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The pulp and paper industry converts roundwood and recycled fibre, collected from wastepaper into printing and writing papers, and other specialty grades of paper. The pulp and paper mills in Ontario have been facing extreme competitive pressures, which have affected their performance leading to several mill closures. The purpose of this study is to evaluate and compare the relative performance of three types of Ontario's pulp and paper mills (using all fibre, only roundwood fibre, and only recycled fibre). This study uses bootstrap data envelopment analysis in analyzing and comparing the operational efficiency of the Ontario's pulp and paper mills, with 224 sample data observations over a period of 17 years. The results indicate low levels of overall technical and managerial efficiencies in the pulp and paper mills using recycled fibre. The results of the study highlight that the pulp and paper industry needs to divert their attention to streamlining the manufacturing processes, reducing costs, improving raw material usage, and making capital investments in the new and improved technology, in order to improve the operational efficiency and competitiveness of the Ontario's pulp and paper mills. The pulp and paper mills using recycled fibre require huge capital investments, especially for installing the latest de-inking technology. The results of this study provide policy makers with detailed performance analysis so that future input resources can be reallocated to improve the performance of the pulp and paper mills in Ontario. [ABSTRACT FROM AUTHOR]

This paper contends that sociotherapy, a sociologically informed approach to therapy, is a viable alternative to the diagnostic model recognized by the College of Registered Psychotherapists in Ontario (CRPO). The Psychotherapy Act (2007) along with the Regulated Health Professions Act (1991) gives the CRPO authorization to regulate the practice of psychotherapy and to control titles affiliated with the act of psychotherapy. I offer a discussion of sociotherapy and socioanalysis as clinical alternatives to the conservative and normalizing approaches endorsed by the College. I situate sociotherapy and socioanalysis in the discipline of sociology and in relation to Freudian psychoanalysis. I offer my own sociotherapeutic practice as an illustration of how the societal and the psychological, the social, and the psychic must be engaged in concert. I underscore the importance of dialogue, as opposed to diagnostics, interpretation as opposed to assessments and psychosocial contemplation as opposed to cognitive-behavioral treatment in clinical practice. [ABSTRACT FROM AUTHOR]

Introduction: The Western Ontario and McMaster University osteoarthritis index (WOMAC) is the most commonly used indicator of disease-specific outcome in knee osteoarthritis for its convenience and reliability. It has two formats the paper-based WOMAC (p-WOMAC) and the electronic WOMAC (e-WOMAC). In China, the p-WOMAC has been widely used though e-WOMAC is yet untested. This study aims to test whether e-WOMAC is consistent with the p-WOMAC before and after the intervention., Methods and Analysis: A total of 70 patients from Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine will be randomly assigned in two groups, named, group A and group B. This study is divided into three stages. In the first stage, patients in group A will be evaluated first by p-WOMAC and then by e-WOMAC. Patients in group B will be evaluated by e-WOMAC and then by p-WOMAC. In the second stage of the study, drug interventions will be implemented. 200 mg celecoxib will be administered orally once a day starting from the second day of enrolment for a period of 21 days. In the third stage, postintervention evaluation will be conducted after administration. Patients in group A will be evaluated first by e-WOMAC and then by p-WOMAC. Patients in group B will be evaluated first by p-WOMAC and then by e-WOMAC. In order to avoid the possible bias because of patients' potential memory, e-WOMAC and p-WOMAC will be taken for each patient at 15 min apart. The primary outcome of the study is the mean score difference in WOMAC, and the secondary outcomes are the score differences in WOMAC subscales: pain, stiffness and physical function., Ethics and Dissemination: The protocol has been approved by the Independent Review Board of SGH (approval number: 2020-814-21-01). The results of the trial will be submitted for publication in a peer-reviewed journal., Trial Registration Number: ChiCTR2100050914., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: The purpose of this study was to investigate the effects of hybrid environments (i.e. where part of the patient record is paper-based and part of it is electronic) upon aspects of novice nurse information seeking (i.e. amount of information accessed, choice of key information sources, type of information and use of information seeking tactics)., Methods: A within group, laboratory, experimental study was conducted using two simulated environments (i.e. a paper environment and a hybrid environment). Thirty-five novice nurses participated in the study., Results: Findings revealed significant differences between the paper and hybrid environments in terms of their effects upon aspects of novice nurse information seeking. Subjects accessed: 1) less information in the hybrid environment than the paper environment, 2) more non-electronic sources of information were accessed by novice nurses in the hybrid environment, and 3) novice nurses used more passive information seeking tactics in the hybrid environment than the paper environment. Qualitative findings from the cued recall data revealed subjects experienced increased cognitive load in the hybrid environment., Conclusions: Hybrid environments may affect aspects of novice nurse information seeking. Future research should explore the effects of hybrid environments upon the information seeking of other types of health professionals (e.g. physicians, physiotherapists) with differing levels of expertise (i.e. novice, intermediate and expert).

Looks at the turnaround safety performance in the Kenora, Ontario pulp and paper mill of Rainy River Forest Products Inc. which used a questionnaire survey technique. Description on the model developed for safety management; Elements assessed in the questionnaire developed; Survey results; Steps taken by the company to improve its safety rules. INSET: Beliefs & Practices for Excellence in Safety on Which the Model.

Objective: Only a minority of suicide decedents leave a suicide note. Typically, the notes are handwritten on paper; however, electronic suicide notes have been reported with increasing frequency. This emerging phenomenon remains generally under-researched. The aim of this study was to compare the psychosocial and clinical antecedents of suicide decedents who left E-notes with those who left paper notes or no notes., Method: The study was embedded in the Southwestern Ontario Suicide Study (SOSS). The SOSS was a three-year case series of consecutive deaths by suicide that occurred in the region between 2012 and 2014. Data on psychosocial and clinical antecedents were collected with a modified version of the Manchester questionnaire used in the UK., Results: Of the 476 suicides files reviewed, 45.8% contained a suicide note. A total of 383 separate suicide notes were left: 74.3% were paper notes and 25.7% were E-notes. The results of the multivariate regression analyses indicate that the likelihood of leaving a suicide note was negatively associated with a history of admissions to a mental health unit, while the likelihood of leaving an E-note was negatively associated with age, positively associated with presence of a mental disorder, and negatively associated with history of hospital admissions., Conclusions: Future studies with larger samples need to consider the timing of the text messages, and appraise whether there was the intent of seeking help or rescue in the text messages., (© 2018 The American Association of Suicidology.)

Background: The Western Ontario Rotator Cuff Index (WORC) is commonly used in orthopedic research to assess the effect of a rotator cuff injury. Questions in the WORC are presented in a visual analog scale format, which requires patients to place a pencil mark along a 10-cm line indicating their responses. The purpose of our study was to determine if a computerized version of a visual analog scale requiring patients drag a cursor along a line was comparable to data collected using the standard paper version of the WORC. Materials and methods: Administration of the WORC was randomized, with the first version given in the waiting room before the office visit, and the second immediately after the office visit, to ensure the participant''s shoulder function had not significantly changed. Results: Thirty-five patients with rotator cuff injury completed the paper and computerized versions of the WORC. There was no significant difference in mean scores for the WORC between the paper (1040.3) and computerized versions (1021.2, P = .488). The intraclass correlation coefficient for the 2 versions was 0.94. Similarly, there were no significant differences in scores between the subset of scores within the WORC (Physical Activity, Work, Sports, Lifestyle, and Emotion, P > .05), and each subset was highly correlated (intraclass correlation coefficient >0.80). Conclusions: There was no significant difference in scores for the WORC index when administered in a computerized format vs a paper format. [Copyright &y& Elsevier]

This study set out to examine pre-analytical factors affecting the frequency of positive results in newborn screening for biotinidase deficiency. This investigation was prompted by an increase in the annual screen positive rate for biotinidase deficiency in Ontario from 2.65x10−4 in 2016 to 6.57x10−4 in 2017. Season and trend decomposition was used to separate seasonality from an underlying trend in the time series of biotindase activity measurements for the period 2014–01-12 to 2019–07-27 (n = 798,770). This analysis revealed a marked seasonal effect (winter = median + ⩽ 17 MRU, summer = mean - ⩽ 20 MRU) and a non-linear negative trend. Seasonal temperature was correlated with biotinidase results (Pearson's r = 0.79) but not with the observed negative trend (Pearson's r = 0.0025). Time series analysis of biotinidase results grouped by print lot of filter paper revealed that recently printed filter paper cards inhibit biotinidase and that this inhibition resolved over time. This study demonstrates that biotindase activity is inhibited by both increased seasonal temperature and collection on newly printed filter cards. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe the documentation of pro re nata (PRN) medication for anxiety and to compare documentation at two hospitals providing similar psychiatric services, one that used paper charts and another that used an electronic health record (EHR). We also assessed congruence between nursing documentation and verbal reports from staff about the PRN administration process. Background: The ability to accurately document patients’ symptoms and the care given is considered a core competency of the nursing profession (Wilkinson, Nursing process and critical thinking, Saddle River, 2007); however, researchers have found poor concordance between nursing notes and verbal reports or observations of events (e.g., Marinis et al., 2010, J Clin Nurs, 19, 1544–1552) and considerable information missing (e.g., Marinis et al., 2010, J Clin Nurs, 19, 1544–1552). Additionally, the administration of PRN medication has consistently been noted to be poorly documented (e.g., Baker et al., 2008, J Clin Nurs, 17, 1122–1131). Design: The project was a mixed‐method, two‐phase study that collected data from two sites. Methods: In phase 1, nursing documentation of PRN medication administrations was reviewed in patient charts; phase 2 included verbal reports from staff about this practice. Results: Nurses using EHR documented more information than those using paper charts, including the reason for PRN administration, who initiated the administration, and effectiveness. There were some differences between written and verbal reports, including whether potential side effects were explained to patients prior to PRN administration. Conclusions: We continue the calls for attention to be paid to improving the quality of nursing documentation. Our results support the shift to using EHR, yet not relying on this method completely to ensure comprehensiveness of documentation. Relevance to clinical practice: Efforts to address the quality of documentation, particularly for PRN administration, are needed. This could be made through training, using structured report templates and by switching to electronic databases. [ABSTRACT FROM AUTHOR]

Background: Dangerous abbreviations on the Institute for Safe Medication Practices Canada's "Do Not Use" list have resulted in medication errors leading to harm. Data comparing rates of use of dangerous abbreviations in paper and electronic medication orders are limited., Objective: To compare rates of use of dangerous abbreviations from the "Do Not Use" list, in paper and electronic medication orders. Secondary objectives include determining the proportion of patients at risk for medication errors due to dangerous abbreviations and the most commonly used dangerous abbreviations., Methods: One-day cross-sectional audits of medication orders were conducted at a 6-site hospital network in Toronto, Canada, between December 2013 and January 2014. Proportions of paper and electronic medication orders containing dangerous abbreviation(s) were compared using a χ 2 test. The proportion of patients with at least 1 medication order containing dangerous abbreviation(s) and the top 5 dangerous abbreviations used were described., Results: Overall, 255 patient charts were reviewed. The proportions of paper and electronic medication orders containing dangerous abbreviation(s) were 172/714 (24.1%) and 9/2207 (0.4%), respectively ( P < 0.001). Almost one-third of patients had medication order(s) containing dangerous abbreviation(s). The proportions of patients with at least 1 medication order during the audit period containing dangerous abbreviation(s) for patients with paper only, electronic only, or a hybrid of paper and electronic medication orders were 50.5%, 5%, and 47.2%, respectively. Those most commonly used were "D/C", drug name abbreviations, "OD," "cc," and "U.", Conclusions: Electronic medication orders have significantly lower rates of dangerous abbreviation use compared to paper medication orders.

Although effluent treatment systems within pulp and paper mills remove many toxicants and improve wastewater quality, there is a need to understand and quantify the effectiveness of the treatment process. At a combined news and kraft pulp and paper mill in northwestern Ontario, Canada, fathead minnow (FHM) reproduction and physiology were examined before, during, and after a short-term (6-d) exposure to 10% (v/v) untreated kraft mill effluent (UTK), 25% (v/v) secondary treated kraft mill effluent (TK), and 100% (v/v) combined mill outfall (CMO). Although UTK exposure significantly decreased egg production, neither TK nor CMO caused any reproductive changes. The expression of six genes responsive to endocrine-disrupting compounds, stress, or metals was then examined in livers of these fish using real-time polymerase chain reaction. In female FHMs, none of the three effluents induced significant expression changes in any genes investigated. By contrast, in males there were significant increases in the mRNA levels of androgen receptor, estrogen receptor (ER) β, and cytochrome P4501A (CYP1A) upon UTK and TK exposure but no changes in ERα or vitellogenin (VTG) gene expression, whereas CMO exposure significantly increased the mRNA levels of ERα, VTG, and CYP1A. Together, these results suggest that kraft effluent before and after biological treatment contained compounds able to induce androgenic effects in FHMs, and that combination of kraft and newsmill effluents eliminated the androgenic compounds while inducing distinct and significant patterns of gene expression changes that were likely due to estrogenic compounds produced by the newsmill. Environ. Toxicol. Chem. 2010;29:430–439. © 2009 SETAC [ABSTRACT FROM AUTHOR]

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Discusses silvicultural programs carried out by Ontario's pulp and paper companies in the decade after World War I. Abitibi Power and Paper Co.'s management of its timber on a sustained yield basis; Industrial forestry initiatives of the period; Historians' argument that only nominal progress was made towards improving forestry practices during the period.

Analyzes three newspapers in Toronto, Ontario as to its treatment of the issue of abortion. Newspapers as the agents of the reconfiguration of power; Differences in the bias of the `Globe and Mail', the `Toronto Sun' and `The Toronto Star'; Reluctance theory.

This paper explores the effects of effluent regulatory activity in the Ontarian pulp and paper industry. The model uses instrumental variables to distinguish between that correlation between emission limits and emissions coming from regulatory capture and that coming from true influence on the part of the regulator. Results suggest that total suspended solids (TSS) limits were more effective than biological oxygen demand (BOD) limits. Firm responses to TSS limits were in part through modulating output and these responses lowered emissions. In contrast, firms reported investing in abatement technology in response to BOD limits, but these investments had no discernible impact on emissions. [ABSTRACT FROM AUTHOR]

The Activated Sludge Model No. 1 was chosen as the basis for model development and was modified to take into account the specific characteristics of pulp and paper effluents. The model was incorporated to the GPS–X simulation environment (Hydromantis, Hamilton, Ontario, Canada) to study operating deficiencies and nutrient transformations, particularly in relation to hulking. The results show that the process of ammonification is not significant at the studied mill and that the process of phosphatification (transformation of soluble organic phosphorus into orthophosphates) seems to be related to settling problems, as indicated by the sludge volume index. The phosphatification rate and the standard oxygen–transfer efficiency were found to decrease as the system entered a bulking state. Understanding the behavior of pulp and paper activated sludge can be improved by the incorporation of industry– specific processes and components to comprehensive models. These models then can be used to gain insight to the causes of bulking. Water Environ. Res., 82, 362 (2010). [ABSTRACT FROM AUTHOR]

Biofilm samples collected from inside and outside the press and former sections of paper machines in a Northwestern Ontario paper mill for a period of 2 years were characterized microbiologically and electrochemically. Bacterial community profiling was done using polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) and selected bacterial isolates were identified using 16S rDNA analysis. The bacterial community showed the presence of Proteobacteria, Firmicutes, and Actinobacteria. Sphingomonas sp. was found to be the most common bacterial species, which showed the highest production of extracellular polymeric substances. Bacteria isolated from biofilms showed better adhesion properties than those from water samples. Cyclic voltammetry and electrochemical impedance spectroscopy studies showed that bacteria isolated from biofilms and feed water collected from inside the machine were more easily oxidized than those from outside, suggesting the need for a more rigorous biofilm abatement strategy for inside paper machines. [ABSTRACT FROM AUTHOR]

This paper examines anti-Black racism in the Ontario public school system. Using the West-Hill Catholic Elementary School (a pseudonym) as a case study, it foregrounds the selective application of punishments inflicted upon Black students, including those often motivated by racist perceptions on the part of teachers, principals, and School Boards. Using the theories of biological determinism1 and the culture of poverty2 as conceptual frameworks, this paper investigates the factors to which school authorities attribute violent behavior on the part of Black students. This paper provides recommendations aimed at mitigating anti-Black racism in the Ontario public school system. Plain Language Summary: Selective Punishment in the Ontario Public School System This paper examines serial cases of anti-Black racism, in particular incidents involving selective punishment within the Ontario public school system under the pretext of discouraging violent behaviour. Using the arrest of a four-year-old Black student at the West-Hill Catholic Elementary School, allegedly for violent behaviour, as a case study, in addition to data from the Toronto District School Board, the paper examines the theory of biological determinism, which is often used to represent Black students as intrinsically prone to violence. Also investigated is the culture of poverty hypothesis that attributes such behaviour on the part of Black students to environmental factors, such as family structure, upbringing and ethics. Drawing on academic publications, this paper argues that race plays a central role in determining who gets rewarded in the Ontario public school system and who gets punished for displaying behaviour construed, by school authorities, as a threat to the school environment. Black racism, in its many modalities, remains an enduring problem, one that requires a broad range of correctives, including changes to teacher education programs, professional development for teachers and school administrators, and the recruitment of Black parents as allies. It would also require non-racist policies to address knee-jerk reactions that have transformed some public schools in Ontario into bootcamps where 'refractory' students are punished with a view to discouraging their classmates from displaying conduct deemed to contravene established regulations. [ABSTRACT FROM AUTHOR]

Between 1886 and 1895, the Sunday newspaper in U.S. cities became a cauldron for an emerging mass, popular culture-one with reach into Canada. The concurrent development of weekend newspapers in Toronto, Canada, distinguished local innovations against the unspecified, general influence of the "American Sunday paper." The Sunday World and the Saturday Globe followed and refuted, respectively, the ideal set by the American Sunday paper, but together defined Canadian weekend leisure reading. The reference in Canadian newspapers to an idealized American Sunday model offers an example of an emergent continental mass popular culture where cultural forms circulated, and were transformed, producing interesting local specificities. [ABSTRACT FROM AUTHOR]

Background Tobacco and non-tobacco-based waterpipe smoking has increased exponentially in many countries in recent decades, particularly among youth and young adults. Although tobacco smoking is banned in many indoor public places, waterpipe smoking, ostensibly non-tobacco, continues in Ontario and other jurisdictions where only tobacco smoking is prohibited. This study assessed air quality and exposure in waterpipe cafes using multiple methods and markers. Methods Indoor (n=12) and outdoor (n=5) air quality was assessed in Toronto, Canada waterpipe cafes from 30 August to 11 October 2012. Real-time measurements of air nicotine, fine particulate matter less than 2.5 microns in diameter (PM2.5) and ambient carbon monoxide (CO) were collected in 2 h sessions. Levels of CO in breath were collected in non-smoking field staff before entering and upon leaving venues. Observations of occupant behaviour, environmental changes and venue characteristics were also recorded. Results In indoor venues, mean values were 1419 mg/m3 for PM2.5, 17.7 ppm for ambient CO, and 3.3 mg/m3 for air nicotine. Levels increased with increasing number of active waterpipes. On outdoor patios, mean values were 80.5 mg/m3 for PM2.5, 0.5 ppm for ambient CO, and 0.6 mg/m3 for air nicotine. Air quality levels in indoor waterpipe cafes are hazardous for human health. Outdoor waterpipe cafes showed less harmful particulate levels than indoors, but mean PM2.5 levels (80.5 mg/m3) were still ‘poor'. Conclusions Staff and patrons of waterpipe cafes are exposed to air quality levels considered hazardous to human health. Results support eliminating waterpipe smoking in hospitality venues indoors and out. [ABSTRACT FROM AUTHOR]

Reports on the endowment of a professorial chair at the University of Toronto's Pulp and Paper Center. Tembec Inc.'s funding of the Frank Dottori Chair; Denial that paper has become obsolete with the advent of the Internet; Need for research and innovation in Canada's pulp and paper science and engineering.

Changes in ecosystems after the removal of stress provide a rich source of information for conservation science. We used a long-term regional data set on the performance of white sucker (Catostomus commersonii) collected before and after the closure of a pulp mill to explore recovery in fish. Physiological indicators, including liver enzymes and plasma steroids, showed some compelling changes after the closure of the mill consistent with reduced exposure to pulp mill effluent but did not unequivocally demonstrate recovery. However, persistent signals in these fish may indicate effects of impoundment or discharge of sewage. We also used quantile regression with environmental covariates and bootstrap iteration to determine if systematic variation remained in relative body weight, liver weight, and gonad weight. In fish formerly exposed to pulp mill effluent, we found evidence of improvements (male gonad weight and liver weight of males and females), degradation (gonad weight of females), and no change (body weight). Although the observed patterns may be associated with closure of the mill, some differences were also found at regional locations, suggesting roles of additional stressors and challenging the clear association of change at the Mattagami River exposure site with the closure of the mill. However, fish captured at this location show responses consistent with regional locations, suggesting no residual impacts and highlights the challenges of identifying changes in fish even after large and known interventions. Environ Toxicol Chem 2021;40:162-176. © 2020 SETAC., (© 2020 SETAC.)

The results and interpretations of published Canadian field studies on the reproductive status of fish in waters receiving pulp and paper mill effluent discharges were reviewed. Most of the information was obtained from indicator measurements such as gonad size, fecundity, and serum steroid levels in wild fish sampled at reference and effluent-exposed sites. Difficulties in selecting appropriate sampling sites, natural variability, and the ecological relevance of the indicator measurements were identified as major complicating factors for the interpretation of the field data. Consequently, it was not possible to conclude to what extent, if any, widespread effects on fish reproduction are being caused by pulp and paper mill effluents or that specific manufacturing processes are causing such effects. Further research on the normal variability and predictive capability of reproductive indicators, for example, using an integrated approach (i.e., laboratory testing, mesocosm studies, and field work), is recommended. [ABSTRACT FROM AUTHOR]

Background: The use of the Internet to administer questionnaires has many potential advantages over the use of pen-and-paper administration. Yet it is important to validate Internet administration, as most questionnaires were initially developed and validated for pen-and-paper delivery. While some have been validated for use over the Internet, these questionnaires have predominately been used amongst the healthy general population. To date, information is lacking on the validity of questionnaires administered over the Internet in patients with chronic diseases such as heart failure., Objectives: To determine the validity of three heart failure questionnaires administered over the Internet compared to pen-and-paper administration in patients with heart failure., Methods: We conducted a prospective randomized study using test-retest design comparing administration via the Internet to pen-and-paper administration for three heart failure questionnaires provided to patients recruited from a heart failure clinic in Toronto, Ontario, Canada: the Kansas City Cardiomyopathy Questionnaire (KCCQ), the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and the Self-Care Heart Failure Index (SCHFI)., Results: Of the 58 subjects enrolled, 34 completed all three questionnaires. The mean difference and confidence intervals for the summary scores of the KCCQ, MLHFQ, and SCHFI were 1.2 (CI -1.5 to 4.0, scale from 0 to 100), 4.0 (CI -1.98 to 10.04, scale from 0 to 105), and 10.1 (CI 1.18 to 19.07, scale from 66.7 to 300), respectively., Conclusions: Internet administration of the KCCQ appears to be equivalent to pen-and-paper administration. For the MLHFQ and SCHFI, we were unable to demonstrate equivalence. Further research is necessary to determine if the administration methods are equivalent for these instruments.

Unlabelled: The purpose of this study was to investigate the effects of a hybrid electronic-paper patient record environment upon health professional information seeking (i.e. amount of information accessed, choice of key sources of information, type of information and use of information seeking tactics). A within group, laboratory, experimental study was conducted using two simulation environments (i.e. a paper patient record and a hybrid or electronic-paper environment). Thirty-five novice nurses participated in this within group, laboratory based study. Findings revealed significant differences between the paper and hybrid environments in terms of their effects upon information seeking., Subjects: (1) accessed less data in the hybrid than the paper environment, (2) accessed more non-electronic sources than electronic sources of information in the hybrid environment, and (3) used more passive information seeking tactics in the hybrid than the paper environment. Findings from the cued recall data revealed subjects experienced increased cognitive load in the hybrid environment. Implications for the design of hybrid environments are discussed.

Background: Published studies of triage scale inter-rater reliability assessment have been conducted mostly using paper case scenarios., Objective: To determine if this method of inter-rater reliability assessment generated significantly different measures from those generated from live triage cases., Methods: This was a multicenter, prospective, observational cohort study of a population-based random sample of patients triaged at 2 emergency departments during a period of 4 months. All patients presenting to the emergency department within the study periods were simultaneously and independently triaged using a 5-level triage acuity scale by 2 to 3 research triage nurses blinded to each other's assessment and to the study objective. After 6 months, the same nurses were asked to assign triage scores to paper case scenarios of the same patients that they had each previously triaged., Results: Each of the 9 research nurses triaged approximately 90 cases. The inter-rater reliabilities as measured by an intraclass correlation coefficient were 0.9 (95% CI = 0.87 to 93) for the live triage assessments and 0.76 (95% CI = 0.73 to 0.79) for the paper case scenarios. The mean triage score assigned to the live cases was significantly less than that assigned to the paper-based cases (3.17; 95% CI = 3.08 to 3.26) (p < 0.001)., Conclusions: There is moderate to high agreement between live cases and paper case scenarios, and the inter-rater reliabilities, although significantly different, are acceptable in both cases. It is impossible to determine which triage setting provides a more accurate triage score but paper case scenarios generally receive lower triage scores than live cases.

A bleached kraft pulp mill discharging effluent to the Mattagami River in northern Ontario, Canada, closed after almost 90 yr of operation. During its operation, effluent from the mill influenced biota in the downstream areas. To assess shifts in the reliance of biota from mill-derived nutrients, the isotopic composition (δ 13 C and δ 15 N) of white sucker (Catostomus commersoni) muscle and whole mayflies (Hexagenia sp.) were compared before (1990s) and after the pulp mill's closure (2012-2014). To better understand other potential sources of spatial and temporal change, samples from 3 other tributaries in the basin with dams, ongoing pulp mill operations, sites receiving sewage, and at several reference sites were collected and compared. Irrespective of time period, biota collected at sites downstream of both dams and active pulp mills tended to have elevated δ 13 C values, but variable changes in δ 15 N (negligible in most cases) when compared with upstream samples. The isotopic composition of mayflies varied at reference sites over time, with decreasing values of δ 13 C and δ 15 N (mayflies only) with increasing depth, and there was evidence of lower δ 13 C in fish after the pulp mill closure. Overall, these results suggest the importance of long-term, regional-scale measurements for documenting the effects of stressors on nutrient use by aquatic species. Environ Toxicol Chem 2020;39:1207-1218. © 2020 SETAC., (© 2020 SETAC.)

Comments on the six papers presented at the Symposium on the Ontario Experience which represent a valuable contribution to the literature on health services research and on treatment systems. Comparison of the Ontario assessment and referral (A/R) centers for addicts to a transistor; Crucial importance of determining outcome; Flow diagrams and design document.

Describes the planning, implementation and assessment of the Term Paper Clinic (TPC) reference service in academic libraries due to shrinking budgets and expanding enrollments. Exploration of innovative ways in academic libraries to provide individualized services to clients; Conduction of the TPC for undergraduates at the University of Toronto.

Discusses abstracts of research papers to be presented at the fifteenth annual meeting of the American Society of Primatologists at Glendon College of York University in Toronto, Ontario on June 19-21, 1992. Ultrasonic imaging of ovarian dynamics during the menstrual cycle in rhesus monkeys; Endocrine and behavioral constraints on reproduction in subordinate male common marmosets; Successful implementation of the video-task paradigm with a squirrel monkey.

The focus of this paper is to present an inductively derived substantive theory, "Negotiating Uncertainty". The theory details the most salient concerns of families who had a close relative who had suffered a severe TBI and how they dealt with the experience during the uncertain trajectory of illness that followed coma. This study was conducted in two acute care neurosurgical units in Level 1 trauma facilities in Toronto, Canada, using the grounded theory research method. There were a total of 36 participants in the study: 11 individuals who were injured and 25 close family members. Supporting data is provided to permit the reader to hear the issues of family members first-hand and to evaluate the recommendations for practice, education, and research.

This paper applies crip theory (McRuer, 2006, 2018) as well as other key conceptual tools from disabled childhood studies (Runswick-Cole et al., 2018) and disability studies in education (Cousik & Maconochie, 2017) as a tactic intended to question and resist the story of overcoming as it manifests itself within the discourses and practices of self-regulation in early learning classrooms. This paper offers a brief overview of the range of self-regulation strategies enacted within educational settings in Ontario, Canada, that purport to support young children in overcoming themselves on their way to normalcy. This paper also engages in crip theory as a strategy to both question and disrupt the taken for granted assumption that self-regulation entails a return towards or a sustaining of the efficient and productive neoliberal individual in school systems. Finally, this paper considers how we might not only invite but embrace the disruptions that occur when embodied differences refuse to be overcome by demands to self-regulate. Ultimately, a key aim of this paper is to resist how discourses and practices of self-regulation in Early Childhood Education and Care (ECEC) establish the overcoming narrative as a means to cure, fix or exclude embodied differences while contemplating the vibrant possibilities embedded within learning with and from disabled childhoods. [ABSTRACT FROM AUTHOR]

This review of the evidence of the health effects of air pollutants focuses on research conducted in Ontario. Seven key Ontario studies are cited. These findings are highly significant for people living in the Great Lakes basin (and particularly the Windsor-Quebec corridor), where high levels of certain air pollutants (eg, ground-level ozone and ultra-fine particles) occur more frequently than in other parts of Canada. The issue is a serious one, requiring an integrated and comprehensive approach by many stakeholders, including the active involvement of organized medicine. It is important that the health effects of these air pollutants are understood. Governments must act to reduce emission levels through statue and regulation bolstered by noncompliance penalties. The findings of research have included the following: in a Toronto study, a 2% to 4% excess of respiratory deaths were attributable to pollutant levels; children living in rural Ontario communities with the highest levels of airborne acids were significantly more likely to report at least one episode of bronchitis, as well as to show decreases in lung function; and have been linked to increases in pollutants, emergency room visits and hospitalizations in Ontario. Every Ontarian is affected by air pollutants, although he or she may be unaware of the asymptomatic effects such as lung and bronchial inflammation. This health problem is preventable; while physicians know of the adverse health impacts of air pollution and they are concerned, individually they now focus on the treatment of symptoms. The major recommendations of the report are as follows: Enactment of more stringent sulphur and nitrogen oxide emission limits, including a provincewide sulphur dioxide reduction of 75% from current cap levels, and the maximum allowable nitrogen oxides emission limits of 6000 tonnes annually from Ontario Hydro. New transportation sector emission limits that should include California-level standards for light and heavy duty vehicles, reductions from off-road engines, an expanded vehicle inspection and maintenance program, and tougher standards for sulphur-in-fuel content. Petitioning the United States Environmental Protection Agency administrator under Section 115 of the United States Clear Air Act to require reductions in the American emission of sulphur dioxide and nitrogen oxides, which damage the health of Canadian residents and their environment. Physician advice to patients about the risks of smog exposure, physician support for more health effects research on air pollution, and physician promotion of the development of air pollution-related health education materials. The recommendations discussed in this paper will, if acted upon, lead to a significant reduction in the overall burden of illness from air pollutants, especially in children and the elderly. These recommendations have been selected from a review of recommendations made by various authorities, and are those that the OMA feels a particular responsibility to support.

The article presents a call for persons interested in presenting a paper at the 1998 meeting of the American Association for the History of Medicine (AAHM). The 1998 meeting of the AAHM will be held May 7 through 10, 1998, in Toronto, Ontario. Those interested in presenting a paper at this meeting are invited to submit an abstract, with seven copies of the original format. Any subject in the history of medicine is suitable for presentation, but the paper must represent original work not already published or in press. Presentations are limited to 20 minutes. Abstracts must be typed single-spaced on one sheet of paper and must not exceed 350 words in length. Abstracts should include not only a statement of a research question but also findings and conclusions to allow assessment by the committee.

Ethnographic researchers have long relied upon observation as a powerful means to learn about social relations. This paper discusses research observation that was conducted as a part of an institutional ethnography (IE) investigating how people use the language and ideas of neurodiversity across different settings. While our research protocol initially called for ethnographic observation to take place at in-person events in Southern Ontario, our approach needed to be re-formulated with the switch to online events during the COVID-19 pandemic. After the shift to online-only spaces, a total of 52 sessions at 7 online events related to neurodiversity or autism were observed by a team of 5 researchers: these events were no longer geographically restricted but were officially "hosted" by institutions in Canada, the US, and the UK. This paper reflects upon the challenges and opportunities we encountered as we conducted observations in digital spaces, including our experiences of navigating the "chat" feature. We discuss the need to analyze the format as well as the content of online events, and present findings on how neurodiversity appeared in these social spaces. Finally, we consider the implications of this research for people who are conducting ethnographic observation in an increasingly online world. [ABSTRACT FROM AUTHOR]

Based upon qualitative interviews with 54 women and men living with HIV across Ontario, Canada, this paper examines the impact of HIV criminalization on the sexual and romantic relationships of people living with HIV. This research highlights the navigation strategies people living with HIV create and employ to both navigate and protect themselves from the law. Through a thematic and intersectional analysis, this study shows how adoption of these strategies is unequal, with access to navigation strategies varying along lines of gender, race, and sexual orientation. As a result, women and racialized people living with HIV face more difficulties navigating the impact of the law. HIV criminalization in Canada fuels and validates HIV stigma and produces vulnerability both within and outside of the relationships of people living with HIV. This paper seeks to understand HIV criminalization from the perspective of those governed by the law, in hopes of producing knowledge which will contribute to legal reform, inform policy, and support the development of efficacious secondary prevention initiatives. [ABSTRACT FROM AUTHOR]

Since the early 2000s, plant closures have been a significant concern in Ontario, Canada. Scholars and policymakers alike aim to investigate the causes of plant closures and determine how to mitigate their impacts. Despite the large body of literature on plant closures, local economic development practitioners' perspectives and experiences have been neglected. To fill this gap, this paper interviewed twenty-two practitioners from various cities in Ontario to understand how practitioners perceive and respond to plant closures. The findings provide a comprehensive overview of the various dynamics of plant closures. Also, based on the findings, seven policy recommendations are presented. [ABSTRACT FROM AUTHOR]

This paper focuses on how social group work is integral to teaching and learning about critical reflection on practice (CRoP), on three different levels. The paper provides an overview of the theory and practice of CRoP, followed by a description of group work in two MSW CRoP course sections at a school of social work in Ontario, Canada. The paper describes the process of integrating CRoP into practicum integration seminar groups to sustain skills in critical reflection, as well as our own group process in our small faculty research and teaching group. By integrating group work and critical reflection literature and by focusing on the development of critical acceptance and mutual aid, this paper will outline benefits, challenges, and opportunities related to the use of groups in facilitating the CRoP process, along with next steps and further discussion. [ABSTRACT FROM AUTHOR]

Presents information on forest policy and research papers submitted at a conference held at Carleton University in Ottawa, Ontario in October 2000. Names of reviewers and conference organizers; List of researchers and overview of their research.

The article offers information on an invite for presenting papers in an oral presentation on the 31st Electrical Insulation Conference (EIC) which will be held in Ontario, Canada from June 2-5, 2013.