impaction, central nervous system histopathology or clinical history suggestive of ABV infection. The proportion of birds meeting at least one of these criteria was significantly higher at the Toronto Zoo (30/132) than elsewhere in Ontario (21/823). Central, peripheral and autonomic nervous tissues were examined for the presence of lymphocytes and plasma cells on histopathology. The presence of virus was assessed by immunohistochemistry and reverse transcriptase-polymerase chain reaction (RT-PCR) on frozen brains and on formalin-fixed paraffin-embedded tissues. Among selected cases, 86.3% (44/51) were considered positive on histopathology, 56.8% (29/51) were positive by immunohistochemistry, and RT-PCR was positive on 88.2% (15/17) of the frozen brains and 78.4% (40/51) of the formalin-fixed paraffin-embedded samples. Histopathological lesions included gliosis and lymphoplasmacytic perivascular cuffing in brain (97.7%), spinal cord (50%), peripheral nerves (55.5%) and myenteric ganglia or nerves (62.8%), resembling lesions described in parrots affected with proventricular dilatation disease. Partial amino acid sequences of the nucleocapsid gene from seven geese were 100% identical amongst themselves and 98.1 to 100% identical to the waterfowl sequences recently described in the USA. Although ABV has been identified in apparently healthy geese, our study confirmed that ABV can also be associated with significant disease in wild waterfowl species.

Resource Development in Ontario's Colleges--What's the Future?

ERIC Educational Resources Information Center

Gouveia, Cindy O. Y.

2016-01-01

This paper provides a brief historical account, and differences in philanthropy between Ontario's colleges and universities. Several theoretical concepts will be explored to explain donor motivation in Ontario's higher education sector. The final section of this paper explores non-traditional resource development strategies that Ontario colleges…

Population-based passive tick surveillance and detection of expanding foci of blacklegged ticks Ixodes scapularis and the Lyme disease agent Borrelia burgdorferi in Ontario, Canada.

PubMed

Nelder, Mark P; Russell, Curtis; Lindsay, L Robbin; Dhar, Badal; Patel, Samir N; Johnson, Steven; Moore, Stephen; Kristjanson, Erik; Li, Ye; Ralevski, Filip

2014-01-01

We identified ticks submitted by the public from 2008 through 2012 in Ontario, Canada, and tested blacklegged ticks Ixodes scapularis for Borrelia burgdorferi and Anaplasma phagocytophilum. Among the 18 species of ticks identified, I. scapularis, Dermacentor variabilis, Ixodes cookei and Amblyomma americanum represented 98.1% of the 14,369 ticks submitted. Rates of blacklegged tick submission per 100,000 population were highest in Ontario's Eastern region; D. variabilis in Central West and Eastern regions; I. cookei in Eastern and South West regions; and A. americanum had a scattered distribution. Rates of blacklegged tick submission per 100,000 population were highest from children (0-9 years old) and older adults (55-74 years old). In two health units in the Eastern region (i.e., Leeds, Grenville & Lanark District and Kingston-Frontenac and Lennox & Addington), the rate of submission for engorged and B. burgdorferi-positive blacklegged ticks was 47× higher than the rest of Ontario. Rate of spread for blacklegged ticks was relatively faster and across a larger geographic area along the northern shore of Lake Ontario/St. Lawrence River, compared with slower spread from isolated populations along the northern shore of Lake Erie. The infection prevalence of B. burgdorferi in blacklegged ticks increased in Ontario over the study period from 8.4% in 2008 to 19.1% in 2012. The prevalence of B. burgdorferi-positive blacklegged ticks increased yearly during the surveillance period and, while increases were not uniform across all regions, increases were greatest in the Central West region, followed by Eastern and South West regions. The overall infection prevalence of A. phagocytophilum in blacklegged ticks was 0.3%. This study provides essential information on ticks of medical importance in Ontario, and identifies demographic and geographic areas for focused public education on the prevention of tick bites and tick-borne diseases.

Population-Based Passive Tick Surveillance and Detection of Expanding Foci of Blacklegged Ticks Ixodes scapularis and the Lyme Disease Agent Borrelia burgdorferi in Ontario, Canada

PubMed Central

Nelder, Mark P.; Russell, Curtis; Lindsay, L. Robbin; Dhar, Badal; Patel, Samir N.; Johnson, Steven; Moore, Stephen; Kristjanson, Erik; Li, Ye; Ralevski, Filip

2014-01-01

We identified ticks submitted by the public from 2008 through 2012 in Ontario, Canada, and tested blacklegged ticks Ixodes scapularis for Borrelia burgdorferi and Anaplasma phagocytophilum. Among the 18 species of ticks identified, I. scapularis, Dermacentor variabilis, Ixodes cookei and Amblyomma americanum represented 98.1% of the 14,369 ticks submitted. Rates of blacklegged tick submission per 100,000 population were highest in Ontario's Eastern region; D. variabilis in Central West and Eastern regions; I. cookei in Eastern and South West regions; and A. americanum had a scattered distribution. Rates of blacklegged tick submission per 100,000 population were highest from children (0–9 years old) and older adults (55–74 years old). In two health units in the Eastern region (i.e., Leeds, Grenville & Lanark District and Kingston-Frontenac and Lennox & Addington), the rate of submission for engorged and B. burgdorferi-positive blacklegged ticks was 47× higher than the rest of Ontario. Rate of spread for blacklegged ticks was relatively faster and across a larger geographic area along the northern shore of Lake Ontario/St. Lawrence River, compared with slower spread from isolated populations along the northern shore of Lake Erie. The infection prevalence of B. burgdorferi in blacklegged ticks increased in Ontario over the study period from 8.4% in 2008 to 19.1% in 2012. The prevalence of B. burgdorferi-positive blacklegged ticks increased yearly during the surveillance period and, while increases were not uniform across all regions, increases were greatest in the Central West region, followed by Eastern and South West regions. The overall infection prevalence of A. phagocytophilum in blacklegged ticks was 0.3%. This study provides essential information on ticks of medical importance in Ontario, and identifies demographic and geographic areas for focused public education on the prevention of tick bites and tick-borne diseases. PMID:25171252

Informal/Formal Learning and Workload among Ontario Secondary School Teachers. NALL Working Paper.

ERIC Educational Resources Information Center

Smaller, Harry; Hart, Doug; Clark, Rosemary; Livingstone, David

Following up on an earlier national survey study of Canadian teachers' formal and informal learning, this study had 13 Ontario secondary teachers keep detailed logs of their day and evening activities, along with notations about what they may have learned as a result of engaging in each activity, for 7 consecutive days in late 1999, and again in…

Perspectives and Plans for Graduate Studies. 11. Engineering 1974. E. Industrial Engineering and Systems Design. Report No. 74-22.

ERIC Educational Resources Information Center

Ontario Council on Graduate Studies, Toronto. Advisory Committee on Academic Planning.

On the instruction of the Council of Ontario Universities, the Advisory Committee on Academic Planning in cooperation with the Committee of Ontario Deans of Engineering has conducted a planning assessment for doctoral work in industrial engineering and systems design. Recommendations for doctoral work in engineering studies are presented.…

Exploring the Alignment between Post-Secondary Education Programs and Earnings: An Examination of 2005 Ontario Graduates

ERIC Educational Resources Information Center

Frank, Kristyn; Walters, David

2012-01-01

This study examines the influence that field of study and level of post-secondary education have on the earnings of recent graduates in Ontario. Graduates of trades, community college, and university programs are compared. Results suggest that graduates of applied and technical programs obtain higher earnings within two years of graduation than…

Clinical Telemedicine Utilization in Ontario over the Ontario Telemedicine Network.

PubMed

O'Gorman, Laurel D; Hogenbirk, John C; Warry, Wayne

2016-06-01

Northern Ontario is a region in Canada with approximately 775,000 people in communities scattered across 803,000 km(2). The Ontario Telemedicine Network (OTN) facilitates access to medical care in areas that are often underserved. We assessed how OTN utilization differed throughout the province. We used OTN medical service utilization data collected through the Ontario Health Insurance Plan and provided by the Ministry of Health and Long Term Care. Using census subdivisions grouped by Northern and Southern Ontario as well as urban and rural areas, we calculated utilization rates per fiscal year and total from 2008/2009 to 2013/2014. We also used billing codes to calculate utilization by therapeutic area of care. There were 652,337 OTN patient visits in Ontario from 2008/2009 to 2013/2014. Median annual utilization rates per 1,000 people were higher in northern areas (rural, 52.0; urban, 32.1) than in southern areas (rural, 6.1; urban, 3.1). The majority of usage in Ontario was in mental health and addictions (61.8%). Utilization in other areas of care such as surgery, oncology, and internal medicine was highest in the rural north, whereas primary care use was highest in the urban south. Utilization was higher and therapeutic areas of care were more diverse in rural Northern Ontario than in other parts of the province. Utilization was also higher in urban Northern Ontario than in Southern Ontario. This suggests that telemedicine is being used to improve access to medical care services, especially in sparsely populated regions of the province.

Outbreak of E. coli O157:H7 associated with lettuce served at fast food chains in the Maritimes and Ontario, Canada, Dec 2012

PubMed Central

Tataryn, J; Morton, V; Cutler, J; McDonald, L; Whitfield, Y; Billard, B; Gad, RR; Hexemer, A

2014-01-01

Background Identification and control of multi-jurisdictional foodborne illness outbreaks can be complex because of their multidisciplinary nature and the number of investigative partners involved. Objective To describe the multi-jurisdictional outbreak response to an E. coli O157:H7 outbreak in Canada that highlights the importance of early notification and collaboration and the value of centralized interviewing. Methods Investigators from local, provincial and federal jurisdictions, using a national outbreak response protocol to clarify roles and responsibilities and facilitate collaboration, conducted a rapid investigation that included centralized re-interview of cases, descriptive methods, binomial probability, and traceback findings to identify the source of the outbreak. Results There were 31 laboratory confirmed cases identified in New Brunswick, Nova Scotia, and Ontario. Thirteen cases (42%) were hospitalized and one case (3%) developed hemolytic uremic syndrome; there were no deaths. Due to early notification a coordinated investigation was initiated before laboratory subtyping was available. Re-interview of cases identified 10 cases who had not initially reported exposure to the source of the outbreak. Less than one week after the Outbreak Investigation Coordinating Committee was formed, consumption of shredded lettuce from a fast food chain was identified as the likely source of the illnesses and the implicated importer/processor initiated a precautionary recall the same day. Conclusion This outbreak investigation highlights the importance of early notification, prompt re-interviewing and collaboration to rapidly identify the source of an outbreak. PMID:29769900

Assessing the representativeness of physician and patient respondents to a primary care survey using administrative data.

PubMed

Li, Allanah; Cronin, Shawna; Bai, Yu Qing; Walker, Kevin; Ammi, Mehdi; Hogg, William; Wong, Sabrina T; Wodchis, Walter P

2018-05-30

QUALICOPC is an international survey of primary care performance. QUALICOPC data have been used in several studies, yet the representativeness of the Canadian QUALICOPC survey is unknown, potentially limiting the generalizability of findings. This study examined the representativeness of QUALICOPC physician and patient respondents in Ontario using health administrative data. This representativeness study linked QUALICOPC physician and patient respondents in Ontario to health administrative databases at the Institute for Clinical Evaluative Sciences. Physician respondents were compared to other physicians in their practice group and all Ontario primary care physicians on demographic and practice characteristics. Patient respondents were compared to other patients rostered to their primary care physicians, patients rostered to their physicians' practice groups, and a random sample of Ontario residents on sociodemographic characteristics, morbidity, and health care utilization. Standardized differences were calculated to compare the distribution of characteristics across cohorts. QUALICOPC physician respondents included a higher proportion of younger, female physicians and Canadian medical graduates compared to other Ontario primary care physicians. A higher proportion of physician respondents practiced in Family Health Team models, compared to the provincial proportion for primary care physicians. QUALICOPC patient respondents were more likely to be older and female, with significantly higher levels of morbidity and health care utilization, compared with the other patient groups examined. However, when looking at the QUALICOPC physicians' whole rosters, rather than just the patient survey respondents, the practice profiles were similar to those of the other physicians in their practice groups and Ontario patients in general. Comparisons revealed some differences in responding physicians' demographic and practice characteristics, as well as differences in responding patients' characteristics compared to the other patient groups tested, which may have resulted from the visit-based sampling strategy. Ontario QUALICOPC physicians had similar practice profiles as compared to non-participating physicians, providing some evidence that the participating practices are representative of other non-participating practices, and patients selected by visit-based sampling may also be representative of visiting patients in other practices. Those using QUALICOPC data should understand this limited representativeness when generalizing results, and consider the potential for bias in their analyses.

Change in Level of Service Inventory-Ontario Revised (LSI-OR) Risk Scores Over Time: An Examination of Overall Growth Curves and Subscale-Dependent Growth Curves.

PubMed

Day, David M; Wilson, Holly A; Bodwin, Kelly; Monson, Candice M

2017-10-01

The dynamic nature of risk to re-offend is an important issue in the management of offenders and has stimulated extensive research into dynamic risk factors that can alter an individual's overall risk to re-offend if addressed. However, few studies have examined the relative importance of these dynamic risk factors, complicating the task of developing case management and treatment plans that will effect the most change. Using a large, high-risk sample and multi-wave data of a common risk assessment tool, the Level of Service Inventory-Ontario Revised (LSI-OR), the current study investigated the relationship among criminogenic risk factors and their role in influencing the overall risk score. Results indicated a diverse pattern of effects on the eight subscale scores, specifically suggesting that changes on Procriminal Attitude/Orientation, Criminal History, and Leisure/Recreation subscales resulted in a quicker rate of change to the overall risk score over time. These results suggest that some factors may be driving the change in overall risk and could potentially effect the most change if prioritized for intervention. Practical implications and implications for further research are discussed.

Compendium of Statistical and Financial Information: Ontario Universities, 2001-02.

ERIC Educational Resources Information Center

Council of Ontario Universities, Toronto.

This compendium presents data about aspects of the Ontario University System, Canada. It is a companion to the "Financial Report of Ontario Universities," the annual series of volumes prepared under the auspices of the Council of Financial OfficersUniversities of Ontario (COFO-UO). The Compendium contains supplementary information on…

Satisfactory Short-Term Results of Navigation-Assisted Gap-Balancing Total Knee Arthroplasty Using Ultracongruent Insert.

PubMed

Yoon, Jung-Ro; Yang, Jae-Hyuk

2018-03-01

The use of highly conforming ultracongruent (UC) polyethylene insert is bone-preserving and became a relatively common alternative to the conventional posterior stabilized total knee arthroplasty (TKA) design. The purpose of this study was to analyze the short-term clinical and radiologic results of UC insert TKA using the navigation-assisted gap-balancing technique. Two hundred thirty-three knees were operated with a mean follow-up period of 8.1 years (minimum of 5 years). Radiologic and clinical outcomes were assessed before operation and at latest follow-up using the Knee Society Score and Western Ontario and McMaster Universities Osteoarthritis Index score. For statistical analysis, paired sample t-test and analysis of variance were used. Significance was considered as P < .05. According to the preoperative deformities (valgus, mild varus, and moderate varus), there were 23 cases (9.9%) of valgus deformity, 180 cases (77.3%) of mild varus deformity, and 30 cases (12.9%) of moderate varus deformity. Overall, the results at mean 8.1 years revealed an improvement in mean Knee Society Score (54 ± 12 to 92 ± 3) and mean Western Ontario and McMaster Universities Osteoarthritis Index scores (62 ± 14 to 17 ± 3). Overall, 220 of 233 cases (94.4%) were in neutral alignment (between -3° and +3°) at latest follow-up. There were no migrating or shifting prosthesis that should be considered as possible failure. There was 0% component revision rate. Navigation-assisted gap-balancing technique using UC insert TKA had satisfactory short-term outcome. Strict gap-balancing technique using the offset-type-force-controlled-spreader-system aided in the satisfactory results. Copyright © 2017 Elsevier Inc. All rights reserved.

Horizons. A Guide to Postsecondary Education in Ontario, 1988/89.

ERIC Educational Resources Information Center

Ontario Ministry of Colleges and Universities, Toronto.

A guide to postsecondary opportunities in Ontario (Canada) is presented to help students choose a course of study after completing secondary school. Information is presented on student costs and student financial aid and the Colleges of Applied Arts and Technology. Apprenticeship programs, diploma programs, and certificate programs are identified…

Horizons, 1984-1985. A Guide to Post-Secondary Education in Ontario.

ERIC Educational Resources Information Center

Ontario Ministry of Colleges and Universities, Toronto.

A comprehensive summary of postsecondary educational opportunities in Ontario is presented to assist students in choosing a course of study. After presenting information on student costs and student financial assistance, general information on Colleges of Applied Arts and Technology is provided. For each college, apprenticeship programs, regular…

Horizons, 1985-86. A Guide to Post-Secondary Education in Ontario.

ERIC Educational Resources Information Center

Ontario Ministry of Colleges and Universities, Toronto.

A comprehensive summary of postsecondary educational opportunities in Ontario is presented to assist students in choosing a course of study. After presenting information on student costs and student financial assistance, general information on Colleges of Applied Arts and Technology is provided. For each college, apprenticeships programs, regular…

Measuring Systemic and Climate Diversity in Ontario's University Sector

ERIC Educational Resources Information Center

Piché, Pierre Gilles

2015-01-01

This article proposes a methodology for measuring institutional diversity and applies it to Ontario's university sector. This study first used hierarchical cluster analysis, which suggested there has been very little change in diversity between 1994 and 2010 as universities were clustered in three groups for both years. However, by adapting…

Perspectives and Plans for Graduate Studies. 6. Solid Earth Science 1973.

ERIC Educational Resources Information Center

Ontario Council on Graduate Studies, Toronto. Advisory Committee on Academic Planning.

Effective planning and rationalization of long-term graduate development in Ontario's universities concerning solid earth sciences are discussed in relation to a report and recommendations of the Council of Ontario Universities and a report of the Advisory Committee on Academic Planning. Recommendations suggest: (1) The universities proceed with…

A Baseline Study of Ontario Teachers' Views of Environmental and Outdoor Education

ERIC Educational Resources Information Center

Pedretti, Erminia; Nazir, Joanne; Tan, Michael; Bellomo, Katherine; Ayyavoo, Gabriel

2012-01-01

This paper describes a research that came about as a result of several converging factors in Ontario: a resurgence of interest in environmental and outdoor education (including outdoor education (OE) centres); recent publications supporting environmental and outdoor education; and curriculum revisions across subject areas that include…

Financing Elementary and Secondary Education in Ontario: Toward the Future.

ERIC Educational Resources Information Center

Thom, Douglas J.

The British North America Act of 1867 mandates the education of Canadians as a provincial responsibility, although some funding comes from federal sources and municipalities share expenditures with provincial authorities. This paper summarizes a study that investigated effective methods of financing elementary and secondary education in Ontario.…

Place-Based Environmental Education in the Ontario Secondary School Curriculum

ERIC Educational Resources Information Center

Mnyusiwalla, Laila; Bardecki, Michal

2017-01-01

This study reviews the Ontario secondary school curriculum in light of recommendations made by the 2007 Bondar Report, "Shaping Our Schools, Shaping Our Future." It analyzes curriculum expectations and enrollment data for the purpose of reporting upon and providing recommendations for place-based environmental education. The extent and…

Mapping the Early Intervention System in Ontario, Canada

ERIC Educational Resources Information Center

Underwood, Kathryn

2012-01-01

This study documents the wide range of early intervention services across the province of Ontario. The services are mapped across the province showing geographic information as well as the scope of services (clinical, family-based, resource support, etc.), the range of early intervention professionals, sources of funding and the populations served…

HOW DO WORK HIERARCHIES AND STRICT DIVISIONS OF LABOUR IMPACT CARE WORKERS' EXPERIENCES OF HEALTH AND SAFETY? CASE STUDIESOF LONG TERM CARE IN TORONTO.

PubMed

Syed, I; Daly, T; Armstrong, P; Lowndes, R; Chadoin, M; Naidoo, V

2016-01-01

According to the Canadian Health Care Association (1), there are 2,577 long-term care ("LTC") facilities across Canada, with the largest proportion (33.4%) located in Ontario. Most studies focus on residents' health, with less attention paid to the health and safety experiences of staff. Given that the work performed in Ontario LTC facilities is very gendered, increasingly racialized, task-oriented, and with strict divisions of labour, this paper explores in what ways some of these factors impact workers' experiences of health and safety. The study objectives included the following research question: How are work hierarchies and task orientation experienced by staff? This paper draws on data from rapid team-based ethnographies of the shifting division of labour in LTC due to use of informal carers in six non-profit LTC facilities located in Toronto, Ontario. Our method involved conducting observations and key informant interviews (N=167) with registered nurses, registered practical nurses, personal support workers, dietary aides, recreation therapists, families, privately paid companions, students, and volunteers. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed. For observations, researchers were paired and covered shifts between 7 a.m. and 11 p.m., as well as into the late night over six days, at each of the six sites. Detailed ethnographic field notes were written during and immediately following observational fieldwork. Our results indicate that employee stress is linked to the experiences of care work hierarchies, task orientation, and strict divisions of labour between and among various staff designations. Findings from this project confirm and extend current research that demonstrates there are challenging working conditions in LTC, which can result in occupational health and safety problems, as well as stress for individual workers.

Examining the association between suicidal behaviors and referral for mental health services among children involved in the child welfare system in Ontario, Canada.

PubMed

Baiden, Philip; Fallon, Barbara

2018-05-01

Although various studies have investigated factors associated with mental health service utilization, few studies have examined factors associated with referral for mental health services among maltreated children. The objective of this study was to examine the association between suicidal thoughts and self-harming behavior and referral for mental health services among children involved in the Child Welfare System in Ontario, Canada. Data for this study were obtained from the Ontario Incidence Study of Reported Child Abuse and Neglect 2013. An estimate 57,798 child maltreatment investigations was analyzed using binary logistic regression with referral for mental health service as the outcome variable. Of the 57,798 cases, 4709 (8.1%), were referred for mental health services. More than seven out of ten maltreated children who engaged in self-harming behavior and two out of three maltreated children who expressed suicidal thoughts were not referred for mental health services. In the multivariate logistic regression model, children who expressed suicidal thoughts had 2.39 times higher odds of being referred for mental health services compared to children with no suicidal thoughts (AOR = 2.39, 99% C.I. 2.05-2.77) and children who engaged in self-harming behavior had 1.44 times higher odds of being referred for mental health services compared to children who did not engage in self-harming behavior (AOR = 1.44, 99% C.I. 1.24-1.67), both after controlling for child demographic characteristics, maltreatment characteristics, and child functioning concerns. Given that referral is the initial step towards mental health service utilization, it is important that child welfare workers receive the necessary training so as to carefully assess and refer children in care who expressed suicidal thoughts or engaged in self-harming behavior for appropriate mental health services. The paper discusses the results and their implications for child welfare policy and practice. Copyright © 2018 Elsevier Ltd. All rights reserved.

Cost analysis of breast cancer diagnostic assessment programs.

PubMed

Honein-AbouHaidar, G N; Hoch, J S; Dobrow, M J; Stuart-McEwan, T; McCready, D R; Gagliardi, A R

2017-10-01

Diagnostic assessment programs (daps) appear to improve the diagnosis of cancer, but evidence of their cost-effectiveness is lacking. Given that no earlier study used secondary financial data to estimate the cost of diagnostic tests in the province of Ontario, we explored how to use secondary financial data to retrieve the cost of key diagnostic test services in daps, and we tested the reliability of that cost-retrieving method with hospital-reported costs in preparation for future cost-effectiveness studies. We powered our sample at an alpha of 0.05, a power of 80%, and a margin of error of ±5%, and randomly selected a sample of eligible patients referred to a dap for suspected breast cancer during 1 January-31 December 2012. Confirmatory diagnostic tests received by each patient were identified in medical records. Canadian Classification of Health Intervention procedure codes were used to search the secondary financial data Web portal at the Ontario Case Costing Initiative for an estimate of the direct, indirect, and total costs of each test. The hospital-reported cost of each test received was obtained from the host-hospital's finance department. Descriptive statistics were used to calculate the cost of individual or group confirmatory diagnostic tests, and the Wilcoxon signed-rank test or the paired t-test was used to compare the Ontario Case Costing Initiative and hospital-reported costs. For the 191 identified patients with suspected breast cancer, the estimated total cost of $72,195.50 was not significantly different from the hospital-reported total cost of $72,035.52 ( p = 0.24). Costs differed significantly when multiple tests to confirm the diagnosis were completed during one patient visit and when confirmatory tests reported in hospital data and in medical records were discrepant. The additional estimated cost for non-salaried physicians delivering diagnostic services was $28,387.50. It was feasible to use secondary financial data to retrieve the cost of key diagnostic tests in a breast cancer dap and to compare the reliability of the costs obtained by that estimation method with hospital-reported costs. We identified the strengths and challenges of each approach. Lessons learned from this study have to be taken into consideration in future cost-effectiveness studies.

Pricing of multiple dosage prescription medications: an analysis of the Ontario Drug Benefit Formulary.

PubMed

Lexchin, Joel

2009-07-01

This paper investigates the pricing strategy (perfect flat pricing, perfect monotonic pricing, intermediate) used for multiple dosage medications listed in the Ontario Drug Benefit Formulary. All multiple dosage solid medications containing a single active ingredient newly listed in the Ontario Drug Benefit Formulary between 1996 and 2005 were identified. The relationship between price and dosage was calculated using a previously developed method. Seventy-three multiple dosage medications were introduced. Where medications were equivalent to existing ones in most cases companies followed the pricing strategy used by therapeutically equivalent drugs already in the formulary. Where there were no equivalent products companies did not adopt any particular pricing strategy. There was no difference in the way that companies priced scored tablets versus unscored tablets and capsules or in the way that they priced drugs that had objective measurements of efficacy/effectiveness, for example blood pressure, versus those that did not have these measurements. When Monotonic pricing is used it leads to higher expenditures whereas flat pricing results in lower expenditures and offers more predictability in expenditures. Provincial governments should consider requiring flat pricing in return for formulary listing.

Ideology and wildlands management: The case of Rondeau Provincial Park, Ontario

NASA Astrophysics Data System (ADS)

Mann, D. L.; Nelson, J. G.

1980-03-01

This is a critical examination of some of the basic concepts that have guided management of parks and related reserves, often termed wildlands. Study is focussed on Rondeau Provincial Park, Ontario, and on concepts such as wilderness, primeval forest, and the Carolinian forest. Deer culling and other management policies and practices have been based upon the idea that the highly valued sassafras, tulip, and other species of the Carolinian forest are decreasing due to browsing. Field mapping and analysis of historic vegetation records indicate that this trend is not in fact occurring. Historic research also reveals difficulties in defining the Carolinian or other perceived types of forest for management purposes. A major reassessment of ideology and management policy and practice seem to be required in Rondeau and other wildlands. Vague or general concepts such as wilderness or preservation should be strongly complemented and supported by more precise statements of objectives, a learning attitude, and experimentation and research. As a result of the technical uncertainties and value judgments frequently involved, management should also be based upon the expressed preferences and continuing involvement of citizens.

Adding insult to injury: The development of psychosocial stress in Ontario wind turbine communities.

PubMed

Walker, Chad; Baxter, Jamie; Ouellette, Danielle

2015-05-01

Though historically dismissed as not-in-my-backyard (NIMBY) attitudes, reports of psychosocial stress linked to wind energy developments have emerged in Ontario, Canada. While the debate and rhetoric intensify concerning whether wind turbines 'actually' cause 'health' effects, less sincere attention has been given to the lived experience and mental well-being of those near turbines. Drawing on theories of environmental stress, this grounded theory, mixed-method (n = 26 interviews; n = 152 questionnaires) study of two communities in 2011 and 2012 traces how and why some wind turbine community residents suffer substantial changes to quality of life, develop negative perceptions of 'the other' and in some cases, experience intra-community conflict. Policy-related forces, along with existing community relationships may help explain much of these differences between communities. We suggest a move beyond debating simply whether or not 'annoyance' represents a 'health impact' and instead focus on ways to minimize and attenuate these feelings of threat (risk) and stress at the community level. Copyright © 2014 Elsevier Ltd. All rights reserved.

Leptospira infections in trappers from Ontario

PubMed Central

Warshawsky, Bryna; Lindsay, L Robbin; Artsob, Harvey

2000-01-01

BACKGROUND: Four trappers presented to the Middlesex-London Health Unit in November, 1997 with similar clinical presentations. All four complained of fever, chills and headache, and three of the four had severe muscle aches. All gave histories of trapping raccoons before the onset of illness. Three of the four men exhibited diagnostic seroconversions to Leptospira grippotyphosa. OBJECTIVE: To describe the four suspected cases of leptospira infections and to determine whether raccoons might serve as a reservoir of infection using field studies. DESIGN: Raccoon serology were undertaken using the microscopic agglutination test against eight serovars of Leptospira interrogans including L grippotyphosa. Raccoons were trapped using Tomahawk live traps, anaesthetized with intramuscular injection of ketamine and acepromazine, bled by cardiac puncture and released. RESULTS: Forty-two raccoons were trapped in Middlesex (n=36) and Kent counties (n=6) from April 25 to May 2, 1998, and 10 (23.8%) of these animals had antibodies to L grippotyphosa. CONCLUSIONS: Infections due to L grippotyphosa or a closely related serovar are a risk for trappers in Ontario, and raccoons are a likely reservoir of this bacterium. PMID:18159265

The Ontario Veterinary College Hip Certification Program -- assessing inter- and intra-observer repeatability and comparison of findings to those of the Orthopedic Foundation for Animals.

PubMed

Chalmers, Heather J; Nykamp, Stephanie; Lerer, Assaf

2013-01-01

In Canada, the Ontario Veterinary College (OVC) has offered radiographic screening for hip dysplasia for many years, but there are other options for this service including the Orthopedic Foundation for Animals (OFA). There are some differences between the OFA and the OVC methods, and this study compares the OVC and OFA hip certification results in 37 dogs. There was good agreement between the two programs but in some instances there was a difference in the pass/fail status of a dog. Neither the OFA nor the OVC was more likely to fail or pass a given dog. The repeatability of the OVC results was assessed by both inter- and intra-observer comparisons in 100 dogs. There was at least 86% agreement among and within radiologists, but in 5 cases the disagreement resulted in a difference in the pass/fail status of the dog. These results illustrate the inherent variation in radiographic hip evaluation and highlight the importance of consensus grading practices to improve the accuracy of hip evaluation.

The impact of Ontario’s extended drinking hours on cross-border cities of Windsor and Detroit

PubMed Central

Vingilis, E.; McLeod, A.I.; Seeley, J.; Mann, R.; Voas, R.; Compton, C.

2008-01-01

Purpose This study evaluated the cross-border safety impact of extended drinking hours from 1:00 to 2:00 a.m., in licensed establishments in Ontario, Canada. Methods This study examined patterns in total and alcohol-related casualties in: (1) Windsor, Ontario, Canada compared to Detroit, Michigan, US with a 2:00 a.m. closing time, and (2) Ontario compared to Michigan for overall trends. The criterion outcome indicators were: (1) monthly motor vehicle casualties (major injuries and fatalities) for the city-regions of Windsor and Detroit and (2) Ontario and Michigan monthly motor vehicle fatalities occurring between 11:00 p.m. and 3:00 a.m. for 4 years pre- and 3 years post-policy change. In order to examine cross-border drinking consequences, data were disaggregated to assess trends of motor vehicle injury collisions involving vehicles with US licence plates and with US drivers aged 16–20 in the Windsor region; similarly trends were assessed for motor vehicle injury collisions involving vehicles with Ontario licence plates in the Detroit region. Results The Windsor region total motor vehicle casualty data showed a non-significant pre–post increase, while the Detroit region showed a statistically significant decrease for total motor vehicle casualties. In the Windsor region, a significant increase was found for alcohol-related motor vehicle casualties after the drinking hours were extended. However, the Detroit region showed a statistically significant decrease in alcohol-related motor vehicle casualties concomitant with Ontario’s drinking hour extension. No similar trends were found for the province of Ontario and the state of Michigan as a whole. Moreover, a significant decrease was found for injury collisions involving vehicles with Ontario licence plates in the Detroit region but no similar pattern was found for injury collisions involving vehicles with US licence plates and with 16–20-year-old US drivers in the Windsor region. Discussion These data seem to support a cross-border impact of the Ontario extended drinking policy. A significant increase in alcohol-related motor vehicle casualties was found in the Windsor region and concomitantly, significant decreases in total and alcohol-related motor vehicle casualties were found in the Detroit region after the extended drinking hours amendment. The Ontario government’s belief that the extended drinking hour policy would “reduce the number of patrons who cross the border when Ontario’s bars and restaurants close” may have been realized. PMID:16169506

Utilization and costs of lumbar and full spine radiography by Ontario chiropractors from 1994 to 2001.

PubMed

Ammendolia, Carlo; Côté, Pierre; Hogg-Johnson, Sheilah; Bombardier, Claire

2009-07-01

In Ontario, chiropractors see one-third of patients who seek care for low back pain. Previous studies suggest that chiropractors have high utilization rates of lumbar and full spine radiography. There has been a proliferation of evidence-based guidelines recommending that plain film radiography be used only to assess high-risk patients with low back pain. Evidence for the use of full spine radiography, except for the evaluation of scoliosis is lacking. It is uncertain what impact the growing evidence against their use has had on radiography utilization by Ontario chiropractors. To describe the annual costs and use of lumbar and full spine plain film radiography among Ontario chiropractors between 1994 and 2001. Time-trend analysis of radiography utilization by Ontario chiropractors. Chiropractic claims data submitted to the Ontario Health Insurance Plan or the Workplace Safety & Insurance Board from 1994/1995 to 2000/2001. Change in the annual cost and proportion of claimants receiving lumbar and full spine radiography. Time-trend analysis of chiropractic claims submitted to the Ontario Health Insurance Plan (OHIP) or Workplace Safety & Insurance Board (WSIB) from 1994/1995 to 2000/2001 fiscal years. During the 7-year period, the proportion of OHIP claimants receiving lumbar spine radiography decreased from 4.54% to 3.25% and for full spine radiography from 3.87% to 3.04%. For WSIB claimants, lumbar spine radiography deceased from 6.49% to 3.30% of claimants and full spine radiography from 1.51% to 0.94%. OHIP payments for lumbar spine radiography decreased 12.7% to $562,944, whereas full spine radiography payments decreased 5.3% to $1,071,408. WSIB lumbar and full spine radiography payments decreased 44.2% and 34.3% to $31,202 and $11,713 respectively. Claims data from the two largest third-party payers of chiropractic services in Ontario, suggest that lumbar and full spine radiography, and their associated costs decreased steadily between 1994 and 2001.

Higher Education in Ontario: The Face of Leadership. Annual Review, 1994.

ERIC Educational Resources Information Center

Council of Ontario Universities, Toronto.

This annual report reviews leadership and service activities provided by the Council of Ontario Universities (COU) to its 20 member institutions. Messages from the COU's Chairman and President comment on the challenges presented by Ontario's Social Contract Act and by the Resource Allocation Review conducted by the Ontario Council on University…

Opening Doors to Nursing Degrees: A Proposal from Ontario's Colleges

ERIC Educational Resources Information Center

Colleges Ontario, 2010

2010-01-01

Ontario needs to expand nursing education options to improve access to the nursing profession, create better pathways amongst all nursing occupations, and build Ontario's capacity to meet the province's long-term nursing needs. Ontario's colleges are capable of playing a larger role within a long-term provincial strategy for sustaining and…

Ascending and Descending into the System: A Comparison of Broadcasting Media Programs in Ontario Colleges

ERIC Educational Resources Information Center

Sianos, Helen

2015-01-01

In 2013 the Ontario Ministry of Training, Colleges and Universities released Ontario's Differentiation Policy Framework for Postsecondary Education, for colleges and universities in the province. All 24 Ontario colleges responded to this Framework by presenting their Strategic Mandate Agreements (SMA). The Framework contrasts the original…

The Ontario Benthos Biomonitoring Network

Treesearch

Chris Jones; Brian Craig; Nicole Dmytrow

2006-01-01

Canada’s Ontario Ministry of the Environment and Environment Canada (Ecological Monitoring and Assessment Network) are developing an aquatic macroinvertebrate biomonitoring network for Ontario’s lakes, streams, and wetlands. We are building the program, called the Ontario Benthos Biomonitoring Network (OBBN), on the principles of partnership, free data sharing, and...

Council of Ontario Universities Working Paper Series, 2001-2002.

ERIC Educational Resources Information Center

Forcese, Dennis; Oosthuizen, Patrick; Aubrey, Jocelyn B.

2002-01-01

Papers in this volume are the first working papers produced by the Council of Ontario Universities. Issue 1, "The Role and State of Ontario Graduate Education" by Dennis Forcese, advocates the reinforcement of graduate education in Ontario institutions to maintain the overall quality of the institutions and to secure the future. The paper outlines…

Compendium of Statistical and Financial Information: Ontario Universities, 2000-01.

ERIC Educational Resources Information Center

Council of Ontario Universities, Toronto.

This compendium presents data on various aspects of the Ontario University System, Canada. It is a companion to the Financial Report of Ontario Universities, the annual series of volumes prepared under the auspices of the Council of Financial Officers-Universities of Ontario (COFO-UO). This compendium contains supplementary information that helps…

Powassan Virus and Other Arthropod-Borne Viruses in Wildlife and Ticks in Ontario, Canada.

PubMed

Smith, Kathryn; Oesterle, Paul T; Jardine, Claire M; Dibernardo, Antonia; Huynh, Chris; Lindsay, Robbin; Pearl, David L; Bosco-Lauth, Angela M; Nemeth, Nicole M

2018-06-04

Powassan virus (POWV) is a tick-borne zoonosis maintained in natural enzootic cycles between ixodid ticks and wild mammals. Reported human cases have increased in recent years; these infections can be fatal or lead to long-term neurologic sequelae. However, both the geographic distribution and the role of common, potential mammalian hosts in POWV transmission are poorly understood, creating challenges to public health surveillance. We looked for evidence of POWV infection among candidate wildlife host species and ticks collected from mammals and birds in southern Ontario. Tissues (including blood) and ticks from trapped wild mammals were collected in the summers of 2015 and 2016. Ticks removed from dogs in 2015-2016 and wildlife diagnostic cases from 2011 to 2013 were also included. Tissue and tick ( Ixodes spp.) homogenates were tested for POWV by reverse transcriptase-polymerase chain reaction (RT-PCR). In addition, sera from wild mammals were tested for antibodies to POWV, West Nile virus (WNV), and heartland virus (HRTV) by plaque reduction neutralization test. All 724 tissue samples were negative for POWV by RT-PCR. One of 53 pools of Ixodes cookei (among 98 total tick pools) was RT-PCR positive for deer tick virus (POWV) lineage. Antibodies to POWV and WNV were detected in 0.4% of 265 and 6.1% of 264 samples, respectively, and all of 219 serum samples tested negative for anti-HRTV antibodies. These results reveal low POWV detection rates in southern Ontario, while highlighting the challenges and need for continued efforts into understanding POWV epidemiology and targeted surveillance strategies.

Continuing education for primary health care nurse practitioners in Ontario, Canada.

PubMed

Baxter, Pamela; DiCenso, Alba; Donald, Faith; Martin-Misener, Ruth; Opsteen, Joanne; Chambers, Tracey

2013-04-01

The Council of Ontario University Programs in Nursing offers a nine-university, consortium-based primary health care nurse practitioner education program and on-line continuing education courses for primary health care nurse practitioners. Our study sought to determine the continuing education needs of primary health care nurse practitioners across Ontario, how best to meet these needs, and the barriers they face in completing continuing education. Surveys were completed by 83 (40%) of 209 learners who had participated in continuing education offered by the Council of Ontario University Programs in Nursing between 2004 and 2007. While 83% (n=50) of nurse practitioners surveyed indicated that continuing education was extremely important to them, they also identified barriers to engaging in continuing education offerings including; time intensity of the courses, difficulty taking time off work, family obligations, finances and fatigue. The most common reason for withdrawal from a continuing education offering was the difficulty of balancing work and study demands. Continuing education opportunities are important to Ontario primary health care nurse practitioners, and on-line continuing education offerings have been well received, but in order to be taken up by their target audience they must be relevant, readily accessible, flexible, affordable and offered over brief, intense periods of time using technology that is easy to use and Internet sites that are easily navigated. Copyright © 2012 Elsevier Ltd. All rights reserved.

Parental perceptions of school-based influenza immunisation in Ontario, Canada: a qualitative study

PubMed Central

MacDougall, Donna; Crowe, Lois; Pereira, Jennifer A; Kwong, Jeffrey C; Quach, Susan; Wormsbecker, Anne E; Ramsay, Hilary; Salvadori, Marina I; Russell, Margaret L

2014-01-01

Objective To understand the perspectives of Ontario parents regarding the advantages and disadvantages of adding influenza immunisation to the currently existing Ontario school-based immunisation programmes. Design Descriptive qualitative study. Participants Parents of school-age children in Ontario, Canada, who were recruited using a variety of electronic strategies (social media, emails and media releases), and identified as eligible (Ontario resident, parent of one or more school-age children, able to read/write English) on the basis of a screening questionnaire. We used stratified purposeful sampling to obtain maximum variation in two groups: parents who had ever immunised at least one child against influenza or who had never done so. We conducted focus groups (teleconference or internet forum) and individual interviews to collect data. Thematic analysis was used to analyse the data. Setting Ontario, Canada. Results Of the 55 participants, 16 took part in four teleconference focus groups, 35 in 6 internet forum focus groups and four in individual interviews conducted between October 2012 and February 2013. Participants who stated that a school-based influenza immunisation programme would be worthwhile for their child valued its convenience and its potential to reduce influenza transmission without interfering with the family routine. However, most thought that for a programme to be acceptable, it would need to be well designed and voluntary, with adequate parental control and transparent communication between the key stakeholder groups of public health, schools and parents. Conclusions These results will benefit decision-makers in the public health and education sectors as they consider the advantages and disadvantages of immunising children in schools as part of a system-wide influenza prevention approach. Further research is needed to assess the perceptions of school board and public health stakeholders. PMID:24902736

Predictors of and Trends in High-Intensity End-of-Life Care Among Children With Cancer: A Population-Based Study Using Health Services Data.

PubMed

Kassam, Alisha; Sutradhar, Rinku; Widger, Kimberley; Rapoport, Adam; Pole, Jason D; Nelson, Katherine; Wolfe, Joanne; Earle, Craig C; Gupta, Sumit

2017-01-10

Purpose Children with cancer often receive high-intensity (HI) medical care at the end-of-life (EOL). Previous studies have been limited to single centers or lacked detailed clinical data. We determined predictors of and trends in HI-EOL care by linking population-based clinical and health-services databases. Methods A retrospective decedent cohort of patients with childhood cancer who died between 2000 and 2012 in Ontario, Canada, was assembled using a provincial cancer registry and linked to population-based health-care data. Based on previous studies, the primary composite measure of HI-EOL care comprised any of the following: intravenous chemotherapy < 14 days from death; more than one emergency department visit; and more than one hospitalization or intensive care unit admission < 30 days from death. Secondary measures included those same individual measures and measures of the most invasive (MI) EOL care (eg, mechanical ventilation < 14 days from death). We determined predictors of outcomes with appropriate regression models. Sensitivity analysis was restricted to cases of cancer-related mortality, excluding treatment-related mortality (TRM) cases. Results The study included 815 patients; of these, 331 (40.6%) experienced HI-EOL care. Those with hematologic malignancies were at highest risk (odds ratio, 2.5; 95% CI, 1.8 to 3.6; P < .001). Patients with hematologic cancers and those who died after 2004 were more likely to experience the MI-EOL care (eg, intensive care unit, mechanical ventilation, odds ratios from 2.0 to 5.1). Excluding cases of TRM did not substantively change the results. Conclusion Ontario children with cancer continue to experience HI-EOL care. Patients with hematologic malignancies are at highest risk even when excluding TRM. Of concern, rates of the MI-EOL care have increased over time despite increased palliative care access. Linking health services and clinical data allows monitoring of population trends in EOL care and identifies high-risk populations for future interventions.

Genetic Characterization of H1N1 and H1N2 Influenza A Viruses Circulating in Ontario Pigs in 2012.

PubMed

Grgić, Helena; Costa, Marcio; Friendship, Robert M; Carman, Susy; Nagy, Éva; Poljak, Zvonimir

2015-01-01

The objective of this study was to characterize H1N1 and H1N2 influenza A virus isolates detected during outbreaks of respiratory disease in pig herds in Ontario (Canada) in 2012. Six influenza viruses were included in analysis using full genome sequencing based on the 454 platform. In five H1N1 isolates, all eight segments were genetically related to 2009 pandemic virus (A(H1N1)pdm09). One H1N2 isolate had hemagglutinin (HA), polymerase A (PA) and non-structural (NS) genes closely related to A(H1N1)pdm09, and neuraminidase (NA), matrix (M), polymerase B1 (PB1), polymerase B2 (PB2), and nucleoprotein (NP) genes originating from a triple-reassortant H3N2 virus (tr H3N2). The HA gene of five Ontario H1 isolates exhibited high identity of 99% with the human A(H1N1)pdm09 [A/Mexico/InDRE4487/09] from Mexico, while one Ontario H1N1 isolate had only 96.9% identity with this Mexican virus. Each of the five Ontario H1N1 viruses had between one and four amino acid (aa) changes within five antigenic sites, while one Ontario H1N2 virus had two aa changes within two antigenic sites. Such aa changes in antigenic sites could have an effect on antibody recognition and ultimately have implications for immunization practices. According to aa sequence analysis of the M2 protein, Ontario H1N1 and H1N2 viruses can be expected to offer resistance to adamantane derivatives, but not to neuraminidase inhibitors.

Genetic Characterization of H1N1 and H1N2 Influenza A Viruses Circulating in Ontario Pigs in 2012

PubMed Central

Grgić, Helena; Costa, Marcio; Friendship, Robert M.; Carman, Susy; Nagy, Éva; Poljak, Zvonimir

2015-01-01

The objective of this study was to characterize H1N1 and H1N2 influenza A virus isolates detected during outbreaks of respiratory disease in pig herds in Ontario (Canada) in 2012. Six influenza viruses were included in analysis using full genome sequencing based on the 454 platform. In five H1N1 isolates, all eight segments were genetically related to 2009 pandemic virus (A(H1N1)pdm09). One H1N2 isolate had hemagglutinin (HA), polymerase A (PA) and non-structural (NS) genes closely related to A(H1N1)pdm09, and neuraminidase (NA), matrix (M), polymerase B1 (PB1), polymerase B2 (PB2), and nucleoprotein (NP) genes originating from a triple-reassortant H3N2 virus (tr H3N2). The HA gene of five Ontario H1 isolates exhibited high identity of 99% with the human A(H1N1)pdm09 [A/Mexico/InDRE4487/09] from Mexico, while one Ontario H1N1 isolate had only 96.9% identity with this Mexican virus. Each of the five Ontario H1N1 viruses had between one and four amino acid (aa) changes within five antigenic sites, while one Ontario H1N2 virus had two aa changes within two antigenic sites. Such aa changes in antigenic sites could have an effect on antibody recognition and ultimately have implications for immunization practices. According to aa sequence analysis of the M2 protein, Ontario H1N1 and H1N2 viruses can be expected to offer resistance to adamantane derivatives, but not to neuraminidase inhibitors. PMID:26030614

Dietary N-nitroso compounds and risk of colorectal cancer: a case-control study in Newfoundland and Labrador and Ontario, Canada

PubMed Central

Zhu, Yun; Wang, Peizhong Peter; Zhao, Jing; Green, Roger; Sun, Zhuoyu; Roebothan, Barbara; Squires, Josh; Buehler, Sharon; Dicks, Elizabeth; Zhao, Jinhui; Cotterchio, Michelle; Campbell, Peter T.; Jain, Meera; Parfrey, Patrick S.; Mclaughlin, John R.

2015-01-01

Several N-nitroso compounds (NOC) have been shown to be carcinogenic in a variety of laboratory animals, but evidence of their carcinogenicity in humans is lacking. We aimed to examine the association between NOC intake and colorectal cancer (CRC) risk and possible effect modification by vitamins C and E and protein in a large case-control study carried out in Newfoundland and Labrador, and Ontario, Canada. A total of 1760 case patients with pathologically confirmed adenocarcinoma and 2481 population controls were asked to complete a self-administered FFQ to evaluate their dietary intakes 1 year before diagnosis (for cases) or interview (for controls). Adjusted OR and 95% CI were calculated across the quintiles of NOC (measured by N-nitrosodimethylamine (NDMA)) intake and relevant food items using unconditional logistic regression. NDMA intake was found to be associated with a higher risk of CRC (highest vs lowest quintiles, OR: 1.42; 95% CI: 1.03,1.96; p-trend=0.005), specifically for rectal carcinoma (OR: 1.61; 95% CI: 1.11,2.35; p-trend=0.01). CRC risk also increased with the consumption of NDMA-containing meats when the highest tertile was compared with the lowest tertile (OR: 1.47; 95% CI: 1.03,2.10; p-trend=0.20). There was evidence of effect modification between dietary vitamin E and NDMA. Individuals with high NDMA and low vitamin E intakes had a significantly increased risk than those with both low NDMA and vitamin E intakes (OR:3.01; 95% CI: 1.43,6.51; p-interaction=0.017). The present results support the hypothesis that NOC intake may be positively associated with CRC risk in humans. Vitamin E, which inhibits nitrosation, could modify the effect of NDMA on CRC risk. PMID:24160559

Impact of Immigration Status on Cancer Outcomes in Ontario, Canada.

PubMed

Cheung, Matthew C; Earle, Craig C; Fischer, Hadas D; Camacho, Ximena; Liu, Ning; Saskin, Refik; Shah, Baiju R; Austin, Peter C; Singh, Simron

2017-07-01

Prior studies have documented inferior health outcomes in vulnerable populations, including racial minorities and those with disadvantaged socioeconomic status. The impact of immigration on cancer-related outcomes is less clear. Administrative databases were linked to create a cohort of incident cancer cases (colorectal, lung, prostate, head and neck, breast, and hematologic malignancies) from 2000 to 2012 in Ontario, Canada. Cancer patients who immigrated to Canada (from 1985 onward) were compared with those who were Canadian born (or immigrated before 1985). Patients were followed from diagnosis until death (cancer-specific or all-cause). Cox proportional hazards models were estimated to determine the impact of immigration on mortality after adjusting for explanatory variables. Additional adjusted models studied the relationship of time since immigration and cancer-specific and overall mortality. From 2000 to 2012, 11,485 cancer cases were diagnosed in recent immigrants (0 to 10 years in Canada), 17,844 cases in nonrecent immigrants (11 to 25 years), and 416,118 cases in nonimmigrants. After adjustment, the hazard of mortality was lower for recent immigrants (hazard ratio [HR], 0.843; 95% CI, 0.814 to 0.873) and nonrecent immigrants (HR, 0.902; 95% CI, 0.876 to 0.928) compared with nonimmigrants. Cancer-specific mortality was also lower for recent immigrants (HR, 0.857; 95% CI, 0.823 to 0.893) and nonrecent immigrants (HR, 0.907; 95% CI, 0.875 to 0.94). Among immigrants, each year from the original landing was associated with increased mortality (HR, 1.004; 95% CI, 1.000 to 1.009) and a trend to increased cancer-specific mortality (HR, 1.005; 95% CI, 0.999 to 1.010). Immigrants demonstrate a healthy immigrant effect, with lower cancer-specific mortality compared with Canadian-born individuals. This benefit seems to diminish over time, as the survival of immigrants from common cancers potentially converges with the Canadian norm.

Education for Global Citizenship: Teacher Agency and Curricular Structure in Ontario Schools

ERIC Educational Resources Information Center

Schweisfurth, Michele

2006-01-01

As a multicultural nation with aspirations to an international peacekeeping role, Canada makes an interesting context in which to study global citizenship education. This article is based on research conducted in Ontario schools. It examines how individual teachers have prioritized global citizenship issues in their teaching, in the context of…

Measuring Social Capital in Hamilton, Ontario

ERIC Educational Resources Information Center

Kitchen, Peter; Williams, Allison; Simone, Dylan

2012-01-01

Social capital has been studied by academics for more than 20 years and within the past decade there has been an explosion of growth in research linking social capital to health. This paper investigates social capital in Hamilton, Ontario by way of a telephone survey of 1,002 households in three neighbourhood groups representing high, mixed and…

Young Patients Detained under the Lieutenant Governor Warrant in Ontario.

ERIC Educational Resources Information Center

Phillips, Michael S.; Spears, Christopher

1987-01-01

Studied 24 patients being held on lieutenant governor warrants in Ontario, Canada who had been placed on warrants as juveniles. Found subjects to be predominantly male with histories of psychiatric illnesses, diagnosed mainly as antisocial personality, and to have been found not guilty by reason of insanity on charges primarily of murder or…

Transitioning from Teacher Leader to Administrator in Rural Schools in Southwestern Ontario

ERIC Educational Resources Information Center

Hohner, Julie; Riveros, Augusto

2017-01-01

This study investigates the experiences of a group of classroom teachers who transitioned into administrative roles as vice-principals in a rural schoolboard in southwestern Ontario. We included both elementary and secondary former teacher leaders who moved into the school administration and explored the aspects of their leadership experience that…

Alternative Pathways to Legitimacy: Promotional Practices in the Ontario For-Profit College Sector

ERIC Educational Resources Information Center

Pizarro Milian, Roger; Quirke, Linda

2017-01-01

This study empirically examines how for-profit career colleges in Ontario, Canada market themselves to prospective students. It uses a mixed-methods approach to review the content of 489 online promotional profiles representing 375 unique for-profit colleges. It finds that for-profit colleges adopt several distinct marketing strategies, including…

Symbolic Resources and Marketing Strategies in Ontario Higher Education: A Comparative Analysis

ERIC Educational Resources Information Center

Pizarro Milian, Roger; Davidson, Cliff

2018-01-01

Existing research on marketing within PSE tends to focus on homogeneous groups of high-status organisations. This study ameliorates this gap in the literature, conducting a comparative analysis of promotional materials produced by public universities and community colleges in Ontario, Canada. We find that these two groups draw on unique strategies…

Great Lakes Teacher's Guide.

ERIC Educational Resources Information Center

Reid, Ron

The Great Lakes are one of the world's greatest reservoirs of fresh water, the foundation of Ontario's economic development, a primary force in ecological systems, and a base for pleasure and recreation. They are also a magnificent resource for the teachers of Ontario. Study of the Great Lakes can bring to life the factors that shape the ecology…

Financing Education in Ontario: Issues and Choices.

ERIC Educational Resources Information Center

Bird, Richard M.

A study of the history of public financing of elementary and secondary education in Ontario and the issues and choices presently facing the province's finance system suggest that proposals for radical change must be considered. Current pressures on the mixed provincial-local system of finance come from the slow rate of economic expansion generally…

Perspectives and Plans for Graduate Studies. 8. Anthropology 1974.

ERIC Educational Resources Information Center

Council of Ontario Universities, Toronto.

At the present time there are two graduate programs in anthropology in Ontario. An examination of the 3-year plans submitted in 1972 revealed that several universities in Ontario were proposing master's work in anthropology. It was decided to place master's work in anthropology under provisional embargo until a "mini-planning assessment"…

Becoming a Guidance Counsellor in Ontario: Formative Influences from Counsellors' Perspective

ERIC Educational Resources Information Center

Nadon, Daniel; Samson, André; Gazzola, Nicola; Thériault, Anne

2016-01-01

Contrary to guidance counsellors elsewhere in North America who hold a master's degree, career and guidance counselling services in secondary schools in Ontario are delivered by teachers who have completed additional undergraduate studies. Guidance counsellors are pivotal components of the school as they complete tasks that promote students'…

Babysitter or Professional? Perceptions of Professionalism Narrated by Ontario Early Childhood Educators

ERIC Educational Resources Information Center

Harwood, Debra; Tukonic, Stephanie

2016-01-01

Self-constructed perceptions of early childhood educator professionalism were explored in a small-scale mixed-method survey using convenience sampling. Fifty-four educators in Ontario, Canada participated in the study and shared their views related to professionalism. A mixed-methodology was employed using an electronic questionnaire composed of…

Early fire history near Seguin Falls, Ontario

Treesearch

Daniel C. Dey; Richard P. Guyette

1996-01-01

This report is one of a series of site-specfic fire histories being developed for red oak (Quercus rubra L.)-pine ecosystems in central Ontario. Collectively, these studies documents the role of fire in upland oak forests. this information also provides an ecological basis for developing silviculture prescriptions that use prescribed burning to...

French Immersion Research Relevant to Decisions in Ontario. Review and Evaluation Bulletins, Number 1.

ERIC Educational Resources Information Center

Parkin, Michael; And Others

Canadian research relevant to French immersion program development in Ontario is reviewed and summarized. The review includes studies on six program or instructional aspects: (1) attitudes and motivation of immersion students and parents; (2) achievement of immersion students in English language arts and other subjects; (3) French proficiency and…

School Disconnectedness: Identifying Adolescents at Risk in Ontario, Canada

ERIC Educational Resources Information Center

Faulkner, Guy E. J.; Adlaf, Edward M.; Irving, Hyacinth M.; Allison, Kenneth R.; Dwyer, John

2009-01-01

Background: There is strong theoretical and empirical support for school connectedness as an important element of healthy youth development. The primary objective of this study was to replicate previous research identifying factors differentiating youth who do not feel connected to their schools in a sample of adolescents in Ontario, Canada. A…

Sulfur pollution: an environmental study of Welland, Ontario

Treesearch

Michael R. Moss

1977-01-01

The distribution of sulfur as an environmental pollutant is analysed in the vicinity of Welland, Ontario. A biogeochemical-cycle approach enables areas of excess accumulation to be compared among all linked ecosystem components. Although the patterns of distribution are similar, the amounts of sulfur accumulated in different ecosystems, grassland and woodland, show...

The Effects on Monopsony on Strategy and Leadership in Ontario Colleges. Professional File. Number 28

ERIC Educational Resources Information Center

Cooke, Michael

2008-01-01

The period 1995 to 2005 was one of significant turbulence for Ontario colleges, marked by increasing globalization, immigration, disruptions in the labour market, new technologies and dramatic reductions in government operating grants. This study examines how colleges and their leaders responded to those strategic challenges in their official…

Institutional Resource Allocation, Student Engagement, and Student Satisfaction at Ontario Universities

ERIC Educational Resources Information Center

Malik, Alana Jayne

2010-01-01

This study examined the relationship between institutional expenditures in student services, levels of student engagement, and measures of student satisfaction across 18 (out of 19) universities in the Province of Ontario, Canada. Information regarding these variables for each institution was assembled from four extant datasets: (a) the "2006…

Administrators' Views on Teacher Evaluation: Examining Ontario's Teacher Performance Appraisal

ERIC Educational Resources Information Center

Maharaj, Sachin

2014-01-01

This study examines the views of administrators (i.e., principals and vice-principals) in Ontario, Canada, with regard to the province's Teacher Performance Appraisal process. A total of 178 responses were collected from a survey that examined five areas: 1) preparation and training; 2) classroom observations; 3) preparing the formal evaluation;…

The Devil Is in the Details: A Response to the Report of the Postsecondary Review in Ontario

ERIC Educational Resources Information Center

Constantinou, Peter; Drea, Catherine

2005-01-01

This article discusses the recommendations of the Postsecondary Review Panel's Final Report--"Ontario: A Leader in Learning." The Postsecondary Review was announced by the government in the Ontario Budget 2004 to "review the design and funding of Ontario's postsecondary education system and recommend innovative ways in which its…

Financial Report of Ontario Universities 1988-89. Volume I--Universities.

ERIC Educational Resources Information Center

Council of Ontario Universities, Toronto. Research Div.

The first volume of a report by the Council of Ontario Universities provides information on the 21 universities and related institutions which receive grants directly from the government of Ontario. It is part of a three-volume set offering detailed information on the revenues and expenses and changes in fund balances at all Ontario universities…

Compendium of Statistical and Financial Information: Ontario Universities, 1998-99.

ERIC Educational Resources Information Center

Council of Ontario Universities, Toronto.

This compendium presents data on various aspects of the Ontario University system. Compiled by the Council of Finance Officers - Universities of Ontario (COFO-UO), it is intended as a companion to the Financial Report of Ontario Universities and as an aid to financial planning and policy. Data are presented in graphical and tabular formats.…

Report of activities, 1997, Resident Geologist program, southern Ontario regional Resident Geologist`s report: Southeastern and Southwestern districts, Mines and Minerals Information Centre, and Petroleum Resources Centre. Ontario Geological Survey open file report number 5974

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sangster, P.J.

1998-10-01

This report reviews activities in the Southeastern and Southwestern Ontario Resident Geologist districts for the year, including mining and exploration activity, mineral property examinations, recommendations for exploration, and Ontario Geological Survey activities and research by others. It also reviews activities at the Ontario Geological Survey Mines and Minerals Information Centre and exploration and development activity in the province`s oil and gas sector.

The importance of place of residence in patient satisfaction.

PubMed

Levinton, Carey; Veillard, Jeremy; Slutsky, Arthur; Brown, Adalsteinn

2011-10-01

To determine the effect of patients' place of residence on their evaluations of care, and to explore related policy implications. We used a conditional regression analysis of stratum matched case controls to examine whether place of residence of patients living in the Greater Toronto Area (GTA) or in Ontario outside of the GTA affects patient satisfaction with their experiences during hospitalization. One hundred and six acute care hospitals located in the province of Ontario, Canada. A total of 101 683 Ontario residents hospitalized as inpatients between 1 October 2002 and 30 June 2004. Patient satisfaction indicators publicly reported in Ontario comprising patient perceptions of consideration, responsiveness, communication, and overall impressions, scored on a continuous scale from 1 to 100. Patients who lived outside Toronto were consistently more satisfied than patients who lived inside Toronto when both types of patients were hospitalized in Toronto (P < 0.0001). In contrast, patients who lived inside Toronto were usually and substantially more satisfied than patients who lived outside Toronto when they were hospitalized in facilities outside Toronto (P < 0.02). These findings were consistent after adjustment for several patient-level predictor variables: age, sex, self-assessed health status and number of hospital stays in the last 6 months. Findings suggest that where patients live has a small but potentially important impact on how they rate their care. Residence may therefore be considered when designing public reporting systems and pay-for-performance programs. Further attention to patient-level factors may be important to accurate and useful public reporting of patient satisfaction.

Comparative diets of subyearling Atlantic salmon and subyearling coho salmon in Lake Ontario tributaries

USGS Publications Warehouse

Johnson, James H.; Ringler, Neil H.

2016-01-01

Restoration of Atlantic salmon (Salmo salar) in Lake Ontario could potentially be negatively affected by the presence of non-native salmonids that are naturalized in the basin. Coho salmon (Oncorhynchus kisutch) have been spawning successfully in Lake Ontario tributaries for over 40 years and their juveniles will reside in streams with juvenile Atlantic salmon for one year. This study sought to examine interspecific diet associations between these species, and to compare diets to the composition of the benthos and drift in three Lake Ontario tributaries. Aquatic insects, mainly ephemeropterans and chironomids were the major prey consumed by subyearling Atlantic salmon whereas terrestrial invertebrates made up only 3.7% of the diet. Ephemeropterans and chironomids were the primary aquatic taxa consumed by subyearling coho salmon but, as a group, terrestrial invertebrates (41.8%) were the major prey. In sympatry, Atlantic salmon fed more actively from the benthos whereas the diet of coho salmon was more similar to the drift. The different feeding pattern of each species resulted in low interspecific diet similarity. There is likely little competition between these species for food in Lake Ontario tributaries as juveniles.

Raising public awareness of aphasia in southern Ontario, Canada: A survey.

PubMed

Patterson, Ruth; Robert, Amélie; Berry, Richard; Cain, Mallory; Iqbal, Maryam; Code, Chris; Rochon, Elizabeth; Leonard, Carol

2015-04-01

Despite the relatively high prevalence of aphasia, research indicates that, world-wide, public awareness of aphasia is lacking. Of the surveys that have been conducted internationally, none has studied the Canadian public's awareness of aphasia. The purpose of the present survey was to assess public awareness and basic knowledge of aphasia of individuals in southern Ontario, Canada. Using the same questionnaire that has been used in other countries, face-to-face surveys were conducted in public places (e.g. parks) at various locations in southern Ontario. Respondents were asked questions pertaining to their awareness and knowledge of aphasia. The number of surveys retained for analysis was 831. In addition to an evaluation of public awareness and knowledge of aphasia, the potential influences of age, gender, and occupation were analysed. For those who had heard of aphasia, questions were asked to determine how or where they had heard of aphasia. Consistent with the literature, overall public awareness and basic knowledge of aphasia in southern Ontario was found to be limited. The factors of age, gender and occupation were found to influence the results. This investigation supports the need for better promotion of aphasia awareness to the public in southern Ontario and, by extension, in Canada.

The Untold Story: Examining Ontario's Community Health Centres' Initiatives to Address Upstream Determinants of Health

PubMed Central

Collins, Patricia A.; Resendes, Sarah J.; Dunn, James R.

2014-01-01

Background: Unlike traditional primary care centres, part of the Community Health Centre (CHC) mandate is to address upstream health determinants. In Ontario, CHCs refer to these activities as Community Initiatives (CIs); yet, little is known about how CIs operate. The objective of this study was to examine the scope, resource requirements, partnerships, successes and challenges among selected Ontario CIs. Methods: We conducted qualitative interviews with 10 CHC staff members representing 11 CIs across Ontario. CIs were identified through an online inventory, recruited by e-mail and interviewed between March and June 2011. Results: Most CIs aim to increase community participation, while addressing social isolation and poverty. They draw minimal financial resources from their CHC, and employ highly skilled staff to support implementation. Most enlist support from various partners, and use numerous methods for community engagement. Successes include improved community relations, increased opportunities for education and employment and rewarding partnerships, while insufficient funding was a commonly identified challenge. Conclusions: Despite minimal attention from researchers and funders, our findings suggest that CIs play key capacity-building roles in vulnerable communities across Ontario, and warrant further investigation. PMID:25410693

Motion to strike claim dismissed in HIV defamation suit.

PubMed

Gold, J; Elliott, R

2001-01-01

On 23 April 2001, the Ontario Superior Court of Justice issued the first Canadian ruling on the issue of whether words inputing that a person is HIV-positive or has AIDS can be the basis of a defamation action per se, in the case of Serdar v Metroland Printing, Publishing and Distributing Ltd.

School Improvement: A Case of Competing Priorities!

ERIC Educational Resources Information Center

Pollock, Katina; Winton, Sue

2012-01-01

Maple Leaf School is a large English elementary school in Ontario, Canada. Wanda Miller, the principal, has been at the school for 2 years. Upon arrival, she engaged the teachers in a collaborative exercise to determine their school goal (as required by the province). Character education was selected. The district insisted that the school adopt an…

Patterns of Tight and Loose Coupling in a Competitive Marketplace: The Case of Learning Center Franchises

ERIC Educational Resources Information Center

Aurini, Janice Danielle

2012-01-01

The concept of coupling--the relationship between the environment, administrative goals, and instructional practices of education organizations--is a staple in New Institutional research. Yet processes of coupling have remained elusive. Drawing on ethnographic research of the "Ontario Learning Center" (OLC) franchise, along with…

Reason-Giving and Medical Futility: Contrasting Legal and Social Discourse in the United States With the United Kingdom and Ontario, Canada.

PubMed

Bosslet, Gabriel T; Baker, Mary; Pope, Thaddeus M

2016-09-01

Disputes regarding life-prolonging treatments are stressful for all parties involved. These disagreements are appropriately almost always resolved with intensive communication and negotiation. Those rare cases that are not require a resolution process that ensures fairness and due process. We describe three recent cases from different countries (the United States, United Kingdom, and Ontario, Canada) to qualitatively contrast the legal responses to intractable, policy-level disputes regarding end-of-life care in each of these countries. In so doing, we define the continuum of clinical and social utility among different types of dispute resolution processes and emphasize the importance of public reason-giving in the societal discussion regarding policy-level solutions to end-of-life treatment disputes. We argue that precedential, publicly available, written rulings for these decisions most effectively help to move the social debate forward in a way that is beneficial to clinicians, patients, and citizens. This analysis highlights the lack of such rulings within the United States. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Multiple Intravenous Infusions Phase 1b

PubMed Central

Cassano-Piché, A; Fan, M; Sabovitch, S; Masino, C; Easty, AC

2012-01-01

Background Minimal research has been conducted into the potential patient safety issues related to administering multiple intravenous (IV) infusions to a single patient. Previous research has highlighted that there are a number of related safety risks. In Phase 1a of this study, an analysis of 2 national incident-reporting databases (Institute for Safe Medical Practices Canada and United States Food and Drug Administration MAUDE) found that a high percentage of incidents associated with the administration of multiple IV infusions resulted in patient harm. Objectives The primary objectives of Phase 1b of this study were to identify safety issues with the potential to cause patient harm stemming from the administration of multiple IV infusions; and to identify how nurses are being educated on key principles required to safely administer multiple IV infusions. Data Sources and Review Methods A field study was conducted at 12 hospital clinical units (sites) across Ontario, and telephone interviews were conducted with program coordinators or instructors from both the Ontario baccalaureate nursing degree programs and the Ontario postgraduate Critical Care Nursing Certificate programs. Data were analyzed using Rasmussen’s 1997 Risk Management Framework and a Health Care Failure Modes and Effects Analysis. Results Twenty-two primary patient safety issues were identified with the potential to directly cause patient harm. Seventeen of these (critical issues) were categorized into 6 themes. A cause-consequence tree was established to outline all possible contributing factors for each critical issue. Clinical recommendations were identified for immediate distribution to, and implementation by, Ontario hospitals. Future investigation efforts were planned for Phase 2 of the study. Limitations This exploratory field study identifies the potential for errors, but does not describe the direct observation of such errors, except in a few cases where errors were observed. Not all issues are known in advance, and the frequency of errors is too low to be observed in the time allotted and with the limited sample of observations. Conclusions The administration of multiple IV infusions to a single patient is a complex task with many potential associated patient safety risks. Improvements to infusion and infusion-related technology, education standards, clinical best practice guidelines, hospital policies, and unit work practices are required to reduce the risk potential. This report makes several recommendations to Ontario hospitals so that they can develop an awareness of the issues highlighted in this report and minimize some of the risks. Further investigation of mitigating strategies is required and will be undertaken in Phase 2 of this research. Plain Language Summary Patients, particularly in critical care environments, often require multiple intravenous (IV) medications via large volumetric or syringe infusion pumps. The infusion of multiple IV medications is not without risk; unintended errors during these complex procedures have resulted in patient harm. However, the range of associated risks and the factors contributing to these risks are not well understood. Health Quality Ontario’s Ontario Health Technology Advisory Committee commissioned the Health Technology Safety Research Team at the University Health Network to conduct a multi-phase study to identify and mitigate the risks associated with multiple IV infusions. Some of the questions addressed by the team were as follows: What is needed to reduce the risk of errors for individuals who are receiving a lot of medications? What strategies work best? The initial report, Multiple Intravenous Infusions Phase 1a: Situation Scan Summary Report, summarizes the interim findings based on a literature review, an incident database review, and a technology scan. The Health Technology Safety Research Team worked in close collaboration with the Institute for Safe Medication Practices Canada on an exploratory study to understand the risks associated with multiple IV infusions and the degree to which nurses are educated to help mitigate them. The current report, Multiple Intravenous Infusions Phase 1b: Practice and Training Scan, presents the findings of a field study of 12 hospital clinical units across Ontario, as well as 13 interviews with educators from baccalaureate-level nursing degree programs and postgraduate Critical Care Nursing Certificate programs. It makes 9 recommendations that emphasize best practices for the administration of multiple IV infusions and pertain to secondary infusions, line identification, line set-up and removal, and administering IV bolus medications. The Health Technology Safety Research Team has also produced an associated report for hospitals entitled Mitigating the Risks Associated With Multiple IV Infusions: Recommendations Based on a Field Study of Twelve Ontario Hospitals, which highlights the 9 interim recommendations and provides a brief rationale for each one. PMID:23074426

Cost-effectiveness analysis of a system-based approach for managing neonatal jaundice and preventing kernicterus in Ontario.

PubMed

Xie, Bin; da Silva, Orlando; Zaric, Greg

2012-01-01

To evaluate the incremental cost-effectiveness of a system-based approach for the management of neonatal jaundice and the prevention of kernicterus in term and late-preterm (≥35 weeks) infants, compared with the traditional practice based on visual inspection and selected bilirubin testing. Two hypothetical cohorts of 150,000 term and late-preterm neonates were used to compare the costs and outcomes associated with the use of a system-based or traditional practice approach. Data for the evaluation were obtained from the case costing centre at a large teaching hospital in Ontario, supplemented by data from the literature. The per child cost for the system-based approach cohort was $176, compared with $173 in the traditional practice cohort. The higher cost associated with the system-based cohort reflects increased costs for predischarge screening and treatment and increased postdischarge follow-up visits. These costs are partially offset by reduced costs from fewer emergency room visits, hospital readmissions and kernicterus cases. Compared with the traditional approach, the cost to prevent one kernicterus case using the system-based approach was $570,496, the cost per life year gained was $26,279, and the cost per quality-adjusted life year gained was $65,698. The cost to prevent one kernicterus case using the system-based approach is much lower than previously reported in the literature.

The New CAAT: (Dis)Illusions of Freedom and the New College Charter in Ontario

ERIC Educational Resources Information Center

Arvast, Anita

2008-01-01

In 2002 a new Ontario college charter signaled a new era for higher education in Ontario. The charter was presumed to usher in a new way of doing higher education, one that provided greater freedom for Ontario colleges and presumably greater access for communities to higher education. Coupled with the Post-Secondary Choice and Excellence Act of…

Opening Doors to Nursing Degrees: Time for Action. A Proposal from Ontario's Colleges

ERIC Educational Resources Information Center

Colleges Ontario, 2015

2015-01-01

This report argues that Ontario must expand the educational options for people who want to become registered nurses (RNs). It argues that the change Ontario requires is to authorize colleges to offer their own high-quality nursing degrees. Until 2005, about 70 per cent of Ontario's RNs were educated at colleges. Today, tens of thousands of RNs who…

Hydrology-based understanding of Ontario Lacus in Titan's south pole

NASA Astrophysics Data System (ADS)

Dhingra, Rajani D.; Barnes, Jason W.; Yanites, Brian J.; Kirk, Randolph L.

2015-11-01

Ontario Lacus is the largest presently filled lake at the south pole of Titan. Many other large basins in south pole exist at lower elevations than Ontario Lacus but are currently empty. To find out what sets Ontario apart from those empty basins, we have carried a detailed hydrological assessment of Ontario Lacus. Topography of the region, as derived from Cassini RADAR altimetry was used to determine the catchment area of Ontario Lacus. We could map the areal extent of catchments as far as southern mid-latitudes. Clouds in southern mid and high latitudes have been observed by Cassini VIMS which indicate possible precipitation in those regions. Precipitation in southern mid-latitudes coupled with the large catchment areas of Ontario Lacus could be the reason behind it being filled. Our mass conservation calculations indicate that if runoff was the only contributor to the lake volume, then the lake might be filled within one Titan year (29.5 Earth years) in entirety. We also observe a non-linear relationship between the longest identifiable stream and the catchment area (Hack's Law) which is consistent with terrestrial hydrological systems and may help in further interpretation of the hydrology of Ontario Lacus.

Large catchment area recharges Titan's Ontario Lacus

NASA Astrophysics Data System (ADS)

Dhingra, Rajani D.; Barnes, Jason W.; Yanites, Brian J.; Kirk, Randolph L.

2018-01-01

We seek to address the question of what processes are at work to fill Ontario Lacus while other, deeper south polar basins remain empty. Our hydrological analysis indicates that Ontario Lacus has a catchment area spanning 5.5% of Titan's surface and a large catchment area to lake surface area ratio. This large catchment area translates into large volumes of liquid making their way to Ontario Lacus after rainfall. The areal extent of the catchment extends to at least southern mid-latitudes (40°S). Mass conservation calculations indicate that runoff alone might completely fill Ontario Lacus within less than half a Titan year (1 Titan year = 29.5 Earth years) assuming no infiltration. Cassini Visual and Infrared Mapping Spectrometer (VIMS) observations of clouds over the southern mid and high-latitudes are consistent with precipitation feeding Ontario's large catchment area. This far-flung rain may be keeping Ontario Lacus filled, making it a liquid hydrocarbon oasis in the relatively dry south polar region.

The Patient Experience in Ontario 2020: What Is Possible?

PubMed

Fooks, Cathy; Obarski, Genevieve; Hale, Lori; Hylmar, Stephanie

2015-01-01

Words are important. They signal an intention behind a thought. So when Ontario's Ministry of Health and Long-Term Care publishes an action plan (Ontario Ministry of Health and Long-Term Care, 2012) that declares itself to be "obsessively patient-centred," curiosity ensues and terms abound. Patient-centred care, patient engagement and patient experience - all seem to be in the mix in Ontario. This paper will propose a set of definitions for these commonly used terms, examine the progress being made in Ontario towards a more patient-centred healthcare system and suggest where we might aim to be by 2020.

Public Attitudes toward Education in Ontario, 1982. Fourth OISE Survey. Informal Series/51.

ERIC Educational Resources Information Center

Livingstone, D. W.; And Others

Results of the Ontario Institute for Studies in Education 1982 Survey, intended primarily to offer ongoing profiles of mass attitudes on major issues of current educational reform, are reported. In addition to documenting trends in public support for general curricular and financing options, the survey focuses on attitudes towards alternative ways…

Pathways from College to University: A Social Science Example from Ontario

ERIC Educational Resources Information Center

LeSage, Ann; Samis, John; Hinch, Ron; Longo, Fabiola; DiGiuseppe, Maurice; Goodman, William; Percival, Jennifer; De La Rocha, Arlene; Rodrigues, Anna; Raby, Phil; Sanchez, Otto

2014-01-01

This study evaluates the impact of a College to University Pathway Program in the Faculty of Social Science and Humanities at The University of Ontario Institute of Technology. The findings support the assertion that Pathway students perform as well as or better than students who enter university directly from secondary school. This finding is…

Resources and Constraints: Public Education and the Economic Environment in Ontario, 1978-1987.

ERIC Educational Resources Information Center

Foot, David K.

Considering the national and provincial economic environments for the next decade, this paper projects financial resources and constraints likely to be faced by school boards in Ontario over the same period. The study utilizes an econometric model developed by the Institute for Policy Analysis of the University of Toronto. The findings indicate…

Validation of FIBER 3.0 for tolerant hardwood stands in Ontario

Treesearch

Jacek Bankowski; Daniel C. Dey; Murray Woods; Jim Rice; Eric Boysen; Brian Batchelor; Roj Miller

1995-01-01

Growth and yield projections aid foresters in assessing timber management opportunities and in making management decisions. With these uses, questions arise about the reliability and limits of growth and yield simulators. Using long-term studies of hardwood stands in Ontario the growth simulator FIBER 3.0 has been tested. Short-term (5 years) projections of stand...

Demand for Substance Abuse Treatment Related to Use of Crystal Methamphetamine in Ontario: An Observational Study

ERIC Educational Resources Information Center

Brands, Bruna; Corea, Larry; Strike, Carol; Singh, Veeran-Anne S.; Behrooz, Renee C.; Rush, Brian

2012-01-01

Concerns about methamphetamine/crystal methamphetamine (MA) have featured prominently in the Canadian media and on addiction treatment agency agendas. We examined MA admissions at addiction treatment agencies to determine if a service gap existed. In 2006, all addiction treatment agencies (n = 124) in Ontario, Canada were invited to complete an…

Exploring the Digital Divide: The Use of Digital Technologies in Ontario Public Schools

ERIC Educational Resources Information Center

Chen, Bodong

2015-01-01

Combining data from a school principal survey with student demographics and achievement data, the present study aimed to develop a much needed understanding of ICT usage in Ontario's K-12 public schools. Results indicated equitable first-order access to technology for schools, early integration of ICT from the earliest grades, frequent application…

Ontario's Old Growth: A Learner's Handbook.

ERIC Educational Resources Information Center

Stabb, Mark

This handbook was written in response to an identified need for more public information on Ontario's old growth forests. It is meant to be taken into old growth stands, where the learner can see, touch, and study the natural ingredients of old growth forests. Much of the handbook is a guide to forest history, helping the learner to discover…

Constraints and motivations related to fishing along the Lake Ontario coast

Treesearch

Matthew P. Brincka; Diane M. Kuehn; Valerie Luzadis

2012-01-01

The number of nonresident anglers along the Lake Ontario coast has decreased over the past 15 years. Therefore, in order to sustain a strong sport fishing industry, local businesses and tourism promoters might want to tap into the large resident angler market group. This study examines resident anglers' social, environmental, and economic constraints/facilitators...

Perspectives and Plans for Graduate Studies. 11. Engineering 1974. D. Mechanical Engineering. Report No. 74-21.

ERIC Educational Resources Information Center

Ontario Council on Graduate Studies, Toronto. Advisory Committee on Academic Planning.

On the instruction of the Council of Ontario Universities, the Advisory Committee on Academic Planning in cooperation with the Committee of Ontario Deans of Engineering has conducted a planning assessment for doctoral work in mechanical engineering. This report presents as overview of the recommendations for each of the assessments conducted in…

Exploring Student and Advisor Experiences in a College-University Pathway Program: A Study of the Bachelor of Commerce Pathway

ERIC Educational Resources Information Center

Percival, Jennifer; DiGiuseppe, Maurice; Goodman, Bill; LeSage, Ann; Hinch, Ron; Samis, John; Sanchez, Otto; Rodrigues, Anna; Raby, Phil; Longo, Fabiola; De La Rocha, Arlene

2015-01-01

Currently, there is great interest across Ontario in the expansion of pathway programs between colleges and universities. Through strategic partnerships, two Ontario-based postsecondary institutions (a college and a university) have developed innovative and effective pathway programs that facilitate the transition of students between institutions…

The Challenges of the Ontario Secondary School Literacy Test for Second Language Students

ERIC Educational Resources Information Center

Cheng, Liying; Klinger, Don A.; Zheng, Ying

2007-01-01

Results from the Ontario Secondary School Literacy Test (OSSLT) indicate that English as a Second Language (ESL) and English Literacy Development (ELD) students have comparatively low success and high deferral rates. This study examined the 2002 and 2003 OSSLT test performances of ESL/ELD and non-ESL/ELD students in order to identify and…

The Application of School Science by Urban High School Youth through Problem-Solving in Everyday Life

ERIC Educational Resources Information Center

Gitari, Wanja

2016-01-01

This qualitative study investigated non-guided applications of school science by high school youth in Ontario in non-school contexts. Although science education (in Ontario and elsewhere) mostly focuses on the meaningful learning of science, learning that can lead to knowledge application, non-guided application of acquired knowledge is rarely…

The enteritis complex in domestic rabbits: A field study

PubMed Central

Percy, Dean H.; Muckle, C. Anne; Hampson, Robert J.; Brash, Marina L.

1993-01-01

A study of the causative agents of enteritis in domestic rabbits from 44 different accessions is described. In descending order of frequency, the organisms most commonly demonstrated were intestinal and hepatic coccidia (Eimeria species), Escherichia coli, Clostridium spp., Salmonella, Bacillus piliformis, and rotavirus. The species of Eimeria identified included those moderately pathogenic and coccidia of low pathogenicity. Using seven antisera against known enterpathogenic strains of E. coli, only one strain, O15, was identified in three cases. Clostridium perfringens or C. spiroforme was demonstrated in the intestinal contents in 11 cases, and lesions compatible with clostridial enteropathy were identified on gross and histopathology. In a serological survey, over 50% of 200 fryer rabbits submitted to Ontario abattoirs and of animals from commercial rabbitries had detectable antibody to rotavirus, indicating the widespread distribution of rotaviral infections in this species. In the cases of enteritis studied, two or more potentially pathogenic organisms were frequently identified, emphasizing that several different organisms may be acting in concert to produce clinical disease. ImagesFigure 1. PMID:17424177

The enteritis complex in domestic rabbits: A field study.

PubMed

Percy, D H; Muckle, C A; Hampson, R J; Brash, M L

1993-02-01

A study of the causative agents of enteritis in domestic rabbits from 44 different accessions is described. In descending order of frequency, the organisms most commonly demonstrated were intestinal and hepatic coccidia (Eimeria species), Escherichia coli, Clostridium spp., Salmonella, Bacillus piliformis, and rotavirus. The species of Eimeria identified included those moderately pathogenic and coccidia of low pathogenicity. Using seven antisera against known enterpathogenic strains of E. coli, only one strain, O15, was identified in three cases. Clostridium perfringens or C. spiroforme was demonstrated in the intestinal contents in 11 cases, and lesions compatible with clostridial enteropathy were identified on gross and histopathology. In a serological survey, over 50% of 200 fryer rabbits submitted to Ontario abattoirs and of animals from commercial rabbitries had detectable antibody to rotavirus, indicating the widespread distribution of rotaviral infections in this species. In the cases of enteritis studied, two or more potentially pathogenic organisms were frequently identified, emphasizing that several different organisms may be acting in concert to produce clinical disease.

Prevalence of HIV and hepatitis C virus infections among inmates of Ontario remand facilities

PubMed Central

Calzavara, Liviana; Ramuscak, Nancy; Burchell, Ann N.; Swantee, Carol; Myers, Ted; Ford, Peter; Fearon, Margaret; Raymond, Sue

2007-01-01

Background Each year more than 56 000 adult and young offenders are admitted to Ontario's remand facilities (jails, detention centres and youth centres). The prevalence of HIV infection in Ontario remand facilities was last measured over a decade ago, and no research on the prevalence of hepatitis C virus (HCV) infection has been conducted in such facilities. We sought to determine the prevalence of HIV infection, HCV infection and HIV–HCV coinfection among inmates in Ontario's remand facilities. Methods A voluntary and anonymous cross-sectional prevalence study of HIV and HCV infections was conducted among people admitted to 13 selected remand facilities across Ontario between Feb. 1, 2003, and June 20, 2004. Data collection included a saliva specimen for HIV and HCV antibody screening and an interviewer-administered survey. Prevalence rates and 95% confidence intervals were calculated and examined according to demographic characteristics, region of incarceration and self-reported history of injection drug use. Results In total, 1877 participants provided both a saliva specimen and survey information. Among the adult participants, the prevalence of HIV infection was 2.1% among men and 1.8% among women. Adult offenders most likely to have HIV infection were older offenders (≥ 30 years) and injection drug users. The prevalence of HCV infection was 15.9% among men, 30.2% among women and 54.7% among injection drug users. Adult offenders most likely to have HCV infection were women, older offenders (≥ 30 years) and injection drug users. The prevalence of HCV–HIV coinfection was 1.2% among men and 1.5% among women. It was highest among older inmates and injection drug users. Among the young offenders, none was HIV positive and 1 (0.4%) was HCV positive. On the basis of the study results, we estimated that 1079 HIV-positive adults and 9208 HCV-positive adults were admitted to remand facilities in Ontario from Apr. 1, 2003, to Mar. 31, 2004. Interpretation Adult offenders entering Ontario remand facilities have a considerably higher prevalence of HIV and HCV infections than the general population. PMID:17664449

Association of Ambient Air Pollution with Respiratory Hospitalization in a Government-Designated “Area of Concern”: The Case of Windsor, Ontario

PubMed Central

Luginaah, Isaac N.; Fung, Karen Y.; Gorey, Kevin M.; Webster, Greg; Wills, Chris

2005-01-01

This study is part of a larger research program to examine the relationship between ambient air quality and health in Windsor, Ontario, Canada. We assessed the association between air pollution and daily respiratory hospitalization for different age and sex groups from 1995 to 2000. The pollutants included were nitrogen dioxide, sulfur dioxide, carbon monoxide, ozone, particulate matter ≤10 μm in diameter (PM10), coefficient of haze (COH), and total reduced sulfur (TRS). We calculated relative risk (RR) estimates using both time-series and case-crossover methods after controlling for appropriate confounders (temperature, humidity, and change in barometric pressure). The results of both analyses were consistent. We found associations between NO2, SO2, CO, COH, or PM10 and daily hospital admission of respiratory diseases especially among females. For females 0–14 years of age, there was 1-day delayed effect of NO2 (RR = 1.19, case-crossover method), a current-day SO2 (RR = 1.11, time series), and current-day and 1- and 2-day delayed effects for CO by case crossover (RR = 1.15, 1.19, 1.22, respectively). Time-series analysis showed that 1-day delayed effect of PM10 on respiratory admissions of adult males (15–64 years of age), with an RR of 1.18. COH had significant effects on female respiratory hospitalization, especially for 2-day delayed effects on adult females, with RRs of 1.15 and 1.29 using time-series and case-crossover analysis, respectively. There were no significant associations between O3 and TRS with respiratory admissions. These findings provide policy makers with current risks estimates of respiratory hospitalization as a result of poor ambient air quality in a government designated “area of concern.” PMID:15743717

Impact of the rural pipeline in medical education: practice locations of recently graduated family physicians in Ontario.

PubMed

Wenghofer, Elizabeth F; Hogenbirk, John C; Timony, Patrick E

2017-02-20

The "rural pipeline" suggests that students educated in rural, or other underserviced areas, are more likely to establish practices in such locations. It is upon this concept that the Northern Ontario School of Medicine (NOSM) was founded. Our analysis answers the following question: Are physicians who were educated at NOSM more likely to practice in rural and northern Ontario compared with physicians who were educated at other Canadian medical schools? We used data from the College of Physicians and Surgeons of Ontario. We compared practice locations of certified Ontario family physicians who had graduated from NOSM vs. other Canadian medical schools in 2009 or later. We categorized the physicians according to where they completed their undergraduate (UG) and postgraduate (PG) training, either at NOSM or elsewhere. We used logistic regression models to determine if the location of UG and PG training was associated with rural or northern Ontario practice location. Of the 535 physicians examined, 67 had completed UG and/or PG medical education at NOSM. Over two thirds of physicians with any NOSM education were practicing in northern areas and 25.4% were practicing in rural areas of Ontario compared with those having no NOSM education, with 4.3 and 10.3% in northern and rural areas, respectively. Physicians who graduated from NOSM-UG were more likely to have practices located in rural Ontario (OR = 2.57; p = 0.014) whereas NOSM-PG physicians were more likely to have practices in northern Ontario (OR = 57.88; p < 0.001). NOSM education was associated with an increased likelihood of practicing in rural (NOSM-UG) and northern (NOSM-PG) Ontario.

The effect of continuing professional development on public complaints: a case-control study.

PubMed

Wenghofer, Elizabeth F; Campbell, Craig; Marlow, Bernard; Kam, Sophia M; Carter, Lorraine; McCauley, William

2015-03-01

This study aimed to investigate the relationship between participation in different types of continuing professional development (CPD), and incidences and types of public complaint against physicians. Cases included physicians against whom complaints were made by members of the public to the medical regulatory body in Ontario, Canada, the College of Physicians and Surgeons of Ontario (CPSO), during 2008 and 2009. The control cohort included physicians against whom no complaints were documented during the same period. We focused on complaints related to physician communication, quality of care and professionalism. The CPD data included all Royal College of Physicians and Surgeons of Canada (RCPSC) and College of Family Physicians of Canada (CFPC) CPD programme activities reported by the case and control physicians. Multivariate logistic regression models were used to determine if the independent variable, reported participation in CPD, was associated with the dependent variable, the complaints-related status of the physician in the year following reported CPD activities. A total of 2792 physicians were included in the study. There was a significant relationship between participation in CPD, type of CPD and type of complaint received. Analysis indicated that physicians who reported overall participation in CPD activities were significantly less likely (odds ratio 0.604; p = 0.028) to receive quality of care-related complaints than those who did not report participating in CPD. Additionally, participation in group-based CPD was less likely (OR 0.681; p = 0.041) to result in quality of care-related complaints. The findings demonstrate a positive relationship between participation in the national CPD programmes of the CFPC and RCPSC, and lower numbers of public complaints received by the CPSO. As certification bodies and regulators alike are increasingly mandating CPD, they are encouraged to continually evaluate the effectiveness of their programmes to maximise programme impact on physician performance at the population level. © 2015 John Wiley & Sons Ltd.

Implementation of a community greenhouse in a remote, sub-Arctic First Nations community in Ontario, Canada: a descriptive case study.

PubMed

Skinner, K; Hanning, R M; Metatawabin, J; Tsuji, L J S

2014-01-01

Food insecurity is prevalent in northern communities in Canada and there is a movement to improve food security through both the re-vitalization of traditional harvesting practices as well as through sustainable agriculture initiatives. Gardening in northern communities can be difficult and may be aided by a community greenhouse. The objective of this project was to conduct a descriptive case study of the context and process surrounding the implementation of a community greenhouse in a remote, sub-Arctic First Nations community in Ontario, Canada. Data sources included semi-directed interviews with a purposive and snowball sample of key informants (n=14), direct observations (n=32 days), written documentation (n=107), and photo-documentation (n=621 total). Digital photographs were taken by both a university investigator during community visits and a community investigator throughout the entire project. The case study was carried out over 33 months; from early 2009 until October of 2011. Thematic data analyses were conducted and followed a categorical aggregation approach. Categories emerging from the data were appointed gardening-related themes: seasons, fertile ground, sustainability, gardeners, ownership, participant growth, and sunshine. Local champions were critical to project success. Uncertainty was expressed by several participants regarding ownership of the greenhouse; the local community members who championed the project had to emphasize, repeatedly, that it was community owned. Positive outcomes included the involvement of many community members, a host of related activities, and that the greenhouse has been a learning opportunity to gain knowledge about growing plants in a northern greenhouse setting. A strength of the project was that many children participated in greenhouse activities. Community and school greenhouse projects require local champions to be successful. It is important to establish guidelines around ownership of a greenhouse and suitable procedures for making the building accessible to everyone without compromising security. Implementing a greenhouse project can engage community members, including children, and provide a great learning opportunity for gardeners in a remote, northern community.

Early Days for the Differentiation Policy Framework in Ontario

ERIC Educational Resources Information Center

Sianos, Helen

2017-01-01

The Ontario Ministry of Training, Colleges and Universities in Canada released "Ontario's Differentiation Policy Framework for Postsecondary Education" in 2013. This chapter examines the mandate as it pertains to the college sector.

Cooperative science to inform Lake Ontario management: Research from the 2013 Lake Ontario CSMI program

USGS Publications Warehouse

Watkins, James M.; Weidel, Brian C.; Fisk, Aaron T.; Rudstam, Lars G.

2017-01-01

Since the mid-1970s, successful Lake Ontario management actions including nutrient load and pollution reductions, habitat restoration, and fish stocking have improved Lake Ontario. However, several new obstacles to maintenance and restoration have emerged. This special issue presents management-relevant research from multiple agency surveys in 2011 and 2012 and the 2013 Cooperative Science and Monitoring Initiative (CSMI), that span diverse lake habitats, species, and trophic levels. This research focused on themes of nutrient loading and fate; vertical dynamics of primary and secondary production; fish abundance and behavior; and food web structure. Together these papers identify the status of many of the key drivers of the Lake Ontario ecosystem and contribute to addressing lake-scale questions and management information needs in Lake Ontario and the other Great Lakes and connecting water bodies.

Outbreak of Salmonella Reading in persons of Eastern Mediterranean origin in Canada, 2014–2015

PubMed Central

Tanguay, F; Vrbova, L; Anderson, M; Whitfield, Y; Macdonald, L; Tschetter, L; Hexemer, A

2017-01-01

Background Salmonella Reading (S. Reading) is a rare serotype of Salmonella subspecies (spp.) in Canada with less than nine cases reported each year (2011–2013). An increase in S. Reading was identified in several Canadian provinces in early 2015, prompting the initiation of a national outbreak investigation. Objectives To describe a multi-provincial S. Reading outbreak in Canada that affected over 30 people. Methods Cases were defined as laboratory-confirmed S. Reading with related pulsed-field gel electrophoresis (PFGE) patterns. Onset dates were between November 2014 and September 2015. ​ Early in the investigation, investigators noted cases were predominantly of Eastern Mediterranean origin, mainly Afghan and Lebanese and many of those affected had consumed food items not typically captured on standard enteric outbreak hypothesis-generating questionnaires. An open-ended three day food consumption survey was conducted with a convenience sample of community informants to better understand food preferences of the affected ethnocultural populations. Results of the survey were used to design a focused questionnaire for case re-interviews and subsequent outbreak cases. Public health investigators obtained food samples from case homes and relevant food premises. Food safety authorities conducted traceback of suspected food items and collected food samples for laboratory testing. Results There were 31 confirmed cases (Ontario=23, Alberta=7, New Brunswick=1) and three probable (Ontario=2, Alberta=1) cases of S. Reading identified as part of the outbreak. The median age was 31 years (range less than one to 85 years) and 53% (18/34) of cases were female. Seven cases were hospitalized. No deaths were reported. Most cases were of Eastern Mediterranean origin (n=23) or had reported consuming Eastern Mediterranean foods (n=3). The predominant ethnic origins reported by cases were Afghan in Ontario (n=12) and Lebanese in Alberta (n=3). Genetic similarity of clinical isolates was further confirmed using whole genome sequencing. ​ Three ethnic bakeries were identified as possible common exposures for the cases; however, traceback of foods of interest from these bakeries did not identify a common supplier and the source of the illness was not identified. In total, 227 food samples from retail premises (n=142), restaurants (n=13) and case homes (n=72) were tested; two food samples, kalonji seeds and tahini, were positive for S. Ruiru and S. Meleagridis. These products were recalled from the marketplace. Conclusion Despite extensive epidemiological, microbiological and food traceback investigations, a common source was not identified for this S. Reading outbreak. Challenges included lack of familiarity with the food items consumed in affected ethnocultural groups, as well as a lack of background data on expected food exposures in the outbreak population. Engaging local partners helped build understanding of food preferences in affected communities. Given Canada’s ethnic and cultural diversity, culturally competent approaches to enteric outbreak investigations and food consumption surveys may be useful. PMID:29770042

Repeated Diagnostic Imaging Studies in Ontario and the Impact of Health Information Exchange Systems.

PubMed

Welk, Blayne; Liu, Kuan; Al-Jaishi, Ahmed; McArthur, Eric; Jain, Arsh K; Ordon, Michael

2016-01-01

Health information exchange systems can link the results of diagnostic imaging tests across hospitals and geographic areas. One of the potential benefits of these systems is a reduction in imaging studies ordered by physicians who do not know about or have access to the previous imaging results. We used administrative data from Ontario, Canada (from the year 2013), to measure how frequently the same cross-sectional imaging study is repeated in a patient. Overall, 12.8% of the specified imaging tests were repeated within 90 days. An area of Southwestern Ontario with a health information exchange system for diagnostic imaging tests had a 13% lower rate of repeat cross-sectional imaging compared with the rest of the province (11.2 vs 12.8%, p < 0.01). The use of linked radiology systems may be able to reduce the number of repeated imaging tests and improve patient safety and hospital efficiency.

Quadrivalent human papillomavirus vaccination in girls and the risk of autoimmune disorders: the Ontario Grade 8 HPV Vaccine Cohort Study.

PubMed

Liu, Erin Y; Smith, Leah M; Ellis, Anne K; Whitaker, Heather; Law, Barbara; Kwong, Jeffrey C; Farrington, Paddy; Lévesque, Linda E

2018-05-28

Despite demonstrated effectiveness in real-world settings, concerns persist regarding the safety of the quadrivalent human papillomavirus (HPV4) vaccine. We sought to assess the risk of autoimmune disorders following HPV4 vaccination among grade 8 girls eligible for Ontario's school-based HPV vaccination program. We undertook a population-based retrospective cohort study using Ontario's administrative health and vaccination databases from 2007 to 2013. The self-controlled case series method was used to compare the rate of a composite end point of autoimmune disorders diagnosed during days 7-60 post-vaccination ("exposed" follow-up) to that at any other time ("unexposed"). The analysis was repeated to assess the effect of a history of immune-mediated diseases and time since vaccination. We also conducted an exploratory analysis of individual autoimmune disorders. Rate ratios and 95% confidence intervals (CIs) were estimated using conditional Poisson regression, adjusted for age, seasonality, concomitant vaccinations and infections. The study cohort consisted of 290 939 girls aged 12-17 years who were eligible for vaccination between 2007 and 2013. There was no significant risk for developing an autoimmune disorder following HPV4 vaccination ( n = 681; rate ratio 1.12, 95% CI 0.85-1.47), and the association was unchanged by a history of immune-mediated disorders and time since vaccination. Exploratory analyses of individual autoimmune disorders found no significant risks, including for Bell palsy ( n = 65; rate ratio 1.73, 95% CI 0.77-3.89), optic neuritis ( n = 67; rate ratio 1.57, 95% CI 0.74-3.33) and Graves disease ( n = 47; rate ratio 1.55, 95% CI 0.92-2.63). We did not observe an increased risk of autoimmune disorders following HPV4 vaccination among teenaged girls. These findings should reassure parents and health care providers. © 2018 Joule Inc. or its licensors.

A descriptive analysis of medical health services utilization of Veterans living in Ontario: a retrospective cohort study using administrative healthcare data.

PubMed

Aiken, Alice B; Mahar, Alyson L; Kurdyak, Paul; Whitehead, Marlo; Groome, Patti A

2016-08-04

Health services utilization by Veterans following release may be different than the general population as the result of occupational conditions, requirements and injuries. This study provides the first longitudinal overview of Canadian Veteran healthcare utilization in the Ontario public health system. This is a retrospective cohort study designed to use Ontario's provincial healthcare data to study the demographics and healthcare utilization of Canadian Armed Forces (CAF) & RCMP Veterans living in Ontario. Veterans were eligible for the study if they released between January 1, 1990 and March 31, 2013. Databases at the Institute for Clinical Evaluative Sciences were linked by a unique identifier to study non-mental health related hospitalizations, emergency department visits, and physician visits. Overall and age-stratified descriptive statistics were calculated in five-year intervals following the date of release. The cohort is comprised of 23, 818 CAF or RCMP Veterans. Following entry into the provincial healthcare system, 82.6 % (95 % CI 82.1-83.1) of Veterans saw their family physician at least once over the first five years following release, 60.7 % (95 % CI 60.0-61.3) saw a non-mental health specialist, 40.8 % (95 % CI 40.2-41.5) went to the emergency department in that same time period and 9.9 % (9.5-10.3) were hospitalized for non-mental health related complaints. Patterns of non-mental health services utilization appeared to be time and service dependant. Stratifying health services utilization by age of the Veteran at entry into the provincial healthcare system revealed significant differences in service use and intensity. This study provides the first description of health services utilization by Veterans, following release from the CAF or RCMP. This work will inform the planning and delivery of support to Veterans in Ontario.

Proceedings of the 2009 Annual Meeting of the Canadian Mathematics Education Study Group = Actes de la Rencontre Annuelle 2009 du Groupe Canadien d'Etude en Didactique des Mathematiques (33rd, Toronto, Ontario, Canada, June 5-June 9, 2009)

ERIC Educational Resources Information Center

Liljedahl, Peter, Ed.; Oesterle, Susan, Ed.; Abu-Bakare, Veda, Ed.

2010-01-01

This submission contains the Proceedings of the 2009 Annual Meeting of the Canadian Mathematics Education Study Group (CMESG), held at York University in Toronto, Ontario. The CMESG is a group of mathematicians and mathematics educators who meet annually to discuss mathematics education issues at all levels of learning. The aims of the Study Group…

Vertebral Augmentation Involving Vertebroplasty or Kyphoplasty for Cancer-Related Vertebral Compression Fractures: An Economic Analysis

PubMed Central

2016-01-01

Background Untreated vertebral compression fractures can have serious clinical consequences and impose a considerable impact on patients' quality of life and on caregivers. Since non-surgical management of these fractures has limited effectiveness, vertebral augmentation procedures are gaining acceptance in clinical practice for pain control and fracture stabilization. The objective of this analysis was to determine the cost-effectiveness and budgetary impact of kyphoplasty or vertebroplasty compared with non-surgical management for the treatment of vertebral compression fractures in patients with cancer. Methods We performed a systematic review of health economic studies to identify relevant studies that compare the cost-effectiveness of kyphoplasty or vertebroplasty with non-surgical management for the treatment of vertebral compression fractures in adults with cancer. We also performed a primary cost-effectiveness analysis to assess the clinical benefits and costs of kyphoplasty or vertebroplasty compared with non-surgical management in the same population. We developed a Markov model to forecast benefits and harms of treatments, and corresponding quality-adjusted life years and costs. Clinical data and utility data were derived from published sources, while costing data were derived using Ontario administrative sources. We performed sensitivity analyses to examine the robustness of the results. In addition, a 1-year budget impact analysis was performed using data from Ontario administrative sources. Two scenarios were explored: (a) an increase in the total number of vertebral augmentation procedures performed among patients with cancer in Ontario, maintaining the current proportion of kyphoplasty versus vertebroplasty; and (b) no increase in the total number of vertebral augmentation procedures performed among patients with cancer in Ontario but an increase in the proportion of kyphoplasties versus vertebroplasties. Results The base case considered each of kyphoplasty and vertebroplasty versus non-surgical management. Kyphoplasty and vertebroplasty were associated with an incremental cost-effectiveness ratio of $33,471 and $17,870, respectively, per quality-adjusted life-year gained. The budgetary impact of funding vertebral augmentation procedures for the treatment of vertebral compression fractures in adults with cancer in Ontario was estimated at about $2.5 million in fiscal year 2014/15. More widespread use of vertebral augmentation procedures raised total expenditures under a number of scenarios, with costs increasing by $67,302 to $913,386. Conclusions Our findings suggest that the use of kyphoplasty or vertebroplasty in the management of vertebral compression fractures in patients with cancer may be a cost-effective strategy at commonly accepted willingness-to-pay thresholds. Nonetheless, more widespread use of kyphoplasty (and vertebroplasty to a lesser extent) would likely be associated with net increases in health care costs. PMID:27293494

It's Who You Know "and" What You Know: The Process of Creating Partnerships between Schools and Communities

ERIC Educational Resources Information Center

Hands, Catherine

2005-01-01

Based on qualitative research, this article aims to clarify the process of creating school-community partnerships. Two secondary schools with numerous partnerships were selected within a southern Ontario school board characterized by economic and cultural diversity. Drawing on the within- and cross-case analyses of documents, observations, and 25…

Austerity, Ontario and Post-Secondary Education: The Case of "Canada's Capital University"

ERIC Educational Resources Information Center

Fanelli, Carlo; Meades, James

2011-01-01

As austerity measures intensify around the world, the axe has come down particularly hard on post-secondary education (PSE). So-called education "reform" has shown itself to be a lightning rod for confrontation. In order to deal with unprecedented government budget shortfalls, caused, it must be recalled, by the lead agents of the…

Access to dental care for persons with developmental disabilities in Ontario.

PubMed

Koneru, Anjani; Sigal, Michael J

2009-03-01

This study was undertaken to determine the proportion of persons primarily with developmental disabilities who encounter difficulties accessing dental care in Ontario, to identify perceived barriers to accessing dental care and to determine if persons with disabilities and their caregivers believe that oral health is important. Community organizations providing services mainly to persons with developmental disabilities in Ontario were recruited to circulate a questionnaire to their members by mail or the Internet. Fourteen organizations mailed out a total of 1,755 paper questionnaires in autumn 2006, of which 420 (23.9%) were returned; in addition, 236 Internet questionnaires were returned. Of the 656 paper and Internet responses, 634 were deemed valid. Most of the respondents had developmental disabilities. Almost three-quarters of respondents (464 [73.2%] ) reported being able to access dental services in Ontario. Personal (internal) factors were more likely to represent barriers to dental care than external factors. The majority of persons with disabilities and most caregivers believed that oral health is important for overall health.

A changing child welfare workforce: What worker characteristics are valued in child welfare?

PubMed

Lwin, Kristen; Fallon, Barbara; Trocmé, Nico; Fluke, John; Mishna, Faye

2018-05-07

A child welfare system is responsible for making difficult decisions. Child welfare workers are charged with assessing and determining when a child is in need of protection, including when it is necessary to intervene on behalf of children when their caregivers' abilities and/or situation is deemed to put them at risk of abuse or neglect. Although the child welfare workforce in Ontario attended to an estimated 125,281 child maltreatment investigations in 2013, little is known about the skills, education, and experiences of these investigating workers. Notwithstanding assumptions about the qualifications and characteristics necessary for effective child welfare practice, few studies explicitly link the specific characteristics of workers to children, youth, and families achieving positive case outcomes. These assumptions have been shaped by a multitude of factors including knowledge of human resources, professional standards, and educational requriements. This study examined data from five cycles over twenty years of Ontario Incidence Studies (-1993, -1998, -2003, -2008, -2013) to provide a profile of child welfare workers. This is the first study to examine the changing profile of child welfare workers in any province in Canada and provides a foundation for developing effective recruitment and professional development strategies, and promoting a positive work environment. Policy and practice implications for the changing needs of these families are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

Defining the physician's duty to warn: consensus statement of Ontario's Medical Expert Panel on Duty to Inform

PubMed Central

Ferris, L E; Barkun, H; Carlisle, J; Hoffman, B; Katz, C; Silverman, M

1998-01-01

Ontario's Medical Expert Panel on Duty to Inform was formed to consider the duty of Ontario physicians in circumstances where a patient threatens to kill or cause serious bodily harm to a third party. The panel was concerned about the implications of any duty to inform on the integrity of the physician-patient relationship, particularly with respect to confidentiality. The panel agreed that regulations safeguarding the confidentiality of patient information ought to be changed only if there is a critical reason for doing so, but, after deliberation, the panel members concluded that the need to protect the public from serious risk of harm is a paramount concern that should supersede the duty of confidentiality. The recommendations reported here were endorsed in principle by the panelists and the groups they represented (the Royal College of Physicians and Surgeons of Canada, the Canadian Medical Protective Association, the College of Physicians and Surgeons of Ontario, the Ontario College of Family Physicians and the Ontario Medical Association) and are being implemented by the College of Physicians and Surgeons of Ontario. PMID:9629112

Evaluation of missing value methods for predicting ambient BTEX concentrations in two neighbouring cities in Southwestern Ontario Canada

NASA Astrophysics Data System (ADS)

Miller, Lindsay; Xu, Xiaohong; Wheeler, Amanda; Zhang, Tianchu; Hamadani, Mariam; Ejaz, Unam

2018-05-01

High density air monitoring campaigns provide spatial patterns of pollutant concentrations which are integral in exposure assessment. Such analysis can assist with the determination of links between air quality and health outcomes, however, problems due to missing data can threaten to compromise these studies. This research evaluates four methods; mean value imputation, inverse distance weighting (IDW), inter-species ratios, and regression, to address missing spatial concentration data ranging from one missing data point up to 50% missing data. BTEX (benzene, toluene, ethylbenzene, and xylenes) concentrations were measured in Windsor and Sarnia, Ontario in the fall of 2005. Concentrations and inter-species ratios were generally similar between the two cities. Benzene (B) was observed to be higher in Sarnia, whereas toluene (T) and the T/B ratios were higher in Windsor. Using these urban, industrialized cities as case studies, this research demonstrates that using inter-species ratios or regression of the data for which there is complete information, along with one measured concentration (i.e. benzene) to predict for missing concentrations (i.e. TEX) results in good agreement between predicted and measured values. In both cities, the general trend remains that best agreement is observed for the leave-one-out scenario, followed by 10% and 25% missing, and the least agreement for the 50% missing cases. In the absence of any known concentrations IDW can provide reasonable agreement between observed and estimated concentrations for the BTEX species, and was superior over mean value imputation which was not able to preserve the spatial trend. The proposed methods can be used to fill in missing data, while preserving the general characteristics and rank order of the data which are sufficient for epidemiologic studies.

Insecticide residues on stream sediments in Ontario, Canada.

PubMed

Miles, J R

1976-12-01

Insecticide residues on suspended and bottom sediments of streams of Ontario, Canada, have been studied in a tobacco-growing and a vegetable muck area. The proportion of TDE to DDT was less than 1 in water and greater than 1 in bottom sediments. The ratio of TDE to DDT in bottom material increased linearly from the contamination point at stream source to the mouth of Big Creek in Norfolk County, Ontario. Bed load samples contained three to six times greater concentrations of insecticides than bottom material. Adsorption of insecticides on suspended sediment decreased in order DDT greater than TDE greater than dieldrin greater than diazinon, which is consistent with the water solubility of these compounds.

Breast cancer care in the Canada and the United States: Ecological comparisons of extremely impoverished and affluent urban neighborhoods

PubMed Central

Gorey, Kevin M.; Luginaah, Isaac N.; Hamm, Caroline; Fung, Karen Y.; Holowaty, Eric J.

2010-01-01

This study examined the differential effect of extreme impoverishment on breast cancer care in urban Canada and the United States. Ontario and California registry-based samples diagnosed between 1998 and 2000 were followed until 2006. Extremely poor and affluent neighborhoods were compared. Poverty was associated with non-localized disease, surgical and radiation therapy (RT) waits, nonreceipt of breast conserving surgery, RT and hormonal therapy, and shorter survival in California, but not in Ontario. Extremely poor Ontario women were consistently advantaged on care indices over their California counterparts. More inclusive health insurance coverage in Canada seems the most plausible explanation for such Canadian breast cancer care advantages. PMID:19840902

Use of clinical placements as a means of recruiting health care students to underserviced areas in Southeastern Ontario: part 1 - student perspectives.

PubMed

MacRae, Michelle; van Diepen, Kelly; Paterson, Margo

2007-02-01

This two-part study examines the present gap between financial and educational incentives required and the recruitment strategies used to draw health science students to underserviced areas in Southeastern Ontario. Part 1 explores the impact of offering travel stipends, rent-free accommodation and interprofessional educational opportunities to health science students on their willingness to participate in clinical placements in underserviced areas. Mixed-method two-part study using a self-administered questionnaire. Canadian university campus. Four hundred and sixty-eight senior level medical, nursing, occupational therapy, physical therapy and X-ray technology students from a Canadian university and affiliated professional school. The influence of currently established incentives on student willingness to complete a clinical placement in designated underserviced communities in Southeastern Ontario. Based on a 75% response rate, the results demonstrate that, in general, students agree that they are more willing to complete a clinical placement in an underserviced community if provided travel stipends (75%), rent-free housing (92%) and interprofessional educational opportunities (65%). Students also identified 15 additional factors influencing willingness. Students are more willing to complete clinical placements in underserviced communities if provided incentives. The findings of this study support an interprofessional clinical education and recruitment enhancement program in Southeastern Ontario.

Planktivory by alewife (Alosa pseudoharengus) and rainbow smelt (Osmerus mordax) on microcrustacean zooplankton and dreissenid (Bivalvia: Dreissenidae) veligers in southern Lake Ontario

USGS Publications Warehouse

Mills, Edward L.; O'Gorman, Robert; Roseman, Edward F.; Adams, Connie; Owens, Randall W.

1995-01-01

The objective of this study was to describe the diet of young-of-the-year and adult alewife (Alosa pseudoharengus) and rainbow smelt (Osmerus mordax) in nearshore waters coincident with the colonization of Lake Ontario by Dreissena. Laboratory experiments and field observations indicated that alewife and rainbow smelt consumed dreissenid veligers and that the veligers remained intact and identifiable in the digestive tract for several hours. Dreissenid larvae were found in field-caught alewife and rainbow smelt in August 1992, even though veliger densities were low (<0.1/L). Zooplankton dominated the diet of all fish and veliger larvae were <0.1% of the biomass of prey eaten by these fish. Density of veligers and the distribution of settled dreissenids declined from west to east along the south shore of Lake Ontario. Based on veliger consumption rates we measured and the abundance of veligers and planktivores, we conclude that planktivory by alewife and smelt in the nearshore waters of Lake Ontario did not substantially reduce the number of veligers during 1991–1993. However, our results indicate that if the density of veligers in Lake Ontario decreases, and if planktivores remain abundant, planktivory on veliger populations could be significant.

Early observations on an emerging Great Lakes invader Hemimysis anomala in Lake Ontario

USGS Publications Warehouse

Walsh, Maureen G.; Lantry, Brian F.; Boscarino, Brent; Bowen, Kelly; Gerlofsma, Jocelyn; Schaner, Ted; Back, Richard; Questel, Jennifer; Smythe, A. Garry; Cap, Roberta; Goehle, Michael; Young, Bryan; Chalupnicki, Marc A.; Johnson, James H.; McKenna, James E.

2010-01-01

Hemimysis anomala, a Ponto-Caspian littoral mysid, is an emerging Great Lakes invader that was discovered in Lakes Michigan and Ontario in 2006. Similar to the native mysid Mysis diluviana, Hemimysis exhibits a diel vertical migration pattern but generally inhabits shallower and warmer waters than M. diluviana. Because basic information on the distribution, habitat use, and biology of Hemimysis in the Great Lakes is scarce, the potential for food web disruption by Hemimysis cannot easily be predicted. Preliminary observations indicate widespread invasion of Hemimysis in Lake Ontario. In this study, we confirm the presence of Hemimysis at sites spanning the northern and southern shores of Lake Ontario and the presence of the individuals during winter months. In one horizontal tow in November 2007, over 26,000 individuals were collected with a length range of 4.4 to 9.0. mm and an average caloric density of 611. cal/g wet weight. The most effective methods for sampling Hemimysis were horizontal tows with either a zooplankton net in the water column or a benthic sled near the lake bottom. Although more quantitative data on the life history and distribution of this species is necessary, our preliminary observations support the prediction that the potential for Hemimysis to impact the nearshore food web in Lake Ontario appears high.

Unintended consequences: two critical events from the 1960s and '70s and their legacy for nursing in Ontario.

PubMed

MacMillan, Kathleen; Mallette, Claire

2004-03-01

In the late 1960s and early '70s, two key events occurred in Ontario that greatly affected the nursing profession: the unionization of the workforce and the move of diploma-granting nursing schools out of the hospitals (first to regional schools, then to the community colleges). At the same time, university nursing programs were undergoing significant changes. A paradigm shift occurred in which baccalaureate-prepared nurses were being educated for practice as well as for roles in education and administration. While all these activities had overall positive implications, there were unintended effects that continue to influence the profession today. These include the detachment of employers from clinical nursing education; fragmentation of the profession between front-line staff and the professional elites (proletarianization); rejection by front-line practitioners and college educators of nursing scholarship in favour of experiential and technical knowledge; and rivalry between college and university educators that has hampered the development of effective collaborations. For this study, interviews were undertaken with three informants, and their recollections were considered in the context of documentation from the College of Nurses of Ontario (the regulatory body), the Ontario Nurses Association (the union) and the Registered Nurses Association of Ontario (the professional association).

Successfully Attaining a Dietetic Internship Position in Ontario on the First Attempt: A Descriptive Survey.

PubMed

Siswanto, Olivia; Brady, Jennifer; Gingras, Jacqui

2015-03-01

We explored the characteristics of Ontario-based dietetic internship program applicants who were successful upon their first application attempt, and we made comparisons between those who were successful and unsuccessful on their first internship application attempt. A 32-item online survey was distributed to graduates from nutrition programs in Ontario and to members of the Dietitians of Canada Student Network, Toronto Home Economics Association, and Ontario Home Economists in Business. Data from a previous study examining the characteristics of unsuccessful internship applicants were obtained from the authors to compare the two groups. Respondents (n = 76) were mostly female (97%), 20-25 years of age (67%), and had a previous degree (46%). Compared with those who were unsuccessful on their first internship application attempt, those who were successful had a significantly higher mean cGPA (3.69 ± 0.39 vs. 3.35 ± 0.41), were more likely to have a prior degree (46% vs. 29%), spent more time preparing their internship application package, and perceived their internship application packages to be stronger. Despite some differences, most applicants met the minimum cGPA requirement outlined by internship programs in Ontario. More internship opportunities can help increase the diversity and human potential in the dietetic profession.

The app will see you now: mobile health, diagnosis, and the practice of medicine in Quebec and Ontario

PubMed Central

Lang, Michael; Zawati, Ma’n H

2018-01-01

Abstract Mobile health applications are increasingly being used as tools of medicine. Outside of the clinic, some of these applications may contribute to diagnoses made absent a physician's care. We argue that this contravenes reservations of diagnosis to healthcare professionals in the law of two Canadian provinces: Quebec and Ontario. On the one hand, the law conceives of diagnosis in relatively broad terms. Drawing an association between symptoms and illness, for example, has been recognized in case law as sufficient. On the other hand, provincial law reserves diagnosis to physicians and other healthcare professionals. We argue that a number of health applications are capable of drawing associations between symptoms and disease and, in doing so, of delivering diagnoses in contravention of the law of Quebec and Ontario. This places mobile health applications in a poorly understood legal space. While prosecution is unlikely, the increasing ubiquity and technological sophistication of health applications promises to make such diagnosis widespread. We suggest that the legal status of such mobile health apps should be given serious attention. While our analysis focuses on the state of the law in Canada's largest provinces, we suggest that our argument will have implications in other jurisdictions. PMID:29707219

Impact of a provincial asthma guidelines continuing medical education project: The Ontario Asthma Plan of Action’s Provider Education in Asthma Care Project

PubMed Central

Lougheed, M Diane; Moosa, Dilshad; Finlayson, Shelagh; Hopman, Wilma M; Quinn, Mallory; Szpiro, Kim; Reisman, Joseph

2007-01-01

BACKGROUND: The Ontario Ministry of Health and Long-Term Care funded the Ontario Lung Association to develop and implement a continuing medical education program to promote implementation of the Canadian asthma guidelines in primary care. OBJECTIVES: To determine baseline knowledge, preferred learning format, satisfaction with the program and reported impact on practice patterns. METHODS: A 3 h workshop was developed that combined didactic presentations and small group case discussions. Outcome measures included a workshop evaluation, baseline assessment of asthma management knowledge and three-month postreflective evaluations. RESULTS: One hundred thirty-seven workshops were delivered to 2783 primary care providers (1313 physicians, 1470 allied health) between September 2002 and March 2005. Of the 2133 participants, 1007 physicians and 1126 allied health professionals submitted workshop evaluations. Most (98%) of the attendees indicated they would recommend the workshop to a colleague. The majority preferred the combination of didactic lecture plus interactive case discussions. A subset of physicians provided consent to use these data for research (n=298 pediatric and 288 adult needs assessments; n=349 postreflective evaluations). Important needs identified included appropriate medication for chronic asthma and development of written action plans. On the postreflective evaluations, 88.7% remained very satisfied, 95.5% reported increased confidence, 91.9% reported an influence on practice and 67.2% reported using a written action plan. CONCLUSIONS: This continuing medical education program addresses identified needs of primary care providers. Participants reported improvements in asthma care, including prescribing practices, use of spirometry and written action plans. Similar programs should be considered as part of multifaceted asthma guidelines dissemination and implementation initiatives in other provinces and nationally. PMID:17372639

Site specific risk assessment of an energy-from-waste/thermal treatment facility in Durham Region, Ontario, Canada. Part B: Ecological risk assessment.

PubMed

Ollson, Christopher A; Whitfield Aslund, Melissa L; Knopper, Loren D; Dan, Tereza

2014-01-01

The regions of Durham and York in Ontario, Canada have partnered to construct an energy-from-waste (EFW) thermal treatment facility as part of a long term strategy for the management of their municipal solid waste. In this paper we present the results of a comprehensive ecological risk assessment (ERA) for this planned facility, based on baseline sampling and site specific modeling to predict facility-related emissions, which was subsequently accepted by regulatory authorities. Emissions were estimated for both the approved initial operating design capacity of the facility (140,000 tonnes per year) and the maximum design capacity (400,000 tonnes per year). In general, calculated ecological hazard quotients (EHQs) and screening ratios (SRs) for receptors did not exceed the benchmark value (1.0). The only exceedances noted were generally due to existing baseline media concentrations, which did not differ from those expected for similar unimpacted sites in Ontario. This suggests that these exceedances reflect conservative assumptions applied in the risk assessment rather than actual potential risk. However, under predicted upset conditions at 400,000 tonnes per year (i.e., facility start-up, shutdown, and loss of air pollution control), a potential unacceptable risk was estimated for freshwater receptors with respect to benzo(g,h,i)perylene (SR=1.1), which could not be attributed to baseline conditions. Although this slight exceedance reflects a conservative worst-case scenario (upset conditions coinciding with worst-case meteorological conditions), further investigation of potential ecological risk should be performed if this facility is expanded to the maximum operating capacity in the future. © 2013.

Medical therapy v. PCI in stable coronary artery disease: a cost-effectiveness analysis.

PubMed

Wijeysundera, Harindra C; Tomlinson, George; Ko, Dennis T; Dzavik, Vladimir; Krahn, Murray D

2013-10-01

Percutaneous coronary intervention (PCI) with either drug-eluting stents (DES) or bare metal stents (BMS) reduces angina and repeat procedures compared with optimal medical therapy alone. It remains unclear if these benefits are sufficient to offset their increased costs and small increase in adverse events. Cost utility analysis of initial medical therapy v. PCI with either BMS or DES. . Markov cohort decision model. Data Sources. Propensity-matched observational data from Ontario, Canada, for baseline event rates. Effectiveness and utility data obtained from the published literature, with costs from the Ontario Case Costing Initiative. Patients with stable coronary artery disease, confirmed after angiography, stratified by risk of restenosis based on diabetic status, lesion size, and lesion length. Time Horizon. Lifetime. Perspective. Ontario Ministry of Health and Long Term Care. Interventions. Optimal medical therapy, PCI with BMS or DES. Lifetime costs, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER). of Base Case Analysis. In the overall population, medical therapy had the lowest lifetime costs at $22,952 v. $25,081 and $25,536 for BMS and DES, respectively. Medical therapy had a quality-adjusted life expectancy of 10.1 v. 10.26 QALYs for BMS, producing an ICER of $13,271/QALY. The DES strategy had a quality-adjusted life expectancy of only 10.20 QALYs and was dominated by the BMS strategy. This ranking was consistent in all groups stratified by restenosis risk, except diabetic patients with long lesions in small arteries, in whom DES was cost-effective compared with medical therapy (ICER of $18,826/QALY). Limitations. There is the possibility of residual unobserved confounding. In patients with stable coronary artery disease, an initial BMS strategy is cost-effective.

Métis Student Self-Identification in Ontario's K-12 Schools: Education Policy and Parents, Families, and Communities

ERIC Educational Resources Information Center

Anuik, Jonathan; Bellehumeur-Kearns, Laura-Lee

2014-01-01

The mandate for school boards to develop self-identification policies for First Nation, Métis, and Inuit students is part of the 2007 Ministry of Education's "Ontario First Nation, Métis and Inuit Education Policy Framework." In this paper, we share findings from a larger study on the Framework that examines Métis student…

Managing the Action/Reflection Polarity Through Dialogue: A Path to Transformative Learning. NALL Working Paper.

ERIC Educational Resources Information Center

Laiken, Marilyn E.

At the Ontario Institute for Studies in Education of the University of Ontario, a course entitled Developing and Leading High Performing Teams: Theory and Practice is experimenting with a design that surfaces the action/reflection paradox for the purpose of learning how to manage this polarity. Whether the product is defined as services or goods,…

A Blueprint for Human Resource Development in the Third Decade of the Ontario Colleges of Applied Arts and Technology: Executive Summary.

ERIC Educational Resources Information Center

Giroux, Roy F.

In 1987, a review of Ontario's community college system was initiated to assess the system's present human resource development practices and plan future directions. A field-based study was conducted to identify and assess current human resource development efforts, identify areas for improvement, and suggest possible future directions. Through…

Just in Time: How Evidence-on-Demand Services Support Decision Making in Ontario's Child and Youth Mental Health Sector

ERIC Educational Resources Information Center

Notarianni, Maryann; Sundar, Purnima; Carter, Charles

2016-01-01

Using the best available evidence to inform decision making is important for the design or delivery of effective health-related services and broader public policy. Several studies identify barriers and facilitators to evidence-informed decision making in Canadian health settings. This paper describes how the Ontario Centre of Excellence for Child…

Making Schools Safe and Inclusive: Gay-Straight Alliances and School Climate in Ontario

ERIC Educational Resources Information Center

Kitchen, Julian; Bellini, Christine

2013-01-01

Gay-straight alliances (GSAs) have become widespread in Ontario schools and, starting in 2012, all schools are required to permit students to form GSAs. While American research suggests that GSAs have a positive impact on school safety and inclusion, there is little research on the impact of GSAs in Canadian schools. This study, based on a survey…

An Examination of the Relative Age Effect in Developmental Girls' Hockey in Ontario

ERIC Educational Resources Information Center

Smith, Kristy L.; Weir, Patricia L.

2013-01-01

The relative age effect (RAE) suggests that athletes may be provided with greater opportunities for success depending on the position of their birthdate in a sport's selection year. While the effect has been well established in men's sports, less is known about women's sports. This study examined the RAE in developmental girls' hockey in Ontario.…

The Emergence of the International Baccalaureate Diploma in Ontario: Diffusion, Pilot Study and Prospective Research

ERIC Educational Resources Information Center

Tarc, Paul; Beatty, Luke

2012-01-01

The International Baccalaureate Diploma Program (IBDP), created in the field of international schools in the late 1960s, has made considerable in-roads into publicly-funded schooling in many educational jurisdictions of the Anglo-West. Although the IBDP did not enter into the Ontario public system until 1991, there are now forty-four (and growing)…

Educators' Beliefs about Raising Lesbian, Gay, Bisexual, and Transgender Issues in the Schools: The Experience in Ontario, Canada

ERIC Educational Resources Information Center

Schneider, Margaret; Dimito, Anne

2008-01-01

This study investigated the experiences of 132 LGBT and heterosexual teachers and school administrators in Ontario, Canada. Participants completed a survey that asked about their comfort addressing LGBT issues in the school setting, how safe they felt, how active they were, and their perceptions of barriers. There were few differences between the…

A critical review of financial measures as reported in the Ontario hospital balanced scorecard.

PubMed

Parkinson, John; Tsasis, Peter; Porporato, Marcela

2007-01-01

For Ontario hospitals in Canada, the Financial Performance and Condition measures in the Ontario hospital balanced scorecard are especially of interest since in the foreseeable future, they may be linked to provincial government funding decisions. However, we find that these measures lack valuable information on key attributes that affect organizational performance. We suggest changes that focus on key drivers of performance and reflect the operational realities of Ontario hospitals.

Applications of Low Altitude Remote Sensing in Agriculture upon Farmers' Requests– A Case Study in Northeastern Ontario, Canada

PubMed Central

Zhang, Chunhua; Walters, Dan; Kovacs, John M.

2014-01-01

With the growth of the low altitude remote sensing (LARS) industry in recent years, their practical application in precision agriculture seems all the more possible. However, only a few scientists have reported using LARS to monitor crop conditions. Moreover, there have been concerns regarding the feasibility of such systems for producers given the issues related to the post-processing of images, technical expertise, and timely delivery of information. The purpose of this study is to showcase actual requests by farmers to monitor crop conditions in their fields using an unmanned aerial vehicle (UAV). Working in collaboration with farmers in northeastern Ontario, we use optical and near-infrared imagery to monitor fertilizer trials, conduct crop scouting and map field tile drainage. We demonstrate that LARS imagery has many practical applications. However, several obstacles remain, including the costs associated with both the LARS system and the image processing software, the extent of professional training required to operate the LARS and to process the imagery, and the influence from local weather conditions (e.g. clouds, wind) on image acquisition all need to be considered. Consequently, at present a feasible solution for producers might be the use of LARS service provided by private consultants or in collaboration with LARS scientific research teams. PMID:25386696

Applications of low altitude remote sensing in agriculture upon farmers' requests--a case study in northeastern Ontario, Canada.

PubMed

Zhang, Chunhua; Walters, Dan; Kovacs, John M

2014-01-01

With the growth of the low altitude remote sensing (LARS) industry in recent years, their practical application in precision agriculture seems all the more possible. However, only a few scientists have reported using LARS to monitor crop conditions. Moreover, there have been concerns regarding the feasibility of such systems for producers given the issues related to the post-processing of images, technical expertise, and timely delivery of information. The purpose of this study is to showcase actual requests by farmers to monitor crop conditions in their fields using an unmanned aerial vehicle (UAV). Working in collaboration with farmers in northeastern Ontario, we use optical and near-infrared imagery to monitor fertilizer trials, conduct crop scouting and map field tile drainage. We demonstrate that LARS imagery has many practical applications. However, several obstacles remain, including the costs associated with both the LARS system and the image processing software, the extent of professional training required to operate the LARS and to process the imagery, and the influence from local weather conditions (e.g. clouds, wind) on image acquisition all need to be considered. Consequently, at present a feasible solution for producers might be the use of LARS service provided by private consultants or in collaboration with LARS scientific research teams.

Payer incentives and physical rehabilitation therapy for nonelderly institutional long-term care residents: evidence from Michigan and Ontario.

PubMed

Wodchis, Walter P; Fries, Brant E; Pollack, Harold

2004-02-01

To examine the effect of payment incentives on the provision of rehabilitation therapy to non elderly nursing home residents. Retrospective cross-sectional study. Nursing homes in Michigan or complex continuing care facilities in Ontario, Canada, in 1998 or 1999. Non elderly nursing home residents (N=5189) admitted to nursing homes. Not applicable. The effect of payment on access to physical therapy (PT) and occupational therapy (OT) and total weekly time for each therapy type. A Medicare policy change from cost-based to a patient-specific case-mix payment method was associated with greater likelihood of receiving OT but reduced weekly minutes of PT and OT provided to residents. Medicare cost-based and private insurance were associated with greater likelihood of receiving OT and PT and more therapy time for both types of therapy compared with private-pay residents. Global budget payment was associated with greater access to PT but fewer weekly minutes of OT and PT. Little information exists to describe the characteristics and treatment of non elderly nursing home residents. This study found that many of these residents received rehabilitation and that residents whose care was paid for by more generous payers, such as Medicare, received more therapy than those paid for by less generous payers.

Encouraging vehicle-to-grid (V2G) participation through premium tariff rates

NASA Astrophysics Data System (ADS)

Richardson, David B.

2013-12-01

The provision of vehicle-to-grid (V2G) services to an electric grid by electric vehicles (EVs) can potentially reduce the cost of vehicle ownership through revenue generation. Recent studies indicate that yearly vehicle profit from V2G may not be sufficient to induce widespread participation. This paper investigates the feasibility of a premium tariff rate for V2G power, similar to current feed-in-tariff (FIT) programs for renewable energy. Using Ontario, Canada as a case study, an hourly time-series model for a fleet of commuter EVs is created. Tariff rates for V2G peak power are calculated based on the same return on investment as the current FIT for renewable energy in Ontario. The tariff rates are competitive with the renewable energy tariffs, especially when EVs are allowed to provide ancillary services to the grid in addition to peak power. Despite the guaranteed rate of return, yearly vehicle profit is low. Two variations are considered to increase vehicle profit, thereby enhancing the attractiveness of V2G. A higher return on investment is favored over direct benefits offered to EV owners. A higher return on investment may be justifiable based on the higher level of risk inherent in V2G when compared to renewable energy.

Prevalence and extent of obstructive coronary artery disease among patients undergoing elective coronary catheterization in New York State and Ontario.

PubMed

Ko, Dennis T; Tu, Jack V; Austin, Peter C; Wijeysundera, Harindra C; Samadashvili, Zaza; Guo, Helen; Cantor, Warren J; Hannan, Edward L

2013-07-10

Prior studies have shown that physicians in New York State (New York) perform twice as many cardiac catheterizations per capita as those in Ontario for stable patients. However, the role of patient selection in these findings and their implications for detection of obstructive coronary artery disease (CAD) are largely unknown. To evaluate the extent of obstructive CAD and to compare the probability of detecting obstructive CAD for patients undergoing cardiac catheterization. An observational study was conducted involving patients without a history of cardiac disease who underwent elective cardiac catheterization between October 1, 2008, and September 30, 2011. Obstructive CAD was defined as diameter stenosis of 50% or more in the left main coronary artery or stenosis of 70% or more in a major epicardial vessel. Observed rates and predicted probabilities of obstructive CAD. Predicted probabilities were estimated using logistic regression models. A total of 18,114 patients from New York and 54,933 from Ontario were included. The observed rate of obstructive CAD was significantly lower in New York at 30.4% (95% CI, 29.7%-31.0%) than in Ontario at 44.8% (95% CI, 44.4%-45.3%; P < .001). The percentage of patients with left main or 3-vessel CAD was also significantly lower in New York than in Ontario (7.0% [95% CI, 6.6%-7.3%] vs 13.0% [95% CI, 12.8%-13.3%]; P < .001). In New York, a substantially higher percentage of patients with low predicted probability of obstructive CAD underwent cardiac catheterization; for example, only 19.3% (95% CI, 18.7%-19.9%) of patients undergoing cardiac catheterization in New York had a greater than 50% predicted probability of having obstructive CAD than those in Ontario at 41% (95% CI, 40.6%-41.4%; P < .001). At 30 days, crude mortality for patients undergoing cardiac catheterization was slightly higher in New York at 0.65% (90 of 13,824; 95% CI, 0.51%-0.78%) than in Ontario at 0.38% (153 of 40,794; 95% CI, 0.32%-0.43%; P < .001). In Ontario compared with New York State, patients undergoing elective cardiac catheterization were significantly more likely to have obstructive CAD. This appears to be related to a higher percentage of patients in New York with low predicted probability of CAD undergoing cardiac catheterization.

A decade of outpatient antimicrobial use in older adults in Ontario: a descriptive study.

PubMed

Tan, Charlie; Graves, Erin; Lu, Hong; Chen, Anna; Li, Shudong; Schwartz, Kevin L; Daneman, Nick

2017-12-21

Antimicrobials are frequently prescribed to community-dwelling older adults. Our aim was to examine the prevalence, quantity and indications of antimicrobial prescriptions to older residents of Ontario. We conducted a population-based analysis of outpatient antimicrobial prescriptions to residents of Ontario aged 65 years or more from 2006 to 2015. Antimicrobial prescriptions, infectious disease diagnoses and prescriber information were determined from linked health care databases. Our analyses were primarily focused on antibiotics, which account for most antimicrobial use. We identified 2 879 779 unique Ontario residents aged 65 years or more over our study period. On average, 40.7% (range 40.1%-41.5%) of older adult outpatients in any given year received 1 or more antibiotic prescriptions. Antibiotic use remained stable over the study period, averaging 25.1 (range 24.1-25.6) defined daily doses per 1000 person-days per year. Selection of antibiotics evolved, with increasing use of penicillins and decreasing use of fluoroquinolones and macrolides. For 65.7% of prescriptions, no infectious disease diagnoses were identified within 7 days of the prescription. Among prescriptions with an associated diagnosis, upper respiratory tract infection was most common (18.9%), followed by urinary tract infection (6.2%), skin/soft-tissue infection (4.3%), lower respiratory tract infection (4.2%) and other infection (1.2%). Most antibiotics were prescribed by family physicians. Antibiotic use among older adult outpatients in Ontario remained stable between 2006 and 2015. Current methods of measuring use are not capable of accurately determining indication, and, thus, additional data sources to monitor the appropriateness of community antimicrobial use are needed. Copyright 2017, Joule Inc. or its licensors.

Modest rise in chlamydia and gonorrhoea testing did not increase case detection in a clinical HIV cohort in Ontario, Canada

PubMed Central

Burchell, Ann N; Grewal, Ramandip; Allen, Vanessa G; Gardner, Sandra L; Moravan, Veronika; Bayoumi, Ahmed M; Kaul, Rupert; McGee, Frank; Millson, Margaret (Peggy) E; Remis, Robert S; Raboud, Janet; Mazzulli, Tony; Rourke, Sean B

2014-01-01

Objectives We described patterns of testing for chlamydia and gonorrhoea infection among persons in specialty HIV care in Ontario, Canada, from 2008 to 2011. Methods We analysed data from 3165 participants in the OHTN Cohort Study attending one of seven specialty HIV care clinics. We obtained chlamydia and gonorrhoea test results via record linkage with the provincial public health laboratory. We estimated the proportion of participants who underwent testing annually, the positivity rate among those tested and the proportion diagnosed with chlamydia or gonorrhoea among all under observation. We explored risk factors for testing and diagnosis using multiple logistic regression analysis. Results The proportion tested annually rose from 15.2% (95% CI 13.6% to 16.7%) in 2008 to 27.0% (95% CI 25.3% to 28.6%) in 2011 (p<0.0001). Virtually all were urine-based nucleic acid amplification tests. Testing was more common among men who have sex with men (MSM), younger adults, Toronto residents, persons attending primary care clinics and persons who had tested in the previous year or who had more clinic visits in the current year. We observed a decrease in test positivity rates over time. However, the annual proportion diagnosed remained stable and in 2011 this was 0.97% (95% CI 0.61% to 1.3%) and 0.79% (95% CI 0.46% to 1.1%) for chlamydia and gonorrhoea, respectively. Virtually all cases were among MSM. Conclusions Chlamydia and gonorrhoea testing increased over time while test positivity rates declined and the overall proportion diagnosed remained stable, suggesting that the modest increase in testing did not improve case detection. PMID:25178285

Validation of Six Short and Ultra-short Screening Instruments for Depression for People Living with HIV in Ontario: Results from the Ontario HIV Treatment Network Cohort Study.

PubMed

Choi, Stephanie K Y; Boyle, Eleanor; Burchell, Ann N; Gardner, Sandra; Collins, Evan; Grootendorst, Paul; Rourke, Sean B

2015-01-01

Major depression affects up to half of people living with HIV. However, among HIV-positive patients, depression goes unrecognized 60-70% of the time in non-psychiatric settings. We sought to evaluate three screening instruments and their short forms to facilitate the recognition of current depression in HIV-positive patients attending HIV specialty care clinics in Ontario. A multi-centre validation study was conducted in Ontario to examine the validity and accuracy of three instruments (the Center for Epidemiologic Depression Scale [CESD20], the Kessler Psychological Distress Scale [K10], and the Patient Health Questionnaire depression scale [PHQ9]) and their short forms (CESD10, K6, and PHQ2) in diagnosing current major depression among 190 HIV-positive patients in Ontario. Results from the three instruments and their short forms were compared to results from the gold standard measured by Mini International Neuropsychiatric Interview (the "M.I.N.I."). Overall, the three instruments identified depression with excellent accuracy and validity (area under the curve [AUC]>0.9) and good reliability (Kappa statistics: 0.71-0.79; Cronbach's alpha: 0.87-0.93). We did not find that the AUCs differed in instrument pairs (p-value>0.09), or between the instruments and their short forms (p-value>0.3). Except for the PHQ2, the instruments showed good-to-excellent sensitivity (0.86-1.0) and specificity (0.81-0.87), excellent negative predictive value (>0.90), and moderate positive predictive value (0.49-0.58) at their optimal cut-points. Among people in HIV care in Ontario, Canada, the three instruments and their short forms performed equally well and accurately. When further in-depth assessments become available, shorter instruments might find greater clinical acceptance. This could lead to clinical benefits in fast-paced speciality HIV care settings and better management of depression in HIV-positive patients.

Parental perceptions of school-based influenza immunisation in Ontario, Canada: a qualitative study.

PubMed

MacDougall, Donna; Crowe, Lois; Pereira, Jennifer A; Kwong, Jeffrey C; Quach, Susan; Wormsbecker, Anne E; Ramsay, Hilary; Salvadori, Marina I; Russell, Margaret L

2014-06-05

To understand the perspectives of Ontario parents regarding the advantages and disadvantages of adding influenza immunisation to the currently existing Ontario school-based immunisation programmes. Descriptive qualitative study. Parents of school-age children in Ontario, Canada, who were recruited using a variety of electronic strategies (social media, emails and media releases), and identified as eligible (Ontario resident, parent of one or more school-age children, able to read/write English) on the basis of a screening questionnaire. We used stratified purposeful sampling to obtain maximum variation in two groups: parents who had ever immunised at least one child against influenza or who had never done so. We conducted focus groups (teleconference or internet forum) and individual interviews to collect data. Thematic analysis was used to analyse the data. Ontario, Canada. Of the 55 participants, 16 took part in four teleconference focus groups, 35 in 6 internet forum focus groups and four in individual interviews conducted between October 2012 and February 2013. Participants who stated that a school-based influenza immunisation programme would be worthwhile for their child valued its convenience and its potential to reduce influenza transmission without interfering with the family routine. However, most thought that for a programme to be acceptable, it would need to be well designed and voluntary, with adequate parental control and transparent communication between the key stakeholder groups of public health, schools and parents. These results will benefit decision-makers in the public health and education sectors as they consider the advantages and disadvantages of immunising children in schools as part of a system-wide influenza prevention approach. Further research is needed to assess the perceptions of school board and public health stakeholders. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Economic evaluation of open vs endovascular repair of blunt traumatic thoracic aortic injuries.

PubMed

Tong, Michael Zhen-Yu; Koka, Pavan; Forbes, Thomas L

2010-07-01

During the last decade, endovascular repair (EV) has replaced open surgical repair (OSR) as the preferred method of treatment of blunt traumatic thoracic aortic injuries (BTAIs) at many trauma centers. This has resulted in reductions in mortality, length of stay, and major complications, including paraplegia, with the added expense of the initial endograft, subsequent surveillance, and reinterventions. The purpose of this study was to conduct an economic evaluation comparing these two methods of repair. We performed an economic comparison of EV and OSR for the treatment of BTAI using a decision tree analysis with transition points derived from our institution's experience and through a review of the literature. Over a 15-year period (1991-2006), 28 patients with BTAI were treated at our center (15 EV, 13 OSR). Costs were obtained from our hospital's case costing center, the Ontario Case Costing Initiative, Ontario's Drug Benefit Formulary, and Ontario's Schedule of Benefits for physician costs. Our center's results were then combined with those from the literature to arrive at an economic model. These combined results revealed that EV, when compared to OSR, resulted in decreased early mortality (7.2% vs 22.5%), decreased composite outcome of mortality and paraplegia (7.7% vs 27.6%) and decreased composite outcome of mortality and major complication (42.5% vs 69.8%). Patients undergoing EV also had shorter intensive care unit stays (12.2 vs 15.3 days), total hospital length of stays (22.5 vs 28.6 days), and ventilator days (8.0 vs 9.2 days). Additionally, patients undergoing EV had decreased total 1-year costs compared with OSR ($70,442 vs $72,833). EV repair of BTAIs offers a survival advantage as well as a reduction in major morbidity, including paraplegia, compared with OSR, and results in a reduction in costs at 1 year. As a result, from the cost-effectiveness point of view, EV is the DOMINANT therapy over OSR for these injuries. Copyright (c) 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Decision Makers' Allocation of Home-Care Therapy Services: A Process Map

PubMed Central

Poss, Jeff; Egan, Mary; Rappolt, Susan; Berg, Katherine

2013-01-01

ABSTRACT Purpose: To explore decision-making processes currently used in allocating occupational and physical therapy services in home care for complex long-stay clients in Ontario. Method: An exploratory study using key-informant interviews and client vignettes was conducted with home-care decision makers (case managers and directors) from four home-care regions in Ontario. The interview data were analyzed using the framework analysis method. Results: The decision-making process for allocating therapy services has four stages: intake, assessment, referral to service provider, and reassessment. There are variations in the management processes deployed at each stage. The major variation is in the process of determining the volume of therapy services across home-care regions, primarily as a result of financial constraints affecting the home-care programme. Government funding methods and methods of information sharing also significantly affect home-care therapy allocation. Conclusion: Financial constraints in home care are the primary contextual factor affecting allocation of therapy services across home-care regions. Given the inflation of health care costs, new models of funding and service delivery need to be developed to ensure that the right person receives the right care before deteriorating and requiring more costly long-term care. PMID:24403672

The Sensitivity of Adverse Event Cost Estimates to Diagnostic Coding Error

PubMed Central

Wardle, Gavin; Wodchis, Walter P; Laporte, Audrey; Anderson, Geoffrey M; Baker, Ross G

2012-01-01

Objective To examine the impact of diagnostic coding error on estimates of hospital costs attributable to adverse events. Data Sources Original and reabstracted medical records of 9,670 complex medical and surgical admissions at 11 hospital corporations in Ontario from 2002 to 2004. Patient specific costs, not including physician payments, were retrieved from the Ontario Case Costing Initiative database. Study Design Adverse events were identified among the original and reabstracted records using ICD10-CA (Canadian adaptation of ICD10) codes flagged as postadmission complications. Propensity score matching and multivariate regression analysis were used to estimate the cost of the adverse events and to determine the sensitivity of cost estimates to diagnostic coding error. Principal Findings Estimates of the cost of the adverse events ranged from $16,008 (metabolic derangement) to $30,176 (upper gastrointestinal bleeding). Coding errors caused the total cost attributable to the adverse events to be underestimated by 16 percent. The impact of coding error on adverse event cost estimates was highly variable at the organizational level. Conclusions Estimates of adverse event costs are highly sensitive to coding error. Adverse event costs may be significantly underestimated if the likelihood of error is ignored. PMID:22091908

Health Services Utilization, Specialist Care, and Time to Diagnosis with Inflammatory Bowel Disease in Immigrants to Ontario, Canada: A Population-Based Cohort Study.

PubMed

Benchimol, Eric I; Manuel, Douglas G; Mojaverian, Nassim; Mack, David R; Nguyen, Geoffrey C; To, Teresa; Guttmann, Astrid

2016-10-01

Canada has amongst the highest incidence of inflammatory bowel disease (IBD) in the world, and the highest proportion of immigrants among G8 nations. We determined differences in prediagnosis delay, specialist care, health services use, and risk of surgery in immigrants with IBD. All incident cases of IBD in children (1994-2009) and adults (1999-2009) were identified from population-based health administrative data in Ontario, Canada. Linked immigration data identified those who arrived to Ontario after 1985. We compared time to diagnosis, postdiagnosis health services use (IBD specific and related), physician specialist care in immigrants and nonimmigrants, and risk of surgery between immigrants and nonimmigrants. Thousand two hundred two immigrants were compared with 22,990 nonimmigrants. Immigrants had similar time to diagnosis as nonimmigrants for Crohn's (hazard ratio [HR] 1.002; 95% confidence intervals [CIs] 0.89-1.12) and ulcerative colitis (HR 1.073; 95% CI 0.95-1.21). For outpatient visits, immigrants with IBD were seen by gastroenterologists more often than nonimmigrants. Immigrants had greater IBD-specific outpatient health services use after diagnosis (odds ratio 1.24; 95% CI 1.15-1.33), emergency department visits (odds ratio 1.57, 95% CI 1.30-1.91), and hospitalizations (odds ratio 1.19; 95% CI 1.02-1.40). In immigrants, there was lower risk of surgery for Crohn's (HR 0.66, 95% CI 0.43-0.99) and ulcerative colitis (HR 0.52, 95% CI 0.31-0.87). Immigrants to Canada had greater outpatient and specialty care and lower risk of surgery, with no delay in diagnosis, indicating appropriate use of the health system.

The Co-Use of Tobacco and Cannabis among Adolescents over a 30-Year Period

ERIC Educational Resources Information Center

Webster, Lauren; Chaiton, Michael; Kirst, Maritt

2014-01-01

Background: This study explores the patterns of use and co-use of tobacco and cannabis among Ontario adolescents over 3 decades and if characteristics of co-users and single substance users have changed. Methods: Co-use trends for 1981-2011 were analyzed using the Centre for Addiction and Mental Health Ontario Student Drug Use and Health Survey,…

The Challenge of Finding Faculty Time for Applied Research Activities in Ontario Colleges

ERIC Educational Resources Information Center

Rosenkrantz, Otte

2013-01-01

The purpose of this study was to explore how the role of Ontario college faculty has evolved since the advent of the Post-Secondary Education Choice and Excellence Act of 2000 and the Colleges of Applied Arts and Technology Act of 2002 in terms of whether or not the decision to create a research culture at the colleges included making time…

An Integrated Multi-Institutional Diabetes Prevention Program Improves Knowledge and Healthy Food Acquisition in Northwestern Ontario First Nations

ERIC Educational Resources Information Center

Ho, Lara S.; Gittelsohn, Joel; Rimal, Rajiv; Treuth, Margarita S.; Sharma, Sangita; Rosecrans, Amanda; Harris, Stewart B.

2008-01-01

This article presents the impact results of a feasibility study in Canada for prevention of risk factors for diabetes in seven northwestern Ontario First Nations. Baseline and follow-up data were collected before and after the 9-month intervention program in schools, stores, and communities that aimed to improve diet and increase physical activity…

An Investigation of School Board Practices in the Purchase and Utilization of Textbooks and Other Classroom-Based Learning Materials.

ERIC Educational Resources Information Center

Fischer, Linda; Lamont, Betty

This report describes a research study for the Ontario Ministry of Education that addresses the issues of policy, expenditure levels, and patterns of use related to textbooks, library books, and other classroom-based learning materials in Ontario schools. The research is based on a survey of public and Roman Catholic separate school boards…

Social determinants of health and retention in HIV care in a clinical cohort in Ontario, Canada.

PubMed

Rachlis, Beth; Burchell, Ann N; Gardner, Sandra; Light, Lucia; Raboud, Janet; Antoniou, Tony; Bacon, Jean; Benoit, Anita; Cooper, Curtis; Kendall, Claire; Loutfy, Mona; Wobeser, Wendy; McGee, Frank; Rachlis, Anita; Rourke, Sean B

2017-07-01

Continuous HIV care supports antiretroviral therapy initiation and adherence, and prolongs survival. We investigated the association of social determinants of health (SDH) and subsequent retention in HIV care in a clinical cohort in Ontario, Canada. The Ontario HIV Treatment Network Cohort Study is a multi-site cohort of patients at 10 HIV clinics. Data were collected from medical charts, interviews, and via record linkage with the provincial public health laboratory for viral load tests. For participants interviewed in 2009, we used three-category multinomial logistic regression to identify predictors of retention in 2010-2012, defined as (1) continuous care (≥2 viral loads ≥90 days in all years; reference category); (2) discontinuous care (only 1 viral load/year in ≥1 year); and (3) a gap in care (≥1 year in 2010-2012 with no viral load). In total, 1838 participants were included. In 2010-2012, 71.7% had continuous care, 20.9% had discontinuous care, and 7.5% had a gap in care. Discontinuous care in 2009 was predictive (p < .0001) of future retention. SDH associated with discontinuous care were Indigenous ethnicity, being born in Canada, being employed, reporting hazardous drinking, and non-injection drug use. Being a heterosexual male was associated with having a gap in care, and being single and younger were associated with discontinuous care and a gap in care. Various SDH were associated with retention. Care discontinuity was highly predictive of future gaps. Targeted strategic interventions that better engage those at risk of suboptimal retention merit exploration. AOR: adjusted odds ratio; ART: antiretroviral therapy; AUDIT: Alcohol Use Disorders Identification Test; CES-D: Center for Epidemiologic Studies Depression Scale; CIs: confidence intervals; HIV: human immunodeficiency virus; IQR: interquartile range; MSM: men who have sex with men; NA-ACCORD: North American AIDS Cohort Collaboration on Research and Design; OCS: Ontario HIV Treatment Network Cohort Study; OHTN: Ontario HIV Treatment Network; OR: odds ratio; PHOL: Public Health Ontario Laboratories; REB: Research Ethics Board; SDH: social determinants of health; US: United States.

A centrally generated primary care physician audit report does not improve colonoscopy uptake after a positive result on a fecal occult blood test in Ontario's ColonCancerCheck program.

PubMed

Stock, D; Rabeneck, L; Baxter, N N; Paszat, L F; Sutradhar, R; Yun, L; Tinmouth, J

2017-02-01

Timely follow-up of fecal occult blood screening with colonoscopy is essential for achieving colorectal cancer mortality reduction. In the present study, we evaluated the effectiveness of centrally generated, physician-targeted audit and feedback to improve colonoscopy uptake after a positive fecal occult blood test (fobt) result within Ontario's population-wide ColonCancerCheck Program. This prospective cohort study used data sets from Ontario's ColonCancerCheck Program (2008-2011) that were linked to provincial administrative health databases. Cox proportional hazards regression was used to estimate the effect of centralized, physician-targeted audit and feedback on colonoscopy uptake in an Ontario-wide fobt-positive cohort. A mailed physician audit and feedback report identifying individuals outstanding for colonoscopy for 3 or more months after a positive fobt result did not increase the likelihood of colonoscopy uptake (hazard ratio: 0.95; 95% confidence interval: 0.79 to 1.13). Duration of positive fobt status was strongly inversely associated with the hazard of follow-up colonoscopy ( p for linear trend: <0.001). In a large population-wide setting, centralized tracking in the form of physician-targeted mailed audit and feedback reports does not improve colonoscopy uptake for screening participants with a positive fobt result outstanding for 3 or more months. Mailed physician-targeted screening audit and feedback reports alone are unlikely to improve compliance with follow-up colonoscopy in Ontario. Other interventions such as physician audits or automatic referrals, demonstrated to be effective in other jurisdictions, might be warranted.

Genetics Consultation Rates Following a Diagnosis of High-Grade Serous Ovarian Carcinoma in the Canadian Province of Ontario.

PubMed

McGee, Jacob; Panabaker, Karen; Leonard, Sean; Ainsworth, Peter; Elit, Laurie; Shariff, Salimah Z

2017-03-01

In 2001, the province of Ontario expanded cancer genetic testing eligibility to include all women with high-grade serous ovarian carcinoma (HGSC) of the ovary, fallopian tube, and peritoneum. The aim of this study was to determine the proportion of women who attended genetics counseling for consideration of BRCA1/2 gene analysis. We also sought to examine if regional differences in consultation rate exist across administrative health regions in the province of Ontario. We identified all women with a pathological diagnosis of HGSC in the province of Ontario between 1997 until 2011. Our primary outcome was the 2-year rate of genetics consultation following a diagnosis of HGSC. We compared consultation rates over time and geographical regions and applied multiple logistic regression to identify predictors of genetics consultation. Of the 5412 women with a diagnosis of HGSC over the study period, 6.6% were seen for genetics consultation within 2 years of diagnosis. Factors predictive of genetics consultation included history of breast cancer (odds ratio [OR], 3.56; 95% confidence interval [CI], 1.87-6.78), era of diagnosis (2009-2011 vs 1997-2000; OR, 10.59; 95% CI, 5.02-22.33), and younger age at diagnosis (OR, 0.95; 95% CI, 0.94-0.97 for each additional year). No regional differences in consultation rate were seen. Despite an increasing rate across eras, a small proportion of women with HGSC undergo genetics consultation. Efforts are required to increase cancer genetics consultation in patients with HGSC in the province of Ontario.

Building Public Health Ontario: experience in developing a new public health agency.

PubMed

Goel, Vivek

2012-06-05

The history and development of Ontario's new public health agency, Public Health Ontario, is explored. The governance model and organizational structure are identified along with an overview of the relationship with the Ontario Ministry of Health and Long-Term Care. The strategic mission and vision are described as are the key functions. The building of the organization through new investments and divestments is explained. The paper concludes with an overview of the challenges encountered and the opportunities ahead.

Transient Elastography and Controlled Attenuation Parameter for Diagnosing Liver Fibrosis and Steatosis in Ontario: An Economic Analysis

PubMed Central

Thavorn, K; Coyle, D

2015-01-01

Background Liver fibrosis is characterized by a buildup of connective tissue due to chronic liver damage. Steatosis is the collection of excessive amounts of fat inside liver cells. Liver biopsy remains the gold standard for the diagnosis of liver fibrosis and steatosis, but its use as a diagnostic tool is limited by its invasive nature and high cost. Objectives To evaluate the cost-effectiveness and budget impact of transient elastography (TE) with and without controlled attenuation parameter (CAP) for the diagnosis of liver fibrosis or steatosis in patients with hepatitis B, hepatitis C, alcoholic liver disease, and nonalcoholic fatty liver disease. Data Sources An economic literature search was performed using computerized databases. For primary economic and budget impact analyses, we obtained data from various sources, such as the Health Quality Ontario evidence-based analysis, published literature, and the Institute for Clinical Evaluative Sciences. Review Methods A systematic review of existing TE cost-effectiveness studies was conducted, and a primary economic evaluation was undertaken from the perspective of the Ontario Ministry of Health and Long-Term Care. Decision analytic models were used to compare short-term costs and outcomes of TE compared to liver biopsy. Outcomes were expressed as incremental cost per correctly diagnosed cases gained. A budget impact analysis was also conducted. Results We included 10 relevant studies that evaluated the cost-effectiveness of TE compared to other noninvasive tests and to liver biopsy; no cost-effectiveness studies of TE with CAP were identified. All studies showed that TE was less expensive but associated with a decrease in the number of correctly diagnosed cases. TE also improved quality-adjusted life-years in patients with hepatitis B and hepatitis C. Our primary economic analysis suggested that TE led to cost savings but was less effective than liver biopsy in the diagnosis of liver fibrosis. TE became more economically attractive with a higher degree of liver fibrosis. TE with CAP was also less expensive and less accurate than liver biopsy. Limitations The model did not take into account long-term costs and consequences associated with TE and liver biopsy and did not include costs to patients and their families, or patient preferences related to diagnostic information. Conclusions TE showed potential cost savings compared to liver biopsy. Further investigation is needed to determine the long-term impacts of TE on morbidity and mortality in Canada and the optimal diagnostic modality for liver fibrosis and steatosis. PMID:26664666

Public Health Ethics, Legitimacy, and the Challenges of Industrial Wind Turbines: The Case of Ontario, Canada

ERIC Educational Resources Information Center

Shain, Martin

2011-01-01

While industrial wind turbines (IWTs) clearly raise issues concerning threats to the health of a few in contrast to claimed health benefits to many, the trade-off has not been fully considered in a public health framework. This article reviews public health ethics justifications for the licensing and installation of IWTs. It concludes that the…

Attitudes and knowledge regarding health care policy and systems: a survey of medical students in Ontario and California.

PubMed

Emil, Sherif; Nagurney, Justine M; Mok, Elise; Prislin, Michael D

2014-10-01

Canada and the United States have similar medical education systems, but different health care systems. We surveyed medical students in Ontario and California to assess their knowledge and views about health care policy and systems, with an emphasis on attitudes toward universal care. A web-based survey was administered during the 2010-2011 academic year to students in 5 medical schools in Ontario and 4 in California. The survey collected demographic data and evaluated attitudes and knowledge regarding broad health care policy issues and health care systems. An index of support for universal health care was created, and logistic regression models were used to examine potential determinants of such support. Responses were received from 2241 students: 1354 from Ontario and 887 from California, representing 42.9% of eligible respondents. Support for universal health care coverage was higher in Ontario (86.8%) than in California (51.1%), p < 0.001. In California, females, self-described nonconservatives, students with the intent to be involved in health care policy as physicians and students with a primary care orientation were associated with support for universal coverage. In Ontario, self-described liberals and accurate knowledge of the Canadian system were associated with support. A single-payer system for practice was preferred by 35.6% and 67.4% of students in California and Ontario, respectively. The quantity of instruction on health care policy in the curriculum was judged too little by 73.1% and 57.5% of students in California and Ontario, respectively. Medical students in Ontario are substantially more supportive of universal access to health care than their California counterparts. A majority of students in both regions identified substantial curricular deficiencies in health care policy instruction.

Attitudes and knowledge regarding health care policy and systems: a survey of medical students in Ontario and California

PubMed Central

Nagurney, Justine M.; Mok, Elise; Prislin, Michael D.

2014-01-01

Background Canada and the United States have similar medical education systems, but different health care systems. We surveyed medical students in Ontario and California to assess their knowledge and views about health care policy and systems, with an emphasis on attitudes toward universal care. Methods A web-based survey was administered during the 2010–2011 academic year to students in 5 medical schools in Ontario and 4 in California. The survey collected demographic data and evaluated attitudes and knowledge regarding broad health care policy issues and health care systems. An index of support for universal health care was created, and logistic regression models were used to examine potential determinants of such support. Results Responses were received from 2241 students: 1354 from Ontario and 887 from California, representing 42.9% of eligible respondents. Support for universal health care coverage was higher in Ontario (86.8%) than in California (51.1%), p < 0.001. In California, females, self-described nonconservatives, students with the intent to be involved in health care policy as physicians and students with a primary care orientation were associated with support for universal coverage. In Ontario, self-described liberals and accurate knowledge of the Canadian system were associated with support. A single-payer system for practice was preferred by 35.6% and 67.4% of students in California and Ontario, respectively. The quantity of instruction on health care policy in the curriculum was judged too little by 73.1% and 57.5% of students in California and Ontario, respectively. Interpretation Medical students in Ontario are substantially more supportive of universal access to health care than their California counterparts. A majority of students in both regions identified substantial curricular deficiencies in health care policy instruction. PMID:25485256

Proceedings of the 2013 Annual Meeting of the Canadian Mathematics Education Study Group = Actes De La Rencontre Annuelle 2013 Du Groupe Canadien D'étude en Didactique Des Mathématiques (37th, St. Catharines, Ontario, Canada, May 24-28, 2013)

ERIC Educational Resources Information Center

Oesterle, Susan, Ed.; Allan, Darien, Ed.

2014-01-01

This submission contains the Proceedings of the 2013 Annual Meeting of the Canadian Mathematics Education Study Group (CMESG), held at Brock University in St. Catharines, Ontario. The CMESG is a group of mathematicians and mathematics educators who meet annually to discuss mathematics education issues at all levels of learning. The aims of the…

Proceedings of the 2002 Annual Meeting of the Canadian Mathematics Education Study Group = Actes de la Rencontre Annuelle 2002 du Groupe Canadien d'Etude en Didactique des Mathematiques (26th, Kingston, Ontario, Canada, May 24-28, 2002)

ERIC Educational Resources Information Center

Simmt, Elaine, Ed.; Davis, Brent, Ed.

2003-01-01

This submission contains the Proceedings of the 2002 Annual Meeting of the Canadian Mathematics Education Study Group (CMESG), held at Queen's University in Kingston, Ontario. The CMESG is a group of mathematicians and mathematics educators who meet annually to discuss mathematics education issues at all levels of learning. The aims of the Study…

Proceedings of the 2005 Annual Meeting of the Canadian Mathematics Education Study Group = Actes de la Rencontre Annuelle 2005 du Groupe Canadien d'Etude en Didactique des Mathematiques (29th, Ottawa, Ontario, Canada, May 27-31, 2005)

ERIC Educational Resources Information Center

Liljedahl, Peter, Ed.

2006-01-01

This submission contains the Proceedings of the 2005 Annual Meeting of the Canadian Mathematics Education Study Group (CMESG), held at the University of Ottawa in Ottawa, Ontario. The CMESG is a group of mathematicians and mathematics educators who meet annually to discuss mathematics education issues at all levels of learning. The aims of the…

Proceedings of the 2016 Annual Meeting of the Canadian Mathematics Education Study Group = Actes De La Rencontre Annuelle 2016 Du Groupe Canadien D'étude en Didactique Des Mathématiques (40th, Kingston, Ontario, Canada, June 3-7, 2016)

ERIC Educational Resources Information Center

Oesterle, Susan, Ed.; Allan, Darien, Ed.; Holm, Jennifer, Ed.

2017-01-01

This submission contains the Proceedings of the 2016 Annual Meeting of the Canadian Mathematics Education Study Group (CMESG), held at Queen's University in Kingston, Ontario. The CMESG is a group of mathematicians and mathematics educators who meet annually to discuss mathematics education issues at all levels of learning. The aims of the Study…

Referrals in Primary Care: Is the Family Physician a “Gatekeeper”?

PubMed Central

Norton, Peter G.; Dunn, Earl V.; Bestvater, David

1989-01-01

The increasing financial restraints on the use of health care resources make it important to examine the appropriateness of present usage patterns. The authors studied referral patterns for a group of academic family physicians practising in a health service organization in Ontario. They found that for all consultant encounters, the family physician directly controlled 65% of these consultations, whereas 13% were continuing consultations with the specialist without direct family physician referral. The remainder were either unknown or referred from other sources, for example, emergency room or specialist-to-specialist referrals. The family physician made the exact same diagnosis as the consultant in 73.4% of cases for which data were available, and the patient was referred to an inappropriate specialist in only 2.7% of cases. PMID:21249055

Teach Our Children: Stroke Education for Indigenous Children, First Nations, Ontario, Canada, 2009–2012

PubMed Central

Bodnar, Pauline; Fenton, Robert; Mason, Brenda; Bandoh, Grace

2017-01-01

Background Because of the heightened risk for stroke among indigenous people, we conducted this multiyear community case study from 2009 through 2012 to address stroke education needs among children aged 11 to 13 years residing in northern urban, rural, and remote First Nations in Ontario, Canada. The goal was to determine what young people understand about stroke and to develop an age-appropriate and culturally appropriate educational product. Community Context This project responded to First Nations requests that we educate their young people about the signs and symptoms of stroke and the need for early response. Ten First Nations and 4 indigenous health organizations took part; 7 contributed to the educational product. Methods This study was developed under the guidance of the Northwestern Ontario Regional Stroke Network Aboriginal Advisory Committee. It employed indigenous researchers and facilitators to ensure that methods used (questions assessing children’s knowledge of stroke and their ideas on how best to deliver messages) reflected the cultural values of participating study sites. Outcome Indigenous children had limited knowledge about stroke and its signs, symptoms, and consequences; children in remote communities were better informed than those in other locations. Educators agreed that a DVD was the most effective way to deliver stroke information to children in this age group. The principal outcome from this 3-year community engagement was an 11.5-minute DVD titled Act F-A-S-T 1-2-3!. Follow-up indicated that the educational tool continued to be used to educate indigenous children and adults about stroke signs and symptoms, the need for early response, and risk reduction. Interpretation Although indigenous communities are each unique in their culture and traditions, all have a strong commitment to improving health and are generous in their support for research that addresses their needs. Our study provides examples of the engagement and participatory research strategies that were effective, the practical supports required, limitations to the study, and how barriers to stroke education can be overcome. PMID:28817789

New species and distributional records of Aleocharinae (Coleoptera, Staphylinidae) from Ontario, Canada, with a checklist of recorded species

PubMed Central

Brunke, Adam J.; Klimaszewski, Jan; Dorval, Julie-Anne; Bourdon, Caroline; Paiero, Steven M.; Marshall, Stephen A.

2012-01-01

Abstract The Aleocharinae (Coleoptera: Staphylinidae) of Ontario were reviewed in the context of recently studied material, primarily from insect surveys conducted by the University of Guelph Insect Collection (Ontario, Canada). Aleochara daviesi Klimaszewski & Brunke sp. n., Agaricomorpha websteri Klimaszewski & Brunke sp. n., Atheta (Microdota) alesi Klimaszewski & Brunke sp. n., Dinaraea backusensis Klimaszewski & Brunke sp. n., and Strigota obscurata Klimaszewski & Brunke sp. n. are described as new to science. We also report 47 new Ontario records and 24 new Canadian records. Callicerus rigidicornis (Erichson) and Alevonota gracilenta (Erichson) are newly reported from North America as adventive species. A checklist, with Canadian distributions by province, of the 224 species of Aleocharinae known from Ontario is given. The following species are placed in subjective synonymy with Dexiogyia angustiventris (Casey): (Dexiogyia asperata (Casey) syn. n., Dexiogyia abscissa (Casey) syn. n., Dexiogyia tenuicauda (Casey) syn. n., Dexiogyia intenta (Casey) syn. n., Dexiogyia alticola (Casey) syn. n.). The following species are placed in subjective synonymy with Acrotona subpygmaea (Bernhauer): (Acrotona avia (Casey) syn. n., Acrotona puritana (Casey) syn. n.). Lectotypes are designated for Thiasophila angustiventris Casey, Thiasophila asperata Casey, Ischnoglossa intenta Casey, Oxypoda rubescans Casey, Chilopora americana Casey, Chilopora fuliginosa Casey, Coprothassa smithi Casey, Atheta subpygmaea Bernhauer, Colpodota puritana Casey, Strigota seducens Casey, Trichiusa compacta Casey, Trichiusa hirsuta Casey and Trichiusa robustula Casey. PMID:22577320

Role of a quality management system in improving patient safety - laboratory aspects.

PubMed

Allen, Lynn C

2013-09-01

The aim of this study is to describe how implementation of a quality management system (QMS) based on ISO 15189 enhances patient safety. A literature review showed that several European hospitals implemented a QMS based on ISO 9001 and assessed the impact on patient safety. An Internet search showed that problems affecting patient safety have occurred in a number of laboratories across Canada. The requirements of a QMS based on ISO 15189 are outlined, and the impact of the implementation of each requirement on patient safety is summarized. The Quality Management Program - Laboratory Services in Ontario is briefly described, and the experience of Ontario laboratories with Ontario Laboratory Accreditation, based on ISO 15189, is outlined. Several hospitals that implemented ISO 9001 reported either a positive impact or no impact on patient safety. Patient safety problems in Canadian laboratories are described. Implementation of each requirement of the QMS can be seen to have a positive effect on patient safety. Average laboratory conformance on Ontario Laboratory Accreditation is very high, and laboratories must address and resolve any nonconformities. Other standards, practices, and quality requirements may also contribute to patient safety. Implementation of a QMS based on ISO 15189 provides a solid foundation for quality in the laboratory and enhances patient safety. It helps to prevent patient safety issues; when such issues do occur, effective processes are in place for investigation and resolution. Patient safety problems in Canadian laboratories might have been prevented had effective QMSs been in place. Ontario Laboratory Accreditation has had a positive impact on quality in Ontario laboratories. Copyright © 2013 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Do patients undergo prostate examination while having a colonoscopy?

PubMed

Hammett, Tess; Hookey, Lawrence C; Kawakami, Jun

2009-01-01

To determine the rate at which physicians report performing a digital rectal examination and comment on the prostate gland before performing colonoscopy in men 50 to 70 years of age. A retrospective chart review of all men 50 to 70 years of age who had a colonoscopy in Kingston, Ontario, in 2005 was completed. It was noted whether each physician described performing a digital rectal examination before the colonoscopy, and if so, whether he or she commented on the prostate. In 2005, 846 eligible colonoscopies were performed by 17 physicians in Kingston, Ontario. In 29.2% of cases, the physician made no comment about having performed a digital rectal examination; in 55.8% of cases, the physician commented on having completed a digital rectal examination but said nothing about the prostate; and in 15.0% of cases, the physician made a comment regarding the prostate. No physician consistently commented on the prostate for all patients, and in no circumstances was direct referral to another physician or follow-up suggested. A colonoscopy presents an ideal opportunity for physicians to use a digital rectal examination to assess for prostate cancer. Physicians performing colonoscopies in men 50 to 70 years of age should pay special attention to the prostate while performing a digital rectal examination before colonoscopy. This novel concept may help maximize resources for cancer screening and could potentially increase the detection rate of clinically palpable prostate cancer.

Prevalence of Intimate Partner Violence Among South Asian Women Living in Southern Ontario.

PubMed

Madden, Kim; Scott, Taryn; Sholapur, Naushin; Bhandari, Mohit

2016-08-01

Intimate partner violence (IPV) affects 4 in 10 women in North America in their lifetime and 13-27 % in the past year. The basis for estimates stems largely from studies involving Caucasian women. Less is known about other minority populations such as South Asian women. This study aimed to assess the prevalence of IPV in the past year among South Asian women living in Southern Ontario. We conducted a survey of South Asian women living in Southern Ontario. All adult self-identified South Asian women attending a cultural event celebrating South Asian women who could understand English or Punjabi were eligible to participate. The survey contained three IPV prevalence questions adapted from the Woman Abuse Screening Tool. A total of 188 women (45 % of potentially eligible women) participated. Nearly 1 in 5 women reported IPV within the past year (19.3 %, 95 % CI 13.9-26.1 %). In this study single women were significantly more likely to have experienced IPV in the past year compared to married women (p = 0.035). Self-identified immigrant and non-immigrant South Asian women in this sample of women living in Southern Ontario experienced violence in proportions comparable to the general population. Programs for women should ensure accessibility and support of all ethnicities given equivalent rates of violence in the community.

Religious Observance Accommodation in Ontario Universities. Discussion Paper.

ERIC Educational Resources Information Center

Reed, Carole Ann

This paper highlights the religious accommodations that Ontario (Canada) universities have undertaken to create an inclusive, supportive learning community for all students, faculty, and staff. It outlines the demographic changes and public policy surrounding religious accommodation issues in Canada and in Ontario in particular, focusing on the…

If You Build It They Will Come (And Persist): Exploring Learning Accessibility for Students with Disabilities in the Ontario College System

ERIC Educational Resources Information Center

Ferguson, Renée J.

2017-01-01

Ontario's colleges accept learners with many backgrounds, experiences, and academic needs. Students with disabilities are a growing and diverse population. Is the Ontario College system providing efficacious and responsive support to these learners?

HOW DO WORK HIERARCHIES AND STRICT DIVISIONS OF LABOUR IMPACT CARE WORKERS’ EXPERIENCES OF HEALTH AND SAFETY? CASE STUDIESOF LONG TERM CARE IN TORONTO

PubMed Central

SYED, I.; DALY, T.; ARMSTRONG, P.; LOWNDES, R.; CHADOIN, M.; NAIDOO, V.

2016-01-01

Background According to the Canadian Health Care Association (1), there are 2,577 long-term care (“LTC”) facilities across Canada, with the largest proportion (33.4%) located in Ontario. Most studies focus on residents’ health, with less attention paid to the health and safety experiences of staff. Given that the work performed in Ontario LTC facilities is very gendered, increasingly racialized, task-oriented, and with strict divisions of labour, this paper explores in what ways some of these factors impact workers’ experiences of health and safety. Objectives The study objectives included the following research question: How are work hierarchies and task orientation experienced by staff? Design and Setting This paper draws on data from rapid team-based ethnographies of the shifting division of labour in LTC due to use of informal carers in six non-profit LTC facilities located in Toronto, Ontario. Methods Our method involved conducting observations and key informant interviews (N=167) with registered nurses, registered practical nurses, personal support workers, dietary aides, recreation therapists, families, privately paid companions, students, and volunteers. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed. For observations, researchers were paired and covered shifts between 7 a.m. and 11 p.m., as well as into the late night over six days, at each of the six sites. Detailed ethnographic field notes were written during and immediately following observational fieldwork. Results Our results indicate that employee stress is linked to the experiences of care work hierarchies, task orientation, and strict divisions of labour between and among various staff designations. Conclusion Findings from this project confirm and extend current research that demonstrates there are challenging working conditions in LTC, which can result in occupational health and safety problems, as well as stress for individual workers. PMID:28066839

Heat stress related dairy cow mortality during heat waves and control periods in rural Southern Ontario from 2010-2012.

PubMed

Bishop-Williams, Katherine E; Berke, Olaf; Pearl, David L; Hand, Karen; Kelton, David F

2015-11-27

Heat stress is a physiological response to extreme environmental heat such as heat waves. Heat stress can result in mortality in dairy cows when extreme heat is both rapidly changing and has a long duration. As a result of climate change, heat waves, which are defined as 3 days of temperatures of 32 °C or above, are an increasingly frequent extreme weather phenomenon in Southern Ontario. Heat waves are increasing the risk for on-farm dairy cow mortality in Southern Ontario. Heat stress indices (HSIs) are generally based on temperature and humidity and provide a relative measure of discomfort which can be used to predict increased risk of on-farm dairy cow mortality. In what follows, the heat stress distribution was described over space and presented with maps. Similarly, on-farm mortality was described and mapped. The goal of this study was to demonstrate that heat waves and related HSI increases during 2010-2012 were associated with increased on-farm dairy cow mortality in Southern Ontario. Mortality records and farm locations for all farms registered in the CanWest Dairy Herd Improvement Program in Southern Ontario were retrieved for 3 heat waves and 6 three-day control periods from 2010 to 2012. A random sample of controls (2:1) was taken from the data set to create a risk-based hybrid design. On-farm heat stress was estimated using data from 37 weather stations and subsequently interpolated across Southern Ontario by geostatistical kriging. A Poisson regression model was applied to assess the on-farm mortality in relation to varying levels of the HSI. For every one unit increase in HSI the on-farm mortality rate across Southern Ontario increases by 1.03 times (CI95% (IRR) = (1.025,1.035); p = ≤ 0.001). With a typical 8.6 unit increase in HSI from a control period to a heat wave, mortality rates are predicted to increase by 1.27 times. Southern Ontario was affected by heat waves, as demonstrated by high levels of heat stress and increased on-farm mortality. Farmers should be aware of these risks, and informed of appropriate methods to mitigate such risks.

"Here for the residents": a case study of cultural competence of personal support workers in a long-term care home.

PubMed

Tayab, Aysha; Narushima, Miya

2015-03-01

This study explores the perception of cultural competence of personal support workers (PSWs) in a long-term care (LTC) home in Ontario. As Canada's demography becomes older and more diverse, LTC homes will increasingly accommodate residents from various cultural backgrounds. However, few studies have examined cultural competence among PSWs in the LTC home setting. The study employed a qualitative case study approach. Data collection and analysis were conducted in three phases: document analysis of organizational policies, a key informant interview with the Director of Care, and two focus groups with PSWs. Our findings illuminated the PSWs' broad definition of culture, the process of developing cultural competence and its strong connections to person-centered care, and the organizational factors that facilitate or hinder PSWs' cultural competence. The ambiguous perception of cultural competence reported by PSWs suggests the need for more education and further research on this topic. © The Author(s) 2014.

Development and Use of Performance Appraisal of Certificated Education Staff in Ontario School Boards. Volume I: Technical Report. Professionalism in Schools Series.

ERIC Educational Resources Information Center

Lawton, S. B.; And Others

This study addresses four questions: (1) What types of performance appraisal policy for educational staff have been adopted by Ontario school boards? (2) To what extent have these policies been implemented in practice? (3) What types of appraisal policies are most effective? and (4) What processes have school boards used to develop and implement…

A Report and Evaluation of the OECA-Integrated Projects V.T.R. Project at Chinguacousy Public Library in Bramalea, Ontario, January 1974-June 1974.

ERIC Educational Resources Information Center

Henderson, John; And Others

In 1974, the Ontario Educational Communications Authority (OECA) undertook a study to measure the feasibility of loaning video tape recording equipment and video tapes to home users. A pilot program in one branch library found that, with the assistance of a video instruction package and an instructional booklet, users quickly mastered the…

The Widespread use of Methoprene for the Prevention and Control of West Nile Virus in Ontario, Canada: Is it Impairing our Streams?

NASA Astrophysics Data System (ADS)

Fletcher, R.; Baker, S. L.; Hayton, A.

2005-05-01

Catch basins have been identified as a major breeding location for the mosquito Culex pipiens, a primary vector for the spread of West Nile Virus in Ontario. Methoprene, an insect growth regulator, has been applied extensively in catch basins to combat the spread of mosquito populations. Since 2003, an estimated 1 million catch basins located around the Canadian shores of Lake Ontario were treated with 0.7g of 30-day, slow release methoprene pellets (4.25% active ingredient). Although studies have shown that methoprene breaks down quickly in the environment and is relatively non-toxic to mammals and fish, the large quantities being applied across Ontario raise concerns over the effects methoprene and its metabolites may have on non-target aquatic insects. The receiving streams of selected catch basins where methoprene was applied regularly were studied to assess the effects of methoprene application on stream macroinvertebrates. Although methoprene was not detected in the receiving waters, some changes in the community assemblages were observed. Many of the observed changes could be attributed to seasonality, however, percent Ephemeroptera, Plecoptera and Trichoptera (EPT) tended to be lower downstream of the storm sewer discharge compared to upstream and pre-application.

The influence of weather and fuel type on the fuel composition of the area burned by forest fires in Ontario, 1996-2006.

PubMed

Podur, Justin J; Martell, David L

2009-07-01

Forest fires are influenced by weather, fuels, and topography, but the relative influence of these factors may vary in different forest types. Compositional analysis can be used to assess the relative importance of fuels and weather in the boreal forest. Do forest or wild land fires burn more flammable fuels preferentially or, because most large fires burn in extreme weather conditions, do fires burn fuels in the proportions they are available despite differences in flammability? In the Canadian boreal forest, aspen (Populus tremuloides) has been found to burn in less than the proportion in which it is available. We used the province of Ontario's Provincial Fuels Database and fire records provided by the Ontario Ministry of Natural Resources to compare the fuel composition of area burned by 594 large (>40 ha) fires that occurred in Ontario's boreal forest region, a study area some 430,000 km2 in size, between 1996 and 2006 with the fuel composition of the neighborhoods around the fires. We found that, over the range of fire weather conditions in which large fires burned and in a study area with 8% aspen, fires burn fuels in the proportions that they are available, results which are consistent with the dominance of weather in controlling large fires.

Household transmission of SARS, 2003

PubMed Central

Wilson-Clark, Samantha D.; Deeks, Shelley L.; Gournis, Effie; Hay, Karen; Bondy, Susan; Kennedy, Erin; Johnson, Ian; Rea, Elizabeth; Kuschak, Theodore; Green, Diane; Abbas, Zahid; Guarda, Brenda

2006-01-01

Background In the 2003 outbreak in Toronto (in Ontario, Canada) of severe acute respiratory syndrome (SARS), about 20% of cases resulted from household transmission. The purpose of our study was to determine characteristics associated with the transmission of SARS within households. Methods A retrospective cohort of SARS-affected households was studied to determine risk factors for household transmission. Questionnaires addressed characteristics of the index case, the household and behaviours among household members. Potential risk factors for secondary transmission of infection were assessed in regression models appropriate to the outcome (secondary cases) and nonindependence of household members. Results The 74 households that participated included 18 secondary cases and 158 uninfected household members in addition to the 74 index cases. The household secondary attack rate was 10.2% (95% confidence interval [CI] 6.7%–23.5%). There was a linear association between the time the index patient spent at home after symptom onset and the secondary attack rate. Infected health care workers who were index cases had lower rates of household transmission. Interpretation SARS transmission in households is complex and increases with the length of time an ill person spends at home. Risk of transmission was lower when the index case was a health care worker. Rapid case identification is the public health measure most useful in minimizing exposure in the home. PMID:17098951

Delayed Referral Results in Missed Opportunities for Organ Donation After Circulatory Death.

PubMed

Krmpotic, Kristina; Payne, Clare; Isenor, Cynthia; Dhanani, Sonny

2017-06-01

Rates of organ donation and transplantation have steadily increased in the United States and Canada over the past decade, largely attributable to a notable increase in donation after circulatory death. However, the number of patients awaiting solid organ transplantation continues to remain much higher than the number of organs transplanted each year. The objective of this study was to determine the potential to increase donation rates further by identifying gaps in the well-established donation after circulatory death process in Ontario. Retrospective cohort study. Provincial organ procurement organization. Patients who died in designated donation hospitals within the province of Ontario, Canada between April 1, 2013, and March 31, 2015. None. Of 1,407 patient deaths following planned withdrawal of life-sustaining therapy, 54.0% (n = 760) were medically suitable for donation after circulatory death. In 438 cases where next of kin was approached, consent rates reached 47.5%. A total of 119 patients became actual organ donors. Only 66.2% (n = 503) of suitable patients were appropriately referred, resulting in 251 missed potential donors whose next of kin could not be approached regarding organ donation because referral occurred after initiation of withdrawal of life-sustaining therapy or not at all. The number of medically suitable patients who die within 2 hours of planned withdrawal of life-sustaining therapy is nearly six times higher than the number of actual organ donors, with the greatest loss of potential due to delayed referral until at the time of or after planned withdrawal of life-sustaining therapy. Intensive care teams are not meeting their ethical responsibility to recognize impending death and appropriately refer potential organ donors to the local organ procurement organization. In cases where patients had previously registered their consent decision, they were denied a healthcare right.

Challenges to evidence-based health promotion: a case study of a Food Security Coalition in Ontario, Canada.

PubMed

Meyer, Samantha B; Edge, Sara S; Beatty, Jocelyn; Leatherdale, Scott; Perlman, Chris; Dean, Jennifer; Ward, Paul R; Kirkpatrick, Sharon I

2017-03-30

Developing the evidence base for health promotion can be challenging because interventions often have to target competing determinants of health, including social, structural, environmental and political determinants; all of which are difficult to measure and thus evaluate. Drawing on a case study of food insecurity, which refers to inadequate access to food due to financial constraints, we illustrate the challenges faced by community-based organizations in collecting data to form an evidence base for the development and evaluation of collective programmes aimed at addressing food insecurity. Interviews were conducted with members of a multi-stakeholder coalition (n = 22 interviewees; n = 10 organizations) who collectively work to address food insecurity in their community through a range of community-based programmes and services. Member organizations also provided a list of measures currently used to inform programme and service development and evaluation. Data were collected in a city in Southern Ontario, Canada between May and September 2015. Participants identified four barriers to collecting data: Organizational needs and philosophies; concerns surrounding clientele wellbeing and dignity; issues of feasibility; and restrictive requirements imposed by funding bodies. Participants also discussed their previous successes in collecting meaningful data for identifying impact. Our results point to the challenge of generating data suitable for developing and evaluating programmes aimed at broader determinants of health, while maintaining the primary goal of meeting clients' needs. Documenting change at intermediate- and macro-levels would provide evidence for the collective effectiveness of current programmes and services offered. However, appropriate resources need to be invested to allow for scientific evaluation. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Incidence rate of pathogen-specific clinical mastitis on conventional and organic Canadian dairy farms.

PubMed

Levison, L J; Miller-Cushon, E K; Tucker, A L; Bergeron, R; Leslie, K E; Barkema, H W; DeVries, T J

2016-02-01

Mastitis is a common and costly production disease on dairy farms. In Canada, the incidence rate of clinical mastitis (IRCM) has been determined for conventionally managed dairy farms; however, no studies to date have assessed rates in organically managed systems. The objectives of this observational study were (1) to determine the producer-reported IRCM and predominant pathogen types on conventional and organic dairy farms in Southern Ontario, Canada, and (2) to evaluate the association of both mean overall IRCM and pathogen-specific IRCM with management system, housing type, and pasture access. Data from 59 dairy farms in Southern Ontario, Canada, distributed across conventional (n=41) and organic management (n=18) systems, were collected from April 2011 to May 2012. In addition to management system, farms were categorized by housing method (loose or tie-stall) and pasture access for lactating cows. Participating producers identified and collected samples from 936 cases of clinical mastitis. The most frequently isolated mastitis pathogens were coagulase-negative staphylococci, Bacillus spp., Streptococcus spp., Staphylococcus aureus, and Escherichia coli. The IRCM was higher on conventional farms than organic (23.7 vs. 13.2 cases per 100 cow-years) and was not associated with housing type (loose or tie-stall), pasture access, or herd-average milk yield. Bulk tank somatic cell count tended to be lower on conventional farms than organic (222,000 vs. 272,000 cells/mL). Pathogen-specific IRCM attributed to Staph. aureus, Bacillus spp., and E. coli was greater on conventional than organic farms, but was not associated with housing or any other factors. In conclusion, organic management was associated with reduced overall and pathogen-specific IRCM. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

A modified case-control study of cryptosporidiosis (using non-Cryptosporidium-infected enteric cases as controls) in a community setting.

PubMed

Pintar, K D M; Pollari, F; Waltner-Toews, D; Charron, D F; McEwen, S A; Fazil, A; Nesbitt, A

2009-12-01

Data from the first sentinel site (Waterloo Region, Ontario) of the Canadian Integrated Enteric Disease Surveillance System (C-EnterNet) were used in a secondary-based case-control study of laboratory-confirmed Cryptosporidium infections to study the role of various exposure factors. The incidence of cryptosporidiosis in Waterloo Region was almost double both the provincial and national rates. Persons ill with one of nine other enteric infections (amoebiasis, campylobacteriosis, cyclosporiasis, giardiasis, listeriosis, salmonellosis, shigellosis, verotoxigenic E. coli infections, yersiniosis) captured by the surveillance system were used as the control group. Of 1204 cases of enteric illness in the sentinel area between April 2005 and December 2007, 36 cases and 803 controls were selected after excluding outbreak and international travel-related cases. Univariable analyses (Pearson chi2 and Fisher's exact tests) and multivariable logistic regression were performed. Results of the multivariable analysis found that cryptosporidiosis was associated with swimming in a lake or river (OR 2.9, 95% CI 1.2-7.4), drinking municipal water (a potential surrogate for urban respondents vs. rural) (OR 2.4, 95% CI 1.04-5.7), and having a family member with a diarrhoeal illness (OR 2.9, 95% CI 1.3-6.4).

Ontario Universities Benefits Survey, 1987-88. Part I: Benefits Excluding Pensions.

ERIC Educational Resources Information Center

University of Western Ontario, London.

Results of the 1987-1988 survey of benefits, excluding pensions, for 17 Ontario, Canada, universities are presented. Information is provided on the following areas: administration and insurance plans, communication of benefits, proposed changes in benefits, provision of life and dismemberment insurance, maternity leave policy, Ontario health…

Attitudes of Ontario Secondary School Teachers toward Aspects of Professional Negotiations and Sanctions.

ERIC Educational Resources Information Center

Selinger, Alphonse D.

1980-01-01

Ontario secondary teachers were more favorable in 1977 than 1974 towards collective bargaining but showed significantly less support for sanctions, especially striking. Still, if their interests were seriously threatened, they would strike. Teacher sex and length of Ontario residence were significant predictors of militancy. (Author/SB)

The Quality Assurance System for Ontario Postsecondary Education: 2010-2014

ERIC Educational Resources Information Center

Liu, Qin

2015-01-01

The period of 2010 to 2014 marked a relatively stable stage in the evolving quality assurance system for Ontario postsecondary education, particularly following massive changes after 2000. The current system consists of three frameworks overseen respectively by three quality assurance agencies--the Ontario Universities Council on Quality…

Facts & Figures, 1999: A Compendium of Statistics on Ontario Universities.

ERIC Educational Resources Information Center

Council of Ontario Universities, Toronto.

This is the sixth edition of statistical and graphical information on the Ontario (Canada) university system. The report contains six sections: (1) Ontario population data, which includes population projections to 2021, income and employment rates by educational attainment, and university participation rates; (2) applicant/registrant data, which…

Building the New Northern Ontario Rural Medical School.

ERIC Educational Resources Information Center

Rourke, James T. B.

2002-01-01

Opening in 2004, the new Northern Ontario Rural Medical School will address the rural doctor shortage in Canada. Supported by Laurentian University and Lakehead University, learning sites will be in hospitals, community clinics, and physicians' offices throughout northern Ontario. The curriculum will be patient-centered and clinical problem-based…

Innovations in Literacy Learning: Reaching the Remote Northwestern Communities of Ontario

ERIC Educational Resources Information Center

Eady, Michelle

2006-01-01

The Sioux Hudson Literacy Council in partnership with AlphaPlus Centre in Toronto, Ontario and Confederation College, Sioux Lookout Campus, is making groundbreaking strides to reach adult learners who reside in remote, isolated communities of Northwestern Ontario. Generous funding from the National Literacy Secretariat in collaboration with…

Consultation: Professional Learning Framework for the Teaching Profession.

ERIC Educational Resources Information Center

Ontario College of Teachers, Toronto.

This publication describes the professional learning framework for teaching that was developed by the Ontario College of Teachers, a self-regulatory body for the teaching profession in Ontario. The Ontario College of Teachers has a mandate, in legislation, to identify and accredit professional learning programs that support standards of practice…

Developing Skills through Partnerships: Symposium Report

ERIC Educational Resources Information Center

Colleges Ontario, 2011

2011-01-01

In November 2005, the province of Ontario and the federal government signed two historic agreements--the Canada-Ontario Labour Market Development Agreement and the Canada-Ontario Labour Market Partnership Agreement. One year later, on Nov. 24, 2006, key labour market stakeholders, including users, delivery agents and government came together to…

Preschool Guidelines: Suburban Model (Ontario Local School District).

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus. Div. of Educational Services.

The Ontario Local Schools District, serving the village of Ontario and Springfield Township, offers this manual of operation which program staff developed to reflect the first year of implementation of a preschool program. Contents concern: (1) needs assessment; (2) program development; (3) facilities, equipment, and supplies; (4) staffing and…

CHANGES IN THE FRESHWATER BENTHIC COMMUNITY OF LAKE ONTARIO SINCE THE INVASION OF DREISSENA 1972-1997

EPA Science Inventory

Population changes of three major benthic taxa are discussed in relation to Dreissena spp. Lake Ontario was sampled pre-invasion (1972) and post-invasion (1994, 1997) for abundance of benthic organisms. In offshore sediments of Lake Ontario, neither species composition nor abunda...

77 FR 30451 - Safety Zone; Olcott Fireworks, Lake Ontario, Olcott, NY

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-23

...-AA00 Safety Zone; Olcott Fireworks, Lake Ontario, Olcott, NY AGENCY: Coast Guard, DHS. ACTION: Notice... Ontario during the Olcott fireworks display. The safety zone established by this proposed rule is necessary to protect spectators, participants, and vessels from the hazards associated with firework display...

The Birth and Slow Death of the Ontario Assessment Instrument Pool.

ERIC Educational Resources Information Center

Raphael, Dennis

1993-01-01

Describes the development of the Ontario Assessment Instrument Pool (OAIP), a curriculum-based item bank for use in Ontario schools. The nearly $10,000,000 project, lacking implementation and evaluation activities, resulted in limited classroom use. The objective-based assessment also contradicted a child-centered educational philosophy. (KS)

Ontario's Policy Framework for Environmental Education: Indoctrination and Integration

ERIC Educational Resources Information Center

Pardy, Bruce

2010-01-01

Outdoor educators should find little to like in the Ontario government's new policy framework for environmental education. Released in February 2009, the document, titled "Acting Today, Shaping Tomorrow," relies heavily on the 2007 Report of the Working Group on Environmental Education in Ontario, "Shaping Our Schools, Shaping Our…

Ontario Universities Statistical Compendium, 1970-71 to 1978-79. Part B, Supporting Data.

ERIC Educational Resources Information Center

Council of Ontario Universities, Toronto.

Data on the 1970-79 conditions of Ontario universities that were used in the derivation of macro-indicators are presented. The supporting data cover the following areas: operating revenue in Ontario universities; operating expenditures; distribution of academic salaries, nonacademic salaries, employee benefits; and nonsalary operating…