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Integrated disease surveillance (IDS) offers the potential for better use of surveillance data to guide responses to public health threats. However, the extent of IDS implementation worldwide is unknown. This study sought to understand how IDS is operationalized, identify implementation challenges and barriers, and identify opportunities for development. Synthesis of qualitative studies undertaken in seven countries. Thirty-four focus group discussions and 48 key informant interviews were undertaken in Pakistan, Mozambique, Malawi, Uganda, Sweden, Canada, and England, with data collection led by the respective national public health institutes. Data were thematically analysed using a conceptual framework that covered governance, system and structure, core functions, finance and resourcing requirements. Emerging themes were then synthesised across countries for comparisons. None of the countries studied had fully integrated surveillance systems. Surveillance was often fragmented, and the conceptualization of integration varied. Barriers and facilitators identified included: 1) the need for clarity of purpose to guide integration activities; 2) challenges arising from unclear or shared ownership; 3) incompatibility of existing IT systems and surveillance infrastructure; 4) workforce and skills requirements; 5) legal environment to facilitate data sharing between agencies; and 6) resourcing to drive integration. In countries dependent on external funding, the focus on single diseases limited integration and created parallel systems. A plurality of surveillance systems exists globally with varying levels of maturity. While development of an international framework and standards are urgently needed to guide integration efforts, these must be tailored to country contexts and guided by their overarching purpose. [ABSTRACT FROM AUTHOR]

Abstract: The energy consumption and fossil CO2 emissions from the Canadian vegetable greenhouse industry were assessed using greenhouse statistics from 2002 to 2007. The fossil CO2 emissions were compared to the fossil CO2 emitted during transport of an equal weight of food by truck and by airplane from two horticultural production centers in the southern USA to four locations in Canada. The calculations in this paper for Canadian greenhouse energy use for heating were verified against farm energy use survey data collected from greenhouse operators in 1996. Allowing for extrapolations to 1996 from the 2002 to 2007 period, the survey data were underestimated by 12%. Since the survey data were not corrected for possible household energy use by greenhouse operators, some underestimation in the heat energy calculations was expected. The fossil CO2 emissions from Canadian greenhouses were 0.35Tg. This estimate is about twice as high as the diesel fuel CO2 emissions required to truck the same weight of vegetables from south to north, but only slightly less than half the CO2 emissions to ship the same vegetables by air. Quebec greenhouse crops had the lowest CO2 emission intensity and the least difference with trucking CO2 emissions, while BC greenhouse crops had the highest CO2 emission intensity and the most difference with trucking CO2 emissions. The study revealed some potential CO2 mitigation practices including alternative fuels such as straw pellets or wood chips, non-recycle-able combustible urban waste and biogas from city waste treatment facilities or manure storage systems. Mitigation of heat energy loss could involve insulating heating lines within greenhouses and doorway designs that minimize the time and area open to the outside air. In order to reduce the CO2 emission intensity, research should aim at a higher ratio of yield to fossil energy use, rather than simply trying to maximize greenhouse yields. [Copyright &y& Elsevier]

Estimates of greenhouse gas (GHG) emissions from Canada's four main livestock industries were integrated with the Canadian Economic and Emissions Model for Agriculture (CEEMA) which operates at the census district level. The livestock crop complex (LCC), which defines the crop area required to feed Canada's livestock, was disaggregated from provincial to district level. The LCC areas were subtracted from the crop areas stored in the CEEMA database to define the maximum area available for non-meat food, fiber, and biofuel feedstock production. The resulting non-livestock residual (NLR) area estimates were 18.7 Mha in the west (excluding rangeland, summerfallow, irrigated cropland and any crops not associated with livestock diets) and 1.0 Mha in the east. The GHG emissions from the NLR in the west were 13.7 Tg CO2e, or 30% of the total GHG emissions from those crops associated with livestock diets. The 1.6 Tg CO2e of GHG from the NLR in Eastern Canada represented 8% of the total GHG emissions from those livestock-related crops. The eastern NLR crop areas were more sensitive to changes in livestock populations than the Western Canada NLR areas because of the more dominant role of livestock production in eastern Canadian agriculture than in the west. The total agricultural GHG emissions budget showed direct but muted sensitivity to changes in Canadian livestock populations in both eastern and Western Canada. The methodology will link agricultural GHG emissions with district level land use decisions. [ABSTRACT FROM AUTHOR]

Abstract: Runoff from agricultural watersheds can carry a number of agricultural pollutants and pathogens; often associated with the sediment fraction. Deposition of this sediment can impact water quality and the ecology of the river, and the re-suspension of such sediment can become sources of contamination for reaches downstream. In this paper a modelling framework to predict sediment and associated microbial erosion, transport and deposition is proposed for the South Nation River, Ontario, Canada. The modelling framework is based on empirical relationships (deposition and re-suspension fluxes), derived from laboratory experiments in a rotating circular flume using sediment collected from the river bed. The bed shear stress governing the deposition and re-suspension processes in the stream was predicted using a one dimensional mobile boundary flow model called MOBED. Counts of live bacteria associated with the suspended and bed sediments were used in conjunction with measured suspended sediment concentration at an upstream section to allow for the estimation of sediment associated microbial erosion, transport and deposition within the modelled river reach. Results suggest that the South Nation River is dominated by deposition periods with erosion only occurring at flows above approximately 250 m3 s−1 (above this threshold, all sediment (suspended and eroded) with associated bacteria are transported through the modelled reach). As microbes are often associated with sediments, and can survive for extended periods of time, the river bed is shown to be a possible source of pathogenic organisms for erosion and transport downstream during large storm events. It is clear that, shear levels, bacteria concentrations and suspended sediment are interrelated requiring that these parameters be studied together in order to understand aquatic microbial dynamics. It is important that any management strategies and operational assessments for the protection of human and aquatic health incorporate the sediment compartments (suspended and bed sediment) and the energy dynamics within the system in order to better predict the concentration of indicator organism. [Copyright &y& Elsevier]

Abstract: Greenhouse gas (GHG) emissions associated with the production of the 21 major field crops in Canada were 16.8 Tg CO2e of N2O and 17.2 Tg of fossil fuel CO2 in 2006. The mean GHG emission intensity on an area basis for these crops was 1.0Mg of CO2e per ha. On a dry matter (DM) basis, the mean GHG emission intensity was 0.33Mg of CO2e Mg− DM. For western Canada, the GHG emission intensity was 0.35 MgCO1 DM. For western Canada, the GHG emission intensity was 0.35 MgCO2e Mg−1 DM and 0.30 MgCO2 DM for eastern Canada. The sensitivity of the GHG emissions to crop-specific GHG emission intensities was demonstrated by examining two biodiesel scenarios. The biodiesel share of the diesel fuel blend was 2% in the first scenario (B2) and 5% in the second scenario (B5). The increased feedstock was assumed to come from canola and soybeans. The B2 scenario increased the emission intensity for western Canada to 0.38 MgCO−1 DM for eastern Canada. The sensitivity of the GHG emissions to crop-specific GHG emission intensities was demonstrated by examining two biodiesel scenarios. The biodiesel share of the diesel fuel blend was 2% in the first scenario (B2) and 5% in the second scenario (B5). The increased feedstock was assumed to come from canola and soybeans. The B2 scenario increased the emission intensity for western Canada to 0.38 MgCO2e Mg−1 DM and the B5 scenario to 0.43 MgCO2 DM. Neither scenario had any appreciable effect on the magnitude of the emission intensity for eastern Canada. The GHG emissions from the canola-dominated western Canadian field crops were increased by the B2 and B5 fuel blend scenarios. In the soybean-dominated east, the two scenarios resulted in decreased GHG emissions from field crops. Canola-based biodiesel potentially eliminates more petrodiesel CO−1 DM. Neither scenario had any appreciable effect on the magnitude of the emission intensity for eastern Canada. The GHG emissions from the canola-dominated western Canadian field crops were increased by the B2 and B5 fuel blend scenarios. In the soybean-dominated east, the two scenarios resulted in decreased GHG emissions from field crops. Canola-based biodiesel potentially eliminates more petrodiesel CO2 emissions than soybean biodiesel. However, for both scenarios, the net potential GHG reductions (petrodiesel offset plus change in GHG emissions from field crops) were 2.60 MgCO2e ha− 1 in the west. The higher meal by-product from soybean oil meant a smaller loss of livestock feed for eastern Canada. [Copyright &y& Elsevier]2e ha−1 in the west. The higher meal by-product from soybean oil meant a smaller loss of livestock feed for eastern Canada. [Copyright &y& Elsevier]

In 1998, MacMillan Bloedel (now Weyerhaeuser) committed to a system of Stewardship Zones and to replacing clearcutting with variable retention over its 1.1 million ha coastal tenure. The decision began a grand experiment in forest planning and practice, which the company committed to monitor and refine through an adaptive management program. The program was most challenging to design and implement for biodiversity. Key elements of the program were: creating a criterion and associated indicators, developing a list of focused questions, and developing a cost-effective design for monitoring and learning. The final step in any adaptive management program is linking the monitoring back to specific management actions. We provide examples of successful linkages back for each of the three major indicators of biodiversity: ecosystem representation, habitat structure, and organisms. We discuss major difficulties that arise when developing management responses to the complex issue of sustaining biological diversity and note four major challenges to the design and implementation of any adaptive management program. [ABSTRACT FROM AUTHOR]

Variable retention is a new approach to harvesting and silvicultural systems that was developed by ecologists in the Pacific Northwest region of North America to address a wide array of forest management goals. Variable retention recognizes that natural disturbances, such as fire, wind or disease, nearly always leave some standing structure from the original forest. This structural complexity plays an important role in forest ecosystem function and biological diversity. A new "retention silvicultural system" was defined that leaves trees distributed throughout harvested areas. This system facilitates retention of structural features of old-growth forests, such as live and dead trees of varying sizes, multiple canopy layers, and coarse woody debris. Weyerhaeuser's British Columbia Coastal Group will use the variable retention approach for all harvesting by 2003. More than 75% of the company's coastal harvesting in British Columbia used variable retention in 2001. Company guidelines describe the amount, type, and spatial distribution of retention for groups and individual trees. An adaptive management program is monitoring the amount and type of structural attributes retained in relation to the original forest. [ABSTRACT FROM AUTHOR]

A field-scale no-till corn plot (120 m×90 m) located on a tile drained silt loam soil near Kintore, Ontario was irrigated with 2.5 cm of water over a 3 h period to examine the effects of irrigation on tile sediment transport in a headwater stream. Flow characteristics and the composition, concentration and size distribution of suspended solids were measured at the tile outlet, an upstream reference site and three sites located downstream of the tile drain. Results show that tile sediments at the study site are fine-grained (D50≈5.0 μm) and consist primarily of quartz, anorthite/albite, dolomite and calcite. Sediment concentrations in tile effluent increased from 8 to 57 mg L−1 after 1.5 h of irrigation and reached a maximum of 72 mg L−1. The sediment yield from the tile drain for the irrigation event was 4.6 kg ha−1. An unsteady, mobile boundary flow model (MOBED) was used to predict flow characteristics in the stream. According to the MOBED model, bed shear stress in the stream was approximately 6 N m−2. This value is significantly greater than the critical shear stress for complete suspension of 1 N m−2 for tile sediments as determined from laboratory experiments using a rotating circular flume. Grain size distributions of suspended solids in the stream were close to the dispersed size distribution because of the high shear stress in the receiving stream. [Copyright &y& Elsevier]

Analyzes needle tissue collected from thirty individuals in each of 57 stands of lodgepole pine from west-central Alberta, Canada. Use of starch gel electrophoresis for eight enzyme systems encoding 12 putative loci; Display of a total of 51 allozymes; Lower average population genetic diversity of harvest-origin stands than unmanaged stands.

Evaluates the transfusion practice in elective orthopedic surgery in Canada. Popularization of autologous blood donation (ABD) on patients in elective surgery; Risk factors contributing for the need of allogeneic transfusion; Requirement for the participation in ABD programs; Suggestions for other preventive strategies for ineligible patients.

Average long-term apparent rates of carbon (C) accumulation (LARCA) were estimated for four peat cores from Arctic and Subarctic Canada. Detailed analyses of dry bulk-density and C content were used to determine variations in C accumulation rates throughout the cores. LARCA range from 12.5 to 16.5 g C m -2 yr -1 over the past 6700–10 000 years. Rates are lower for the surface layers of Arctic high-centred peat polygons, at 5.3 to 7.1 g C m -2 yr -1 for the last 3500–4500 years. By comparison, the rate for the near-surface peat from a Sphagnum fuscum hummock in the high Subarctic was considerably higher, at 24.1 g C m -2 yr -1 . The highest carbon accumulation rates were from core segments older than 4500 BP, which represent fen stages according to palaeoecological analysis. The average LARCA in our study are considerably lower than recent estimates of average carbon accumulation in Boreal peatlands. This difference is attributable partly to lower carbon percentages in our cores compared to the mean or estimated values of 50 to 51.7% used in those studies. Another factor is the presence of ground ice, which exaggerates the apparent peat depth and leads to erroneously high values if cumulative carbon estimates are based on depth. Using cumulative dry bulk-density, as we have done, eliminates the influence of ground ice and thus makes more accurate estimates possible. [ABSTRACT FROM AUTHOR]

Examines the patterns and control of the development of wetland ecosystems in Ontario. Control of the basin in part by basin morphology; Variation of the accumulation rate of sediment within the basins; Comparison of the sequence of communities occupying basins during the postglacial period.

Highlights: [•] Indices indicate that climate may become more favorable for crop production. [•] DNDC projects crop yields will increase in Canada under climate change. [•] DNDC estimates less crop water stress in the future. [•] N2O emissions are projected to increase for wheat in western Canada. [Copyright &y& Elsevier]

• No-till (NT) stores more soil organic C in Western Canadian conditions. • The rate of C gain with NT decreases over time. • Soil texture influences the rate of C change under NT. Accurate estimates of soil organic carbon (SOC) stock change as influenced by tillage practices are prerequisites to quantify the impact of mitigation measures on greenhouse gas emissions associated with crop production. In this study, we compiled SOC stock change data as influenced by tillage practices, i.e. no-till (NT) versus conventional tillage (CT), on agricultural soils in Canada. We determined the rate of C change as a function of soil texture and climate stratified by time since the management change. In the cool and humid climates of Eastern Canada, the impacts of NT were inconsistent and resulted in a decline in C storage rate in the years shortly following management change, but SOC recovered over time. Carbon losses were particularly high on fine and coarse textured soils, whereas in medium textured soils NT tended to increase SOC. On the Canadian prairies NT consistently increased SOC. The rate of gain in SOC under NT decreased over time with higher rates in the 3−10 years following a change to NT at a rate of 740 kg C ha−1 yr−1 or 1.3 % yr−1. Rates declined to 260 kg C ha−1 yr−1 or 0.87 % yr−1 for periods from 11–20 years after tillage change, and to 95 kg C ha-1 yr−1 or 0.23 % for periods longer than 20 years. The results of this work clearly show climate, soil texture and duration of management as main drivers of SOC change under NT in Canada and key factors that must be considered in the development of either national or regional SOC models. The results of this study suggest that more detailed stratification of soil texture, climate and duration of NT adoption is required for more accurate estimates of SOC storage rates associated with NT for Canada. [ABSTRACT FROM AUTHOR]

Background: Previous studies have demonstrated that earlier epinephrine administration is associated with improved survival from out-of-hospital cardiac arrest (OHCA) with shockable initial rhythms. However, the effect of epinephrine timing on patients with nonshockable initial rhythms is unclear. The objective of this study was to measure the association between time to epinephrine administration and survival in adults and children with emergency medical services (EMS)-treated OHCA with nonshockable initial rhythms., Methods: We performed a secondary analysis of OHCAs prospectively identified by the Resuscitation Outcomes Consortium network from June 4, 2011, to June 30, 2015. We included patients of all ages with an EMS-treated OHCA and an initial nonshockable rhythm. We excluded those with return of spontaneous circulation in <10 minutes. We conducted a subgroup analysis involving patients <18 years of age. The primary exposure was time (minutes) from arrival of the first EMS agency to the first dose of epinephrine. Secondary exposure was time to epinephrine dichotomized as early (<10 minutes) or late (≥10 minutes). The primary outcome was survival to hospital discharge. We adjusted for Utstein covariates and Resuscitation Outcomes Consortium study site., Results: From 55 568 EMS-treated OHCAs, 32 101 patients with initial nonshockable rhythms were included. There were 12 238 in the early group, 14 517 in the late group, and 5346 not treated with epinephrine. After adjusting for potential confounders, each minute from EMS arrival to epinephrine administration was associated with a 4% decrease in odds of survival for adults, odds ratio=0.96 (95% confidence interval, 0.95-0.98). A subgroup analysis (n=13 290) examining neurological outcomes showed a similar association (adjusted odds ratio, 0.94 per minute; 95% confidence interval, 0.89-0.98). When epinephrine was given late in comparison with early, odds of survival were 18% lower (odds ratio, 0.82; 95% confidence interval, 0.68-0.98). In a pediatric analysis (n=595), odds of survival were 9% lower (odds ratio, 0.91; 95% confidence interval, 0.81-1.01) for each minute delay in epinephrine., Conclusions: Among OHCAs with nonshockable initial rhythms, the majority of patients were administered epinephrine >10 minutes after EMS arrival. Each minute delay in epinephrine administration was associated with decreased survival and unfavorable neurological outcomes. EMS agencies should consider strategies to reduce epinephrine administration times in patients with initial nonshockable rhythms., (© 2018 American Heart Association, Inc.)

Background: The Cardiac Arrest Survivors with Preserved Ejection Fraction Registry (CASPER) enrolls patients with apparently unexplained cardiac arrest and no evident cardiac disease to identify the pathogenesis of cardiac arrest through systematic clinical testing. Exercise testing, drug provocation, advanced cardiac imaging, and genetic testing may be useful when a cause is not apparent., Methods and Results: The first 200 survivors of unexplained cardiac arrest from 14 centers across Canada were evaluated to determine the results of investigation and follow-up (age, 48.6±14.7 years, 41% female). Patients were free of evidence of coronary artery disease, left ventricular dysfunction, or evident repolarization syndromes. Advanced testing determined a diagnosis in 34% of patients at baseline, with a diagnosis emerging during follow-up in 7% of patients. Of those who were diagnosed, 28 (35%) had an underlying structural condition and 53 (65%) had a primary electric disease. During a mean follow-up of 3.15±2.34 years, 23% of patients had either a shock or an appropriate antitachycardia pacing from their implantable cardioverter defibrillator, or both. The implantable cardioverter defibrillator appropriate intervention rate was 8.4% at 1 year and 18.1% at 3 years, with no clear difference between diagnosed and undiagnosed subjects, or between those diagnosed with a primary electric versus structural pathogenesis., Conclusions: Obtaining a diagnosis in previously unexplained cardiac arrest patients requires systematic clinical testing and regular follow-up to unmask the cause. Nearly half of apparently unexplained cardiac arrest patients ultimately received a diagnosis, allowing for improved treatment and family screening. A substantial proportion of patients received appropriate implantable cardioverter defibrillator therapy during medium-term follow-up., Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00292032., (© 2016 American Heart Association, Inc.)