Journal articles on the topic 'Regional planning – Ontario – Vaughan'
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Vavakova, Blanka, and David A. Wolfe. "Regional innovation policy: Rhône‐alpes and Ontario." Regional & Federal Studies 9, no. 3 (September 1999): 107–29. http://dx.doi.org/10.1080/13597569908421099.
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Lipsett-Moore, Geoff, Dan McKenney, and Scott Jones. "Multi-scale species modelling in Ontario: A workshop on needs and opportunities." Forestry Chronicle 79, no. 1 (February 1, 2003): 147–48. http://dx.doi.org/10.5558/tfc79147-1.
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A workshop on multi-scale species modelling was recently held in Sault Ste. Marie, Ontario. We reviewed Australian experiences with this type of spatial modelling (including development and validation of different approaches) and current needs, activities and impediments to species modelling in Ontario. Multi-scale species modelling can support regional conservation planning, the design of monitoring activities, forest planning and indicator development. Several recommendations were generated. Key words: spatial modelling, GLM, GAM, monitoring, indicators, conservation planning
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Glaves, Richard, and Peter R. Waylen. "REGIONAL FLOOD FREQUENCY ANALYSIS IN SOUTHERN ONTARIO USING L-MOMENTS." Canadian Geographer / Le Géographe canadien 41, no. 2 (June 1997): 178–93. http://dx.doi.org/10.1111/j.1541-0064.1997.tb01157.x.
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GLAVES, RICHARD, and PETER R. WAYLEN. "REGIONAL FLOOD FREQUENCY ANALYSIS IN SOUTHERN ONTARIO USING L-MOMENTS." Canadian Geographer/Le Géographe canadien 43, no. 1 (March 1999): 104. http://dx.doi.org/10.1111/j.1541-0064.1999.tb01364.x.
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Rasmussen, Tove, and George G. Mulamoottil. "Environmentally-sensitive Area Planning in Ontario: Status and Problems in Implementation." Environmental Conservation 18, no. 3 (1991): 219–27. http://dx.doi.org/10.1017/s037689290002213x.
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Increasing public awareness of the need to protect Environmentally Sensitive Areas (ESAs), as well as the establishment of regional municipalities, provided the impetus for local governments to initiate ESA planning in Ontario. As of 1981, twenty municipalities—primarily regional municipalities and counties—had adopted ESA programmes.This paper examines the current status of ESA-protection planning in Ontario and the problems encountered by municipalities in adopting and implementing ESA programmes. Using a questionnaire survey, data were collected concerning 66 municipalities, and a review was carried out of the ESA policies in 36 Official Plans. The results show that an additional 11 municipalities have adopted ESA programmes since 1981, and that most of these have been designated cities. The primary problems encountered by municipalities in implementing ESA-protection programmes have been a lack of landowner support, weakness of any provincial policy-directive, and shortness of funding. These problems are also faced by uninvolved municipalities, and play an important role in preventing them from adopting ESA programmes.If a wider municipal adoption of ESA programmes is to be achieved, a stronger commitment will be needed from the Provincial Government in the form of guiding policies, financial assistance, and incentives to landowners who wish to protect their sensitive lands. A greater emphasis on landowner contact and public education programmes will also be required. Municipalities should cooperate with other conservation agencies and organizations in working towards this end.
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Kirchhoff, Denis, Dan McCarthy, Debbe Crandall, and Graham Whitelaw. "Strategic environmental assessment and regional infrastructure planning: the case of York Region, Ontario, Canada." Impact Assessment and Project Appraisal 29, no. 1 (March 2011): 11–26. http://dx.doi.org/10.3152/146155111x12913679730430.
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Buzzelli, Michael. "Exploring Regional Firm-Size Structure in Canadian Housebuilding: Ontario, 1991 and 1996." Urban Geography 25, no. 3 (May 2004): 241–63. http://dx.doi.org/10.2747/0272-3638.25.3.241.
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Mabee, Warren E., and Jaconette Mirck. "A Regional Evaluation of Potential Bioenergy Production Pathways in Eastern Ontario, Canada." Annals of the Association of American Geographers 101, no. 4 (July 2011): 897–906. http://dx.doi.org/10.1080/00045608.2011.568878.
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Ray, D. Michael, Ian MacLachlan, Rodolphe Lamarche, and KP Srinath. "Economic shock and regional resilience: Continuity and change in Canada's regional employment structure, 1987–2012." Environment and Planning A: Economy and Space 49, no. 4 (December 6, 2016): 952–73. http://dx.doi.org/10.1177/0308518x16681788.
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This article analyses regional resilience to economic shock in Canada from 1987 to 2012, a period that included severe recessions and major free-trade agreements. Employment is cross-tabulated by region, industry and gender and partitioned cumulatively using three-way multifactor partitioning for each period from 1987–1988 to 1987–2012. Employment loss in each recession is found to be more closely associated with industry-mix in the preceding growth period than with the region effect. At each recession, manufacturing had much bigger employment losses and a much weaker recovery than business services. Thus manufacturing amplifies economic shocks, while business services act as regional shock absorbers. Manufacturing employment decline in Ontario was influenced by trade liberalization and far exceeds what would be expected from the industry and region effects alone. Female employment growth outpaced male employment growth in every region and in every industry group apart from business and appeared to be more resilient to recession. But corrected for their industry composition and regional disparities, these gender differences are substantially reduced.
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Wang, Xiuquan, Guohe Huang, Qianguo Lin, and Jinliang Liu. "High-Resolution Probabilistic Projections of Temperature Changes over Ontario, Canada." Journal of Climate 27, no. 14 (July 10, 2014): 5259–84. http://dx.doi.org/10.1175/jcli-d-13-00717.1.
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Abstract Planning of mitigation and adaptation strategies to a changing climate can benefit from a good understanding of climate change impacts on human life and local society, which leads to an increasing requirement for reliable projections of future climate change at regional scales. This paper presents an ensemble of high-resolution regional climate simulations for the province of Ontario, Canada, developed with the Providing Regional Climates for Impacts Studies (PRECIS) modeling system. A Bayesian statistical model is proposed through an advance to the method proposed by Tebaldi et al. for generating probabilistic projections of temperature changes at gridpoint scale by treating the unknown quantities of interest as random variables to quantify their uncertainties in a statistical way. Observations for present climate and simulations from the ensemble are fed into the statistical model to derive posterior distributions of all the uncertain quantities through a Markov chain Monte Carlo (MCMC) sampling algorithm. Detailed analyses at 12 selected weather stations are conducted to investigate the practical significance of the proposed statistical model. Following that, maps of projected temperature changes at different probability levels are presented to help understand the spatial patterns across the entire province. The analysis shows that there is likely to be a significant warming trend throughout the twenty-first century. It also suggests that people in Ontario are very likely to suffer a change greater than 2°C to mean temperature in the forthcoming decades and very unlikely to suffer a change greater than 10°C to the end of this century.
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MCKENNA, MEGAN K. L., and ROGER A. ROBERGE. "Restructuring, gender and employment in flux: a geography of regional change in Cornwall, Ontario." Canadian Geographer/Le Géographe canadien 45, no. 2 (June 2001): 223–36. http://dx.doi.org/10.1111/j.1541-0064.2001.tb01485.x.
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Hertz, Sherrie, Leonard Kaizer, Monika K. Krzyzanowska, Vicky Simanovski, and Kathy Vu. "Developing a culture of safety in systemic cancer treatment at the system level." Journal of Clinical Oncology 31, no. 31_suppl (November 1, 2013): 230. http://dx.doi.org/10.1200/jco.2013.31.31_suppl.230.
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230 Background: Chemotherapy ordering, preparation and delivery involve multiple providers and complex systems where high impact errors may occur. Cancer Care Ontario, a provincial agency responsible for continually improving cancer services in Ontario, Canada employs a comprehensive systematic approach to build a culture of safety for systemic treatment. Methods: A comprehensive strategy is applied at 77 systemic treatment hospitals in the Province. A multi-pronged approach is used that includes: 1) system planning, organization and funding, 2) engagement of health care providers working at the regional and local levels, 3) guidelines implementation and, 4) quality measurement. Results: Institutions are organized into regional networks, according to four levels of service complexity based on quality standards, planning, funding, coordination and health human resources. A customized, system-wide incident reporting system is available. Quality improvement is undertaken in several ways. Regional clinical and administrative leaders foster engagement with local providers and work is facilitated by a provincial multidisciplinary community of practice, an annual Safety Symposium, and local improvement projects with funding support. In this way, collaborative sharing and learning occurs across the Province. Comprehensive evidence-based guidelines have been produced addressing safe labeling, administration, handling and the use of computerized prescriber order entry systems. Routine performance management together with guideline concordance measurement, public reporting, planning for improvement and re-evaluation strategies, has produced system improvements. Conclusions: A comprehensive, evidence-based and systematically applied approach to providing systemic cancer treatment can produce a culture of safety that is coordinated and standardized across multiple providers and provider sites.
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Cocklin, C., S. C. Lonergan, and B. Smit. "Assessing Options in Resource Use for Renewable Energy through Multiobjective Goal Programming." Environment and Planning A: Economy and Space 18, no. 10 (October 1986): 1323–38. http://dx.doi.org/10.1068/a181323.
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Forest-energy plantations have been recognized as a possible source of renewable energy throughout the world, but the regional consequences of extensive plantation development have not been considered. In an effort to understand better the trade-offs that exist between economic, environmental, and energy concerns associated with regional development projects, a goal-programming model of forest-energy plantation development in Eastern Ontario, Canada has been developed. The results indicate not only the potential for energy plantations, but the utility in using goal-programming as a resource-assessment tool as well. The method is particularly useful in identifying potential conflicts among regional development goals, and can also address uncertainties with respect to decision priorities and production relationships.
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Milkovich, John, Tim Hanna, Carolyn Nessim, Teresa M. Petrella, Louis Weatherhead, An-Wen Chan, Jonathan C. Irish, et al. "Restructuring Skin Cancer Care in Ontario: A Provincial Plan." Current Oncology 28, no. 2 (March 12, 2021): 1183–96. http://dx.doi.org/10.3390/curroncol28020114.
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There is a global rise in skin cancer incidence, resulting in an increase in patient care needs and healthcare costs. To optimize health care planning, costs, and patient care, Ontario Health developed a provincial skin cancer plan to streamline the quality of care. We conducted a systematic review and a grey literature search to evaluate the definitions and management of skin cancer within other jurisdictions, as well as a provincial survey of skin cancer care practices, to identify care gaps. The systematic review did not identify any published comprehensive skin cancer management plans. The grey literature search revealed skin cancer plans in isolated regions of the United Kingdom (U.K.), National Institute for Health and Care Excellence (NICE) guidelines for skin cancer quality indicators and regional skin cancer biopsy clinics, and wait time guidelines in Australia and the U.K. With the input of the Ontario Cancer Advisory Committee (CAC), unique definitions for complex and non-complex skin cancers and the appropriate cancer services were created. A provincial survey of skin cancer care yielded 44 responses and demonstrated gaps in biopsy access. A skin cancer pathway map was created and a recommendation was made for regional skin cancer biopsy clinics. We have created unique definitions for complex and non-complex skin cancer and a skin cancer pathways map, which will allow for the implementation of both process and performance metrics to address identified gaps in care.
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Pang, Jocelyn, Christina D’Antonio, Esti Heale, Philip Boll, Peter Blake, Jenna M. Evans, and Michelle Hladunewich. "Provincial Needs Assessment to Determine the Current State of Glomerulonephritis Care in Ontario." Canadian Journal of Kidney Health and Disease 6 (January 2019): 205435811987740. http://dx.doi.org/10.1177/2054358119877405.
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Background: Despite its relative rarity, glomerulonephritis (GN) accounts for 20% of prevalent end-stage renal disease patients in Ontario. Early identification and appropriate management of GN to delay progression of disease can reduce patient morbidity and health system costs. As such, a provincial GN needs assessment was conducted to inform on the development of the provincial GN strategic framework in Ontario. Objective: To understand the current state of GN care in Ontario from nephrologist, hospital administrator, and patient and family perspectives. Design: Cross-sectional. Settings: 26 regional renal programs in Ontario. Patients: 23 patients and family members living with GN who do not require renal replacement therapy. Measurements: Patient and family member interviews as well as a survey of nephrologists. Methods: The study included 3 components: (1) interviews with patients and family members, (2) a survey of nephrologists, and (3) interviews with regional renal programs. The Ontario Renal Network provincial office developed the needs assessment questions and the physician survey questions after consultation with practicing nephrologists and hospital administrators. Thematic analysis was used to assess interview data and descriptive statistics to assess survey data. Results: Interviews with patients and family members (n = 23) identified gaps in care related to diagnosis and referral to nephrology care, education and decision-making, and psychosocial supports. The survey of nephrologists (n = 74) identified various issues that contribute to unstandardized GN care across Ontario, including a lack of provincial expertise in providing complex GN care, access to medication, multidisciplinary team support as well as patient education, and psychosocial supports. Interviews with regional renal programs aligned with interview and survey findings (n = 11). Limitations: Interviews with patients and family members were facilitated by 1 interviewer and limited to 20 interviews due to resource limitations. All nephrologists, patients, and family members who participated in the survey and interviews were volunteers and English-speaking, which may have resulted in self-selection bias. Conclusions: The provincial GN needs assessment emphasized the necessity to develop and implement a provincial GN strategy. The strategic framework includes 4 objectives: (1) ensure patients are supported to make informed decisions, (2) establish a provincial model of care, (3) leverage data to enable planning, decision-making, and monitoring of outcomes, and (4) ensure appropriate access to medication. This is the first Ontario strategy to address provincial gaps in GN care.
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Puric-Mladenovic, Danijela, and Silvia Strobl. "Designing natural heritage systems in southern Ontario using a systematic conservation planning approach." Forestry Chronicle 88, no. 06 (December 2012): 722–35. http://dx.doi.org/10.5558/tfc2012-138.
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Landscape planning in settled landscapes includes identifying larger areas of natural vegetation to be conserved protected and/or managed for various environmental and public services. These “green backbones” of the landscape, called Natural Heritage Systems (NHS) in the settled landscapes of southern Ontario, Canada, should have appropriate land use planning and natural areas management actions and related policies to protect and enhance biodiversity and ecological functions. As such, an NHS should be derived using a rigorous and defensible methodology while ensuring public involvement and input during this process. This paper describes the methodology for regional NHS design currently being implemented by OMNR in collaboration with numerous conservation partners and municipalities in southern Ontario. The methodology combines the principles and methods of landscape planning, conservation planning, and spatial analysis, while ensuring that the process is adaptable and repeatable over time and different scales. For each landscape, explicit and transparent conservation objectives, features and targets are identified based on stakeholder inputs. Numerous conservation and restoration objectives are translated into explicit quantitative targets for each analysis unit, and a mathematical optimization algorithm is used to represent all the targets at minimal cost (least land area). The methodology is illustrated using examples from a pilot study in Ecodistrict 7E–5 with some references to ongoing NHS implementation projects as well as potential applications of this method.
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KIRCHHOFF, DENIS, DAN MCCARTHY, DEBBE D. CRANDALL, LAURA MCDOWELL, and GRAHAM WHITELAW. "A POLICY WINDOW OPENS: STRATEGIC ENVIRONMENTAL ASSESSMENT IN YORK REGION, ONTARIO, CANADA." Journal of Environmental Assessment Policy and Management 12, no. 03 (September 2010): 333–54. http://dx.doi.org/10.1142/s1464333210003632.
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Government agenda setting has been a focus of research in the field of policy sciences for over two decades. The concept of a policy window is explored as a driver of governmental agenda setting. The Regional Municipality of York, Ontario, Canada was chosen as a case study for exploring the application of strategic environmental assessment at the municipal level through a policy window lens. Problem, policy and political streams converged to provide the necessary conditions for improved environmental assessment and infrastructure planning in York Region. A focusing event and the resulting crisis motivated stakeholders to identify and act on the problem. An SEA-type approach was initiated as one key response. A variety of activities were initiated by York Region including the development of a Sustainability Strategy, synchronisation of master planning, wider consideration of alternatives at the master plan level and improved public consultation. Conclusions are drawn and several recommendations are presented and discussed.
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McLeod, Fraser, Leela Viswanathan, Jared Macbeth, and Graham S. Whitelaw. "Getting to Common Ground: A Comparison of Ontario, Canada’s Provincial Policy Statement and the Auckland Council Regional Policy Statement with Respect to Indigenous Peoples." Urban Planning 2, no. 1 (April 3, 2017): 72–87. http://dx.doi.org/10.17645/up.v2i1.850.
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Indigenous rights are crucial to contemporary land use planning and policy in settler states. This article comparatively analyzes the manifest and latent content of the 2014 Provincial Policy Statement of Ontario, Canada (PPS) and the 1999 Auckland Council Regional Policy Statement of Aotearoa New Zealand (ACRPS) in order to evaluate their relative capacity to recognize the rights of Indigenous peoples. While the results show that jurisdiction is an impediment to fostering common ground between Indigenous peoples and settler states, the authors conclude that the PPS and the ACRPS serve vital roles in building dialogue and equitable planning outcomes.
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Wang, Shuo, Jinxin Zhu, Gordon Huang, Brian Baetz, Guanhui Cheng, Xueting Zeng, and Xiuquan Wang. "Assessment of climate change impacts on energy capacity planning in Ontario, Canada using high-resolution regional climate model." Journal of Cleaner Production 274 (November 2020): 123026. http://dx.doi.org/10.1016/j.jclepro.2020.123026.
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De Sousa, Christopher. "Trying to Smart-In-Up and Cleanup Our Act by Linking Regional Growth Planning, Brownfields Remediation, and Urban Infill in Southern Ontario Cities." Urban Planning 2, no. 3 (August 24, 2017): 5–17. http://dx.doi.org/10.17645/up.v2i3.1026.
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The reuse of brownfields as locations for urban intensification has become a core strategy in government sustainability efforts aimed at remediating pollution, curbing sprawl and prioritizing renewal, regeneration, and retrofitting. In Ontario, Canada’s most populous, industrialized, and brownfield-laden province, a suite of progressive policies and programs have been introduced to not only facilitate the assessment and remediation of the brownfields supply, but to also steer development demand away from peripheral greenfields and towards urban brownfields in a manner that considers a wider regional perspective. This article examines the character and extent of brownfields infill development that has taken place in three Ontario cities (Toronto, Waterloo, and Kingston) since the provincial policy shift in the early 2000s. Using property assessment data and cleanup records, the research finds that redevelopment activity has been extensive in both scale and character, particularly in Toronto where the real estate market has been strong. While the results are promising in terms of government efforts to promote smarter growth that builds “in and up” instead of out, they also reveal that government could be doing more to facilitate redevelopment and influence its sustainability character, particularly in weaker markets.
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Sándor, George Kb, Howard M. Clarke, Hugh G. Thomson, and Ronald M. Zuker. "Pediatric Burns: A Decade Later." Canadian Journal of Plastic Surgery 5, no. 4 (December 1997): 210–12. http://dx.doi.org/10.1177/229255039700500404.
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The Hospital for Sick Children, Toronto, Ontario serves as a regional pediatric burn centre for metropolitan Toronto and the province of Ontario. The demographics and outcomes of the admissions of burn patients are reviewed periodically to help in future planning of resources and preventive strategies. This study was designed to review recent admissions and detect trends of the past decade by comparing admission and outcome data from two cohorts: one from 1986 to 1988 and one from 1977 to 1979. The number of admissions increased during the past decade. There was a lower proportion of patients with flame burns and a higher proportion with scald burns. This may be due to a combination of preventive measures and changing demographics. The overall mortality rate decreased from 2.2% in the previous decade to 0.78% in the past decade.
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Moody, Lesley, Suman Dhanju, Sarah Benn, Isabela Olaru, Nadia Sliz, Amy Snow, Sara Khan, and Simron Singh. "Systematically implementing an electronic platform to improve patient experience measurement in Ontario, Canada." Journal of Clinical Oncology 35, no. 8_suppl (March 10, 2017): 111. http://dx.doi.org/10.1200/jco.2017.35.8_suppl.111.
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111 Background: Cancer Care Ontario organizes and ensures quality cancer care for 13.5 million residents in Ontario, Canada and is systematically deploying a web-based tool, called Electronic Patient Reported Experience Measures (ePREM), through a touch-screen platform previously deployed within Regional Cancer Centres (RCCs). ePREM has been used to disseminate the first patient reported experience measure (PREM), called Your Voice Matters (YVM). YVM will be collected on all patients in Ontario undergoing cancer treatment in real time, creating the largest known, linkable patient experience dataset. Methods: Implementation feasibility and readiness was assessed across all 14 Regional Cancer Programs through a provincial assessment which informed the phased implementation. Implementation was rooted in a change management framework: clinical and administrative champions, available resources, existing technical environment and competing program priorities. In March 2016 a four-wave implementation was initiated controlling for readiness and centre volumes, with a focus on extensive stakeholder engagement, tool training, launch and operational support. To date, ePREM is fully operational in 10 of 15 RCCs. Results: Provincial deployment was 66% complete in October 2016. By March 2017 full provincial implementation will be complete. Successful implementation has been directly linked to an adaptive design within the implementation and change management framework as a four-wave roll out. Key factors included: multi-faceted communications with centre leadership, and implementation teams. During this initial data stabilization phase, there were 9,266 completed surveys submitted and 10,932 partial survey responses submitted. Conclusions: PREMs are appropriate quality improvement indicators for cancer patients within the treatment phase. ePREMs enables systematic, linkable collection of real time PREMs to improve the patient experience in Ontario and contribute to the planning of new initiatives. Upon full provincial implementation ePREMs will allow for the largest known dataset of PREMs. Successful implementation has been directly linked to an adaptive, four-wave approach.
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Morgan, Thomas D., Carly F. Graham, Andrew G. McArthur, Amogelang R. Raphenya, Douglas R. Boreham, Richard G. Manzon, Joanna Y. Wilson, et al. "Genetic population structure of the round whitefish (Prosopium cylindraceum) in North America: multiple markers reveal glacial refugia and regional subdivision." Canadian Journal of Fisheries and Aquatic Sciences 75, no. 6 (June 2018): 836–49. http://dx.doi.org/10.1139/cjfas-2016-0528.
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Round whitefish (Prosopium cylindraceum) have a broad, disjunct range across northern North America and Eurasia, and little is known about their genetic population structure. We performed genetic analyses of round whitefish from 17 sites across its range using nine microsatellites, two mitochondrial DNA (mtDNA) loci, and 4918 to 8835 single-nucleotide polymorphism (SNP) loci. Our analyses identified deep phylogenetic division between eastern and western portions of the range, likely indicative of origins from at least two separate Pleistocene glacial refugia. Regionally, microsatellites and SNPs identified congruent patterns in subdivision, and population structure was consistent with expectations based on hydrologic connectivity. Within the Laurentian Great Lakes, Lake Huron and Lake Ontario were identified as key areas of interest. Lake Huron appears to be a contemporary source population for several other Great Lakes, and Lake Ontario contains a genetically discrete group of round whitefish. In all cases, multiple genetic markers yielded similar patterns, but SNPs offered substantially enhanced resolution. We conclude that round whitefish have population subdivision on several scales important for understanding their evolutionary history and conservation planning.
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Dobranowski, Julian, Saul Melamed, Deanna Langer, and Colleen Bedford. "The cancer imaging program quality framework at Cancer Care Ontario: The first five years." Journal of Clinical Oncology 32, no. 30_suppl (October 20, 2014): 244. http://dx.doi.org/10.1200/jco.2014.32.30_suppl.244.
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244 Background: The Cancer Imaging Program (CIP) at Cancer Care Ontario was established in 2009 to improve the quality of cancer imaging in Ontario. Methods: After initial selection of a Provincial clinical lead in 2009, fourteen regional clinical leads were selected to represent all geographical regions of the province. Through a stakeholder survey and a priority setting process the following four high-level areas of priority emerged to support quality improvement of cancer imaging: (1) Developing and Fostering an Imaging Community of Practice, (2) Imaging Appropriateness, (3) Timely Access to Imaging, and (4) Standardized/Synoptic Reporting. Results: (1) An Imaging Community of Practice was established with the regional clinical leads, who participate in monthly meetings to build and strengthen inter-regional relationships and share information on regional activities and priorities; (2) Best practice standards for imaging in lung and colorectal cancer have been developed by consolidating and endorsing national and international guidelines. New imaging guidelines are being developed by the Program in Evidence-Based Care. Evidence-based recommendations being developed for focal tumour ablation procedures; (3) Three Interventional Radiology procedures (CT-guided lung biopsies, peripherally inserted central catheters and portacaths) have been selected for an ongoing wait time collection that captures monthly point-in-time data. The data has initiated discussions on appropriate benchmarks and identification of factors that may contribute wait times; and (4) Synoptic Radiology Reporting enables the collection of uniform and complete data to improve the information available to referring clinicians for diagnosis and treatment planning. Work is underway in the development of: implementation roadmap, evidence-based clinical checklists, infrastructure to store and share synoptic reports, and international standards for synoptic radiology reporting. Conclusions: The establishment of the CIP as a clinical program under a provincial cancer agency has enabled the development of an Imaging Community of Practice and allowed for work on provincial-wide initiatives that enable quality improvement of cancer imaging.
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MARTIN, LARRY R. G., STEPHEN D. MURPHY, and SOONYA P. Quon. "Effective Planning and Implementation of Ecological Rehabilitation Projects: A Case Study of the Regional Municipality of Waterloo (Ontario, Canada)." Environmental Management 27, no. 3 (March 1, 2001): 421–33. http://dx.doi.org/10.1007/s002670010159.
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Gutierrez, Eric, Padraig Richard Warde, Dianne Belfour-Barnett, Garth Matheson, Elaine Meertens, and Lisa Favell. "Development of a capital investment strategy for radiation (RT) equipment in Ontario." Journal of Clinical Oncology 31, no. 31_suppl (November 1, 2013): 279. http://dx.doi.org/10.1200/jco.2013.31.31_suppl.279.
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279 Background: To ensure appropriate access to radiation treatment (RT) for Ontario cancer patients for the next decade and that future capital investments in radiation equipment are appropriately timed and strategically placed, Cancer Care Ontario (CCO) has updated its RT Capital Investment Strategy. The strategy was designed around 4 core principles: i) recognizing treatment machine capacity should match the demand resulting from increasing cancer incidence rates and increasing utilization rates as per CCO goals; ii) keeping pace with advancing technology; iii) ensuring value for money by maximising the use of current infrastructure; and iv) minimizing costs through centralized planning and procurement processes. Methods: A multidisciplinary provincial expert panel reviewed and revised the planning parameters used to project treatment demand and required capacity (including fractions of RT per treated case, number of cases treated per hour, uptime of treatment units). The panel reviewed current practice, impact of new and emerging treatment technologies and benchmarks from other jurisdictions. To project the future demand for radiation therapy, growth in cancer incidence (by county) as well as modest improvement in RT utilization rates were assumed. Results: Recommendations included: i) moving to 12-hour treatment days in all large centres and on 50% of equipment in centres operating fewer than 6 treatment units; ii) ensuring appropriate funding for the replacement of existing RT equipment; iii) equipping constructed rooms in 4 regional cancer centers – thereby adding 6 linacs; iv) equipping swing bunkers across the province – thereby adding 10 linacs; and v) planning for the construction of new facilities to add RT capacity in 3 regions of the province. Conclusions: Funding to implement recommendations from previous capital investment strategies has resulted in an equitable distribution of RT resources across the province. We believe the planning strategies and recommendations outlined in the strategy will improve access to quality RT care as close to home as feasible for Ontario patients.
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Penner, Margaret, Murray Woods, John Parton, and Al Stinson. "Validation of empirical yield curves for natural-origin stands in boreal Ontario." Forestry Chronicle 84, no. 5 (October 1, 2008): 704–17. http://dx.doi.org/10.5558/tfc84704-5.
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In Ontario, yield tables for forest management planning have remained relatively unchanged since initial work in the 1950s that was based on a limited number of temporary sample plots. In 2000, the Forestry Research Partnership accelerated work on the Benchmark Yield Curve Project (initiated several years earlier by the Ontario Ministry of Natural Resources, OMNR) to update these tables. The resulting yield curves incorporated data from more than 3000 permanent sample plots (PSPs) maintained in Ontario as well as PSPs from neighbouring and ecologically similar jurisdictions. Two stratifications were considered: OMNR’s Northeast Region standard forest units and leading species. The 10 forest units considered cover the major commercial species in the boreal forest in Ontario. Equations were fit to the data to predict the growth and yield by stratum. The equations were validated against independently collected data and compared to predictions from the current wood supply yield curves in Ontario: Plonski’s yield tables, modified Plonski, and northeast regional curves. Results of the validation showed that, with the exception of the MW2 and SF1 forest units, the new yield curves generally had less bias for gross total volume than Plonski and modified Plonski. Results for net merchantable volume were consistent with those for gross merchantable volume. The MW2 and SF1 forest units are more mixed in terms of species type, species light tolerance, and age. A leading species approach resulted in better predictions and is recommended for these forest units. Key words: wood supply, benchmark yield curves, mixedwood yield, yield model, Forestry Research Partnership
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Ang, Michelle, Eric Gutierrez, Nicoda Foster, Lisa Favell, and Padraig Richard Warde. "Improving radiotherapy utilization rates in Ontario." Journal of Clinical Oncology 32, no. 30_suppl (October 20, 2014): 48. http://dx.doi.org/10.1200/jco.2014.32.30_suppl.48.
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48 Background: Radiotherapy (RT) utilization is the proportion of patients (Pts) with a new diagnosis of carcinoma that receives at least one course of RT during the duration of their illness (MacKillop et al). In Ontario, the benchmark for utilization is 42%, and the target rate for Cancer Care Ontario (CCO) is 48%. However in 2005/06 Ontario’s utilization rate was only 35%. This shortfall implies that a significant number of Pts in Ontario were not receiving the best possible treatment. Methods: CCO has developed Capital Investments Strategies to take into account a growing population, an increased incidence of cancer (2.7% per annum), and changing demographics. The most recent (2012) has developed a plan for a gradual improvement in utilization at a rate of 0.5% per annum. With support from the Ministry of Health and Long-Term Care (MOHLTC), the amount of RT Units (RTUs) available increased from 77 (2005/06) to 103 (2013/14). In addition, the MOHLTC supported training programs for provincial Medical Physicists and Radiation Therapists to ensure effective staffing for increased RTUs. Results: Due to investments in RTUs and training, the number of Pts treated in Ontario has risen over 38% from 26,448 in 2005/06 to 36,613 in 2012/13. As a result, provincial utilization rates have risen from 35.1% in 2004/05 to 38.8% in 2012/13, closer to provincial targets. Notable improvements have been seen in centres such as The Carlo Fidani Peel Regional Cancer Centre, where the total number of RT Pts treated increased from 623 (2005/06) to 2532 (2012/13). Similar improvements are seen in other Local Health Integration Networks where comparable investments have been made. These improvements have been attained at the same time as provincial RT wait times have significantly improved from 80.2% (Jan 2010) to 91.6% (Dec 2012) of Pts seen within targets, exceeding provincial targets of 87%. Conclusions: The increase in RT utilization rates provincially demonstrates the success of developing a comprehensive capital investment strategy and coupling it with increased investments in human resource planning. The increased utilization rate has outpaced the increasing cancer incidence and demonstrates the success of these strategies, providing better access to care for cancer Pts in Ontario.
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Cheng, Siu Mee. "Study of the Local Health Integration Network: impact of Ontario’s Regionalization Policy." Journal of Integrated Care 26, no. 4 (October 15, 2018): 277–85. http://dx.doi.org/10.1108/jica-02-2018-0009.
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Purpose The purpose of this paper is to undertake an examination of the Local Health Integration Network (LHIN) Health Policy proposal. This policy established a decentralized approach to health system management in the province of Ontario, Canada by creating 14 crown agencies, LHINs. Design/methodology/approach This policy is examined against the five policy stages of the Stages Model: agenda setting, formulation, legitimation, implementation and evaluation. The examination was based on a review of grey literature, including key government reports and briefs. Findings This policy did not follow the Stages Model sequentially: the policy was implemented while it was still undergoing its legitimacy phase. Formal reviews were undertaken following implementation and found areas for improvement: poor integration amongst all the LHINs; poor patient navigation persists; LHINs lack the capacity and competency to engage in regional capacity planning; and planning and integration is not centered around patient needs. As a result, a decade after the introduction of LHINs, the Ontario HealthCare System has not achieved systems improvement when measured against accepted government indicators of performance. Originality/value This integration policy highlights the context and evolution of Ontario’s healthcare system governance in the past decade and contributes to the body of knowledge on the impact of regionalization on health systems and patient care.
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Linton, Jonathan D., Julian Scott Yeomans, and Reena Yoogalingam. "Policy Planning Using Genetic Algorithms Combined with Simulation: The Case of Municipal Solid Waste." Environment and Planning B: Planning and Design 29, no. 5 (October 2002): 757–78. http://dx.doi.org/10.1068/b12862.
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Previous research had introduced a genetic algorithm procedure for creating alternative policy options for municipal solid waste (MSW) management planning. These alternatives were generated during the design phase of planning, with the final policy determined in subsequent comparative analysis. However, because of the many uncertain factors that exist within MSW systems, this earlier procedure cannot be applied to situations containing such stochastic components. In this paper, it is shown that a generic algorithm approach can be simultaneously combined with simulation to incorporate these stochastic elements in the policy option generation phase; thereby permitting uncertainty to be directly integrated into the construction of the alternatives during the planning-design phase. This procedure is applied to case data taken from the Regional Municipality of Hamilton–Wentworth in the Province of Ontario, Canada. It can be shown that this procedure extends the earlier approach and provides many practical planning benefits for problems when uncertain conditions are present.
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Gilbert, Julie, Sarah Wheeler, Junell D'Souza, Jonathan Crawford Irish, Elaine Meertens, Vicky Simanovski, and Garth Matheson. "Expansion of high-quality specialized services: The gynecologic oncology experience in Ontario hospitals." Journal of Clinical Oncology 36, no. 30_suppl (October 20, 2018): 39. http://dx.doi.org/10.1200/jco.2018.36.30_suppl.39.
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39 Background: In Ontario’s publicly funded cancer system, patient access to Gynecological Oncology (GyneOnc) care is threatened by growing demand, waiting times and need for lengthy patient travel. Cancer Care Ontario has published organizational standards that lay out the minimum clinical elements and infrastructure needed for a high quality program. Capacity planning and readiness assessments were used to guide GyneOnc expansion into non-academic regional cancer centres to alleviate system pressure. We evaluated early expansion activities to learn about critical factors and generate recommendations for future growth of this specialized oncology service. Methods: Capacity planning for new centres factored health human resources (HHR), patient volume and travel distances, ensuring that existing programs maintain critical mass. Evaluation included review of documents and readiness assessments related to the expansion projects undertaken to date. Interviews were done with GyneOncologists and administrators working at local and provincial levels to discover areas of risk, key factors for success, and recommended strategies for future expansion. Results: Gyne Onc programs need adequate resourcing (minimum 3 GyneOncs) to meet patient demand, support on-call and offer resilience to parental/medical leaves. Programs need engagement from other surgical and medical subspecialties, and clinical services (e.g. pathology, diagnostic imaging) for integrated, multidisciplinary care. Academic appointments, residencies, fellowships, and support for research provide links with universities, important for credibility. Endorsement by senior leadership - both management and clinical - is crucial. Organizational standards need specificity around the infrastructure and multidisciplinary environment needed for program success. Conclusions: HHR planning and readiness assessment are critical enablers in the expansion of specialized services like GyneOnc beyond academic centres. New programs need to consider the adequacy and appropriateness of staffing models, broad engagement of the clinical team, and linkages to academia, in order to ensure program sustainability and acceptability.
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Singh, Simron, Ashley C. Farrelly, Catherine Chan, Narges Nazeri-Rad, Brett Nicholls, Glenn Bauman, Daniela Bellicoso, et al. "Assessing burnout among oncologists in Ontario, Canada." Journal of Clinical Oncology 38, no. 29_suppl (October 10, 2020): 41. http://dx.doi.org/10.1200/jco.2020.38.29_suppl.41.
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41 Background: Provider experience and physician burnout has been recognized as a critical issue in medicine. Ontario, Canada has a single payer cancer system run by Ontario Health (Cancer Care Ontario) with a mandate covering system level planning and delivery of cancer services, funding, and quality improvement. As part of a larger provincial initiative to address clinician burnout, we examined the prevalence and drivers of burnout in practicing physician oncologists in Ontario. Methods: In November-December 2019, surgical, medical, hematological, and radiation oncologists in Ontario were invited to complete an anonymous online survey to assess burnout and its drivers. Burnout prevalence was assessed through the Maslach Burnout Inventory – Human Services Survey for Medical Personnel (MBI-HSS MP). Data on demographic, workplace, engagement, and practice profiles were collected. Logistic regression modeling was conducted to assess key variables associated with “high” burnout using a common definition of high scores on the MBI subscales of emotional exhaustion (EE) (> 27) and/or depersonalization (DP) (>10). Results: Response rate to the survey was 44% (n=418) with 72% reporting high levels of burnout. Mean scores for EE (30.7, SD 12.1) and DP (9.9, SD 6.7) were consistent with high burnout. Participants endorsed known drivers of burnout including: 1) a poor culture of wellness at work (e.g., not comfortable talking to leadership (72%), 2) inefficiencies of practice (e.g. feeling insufficient documentation time (67%)) and 3) personal resilience (e.g. not feeling they are contributing professionally in ways they value (21%)). Age (<45yrs) (OR: 2.15), poor/marginal control over workload (OR: 4.42), feeling used/unappreciated (OR: 2.63), working atmosphere that feels hectic/chaotic (OR: 2.68), and insufficient time for documentation requirements (OR: 2.52) significantly impacted the odds of high burnout in the regression model (p<0.05). Conclusions: The high rate of burnout among oncology physicians in a single payer public cancer system in Ontario is concerning for the wellbeing of providers, patients and system sustainability. Drivers important for maintaining a culture of wellness and efficiency of practice will require local, regional and provincial health policy to improve. Next steps will include raising awareness with provincial initiatives/policy to address key burnout drivers, and examining the impact of working under pandemic conditions (Covid-19) on oncologist burnout.
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Helferty, Natalie. ""Localization": A means to reduce negative transportation impacts in the "natural city"." Ekistics and The New Habitat 71, no. 427-429 (December 1, 2004): 233–35. http://dx.doi.org/10.53910/26531313-e200471427-429193.
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The author runs "Natural Heritage Consulting" in Richmond Hill, Ontario, Canada. She is a former Adjunct Professor at Ryerson University having taught Applied Ecology as a joint program between the School of Occupational and Public Health and the School of Urban and Regional Planning. She has provided environmental policy input on government initiatives such as the formation of the Greenbelt around the City of Toronto in her capacity as a member of the Province of Ontario's Greenbelt Task Force. The text that follows is a revised and edited version of a paper presented by the author at the Natural City conference - "Success Stories" - organized by the Centre for Environment, University of Toronto from 31 May to 2 June, 2006.
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Gertler, M. S., and S. DiGiovanna. "In Search of the New Social Economy: Collaborative Relations between Users and Producers of Advanced Manufacturing Technologies." Environment and Planning A: Economy and Space 29, no. 9 (September 1997): 1585–602. http://dx.doi.org/10.1068/a291585.
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Geographers and other social scientists have paid considerable attention recently to what has been characterized as the increasingly social character of economic activity. Of particular interest has been the rise of more collaborative relations among firms and the formation of territorial production networks predicated upon joint product development and manufacturing, trust-based buyer—supplier interaction, and the freer exchange of proprietary information. Much of the empirical evidence for such claims comes from a relatively small number of regional case studies of particular industries which have enjoyed a high degree of economic success in recent years. At issue, however, is the extent to which such collaborative activity has diffused to other industries and other regions, especially the more mature industrial regions. Furthermore, even in cases where collaborative relationships have been documented, much debate remains over their effectiveness and the kinds of benefits arising from such activity, especially in North America. Previous research on the adoption and implementation of advanced manufacturing technology (AMT) in Ontario indicates that strong collaboration between AMT producers (largely outside the region) and AMT users is relatively rare. In this paper this work is deepened and extended by an examination of the frequency of collaboration, the forms such collaboration takes, and the factors which seem to be critical in determining whether or not firms will collaborate with one another. Evaluating the results of a survey analysis of AMT users, follow-up interviews both with users and with producers, and a comparison with the AMT sector in Germany, the authors conclude that the apparent scarcity of collaborative activity in the Ontario AMT industry is closely related to the physical and organizational distance between suppliers and customers, and also arises from the high degree of foreign ownership of AMT users in Ontario. They conclude that, despite the well-recognized rise of global economic players, nationality of ownership and geography still matter.
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Al-Aasm, Ihsan S., Richard Crowe, and Marco Tortola. "Dolomitization of Paleozoic Successions, Huron Domain of Southern Ontario, Canada: Fluid Flow and Dolomite Evolution." Water 13, no. 17 (September 6, 2021): 2449. http://dx.doi.org/10.3390/w13172449.
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Integrated petrographic, isotopic, fluid inclusion microthermometry, and geochemical analyses of Paleozoic carbonate successions from multiple boreholes within the Huron Domain, southern Ontario were conducted to characterize the diagenetic history and fluid composition, on a regional scale, and evaluate the nature and origin of dolomitized beds. Multiple generations of non-stochiometric dolomite have been observed. These dolomites occur as both replacement (D1 and D2) and cement (saddle dolomite; SD) and formed either at near-surface to shallow burial zone (D1) or intermediate burial (D2 and SD). Petrographic and geochemical data of dolomite types and calcite cement suggest that these carbonates have experienced multiple fluid events that affected dolomite formation and other diagenetic processes. Cambrian and Ordovician strata have two possibly isolated diagenetic fluid systems; an earlier fluid system that is characterized by a pronounced negative shift in oxygen and carbon isotopic composition, more radiogenic Sr ratios, warm and saline signatures, higher average ∑REE compared to warm water marine brachiopods, negative La anomaly, and positive Ce anomaly; and a later Ordovician system, characterized by less negative shifts in oxygen and carbon isotopes, comparable Th, hypersaline, a less radiogenic, less negative La anomaly, and primarily positive Ce anomaly but also higher average ∑REE compared to warm water marine brachiopods. Ordovician, Silurian, and Devonian Sr isotopic ratios, however, show seawater composition of their respective age as the primary source of diagenetic fluids with minor rock/water interactions. In contrast, the isotopic data of the overlying Silurian and Devonian carbonates show overlaps between δ13C and δ18O values. However, δ18O values show evidence of dolomite recrystallization. D2 shows wide Th values and medium to high salinity values. Higher Th and salinity are observed in SD in the Silurian carbonates, which suggest the involvement of localized fluxes of hydrothermal fluids during its formation during Paleozoic orogenesis. Geochemical proxies suggest that in both age groups the diagenetic fluids were originally of coeval seawater composition, subsequently modified via water-rock interaction possibly related to brines, which were modified by the dissolution of Silurian evaporites from the Salina series. The integration of the obtained data in the present study demonstrates the linkage between fluid flux history, fluid compartmentalization, and related diagenesis during the regional tectonic evolution of the Michigan Basin.
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Krzyzanowska, Monika Karolina, Julia Gao, Helena He, Sherrie Hertz, Vishal Kukreti, and Leonard Kaizer. "Quality of adjuvant chemotherapy in stage III colon cancer." Journal of Clinical Oncology 30, no. 34_suppl (December 1, 2012): 228. http://dx.doi.org/10.1200/jco.2012.30.34_suppl.228.
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228 Background: The goal of the Systemic Treatment Program at Cancer Care Ontario is to ensure equitable access to high quality systemic therapy for all patients in Ontario. To provide information on performance and inform planning we evaluated the quality of care in stage III colon cancer pertaining to adjuvant chemotherapy using multiple indicators focusing on access, guideline concordance and toxicity. Methods: Patients with stage III colon cancer in 2010 were identified from the Ontario Cancer Registry then linked with several other health administrative databases to obtain information regarding wait times, consultation with medical oncology, receipt of guideline concordant adjuvant chemotherapy and treatment related toxicity. Results: In 2010, 1,133 patients were diagnosed with stage III colon cancer in Ontario of whom 49% were women and 60% were older than 65. 92% of patients were seen by a medical oncologist within four months of diagnosis. Among patients seen at one of the regional cancer centres, 56% consulted with an oncologist within the provincial target of 14 days from referral. Overall, 47% of patients received oxaliplatin-based adjuvant chemotherapy therapy; 70% of those younger than 65 versus 34% of those older than 65. Among patients older than 65 on whom information regarding oral chemotherapy use is available in Ontario, 58% received adjuvant chemotherapy (59% oxaliplatin-based, 41% capecitabine). With respect to timeliness of adjuvant chemotherapy, 85% of patients received chemotherapy within 120 days from diagnosis, 57% started treatment within 60 days of surgery and 61% started within 28 days of consultation with a medical oncologist. Among patients who received oxaliplatin based adjuvant chemotherapy, 42% had at least one ER visit and 18% at least one hospital admission during adjuvant treatment. There was evidence of geographic and age-based variation across multiple indicators. Conclusions: While good quality was observed for several of the indicators examined, opportunities for improvement were identified in access to treatment and toxicity management. Evaluating multiple indicators in the same population provides a broader perspective on quality facilitating a focused, efficient approach to improvement efforts.
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Naidoo, Raveeni, Erin M. Warriner, Wieslaw J. Oczkowski, Alexandre Sévigny, and Karin R. Humphreys. "A Case of Foreign Accent Syndrome Resulting in Regional Dialect." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 35, no. 3 (July 2008): 360–65. http://dx.doi.org/10.1017/s0317167100008970.
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Background:Foreign Accent Syndrome (FAS) is a rare acquired syndrome following neurological damage that results in articulatory distortions that are commonly perceived as a “foreign” accent. The nature of the underlying deficit of FAS remains controversial. We present the first reported Canadian case study of FAS following a stroke. We describe a stroke patient, RD, who suffered an acute infarction to the left internal capsule, basal ganglia and frontal corona radiata. She was diagnosed as having FAS without any persistent aphasic symptoms. Family, friends, and health care professionals similarly described her speech as sounding like she had a Canadian East Coast accent, a reported change from her native Southern Ontario accent.Method:An investigation of this case was pursued, incorporating neuroimaging, neuropsychological and speech pathology assessments, and formalized linguistic analyses.Results:Linguistic analyses confirmed that RD’s speech does in fact have salient aspects of Atlantic Canadian English in terms of both prosodic and segmental characteristics. However, her speech is not entirely consistent with an Atlantic Canadian English accent.Interpretation:The fact that RD’s speech is perceived as a regional variant of her native language, rather than the “generic foreign accent” of FAS described elsewhere, suggests that the perceived “foreignness” in FAS is not primarily due to dysfluencies which indicate a non-native speaker, but rather due to very subtle motor-planning deficits which give rise to systemic changes in specific phonological segments. This has implications for the role of the basal ganglia in speech production.
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Tittler, Rebecca, Christian Messier, and Philip J. Burton. "Hierarchical forest management planning and sustainable forest management in the boreal forest." Forestry Chronicle 77, no. 6 (December 1, 2001): 998–1005. http://dx.doi.org/10.5558/tfc77998-6.
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In keeping with international efforts to encourage sustainable forest management, new legislation, regulations, and certification criteria have been brought into effect across boreal regions of the world in the past decade or less. These initiatives have established hierarchical systems of forest management planning that consider multiple uses of the forest and various aspects of sustainable forest management at different scales. We describe the systems established in Quebec, Ontario, Saskatchewan, Alberta, and British Columbia, Russia, Finland, and Sweden. Most jurisdictions employ some form of three-level planning framework, in which strategic, tactical, and operational plans and considerations are presented with successively greater detail and spatial explicitness. However, planning scales and time horizons vary considerably, as does the level of consideration given to biodiversity and social concerns. We examine these systems in the context of sustainable forest management, raising a number of questions to be addressed in future research, adaptive management, and policy reform. In particular, we note (1) a need of new landscape and regional planning tools to evaluate the long-term and large-scale impacts of various land uses and (2) a general lack of responsiveness to global carbon and climate change concerns. Key words: forest management planning, sustainable forest management, boreal forest, forest policy, planning hierarchies, hierarchical planning
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Trippl, Michaela, Simon Baumgartinger-Seiringer, Elena Goracinova, and David A. Wolfe. "Automotive regions in transition: Preparing for connected and automated vehicles." Environment and Planning A: Economy and Space 53, no. 5 (January 20, 2021): 1158–79. http://dx.doi.org/10.1177/0308518x20987233.
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The advent of ‘connected and automated vehicles’ (C/AV) is posing substantial transformation challenges for traditional automotive regions across the world. This article seeks to examine both conceptually and empirically how automotive regions reconfigure their industrial and support structures to promote new path development in the C/AV field. Drawing on recent conceptual advances at the intersection of evolutionary economic geography and innovation system studies, we develop an analytical framework that casts light on how regional preconditions provide platforms for asset modification that underpin different routes of transformation. We distinguish between a reorientation route and an upgrading route. The framework is applied to a comparative analysis of industrial path development and system reconfiguration towards C/AV in two automotive regions, namely Ontario (Canada) and the Austrian automotive triangle.
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Bhatti, Ahmad Zeeshan, Aitazaz Ahsan Farooque, Qing Li, Farhat Abbas, and Bishnu Acharya. "Spatial Distribution and Sustainability Implications of the Canadian Groundwater Resources under Changing Climate." Sustainability 13, no. 17 (August 31, 2021): 9778. http://dx.doi.org/10.3390/su13179778.
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Groundwater availability, utilization, sustainability, and climate change implications were assessed at regional and provincial scales of Canada. It remains an unexplored resource, estimated to be renewing between 380 and 625 km3/year. However, the provinces have initiated developing their quantitative and qualitative databases for their accurate inventory. Sustainable groundwater availability at the national scale was estimated as 19,832 m3/person/year (750 km3/year), with high regional variations ranging from 3949 in the densely populated Prince Edward Island (PEI) province to 87,899 in the thinly populated Newfoundland and Labrador (NFL). It fulfills 82%, 43%, and 14% of water requirements of the rural population, irrigation, and industry, respectively. It is the potable water source for more than 9 million people countrywide (24% of the population), and provinces of Quebec, and Ontario (1.3 million people), and PEI (0.15 million people) particularly depend on it. It is mostly a free or nominally charged commodity, but its utilization was found to be well under sustainable limits (40% of recharge) at the provincial scales, i.e., under 4% for all the provinces except New Brunswick (NB), which also had just 8% extraction of sustainable availability. Nevertheless, localized issues of quantitative depletion and qualitative degradation were found at scattered places, particularly in Ontario and Quebec. Climate change impacts of warming and changing precipitations on groundwater underscored its stability with some temporal shifts in recharge patterns. In general, increased recharge in late winters and springs was observed due to reduced frost and more infiltration, and was somewhat decreasing in summers due to more intense rainfall events.
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Rush, Brian, Scott Veldhuizen, and Edward Adlaf. "Mapping the prevalence of problem gambling and its association with treatment accessibility and proximity to gambling venues." Journal of Gambling Issues, no. 20 (June 1, 2007): 193. http://dx.doi.org/10.4309/jgi.2007.20.6.
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This study examined geographic variation in the prevalence of problem gambling in Ontario and the association with various demographic factors and proximity to treatment for problem gambling and gambling venues. Drawing upon multiple sources, secondary data analysis was undertaken based on multivariate statistical methods and techniques of geographic information systems (GIS). Regional variation in prevalence of problem gambling was found in the province. P revalence of problem gambling was associated with many demographic characteristics, as well as mental disorders, co-occurring substance abuse problems, and physical health status. Geographic access to treatment was not associated with the risk of being a problem gambler. However, proximity to gambling venues was marginally important in predicting risk of problem gambling. Results are interpreted in the context of needs-based planning of treatment and prevention programs for problem gambling.
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Kouroukis, C. Tom, Christopher Bredeson, Aaron Pollett, Elaine Meertens, Julia Monakova, Jonathan Wang, Jennifer Hart, Hasmik Beglaryan, Lesley Moody, and Sherrie Hertz. "A systematic approach for high-quality care in complex malignant hematology." Journal of Clinical Oncology 37, no. 27_suppl (September 20, 2019): 57. http://dx.doi.org/10.1200/jco.2019.37.27_suppl.57.
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57 Background: Capacity limits in Ontario, Canada, resulted in long waits and out-of-country care for hematopoietic cell therapy (HCT) and inconsistent access for acute leukemia (AL) patients. A multi-pronged system improvement approach was implemented to ensure high quality care as close to home as possible. Methods: Robust forecasting models and physician workload benchmarks were developed to quantify needs and drive health human resource and capital planning. Clinical and organizational guidelines were developed for new models of care, pathology and laboratory medicine services, and networks of care. Funding models were introduced to support care needs and service models. A comprehensive measurement strategy, including patient reported experience measures, was developed. Results: Six services sites providing HCT and AL care are networked with four AL sites and three supporting sites. Capital expansion projects have been completed and others continue. Two biomarker reference centers were established to serve as quality leads and ensure timely testing. Average turnaround time is 12 days for cytogenetic testing. 19 additional physician specialists and 5 additional fellowships were approved for allocation across Ontario. Three nurse practitioners participated in mentorship programs. Access has improved and wait times are monitored. In 2018 there were 736 autologous and 357 allogeneic transplants done vs 396 and 159 respectively in 2014. 43 patients were referred out of country in 2016 compared with two in 2018, with a median wait of 70 days from AL remission to transplant in 2018. Nine (of 14) regional cancer centers offer outpatient AL consolidation. Patient experience was highest in treatment planning, physical comfort and patient preferences. Conclusions: A multi-pronged approach to planning, funding and quality assurance resulted in measureable increased capacity and high quality care closer to home.
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MacPherson, A. D., and J. E. McConnell. "Recent Canadian Direct Investment in the United States: An Empirical Perspective from Western New York." Environment and Planning A: Economy and Space 24, no. 1 (January 1992): 121–36. http://dx.doi.org/10.1068/a240121.
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The scale, sectoral composition, and regional economic impact of recent Canadian direct investment in Western New York are examined. Empirical perspectives on the role of the Canada—United States Free Trade Agreement (FTA) are presented, notably with regard to Western New York's growing absorption of Canadian industrial capital. Data from a postal survey of Canadian investors are described. The results suggest that the FTA has not been a strategic factor in recent investment patterns. Instead, the data reveal an important role for locational and market considerations, few of which pertain to official regulations of bilateral commerce. Some of the empirical results suggest an economic synergy between southern Ontario and Western New York. Specifically, both regions appear to have captured significant commercial benefits from recent cross-border investment. The paper concludes with a brief research agenda for future geographical work on the economic impact of more liberal investment relations between the two countries.
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Lockhart, Elizabeth, Michelle Ang, Laura Zychla, Kate Bak, Lynne Nagata, Hasmik Beglaryan, Jillian Ross, et al. "Clinical specialist radiation therapists (CSRT): Creating capacity while improving quality of care." Journal of Clinical Oncology 34, no. 7_suppl (March 1, 2016): 124. http://dx.doi.org/10.1200/jco.2016.34.7_suppl.124.
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124 Background: Ontario’s cancer system faces many challenges, including a rising incidence of cancer, aging population, increasingly complex cancer treatment, and health human resource (HHR) constraints. In response, Cancer Care Ontario and the Ontario Ministry of Health and Long Term Care collaborated on a project to assess whether a new advanced practice radiation therapist role – the ‘Clinical Specialist Radiation Therapist’ (CSRT) – could enhance access to high quality, innovative care by optimizing the use of HHR. Methods: This innovative model of care aims to enable radiation therapists with advanced training and accreditation (CSRTs) to assume responsibility for certain activities traditionally performed by radiation oncologists (ROs) while maintaining and improving the quality, accessibility and efficiency of radiotherapy (RT) for patients. To assess CSRTs’ impacts standardized metrics, including efficiency (access, wait times (WTs), team function) and quality (new/enhanced services, patient experience) measures, were used. Results: Currently there are 24 CSRTs in 9 of 14 regional cancer centres. 2014/15 data demonstrated that CSRTs can improve the efficiency of referral processes and clinic operations, decrease WTs, and increase capacity (2-28 additional patients seen in clinic/month). Optimized team function and time savings (5-66 RO hours/month) have been achieved through CSRTs’ assumption of certain patient assessment and treatment planning activities. Efficiencies have improved patient experience by facilitating quicker, more coordinated flow through the RT process, and greater continuity of care. Further, CSRTs have enhanced access to high quality RT, through > 75 innovative initiatives (rapid access clinics, telemedicine consults). Conclusions: The CSRT role demonstrates how innovative models of care can improve patient access to high quality cancer care. With 24 CSRTs implemented, opportunities for analysis of factors which facilitate achievement of maximal impact and position sustainability exist. Such investigations could inform the refinement and further implementation of CSRTs in Ontario and other jurisdictions, improving patients’ access to RT more broadly.
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Lin, Q. G., and G. H. Huang. "Interval-fuzzy stochastic optimization for regional energy systems planning and greenhouse-gas emission management under uncertainty—a case study for the Province of Ontario, Canada." Climatic Change 104, no. 2 (January 16, 2010): 353–78. http://dx.doi.org/10.1007/s10584-009-9795-8.
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Hertz, Sherrie, Jillian Ross, Leonard Kaizer, and Carol Anne Sawka. "Quality oversight for specialized cancer services." Journal of Clinical Oncology 30, no. 34_suppl (December 1, 2012): 103. http://dx.doi.org/10.1200/jco.2012.30.34_suppl.103.
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103 Background: Cancer Care Ontario (CCO), a provincial agency responsible for continually improving cancer services in Ontario, Canada, reviews selected services with a view to understanding and resolving issues of access, quality, innovation, and funding. Specialized cancer services are low-volume, high-complexity, high-cost, and are not available in every region. They tend to be high-risk, involve a rapidly evolving scientific knowledge base, and a high degree of specialization. A specialized services oversight (SSO) approach has been implemented to address the challenge for optimization of service delivery while providing equitable access to safe, high-quality, best practice care. Methods: The SSO approach involves 1) establishing a provincial forum for expert clinical advice; 2) A regular and systematic process for literature and jurisdictional reviews; 3) provincial-level demand and capacity forecasting; 4) provincial funding linked to evidenced-based eligibility/quality criteria; 5) communication/awareness strategies for appropriate and equitable access. Enablers are CCO structures for performance management, stakeholder engagement, service planning, data management, and CCO’s guiding principles of "transparency, equity, evidence, performance-oriented, active engagement, and value for money." Results: The SSO approach has been implemented in full for PET scanning services, and in part for stem cell transplant (SCT), sarcoma, molecular oncology, prostate brachytherapy, and selected neuroendocrine cancer care. Stakeholder acceptance of the approach has been high. Outputs include provincial guidelines on indications for SCT, performance metrics and benchmarks, multicentre sharing of information, and inter-regional referral processes. Conclusions: Implementation of the SSO approach has introduced provincial-level system planning, formal evidence scanning, sharing of best practices, and performance measurement for high-complexity services where there was no such oversight in the past. The approach is anticipated to avoid access crises and support timely and equitable access to services of high quality, which make optimal use of resources.
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Medland, Sally J., Richard R. Shaker, K. Wayne Forsythe, Brian R. Mackay, and Greg Rybarczyk. "A multi-Criteria Wetland Suitability Index for Restoration across Ontario’s Mixedwood Plains." Sustainability 12, no. 23 (November 28, 2020): 9953. http://dx.doi.org/10.3390/su12239953.
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Significant wetland loss (~72%; 1.4 million hectares) in the Province of Ontario, Canada, has resulted in damage to important ecosystem services that mitigate the effects of global change. In response, major agencies have set goals to halt this loss and work to restore wetlands to varying degrees of function and area. To aid those agencies, this study was guided by four research questions: (i) Which physical and ecological landscape criteria represent high suitability for wetland reconstruction? (ii) Of common wetland suitability metrics, which are most important? (iii) Can a multi-criteria wetland suitability index (WSI) effectively locate high and low wetland suitability across the Ontario Mixedwood Plains Ecozone? (iv) How do best sites from the WSI compare and contrast to both inventories of presettlement wetlands and current existing wetlands? The WSI was created based on seven criteria, normalized from 0 (low suitability) to 10 (high suitability), and illustrated through a weighted composite raster. Using an Analytical Hierarchy Process (AHP) and importance determined from a scoping review of relevant literature, soil drainage had the greatest meaning and weight within the WSI (48.2%). The Getis-Ord Gi* index charted statistically significant “hot spots” and “cold spots” of wetland suitability. Last, the overlay analysis revealed greater similarity between high suitability sites and presettlement wetlands supporting the severity of historic wetland cannibalization. In sum, this transferable modeling approach to regional wetland restoration provides a prioritization tool for improving ecological connectivity, services, and resilience.
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Topcu, Basak, Goretty M. Dias, and Sadaf Mollaei. "Ten-Year Changes in Global Warming Potential of Dietary Patterns Based on Food Consumption in Ontario, Canada." Sustainability 14, no. 10 (May 21, 2022): 6290. http://dx.doi.org/10.3390/su14106290.
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Many studies have evaluated the life cycle environmental impacts of diets based on a single period, but few studies have considered how environmental impacts of diets change over time, even though dietary patterns (DPs) change due to policy and socio-demographic factors. This study evaluated changes in the global warming potential (GWP) of DPs in the province of Ontario, Canada, using a life cycle assessment. We quantified the farm-to-fork GWP of six DPs (Omnivorous, No Pork, No Beef, No Red Meat, Pescatarian, and Vegetarian), using dietary intake data from a 2014 and 2015 survey. Throughout this period, the biggest decrease in GWP was for DPs containing beef, even though these DPs still have the highest GWP (3203 and 2308 kg CO2e, respectively, based on the annual energy intake of one individual). Across all DPs, plant-based proteins contributed less than 5% to GWP, while meat and fish contributed up to 62% of the total GWP. Ten-year GWP reductions are insufficient to meet climate change and other sustainability goals, and major dietary shifts are needed, particularly substituting animal-based proteins with plant-based proteins. To design effective interventions for shifting towards sustainable diets, research is needed to understand how socio-demographic and regional differences influence individuals’ food choices.
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Kukreti, Vishal, Sara Lankshear, Arthur G. Manzon, Nancy Wolf, Shafiq Habib, Sherrie Hertz, Saul Melamed, Tim Yardley, and Lisa Sarsfield. "The Ontario oncology electronic medical record (EMR): The integration of end user and provincial needs." Journal of Clinical Oncology 31, no. 31_suppl (November 1, 2013): 248. http://dx.doi.org/10.1200/jco.2013.31.31_suppl.248.
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248 Background: The use of ambulatory electronic medical record (EMR) systems within oncology provides an opportunity for aligning provincial, local and end-user patient-centred quality indicators in the design, delivery and evaluation of clinical care and resource utilization. The aim of this provincial initiative is to define the “meaningful use” for the Oncology EMR by identifying the essential data elements and functional requirements required to facilitate integrated care, information standards (both local and provincial), and system integration needs. This paper presents the results of a provincial field study designed to determine end-user needs for information and quality metrics. Methods: Data collection included two separate onsite focus groups at each of the 13 regional cancer programs, with a focus on Clinical and Operational requirements. A total of 141 participants, representing physicians, interprofessional clinical team members, administrators and health information specialists were involved. An additional online survey was used for optimal engagement, with a total of 194 respondents, primarily nurses and physicians. Inclusion and exclusion criteria were developed to assist in coding and distillation of concepts generated. Results: A total of 1,598 ideas were generated (Clinical = 997, Operational = 601). Multiple rounds of content analysis were used to eliminate duplicates, identify common themes and distill the wealth of information down to the “vital few” discrete information requirements that should be included in the oncology EMR. At this time, 63 clinical and 55 operational concepts have been identified to support clinical care as well as operational planning and system evaluation. The online survey has helped define the data required for a Provincial Oncology Patient Profile within the EMR. Conclusions: The study employed significant consultation to merge end user and existing provincial quality measurement needs in order to define the Ontario Oncology EMR. A full spectrum of quality indicators identified through these processes will inform the future provincial priorities for information standards and quality monitoring that will be facilitated by a standardized EMR.
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Fedoruk, J. C., Wayne L. Currie, and Meikel Gobet. "Locations of Cardiac Arrest: Affirmation for Community Public Access Defibrillation (PAD) Program." Prehospital and Disaster Medicine 17, no. 4 (December 2002): 202–5. http://dx.doi.org/10.1017/s1049023x00000509.
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AbstractBackground:The purpose of this study was to describe the regional locations of cardiac arrest, and to identify public locations and the annual incidence of arrests within the identified locations, in order to help to determine optimal placement of Automatic External Defibrillators (AEDs) under the regional Public Access Defibrillation (PAD) Program. This is a retrospective study.Methods:The locations of cardiac arrest were abstracted from Ambulance Call Reports (ACRs) collected by the Essex-Kent Base Hospital Centre from regional ambulance services throughout the City of Windsor, and the Counties of Essex and Kent, Ontario, Canada, from 01 January 1994 through 31 December 2000. Arrest locations were grouped into five categories, and then the number of public venues was determined. Public sites were grouped into 28 Public Locations. Also included in the Public Sites were both General Industry and Outdoors categories. Categories identified but excluded from Public Sites were Institutions and Private Residences.Results:During the study, 2,295 arrests occurred, 152 cases were excluded, 2,142 arrests were categorized, (average annual incidence of 306 ±50.4 cardiac arrests), 329 (15.4%) of which were in Public Sites. Nineteen public venues had an average of >1 arrest/year, and nine public venues had an average of ≤1 arrest/year during the study, period. Calculations of the annual incidence of arrests for each public location were completed.Conclusions:These findings have significant prehospital emergency cardiac care implications for communities that wish to strengthen/improve their responses to out-of-hospital cardiac arrests. Public Access Defibrillation Programs should identify the site-specific incidence of arrest within their communities in order to provide legitimacy for funding and planning of programs. Training and availability of AEDs will reduce the time to first shock, thus strengthening the chain-of-survival and will save more lives.