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Background: This paper provides a critical review of the decision‐making process of the Ontario Ministry of Health and Long‐Term Care (MOHLTC) regarding which migraine treatment drugs will be covered under the Ontario Drug Benefit Formulary (ODB). Main Text: Under MOHLTC policy, triptans and OnabotulinumtoxinA are available to patients only through the Exceptional Access Program (EAP). This policy, and justifications for it, are examined with reference to clinical guidelines, patient experiences, and health policy literature. The contexts and consequences of compromised access are outlined. Improvements in access to these treatments are suggested by highlighting how a country with similar healthcare infrastructure – Australia – employs policies that more adequately meet the needs of migraine patients as they secure treatments. Conclusions: Despite clinically significant gains in the discovery of safe and effective migraine‐specific treatments the ODB thus far has failed to align its practice with current clinical recommendations. This forces patients to rely heavily on medication that, while still effective for some, is potentially suboptimal. This review concludes it is prudent, at minimum, to follow clinical recommendations that advocate for the removal of triptans from EAP and recategorize them as Limited Use drugs. Ideally, moving them to a general benefit would further remove the barriers experienced by patients attempting to access this treatment. [ABSTRACT FROM AUTHOR]

Introduction and Aims The aim of our paper is to present trend data concerning public opinion on alcohol policy in the Canadian province of Ontario over a 16-year period (1996-2011), to assess if the level of support for alcohol control policies changed over this period and if any changes in public support for alcohol policy parallel real changes in alcohol distribution in Ontario. Design and Methods Selected policy-related items from 10 probability surveys of Ontario adults were analysed by means of logistic regression. Results A significant decline was found for attitudes supporting restricting corner stores sales and government control of liquor stores. A weaker decline was seen for attitudes towards reducing the number of places to buy alcohol. However, an increasing trend for attitudes favouring the status quo or greater control through taxes and hours of sale was found. There was no significant trend for attitudes towards maintaining the current level or reducing the number of liquor or beer stores. While there was some variation in trends in support by demographic characteristics and drinking level, not one sector stood out. Discussion and Conclusions A gradual erosion of support is evident and concurrent with gradual increase in access to alcohol in Ontario during the time-period under study. The decline in support for alcohol control measures seems to be a general rather than a focused development. It appears that this was largely due to a shift in a greater percentage supporting the status quo, not a move towards increasing access to alcohol. [ABSTRACT FROM AUTHOR]

Background: This paper describes a study that explores the experiences of internationally educated nurses (IENs) in their efforts to gain entry to practice as Registered Nurses (RNs) in the province of Ontario, Canada. Aim: The aim was to uncover, in part, the issues related to professional nursing credentialling. Methods: This study was guided by a biographical narrative (qualitative) research methodology. A convenience sample of 12 IEN students volunteered for this study representing the Philippines, Mainland China, Korea, Ukraine and India. Findings: The findings were that the IENs progress through a three-phase journey in their quest for licensure in Ontario. These phases include: (1) hope – wanting the Canadian dream of becoming an RN in Ontario; (2) disillusionment – discovering that their home-country nursing qualifications do not meet Ontario RN entry to practice; and (3) navigating disillusionment – living the redefined Canadian dream by returning to nursing school to upgrade their nursing qualifications. Conclusions: Professional regulatory nursing bodies and nursing educators, as well as practising nurses, must be aware of the potentially confusing and unpleasant processes IENs go through as they qualify for the privilege of practising nursing in Ontario. [ABSTRACT FROM AUTHOR]

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Objectives: Oral health inequalities impose a substantial burden on society and the healthcare system across Canadian provinces. Monitoring these inequalities is crucial for informing public health policy and action towards reducing inequalities; however, trends within Canada have not been explored. The objectives of this study are as follows: (a) to assess trends in income‐related inequalities in oral health in Ontario, Canada's most populous province, from 2003 to 2014, and (b) to determine whether the magnitude of such inequalities differ by age and sex. Methods: Data representative of the Ontario population aged 12 years and older were sourced from the Canadian Community Health Survey (CCHS) cycles 2003 (n = 36,182), 2007/08 (n = 36,430) and 2013/14 (n = 41,258). Income‐related inequalities in poor self‐reported oral health (SROH) were measured using the Slope Index of Inequality (SII) and Relative Index of Inequality (RII) and compared across surveys. All analyses were sample‐weighted and performed with STATA 15. Results: The prevalence of poor SROH was stable across the CCHS cycles, ranging from 14.1% (2003 cycle) to 14.8% (2013/14 cycle). SII estimates did not change (18.7‐19.0), while variation in RII estimates was observed over time (2003 = 3.85; 2007/08 = 4.47; 2013/14 = 4.02); differences were not statistically significant. SII and RII were lowest among 12‐ to 19‐year‐olds and gradually higher among 20‐ to 64‐year‐olds. RII was slightly higher among females in all survey years. Conclusion: Absolute and relative income‐related inequalities in SROH have persisted in Ontario over time and are more severe among middle‐aged adults. Therefore, oral health inequalities in Ontario require attention from key stakeholders, including governments, regulators and health professionals. [ABSTRACT FROM AUTHOR]

In mainstream media, policy circles and academic scholarship, economic discourses have highlighted the importance of knowledge, creativity and innovation for generating economic growth. This has been translated into an urban planning and policy agenda which favours the establishment of research parks, innovation clusters, and especially universities along with amenities to attract creative-class workers. In much of this literature universities are invested with an almost magical power to spur economic growth, and the benign language of 'transition' is used suggesting a rather seamless progression from one urban economic engine to another. Through analysis of policy documents and key informant interviews related to the establishment of a new university in Oshawa, Ontario, this case study seeks to challenge the straightforward relationship that is assumed to exist between universities and local economic development. Like other lagging regions across the OECD attempting to repair their economies through creative and knowledge urbanism, Oshawa's recent achievements are tempered by growing concerns about poverty, homelessness and inequality. Planners and policymakers that mistake the complexities of economic restructuring for a smooth 'urban transition' put their cities and citizens at risk of creating new problems out of efforts to improve local conditions. [ABSTRACT FROM AUTHOR]

Objective. Increasing our understanding of the differences between obesity and overweight status across various geographical areas may have important public health implications. We aimed to explore prevalence and factors (i.e., demographic and lifestyle) associated with overweight and obesity among youth across urban, suburban and rural settings. Methods. A cross-sectional study used self-reported data collected from students (grades 9–12) attending 76 high schools in Ontario, Canada, as part of the SHAPES-Ontario study (2005–2006). Of the 34 578 eligible students selected to complete the Physical Activity Module in the 76 participating schools, 73.5% (n=25 416; 50.8% males, 49.2% females) completed the survey. Univariate and multivariate analyses were conducted using body mass index for weight measurement and self-reported data on lifestyle factors, and self-perception of body weight. Results. The overall prevalence of overweight and obesity was 14.3% and 6.3%, respectively. The prevalence of overweight in urban, suburban and rural areas was 14.6%, 13.8% and 15.1%, respectively, while the prevalence of obesity was 6.3%, 6.0% and 6.7%, respectively, and the difference was significant (χ2= 16.53, p<0.05). In the multivariate logistic regression analysis, age, TV watching, level of urbanization and perception of body weight were important predictors of overweight and obesity. Conclusion. Our understanding of how overweight and obesity rates vary depending on the level of urbanization may help health professionals to either tailor programs to the needs of the individuals living in these different areas or to target existing programs to the contexts where they are most likely to have an impact. [ABSTRACT FROM AUTHOR]

This article discusses hillslope runoff and wetland connectivity in two Precambrian Shield watersheds in Ontario, Canada. Groundwater flow was intermittent during the study period and micro-basins located on the upper hillslope appeared to be partly responsible for the observed rapid wetland runoff. A subsurface channel of glacial cobbles hydrologically connected the microbasins to a downslope wetland. The antecedent water table position controlled the runoff response from the hilltop microbasins.

Objective The Multiple Mini-Interview (MMI) has previously been shown to have a positive correlation with early medical school performance. Data have matured to allow comparison with clerkship evaluations and national licensing examinations. Methods Of 117 applicants to the Michael G DeGroote School of Medicine at McMaster University who had scores on the MMI, traditional non-cognitive measures, and undergraduate grade point average (uGPA), 45 were admitted and followed through clerkship evaluations and Part I of the Medical Council of Canada Qualifying Examination (MCCQE). Clerkship evaluations consisted of clerkship summary ratings, a clerkship objective structured clinical examination (OSCE), and progress test score (a 180-item, multiple-choice test). The MCCQE includes subsections relevant to medical specialties and relevant to broader legal and ethical issues (Population Health and the Considerations of the Legal, Ethical and Organisational Aspects of Medicine[CLEO/PHELO]). Results In-programme, MMI was the best predictor of OSCE performance, clerkship encounter cards, and clerkship performance ratings. On the MCCQE Part I, MMI significantly predicted CLEO/PHELO scores and clinical decision-making (CDM) scores. None of these assessments were predicted by other non-cognitive admissions measures or uGPA. Only uGPA predicted progress test scores and the MCQ-based specialty-specific subsections of the MCCQE Part I. Discussion The MMI complements pre-admission cognitive measures to predict performance outcomes during clerkship and on the Canadian national licensing examination. [ABSTRACT FROM AUTHOR]

Griffiths RW, Newlands NK, Noakes DLG, Beamish FWH. Northern pike ( Esox lucius) growth and mortality in a northern Ontario river compared with that in lakes: influence of flow. Ecology of Freshwater Fish 2004: 13: 136–145. © Blackwell Munksgaard, 2004 We measured the growth and mortality characteristics of northern pike ( Esox lucius) in a northern Ontario river and examined the influence of flow on these characteristics by comparing our measurements with those estimated for a lake at the same latitude based on published studies. Pike ranged in total length from 229 to 784 mm, in mass from 70 to 4250 g, and in age from 1 to 10 years. The population showed a preponderance of 2–5-year olds, with few fish surviving beyond 7 years of age. Growth, in terms of length increase, was similar to that reported for circumpolar populations. Mean total length at 5 years of age was 577 mm, growth rate of young adults was 62.5 mm year−1, growth was isometric, longevity was 10 years of age, and the adult annual mortality rate was 49%. Growth and mortality characteristics of this riverine population were similar to those estimated for a lacustrine population at the same latitude. Flow thus had little measurable effect on the growth or mortality of pike possibly because of the overwhelming effect of other abiotic variables such as temperature, length of growing season and productivity. Consequently, growth characteristics of lacustrine populations can be used to assess the health and condition of riverine populations. [ABSTRACT FROM AUTHOR]

Abstract Aim An analysis is presented to examine whether variation in breeding waterfowl estimates can be explained by weather patterns prior to annual surveys. Location The location of the study is north-western Ontario, Canada. Methods Annual, systematic survey data for breeding waterfowl are available from the 1950s to the present for north-western Ontario. Regional monthly climate data for this area were compiled using weather data derived from interpolated annual climate surfaces. These data were analysed using stepwise multiple linear regression for each species and for waterfowl functional groups to assess whether monthly climate data accounted for some of the variation in waterfowl numbers. Results For all dabbling ducks pooled, 12% of the variation in annual abundance was explained by April temperatures, with more dabbling ducks observed in years when April was relatively cool. For diving ducks, 23% of the variation in pooled abundance was explained by April temperatures and February precipitation, where more diving ducks were observed in years when February had relatively less precipitation and April was cool. Patterns for individual species varied. Main conclusions Mean monthly weather data for months prior to surveys explained some of the variation in numbers of waterfowl observed in annual surveys. This suggests that future incorporation of weather data into waterfowl population models may help refine population estimates. [ABSTRACT FROM AUTHOR]

Canonical correspondence analysis (CCA) was used to explore the relationship between measured environmental variables and surficial diatom (Bacillariophyceae) assemblages in alkaline lakes from southeastern Ontario. Total nitrogen (TN), watershed area, alkalinity, and maximum depth each explain significant (P ≤ 0.05) directions of variance in the distribution of diatom taxa. TN was highly correlated to total phosphorus (TP) (r = 0.92), chlorophyll a (r = 0.86), and Secchi depth (r = 0.77). When a series of CCAs were run with the first axis constrained to each of these variables in turn, the ratio of the eigenvalue of the first axis to that of the second axis (&lamda;[sub1]/&lamda;[sub2]) was highest for TN, indicating that Tn best explained the distribution of the diatom assemblages in this set of lakes, Furthermore, results of Monte Carlo permutation tests indicated that these four variables did not act independently on the diatom assemblages. Therefore, TN was selected to represent these four closely related variables to infer take trophic status. Weighted-averaging regression and calibration (with classical deshrinking) were used to develop transfer functions to infer TN from the relative abundanees of 83 diatom taxa recovered from the surficial sediments of 51 takes. There was a good correlation between diatom-inferred TN concentrations and measured TN concentrations (r[sup;2] = 0.75, n = 51) The weighted-averaging regression and calibration model was used to infer lake trophic status (represented by TN) from diatom assemblages preserved in the sediments from Little Round Lake, Ontario. These data were used in confunction with historical land-use data in order to quantify the sequence and extent of nutrient enrichment related to human activity in the watershed area. [ABSTRACT FROM AUTHOR]

Mechanisms that have been proposed to explain the relationship between abundance (mean abundance at occupied sites) and distribution (proportion of sites occupied) have been based on (1) differences among species that affect either their ability to exploit resources or theirability to move through the landscape, (2) differences in species' landscapes that effect rates of successful dispersal of individuals, or (3) statistical arguments. Existence of an intra-specific abundance-distribution relationship where species differences can not be a factor would provide evidence that differences in species' landscapes likely contribute to the inter-specific abundance-distribution relationship. We examined the intra-specific relationship between abundance and distribution for 20 species of boreal forest songbirds. Abundance and distribution were calculated for each species in 52 to 119 locations over an area of 300 km x 100 km of northwestern Ontario. Based onseparate regressions, 16 of the species demonstrated significant positive relationships between abundance and distribution at alpha = 0.05. The weighted mean partial correlation for all species combined wasgreater than zero (P < 0.05). Meta-analysis indicated that there is no significant variation in the abundance-distribution correlation among species. This study provides evidence that amount of habitat within a landscape contributes to a positive intra-specific abundance-distribution relationship and therefore suggests that this factor could also contribute to the positive abundance-distribution relationship that is commonly found among species within an assemblage. [ABSTRACT FROM AUTHOR]

The fate and bioavailability of 2,3,7,8-tetrachlorodibenzofuran (TCDF; 4,6-tritium labeled) was examined over a 3-year (852-d) period in littoral enclosures (34 m3) in a small oligotrophic lake in the Experimental Lakes Area. Tetrachlorodibenzofuran was added as asingle dose (10.4 g/34 m3) or as five small multiple additions over a 5-d period in a sediment slurry. Tetrachlorodibenzofuranwas rapidly redistributed, mainly to bottom sediments (water column t1/2 ~1.8 d), reflecting removal on settling particles. Between 0 and 120 d, 80 to 90% of TCDF in the water column was associated with particles (>1 mum). The highest concentration of TCDF in suspended particles was consistently observed in the smallest size fraction (0.22-1 mum) at 326 to 464 d posttreatment. Mode of addition had no effect on TCDF concentrations in water (unfiltered) or surficial sediments (0-2 cm) or pore waters throughout the experiment. Mean TCDF concentrations in surficial sediment (0-120 d) were 1,830 1 1,180 pg/g (organic carbon [OC] basis), whereas they averaged 1,260 1 596 pg/gOC from 318 to 851 d posttreatment. Increasing concentrations of TCDF in lower sediment layers at 852 d suggests that TCDF was either diffusing into the sediment or undergoing burial. Fugacity (f) calculations indicated that the TCDF in enclosures shifted from disequilibriumfavoring the water column (days 0-9) to a disequilibrium with respect to bottom sediments (fwater/fsediment = 0.06-0.003) from day 21 onward. Initially, TCDF was more bioavailable to filtering and deposit feeders (mussels, Chironomidae, Hexagenia sp., and zooplankton) in enclosures receiving multiple additions; however, differences were rarely statistically significant. Concentrations of TCDF in all organisms were initially high, and they decreased in later sampling periods. Biota-sediment-accumulation factors (BSAFs) in mussels and crayfish were >1 in the early sampling periods, which reflected [ABSTRACT FROM AUTHOR]

Total Hg concentrations were determined in blood and feather samplesof breeding common loons (Gavia immer) and their chicks from 24 lakes in Ontario with a range of water chemistry and fish Hg concentrations. In paired comparisons, males had significantly higher blood (p < 0.005) and feather (p < 0.05) Hg concentrations than their female mates. Sex differences in Hg concentrations were attributable to size differences between the two sexes and to the possible transfer of Hg toeggs by females during egg-laying. Significantly higher blood (p < 0.001) and feather (p < 0.01) Hg concentrations were found in adult loons compared to their chicks. Adult blood Hg concentrations were significantly correlated with those of their chicks (r = 0.62, p < 0.05).Adult blood concentrations averaged about 13 times those of corresponding chicks. Both adult and chick blood Hg concentrations were positively correlated with fish Hg concentrations (r = 0.71 and 0.51, respectively), indicating that adult loons in central Ontario, like theirchicks, probably feed mainly on their breeding lakes and reflect thefish Hg concentrations of those lakes. Three of 24 lakes had 20- to 50-g fish (mainly perch and sunfish) with Hg concentrations at or exceeding the critical concentration (0.3--0.4 mu g/g wet weight or ~ 1--2 mu g/g dry weight) reported to cause reproductive impairment in loons. Monitoring Hg in blood (adult and chick) and feathers (chicks only) is useful for assessing the local bioavailability of methylmercury and the degree of current dietary Hg exposure in loons and other piscivorous birds. [ABSTRACT FROM AUTHOR]