Journal articles on the topic 'Special assessments – Ontario'

This article provides an overview of an assessment that TESL Canada undertook of Employment and Immigration Canada's pilot programme, the Settlement Language Training Program (198617). Ten projects in the programme in Ontario, Manitoba, and B.C. were studied. The programme was well received. Its community based delivery and the availability of babysitting and transportation supports were important to its success. Good needs assessment for outreach and curriculum proved to be critical. Special attention needs to be paid to the needs of learners with low levels of literacy. Implications for future initiatives of this type are drawn on the topics of needs assessments, decision making structures, delivery agencies, time-frames and funding levels, and programme models.

In accordance with the Species at Risk Act (SARA), the Committee on the Status of Endangered Wildlife in Canada (COSEWIC) is nationally responsible for assessing wildlife species considered to be at risk of extinction. A parliamentary review of SARA provides impetus for an up-to-date summary of recent assessments (2006–2008) and a spatiotemporal analysis of the status of Canada's largest vertebrate group of species at risk, fishes. From April 1978 through December 2008, COSEWIC had assessed 13 wildlife species as extinct and 564 at some level of risk (extirpated, endangered, threatened, special concern). Among these 577 assessments, 112 are for fishes (76% freshwater and diadromous; 24% marine). Slightly more than one-quarter (27%) of Canada's 205 freshwater and diadromous species of fishes, many of which are in southwestern Ontario and southeastern Quebec, have been assessed as being at risk throughout all or parts of their ranges. The percentage of Canadian freshwater and diadromous fish species assessed by COSEWIC as endangered or threatened (16%) is similar to the percentage of freshwater and diadromous fishes in the US that have been listed under the Endangered Species Act (12%). The proportion of wholly freshwater fishes assessed by COSEWIC that have been added to SARA's legal schedule is somewhat lower than that of other taxa. However, whereas the US listed its first marine fish in 2005, the Canadian government has to date not accepted COSEWIC's advice to list an endangered or threatened marine fish since the proclamation of SARA in 2003.

Background and Objectives: The purpose of the paper is to illustrate the real life clinical outcomes of a retrospective cohort of knee Osteoarthritis (OA) patients treated with a novel laser disease management program; at the same time, to defi ne the most effective operative procedure. The new laser technique mimics the in-vitro benefi ts of Low-Level Laser Therapies (LLLT). The study compared the 3month effi cacy and 6-month persistence of clinical and functional benefi ts after application of laser energy either externally with a standard High Power Laser Therapy (HPLT) laser device (AG1 device, FP3 version), or intra-articularly with the patented, low-energy AG8 intra articular fi ber device (ultrasound-guided, same wavelengths, no handpiece). This innovative laser device reduces to one hundredth the applied energy density. The pain suppressing effi cacy of the LLLT-like laser FP3 procedure is intended to act synergically with the strong biorestructuring and pain suppressing effi cacy of natural origin polynucleotides (PN-HPT™ or Highly Purifi ed Technology™) injected before the laser session. PN-HPT™ are widely used in knee OA management for their persistent viscosupplementation properties overlapping those of high molecular weight hyaluronic acid. Trial design: retrospective comparison of:  Short term 3 month effi cacy outcomes on pain and disability  6-month persistence of clinical improvements in two cohorts of patients with severe knee osteoarthritis. The active cohort knee OA patients (105 agonistic or recreative practitioners with persistent knee pain and disability resistant to conventional medical or physical therapies) were treated with an innovative intra articular low-energy AG8 physical therapy protocol (ambulatory “AG8 Protocol 3” combined with a preliminary PN-HPT™ knee injection); the control-cohort patients (109 patients with knee disease of similar severity) were treated with a standard, multi frequency HPLT ambulatory treatment protocol (FP3 device). Outcome parameters: Western Ontario and McMaster Universities (WOMAC) assessments at baseline (T0) and after 2 weeks (T2) and 3 months (T3). Secondary parameters: Nociceptive and neuropathic pain; assessment: standard 10 cm Visual Analogue Scale (VAS) immediately before and at the end of each treatment session. Results: Treatment with the AG8 protocol 3 / PN-HPT™ intra articular combination was associated with strongly signifi cant short term (2 weeks) and medium-term (3 months) benefi ts vs. controls treated with a conventional FP3 extra-articular treatment protocol both for the WOMAC Total Score and WOMAC Pain and Function subscores. Benefi ts for the WOMAC Stiffness subscore were borderline non-signifi cant. The subgroup analysis showed that the 2A (Grade-2 KL primary OA) and 2B (Grade-2 KL secondary (post-surgical) OA) mainly contributed to overall benefi ts. Conclusion: The study showed the intra-articular Laser Needling® technique (ultrasound-guided AG8 laser device, Protocol 3 plus infi ltration of a facilitating agent such as intra-articular PN-HPT™ gel) to be more effective on knee OA pain than the traditional extra-articular FP3 laser technique, with special reference to pain associated with primary OA.

Introduction: Patients of specialized nicotine dependence clinics are hypothesized to form a distinct subpopulation of smokers due to the features associated with treatment seeking. The aim of the study was to describe this subpopulation of smokers and compare it to smokers in general population.Material and methods: A chart review of 796 outpatients attending a specialized nicotine dependence clinic, located in Toronto, Ontario, Canada was performed. Client smoking patterns and sociodemographic characteristics were compared to smokers in the general population using two Ontario surveys – the Ontario Tobacco Survey (n = 898) and the Centre for Addiction and Mental Health Monitor (n = 457).Results: Smokers who seek treatment tend to smoke more and be more heavily addicted. They were older, had longer history of smoking and greater number of unsuccessful quit attempts, both assisted and unassisted. They reported lower education and income, had less social support and were likely to live with other smokers.Conclusions: Smokers who seek treatment in specialized centers differ from the smokers in general population on several important characteristics. These same characteristics are associated with lower chances for successful smoking cessation and sustained abstinence and should be taken into consideration during clinical assessment and treatment planning.

High quality pediatric homecare requires comprehensive assessment of the needs, supports, and health care challenges of children with special healthcare needs and their families. There is no standardized homecare assessment system to evaluate children’s clinical needs in the home (support services, equipment, etc.) in Ontario, Canada, which contributes to inequitable homecare service allocation. In 2017, the interRAI Pediatric Home Care assessment tool (PEDS-HC) was implemented on a pilot basis in several regions of Ontario. This qualitative descriptive study explores the experiences of homecare coordinators using the PEDS-HC, seeking to understand the utility and feasibility of this tool through focus group discussion. Four major themes were identified including: the benefits of the tool; areas for modification; challenges to use; and Clinical Assessment Protocols to develop. These themes can guide modifications to the tool to improve utility and improve pediatric home care services. The PEDS-HC is an effective tool to assess children needing homecare in a standardized and comprehensive manner. Use of the tool can improve the quality of homecare services by ensuring equity in service provision and facilitate early identification of clinical issues to prevent unexpected health deteriorations.

Purpose In Canada, recommendations for clinical management of hereditary breast and ovarian cancer among individuals carrying a deleterious BRCA1 or BRCA2 mutation have been available since 2007. Eight years later, very little is known about the uptake of screening and risk-reduction measures in this population. Because Canada's public health care system falls under provincial jurisdictions, using provincial health care administrative databases appears a valuable option to assess management of BRCA1/2 mutation carriers. The objective was to explore the usefulness of public health insurance administrative databases in British Columbia, Ontario, and Quebec to assess management after BRCA1/2 genetic testing. Methods Official public health insurance documents were considered potentially useful if they had specific procedure codes, and pertained to procedures performed in the public and private health care systems. Results All 3 administrative databases have specific procedures codes for mammography and breast ultrasounds. Only Quebec and Ontario have a specific procedure code for breast magnetic resonance imaging. It is impossible to assess, on an individual basis, the frequency of others screening exams, with the exception of CA-125 testing in British Columbia. Screenings done in private practice are excluded from the administrative databases unless covered by special agreements for reimbursement, such as all breast imaging exams in Ontario and mammograms in British Columbia and Quebec. There are no specific procedure codes for risk-reduction surgeries for breast and ovarian cancer. Conclusion Population-based assessment of breast and ovarian cancer risk management strategies other than mammographic screening, using only administrative data, is currently challenging in the 3 Canadian provinces studied.

There is not a great deal of empirical research on adolescent sex offenders and even less on mentally retarded adolescent sex offenders. This study provides some preliminary data in this area. Results of a survey of the extent and types of sexual problems evident amongst groups of mentally retarded and intellectually normal adolescents (N = 196), seen at an assessment and treatment centre in southwestern Ontario during a 14 month period is presented. In addition three groups of ten adolescents each (mentally retarded and intellectually normal sex offenders and one group of mentally retarded non-offenders with behavioural problems) were investigated to gain a more indepth perspective of characteristics of these adolescents and their backgrounds. Considering the high recidivism rate for these groups, indications for treatment are discussed with special consideration for the mentally retarded offenders.

In Ontario, as the number of students requiring special education support continues to rise, the transition to inclusive classrooms has become more challenging for teachers due to limited time and lack of resources and support in the classrooms. However, this study explored how eight elementary school teachers addressed these obstacles in their successful transitions to inclusion through the integration of technology, Universal Design for Learning (UDL) and the Response to Intervention (RTI) frameworks in both online and physical classrooms. Through online interviews and classroom observations, the teachers orally shared and demonstrated how technology could increase student engagement, differentiate instruction, provide students with alternative instruction and assessment methods, and build teacher capacity within the classrooms. Despite this successful integration of technology and instructional frameworks, inefficiencies were revealed in screening approaches and teachers’ access to streamlined assessment resources to identify the needs of students. A discussion examined the teachers’ barriers in supporting the needs of all learners with proposed technology-based considerations that may assist other teachers in their transitions to inclusive classrooms.

ObjectiveThe objective of this study was to estimate background rates of selected thromboembolic and coagulation disorders in Ontario, Canada.DesignPopulation-based retrospective observational study using linked health administrative databases. Records of hospitalisations and emergency department visits were searched to identify cases using International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Canada diagnostic codes.ParticipantsAll Ontario residents.Primary outcome measuresIncidence rates of ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, deep vein thrombosis, pulmonary embolism, idiopathic thrombocytopaenia, disseminated intravascular coagulation and cerebral venous thrombosis during five prepandemic years (2015–2019) and 2020.ResultsThe average annual population was 14 million with 51% female. The mean annual rates per 100 000 population during 2015–2019 were 127.1 (95% CI 126.2 to 127.9) for ischaemic stroke, 22.0 (95% CI 21.6 to 22.3) for intracerebral haemorrhage, 9.4 (95% CI 9.2 to 9.7) for subarachnoid haemorrhage, 86.8 (95% CI 86.1 to 87.5) for deep vein thrombosis, 63.7 (95% CI 63.1 to 64.3) for pulmonary embolism, 6.1 (95% CI 5.9 to 6.3) for idiopathic thrombocytopaenia, 1.6 (95% CI 1.5 to 1.7) for disseminated intravascular coagulation, and 1.5 (95% CI 1.4 to 1.6) for cerebral venous thrombosis. Rates were lower in 2020 than during the prepandemic years for ischaemic stroke, deep vein thrombosis and idiopathic thrombocytopaenia. Rates were generally consistent over time, except for pulmonary embolism, which increased from 57.1 to 68.5 per 100 000 between 2015 and 2019. Rates were higher for females than males for subarachnoid haemorrhage, pulmonary embolism and cerebral venous thrombosis, and vice versa for ischaemic stroke and intracerebral haemorrhage. Rates increased with age for most of these conditions, but idiopathic thrombocytopaenia demonstrated a bimodal distribution with incidence peaks at 0–19 years and ≥60 years.ConclusionsOur estimated background rates help contextualise observed events of these potential adverse events of special interest and to detect potential safety signals related to COVID-19 vaccines.

The Royal College of Physicians and Surgeons of Canada (RCPSC) adopted a plan to transform, over a seven-year horizon (2014-2021), residency education across all specialties to competency-based medical education (CBME) curriculum models. The RCPSC plan recommended implementing a more responsive and accountable training model with four discrete stages of training, explicit, specialty specific entrustable professional activities, with associated milestones, and a programmatic approach to assessment across residency education. Embracing this vision, the leadership at Queen’s University (in Kingston, Ontario, Canada) applied for and was granted special permission by the RCPSC to embark on an accelerated institutional path. Over a three-year period, Queen’s took CBME from concept to reality through the development and implementation of acomprehensive strategic plan. This perspective paper describes Queen’s University’s approach of creating a shared institutional vision, outlines the process of developing a centralized CBME executive team and twenty-nine CBME program teams, and summarizes proactive measures to ensure program readiness for launch. In so doing, Queen’s created a community of support and CBME expertise that reinforces shared values including fostering co-production, cultivating responsive leadership, emphasizing diffusion of innovation, and adopting a systems-based approach to transformative change.

Aim. To evaluate the results of complex treatment with application of methods of correction of chronic venous insufficiency in patients with osteoarthritis of the knee joints in combination with varicose disease of the lower extremities. Methods. Examination of a cardio-vascular surgeon, orthopedist or rheumatologist, triplex scanning the veins of the lower extremities, arthrosonography and X-ray imaging of the knee joints, assessment of the severity of chronic venous insufficiency according to a CEAP scale [Clinical signs, Etiologic classification, Anatomic distribution, Pathophysiologic Dysfunction (1984)], and the degree of gonarthrosis according to the special Leken’s index and WOMAC index (Western Ontario and McMaster Universities Arthritis Index). The investigations were performed before treatment and repeatedly during the year in the course of treatment. According to the indications both conservative therapy and surgical treatment were used. Results. As a result of the complex treatment of patients achieved was a reduction in the severity of symptoms of gonarthrosis, which manifested with a decrease in the total value of the Leken’s index and the WOMAC functional index. Positive results were obtained in the group of patients who underwent surgery, and in the group of patients who received conservative treatment. Conclusion. Inclusion in the treatment of the methods aimed at eliminating manifestations of chronic venous insufficiency leads to improved results of treatment of osteoarthritis of the knee joints.

The CREC Riser Simulator is a mini-fluidized bench scale unit invented and implemented in 1992, at the CREC (Chemical Reactor Engineering Centre), University of Western Ontario The CREC Riser Simulator can be operated at short reaction times, in the 3 s to 20 s range. The present review describes and evaluates the original basic concept of the 1992-CREC Riser Simulator Unit, and the improved design of the 2019-CREC Riser Simulator. Both the initial and the enhanced units are specially engineered to allow the rigorous assessment of both catalyst performance and catalytic reaction kinetics. Kinetic parameters of relatively simple and accurate mathematical models can be calculated using experimental data from the CREC Riser Simulator. Since its inception in 1992, the CREC Riser Simulator has been licensed to and manufactured for a significant number of universities and companies around the world. Several examples of scenarios where the CREC Riser Simulator can be employed to develop fluidized bed catalytic and heterogeneous reactor simulations are reported in this review. Among others, they include (a) hydrocarbon catalytic cracking, (b) the catalytic conversion of tar derived biomass chemical species, (c) steam and dry catalytic methane reforming, (d) the catalytic oxydehydrogenation of light paraffins, (e) the catalytic desulfurization of gasoline, and (f) biomass derived syngas combustion via chemical looping. In this review, special emphasis is given to the application of the CREC Riser Simulator to TIPB (tri-iso-propyl-benzene) catalytic cracking and the light paraffins catalytic oxydehydrogenation (PODH).

The New York State Angler Study will evaluate the association between past and current consumption of contaminated fish from Lake Ontario and both short- and long-term health effects in a population-based cohort. It will measure fish consumption and reproductive and developmental health among 10,518 male anglers and 6,651 of their wives or partners, as well as among 913 female anglers. To characterize exposure among subgroups of the cohort, further analytical methods were developed and implemented to measure specific polychlorinated biphenyls (PCB) congeners, methylmercury, and other substances in biological samples. Exposure assessment has been completed for a stratified random sample of 321 anglers. In addition, analyses for 79 congeners of PCBs are complete for 177 anglers. A special study of duck andturtle consumers currently is underway. Telephone interviews have been completed with 2,454 of the 2,999 women who planned a pregnancy between 1991 and 1994. The entire cohort of male anglers, partners of male anglers, and female anglers has been submitted for matching with the New York State live birth and fetal death registries to obtain lifetime reproductive histories. A medical record abstraction study will assess perinatal and developmental outcomes among the 3,442 births that occurred between 1986 and 1991. Finally, a study of breast milk from currently lactating women is underway, and 215 breast milk samples have been collected from the planned pregnancy subcohort. Progress on each of the study components is discussed herein.

Abstract Primary Subject area Public Health and Preventive Medicine Background It is well established that significant health disparities continue to affect Canadian Indigenous children living both in remote and urban areas. A critical component of health promotion is health knowledge dissemination. A 2011 Health Council of Canada study identified the need for better community knowledge of parenting and child health as intervention targets among Indigenous communities across Canada. Objectives In the present study, we aimed to explore the perspectives of Inuit parents and caregivers in one urban setting (Ottawa, Ontario) on the dissemination of child health knowledge specifically, with the intention of guiding future community-based child health promotion initiatives. Design/Methods Ottawa, being home to the largest Inuit population living outside Inuit Nunangat, provided an ideal study location. Many Inuit report relocating to Ottawa for employment, education, or for greater access to heath services. We therefore partnered with the Ottawa-based Inuuqatigiit Centre for Children, Youth, and Families, to design and conduct a needs assessment through a series of focus groups. Focus groups explored participants’ current sources of child health knowledge, child health topics of interest, and preferred formats for child health knowledge dissemination. Focus groups were held at Inuuqatigiit and included a meal of country food shared by study participants and research team members to support relationship-building and engagement. Focus groups were analyzed using an inductive approach to qualitative thematic analysis. Results 24 Inuit parents and caregivers participated in 4 focus groups. Factors affecting preferred sources of health knowledge included trustworthiness, fear of discrimination, cultural differences, and having a holistic approach. Participants identified several child health issues that should be the focus of future child health knowledge sharing initiatives, in particular those in which a sense of cultural dissonance was felt between traditional and Western approaches. In-person and online/interactive sessions were preferred over written materials. Many participants agreed that child health knowledge-sharing initiatives should be designed and delivered with involvement of the community. Participants also emphasized the importance of synthesizing traditional knowledge of Elders with that of health professionals. Conclusion There is a need for better child health knowledge dissemination strategies among the Ottawa Inuit community as a crucial aspect of health promotion. Special considerations when designing such initiatives must be given to historical dynamics of trust and mistrust of the health professions, to addressing cultural differences, and to the role of community members in the design and implementation of initiatives.

Pentachlorophenol is used as an industrial wood preservative for utility poles, crossarms, fence posts, and other purposes (79%);for NaPCP (12%); and miscellaneous, including mill uses, consumer wood preserving formulations and herbicide intermediate (9%) (CMR, 1980). As a wood preservative, pentachlorophenol acts as both a fungicide and insecticide (Freiter, 1978). The miscellaneous mill uses primarily involve the application of pentachlorophenol as a slime reducer in paper and pulp milling and may constitute ∼6% of the total annual consumption of pentachlorophenol (Crosby et al., 1981). Sodium pentachlorophenate (NaPCP) is also used as an antifungal and antibacterial agent (Freiter, 1978). Pentachlorophenol also is used as a general herbicide (Martin and Worthing, 1977). Photolysis and microbial degradation are the important chemical removal mechanisms for pentachlorophenol in water. In surface waters, pentachlorophenol photolyzes rapidly (ECETOC, 1984; Wong and Crosby. 1981; Zepp et al., 1984); however, the photolytic rate decreases as the depth in water increases (Pignatello et al., 1983). Pentachlorophenol is readily biodegradable in the presence of accli-mated microorganisms; however, biodegradation in natural waters requires the presence of microbes that can become acclimated. A natural river water that had been receiving domestic and industrial effluents significantly biodegraded pentachlorophenol after a 15-day lag period, while an unpolluted natural river water was unable to biodegrade the compound (Banerjee et al., 1984). Even though pentachlorophenol is in ionized form in natural waters, sorption to organic particulate matter and sediments can occur (Schellenberg et al., 1984), with desorption contributing as a continuing source of pollution in a contaminated environment (Pierce and Victor, 1978). Experimentally determined BCFs have shown that pentachlorophenol can significantly accumulate in aquatic organisms (Gluth et al., 1985; Butte et al., 1985; Statham et al., 1976; Veith et al., 1979a,b; Ernst and Weber, 1978), which is consistent with its widespread detection in fish and other organisms. Direct photolysis may be an important environmental sink for pen tachlorophenol present in the atmosphere. The detection of pen tachlorophenol in snow and rain water (Paasivirta et al., 1985; Bevenue et al., 1972) suggests that removal from air by dissolution is possible. Soil degradation studies indicate that pentachlorophenol is biodegrad able; microbial decomposition is an important and potentially domin ant removal mechanism in soil (Baker et al., 1980; Baker and Mayfield, 1980; Edgehill and Finn, 1983; Kirsch and Etzel, 1973; Ahlborg and Thunberg, 1980). The degree to which pentachlorophenol leaches in soil is dependent on the type of soil. In soils of neutral pH, leaching may be significant, but in acidic soils, adsorption to soil generally increases (Callahan et al. , 1979; Sanborn et al. , 1977). The ionized form of pentachlorophenol may be susceptible to adsorption in some soils (Schellenberg et al., 1984). In laboratory soils, pen tachlorophenol decomposes faster in soils of high organic content as compared with low organic content, and faster when moisture content is high and the temperature is conducive to microbial activity. Half- lives are usually ∼2-4 weeks (Crosby et al., 1981). Monitoring studies have confirmed the widespread occurrence of pentachlorophenol in surface waters, groundwater, drinking water and industrial effluents (see Table 2). The U.S. EPA's National Urban Runoff Program and National Organic Monitoring Survey reported frequent detections in storm water runoff and public water supplies (Cole et al., 1984; Mello, 1978). Primary sources by which pen tachlorophenol may be emitted to environmental waters may be through its use in wood preservation and the associated effluents and its pesticidal applications. Pentachlorophenol can be emitted to the atmosphere by evaporation from treated wood or water surfaces, by releases from cooling towers using pentachlorophenol biocides or by incineration of treated wood (Skow et al., 1980; Crosby et al., 1981). Pentachlorophenol has been detected in ambient atmospheres (Caut reels et al., 1977), in snow and rain water (Paasivirta et al,. 1985; Bevenue et al., 1972) and in emissions from hazardous waste incinera tion (Oberg et al., 1985). The U.S. Food and Drug Administration's Total Diet Study (conducted between 1964 and 1977) found pen tachlorophenol residues in 91/4428 ready-to-eat food composites (See Tables 4 and 5). The average American dietary intake of pen tachlorophenol during 1965-1969 was estimated to range from <0.001-0.006 mg/day (Duggan and Corneliussen, 1972). The most likely source of pentachlorophenol contamination in many food prod ucts may be the exposure of the food to pentachlorophenol-treated wood materials such as storage containers (Dougherty, 1978). Acute toxicity data indicated that salmonids are more sensitive to the toxic effects of pentachlorophenol than other fish species, with LC50 values of 34-128 μ g/l for salmonids and 60-600 μ g/l for other species. More recent data showed that carp larvae, bluegills, channel catfish and knifefish also had LC50 values < 100 μ gl (see Table 10). The most sensitive marine fishes were pinfish larvae, the goby, Gobius minutus, and eggs and larvae of the flounder, Pleuronectes platessa, all with LC50 values <100 μ g/l (Adema and Vink, 1981). The most sensitive freshwater invertebrate species were the chironomid, Chironomus gr. thummi (Slooff, 1983) and the snail, Lymnaea luteola (Gupta et al., 1984). The most sensitive marine invertebrates were the Eastern oyster (Borthwick and Schimmel, 1978), larvae of the crusta ceans, Crangon crangon and Palaemon elegans (VanDijk et al. , 1977), and the copepod, Pseudodiaptomus coronatus (Hauch et al., 1980), all with LC50 values <200 μ g/l. In chronic toxicity tests, the lowest concentration reported to cause adverse effects was 1.8 μ g/l (NaPCP), which inhibited growth of sockeye salmon (Webb and Brett, 1973). The marine species tested displayed similar thresholds for chronic toxicity. Both acute and chronic toxicity increased at lower pH, probably because a lower pH favors the un-ionized form of pentachlorophenol, which is taken up more readily and is therefore more toxic than ionized pentachlorophenol (Kobayashi and Kishino, 1980; Spehar et al., 1985). Data concerning the effects of pentachlorophenol on aquatic plants were highly variable. Therefore, it was difficult to draw conclusions from these data. Pentachlorophenol did not appear to bioaccumulate in aquatic or ganisms to very high concentrations. BCFs for pentachlorophenol were <1000 for most species tested. The highest BCF was 3830 for the polychaete, Lanice conchilega (Ernst, 1979). Some species appear to have an inducible pentachlorophenol-detoxification mechanism, as evidenced in several experiments in which pentachlorophenol tissue levels peaked in 4-8 days and declined thereafter despite continued exposure (Pruitt et al., 1977; Trujillo et al., 1982). A study by Niimi and Cho (1983) indicated that uptake of waterborne pentachlorophenol from gills was much greater than uptake from food, indicating that bioconcentration of pentachlorophenol through the food chain is unlikely. Biomonitoring data of Lake Ontario fishes showed that similar pentachlorophenol levels were found in predators andforage species. Studies with experimental ecosystems have indicated that ecological effects may occur at pentachlorophenol levels as low as those causing chronic toxicity in sensitive species in single-species tests. The lowest concentration that caused adverse effects in these studies was 15.8 μ g/l, which caused a reduction in numbers of individuals and species in a marine benthic community (Tagatz et al., 1978). Pentachlorophenol is readily absorbed from the gastrointestinal tract of rats, mice, monkeys and humans (Braun et al. , 1977, 1978; Ahlborg et al., 1974; Braun and Sauerhoff, 1976). Peak plasma concentrations are reached within 12-24 hours after oral administration to monkeys (Braun and Sauerhoff, 1976), but 4-6 hours after oral administration to rats (Braun et al., 1977). After oral administration, the highest concentration of radioactivity was found in the liver and gastrointesti nal tract of monkeys (Braun et al., 1977). In rats and mice, tet rachlorohydroquinone was identified in the urine (Jakobson and Yllner, 1971; Braun et al., 1977; Ahlborg et al., 1974) as well as unmetabolized pentachlorophenol and glucuronide-conjugated pen tachlorophenol. Although Ahlborg et al. (1974) reported that oxidative dechlorination of pentachlorophenol occurs in humans, as evidenced by the presence of tetrachlorohydroquinone in the urine of workers occupationally exposed (probably by inhalation), analysis of human urine after ingestion of pentachlorophenol revealed the presence of conjugated pentachlorophenol and unmetabolized pentachlorophenol (Braun et al., 1978). The primary route of excretion after oral administrtation of all species studied is in the urine (Braun et al. , 1977, 1978; Ahlborg et al., 1974; Larsen et al., 1972; Braun and Sauerhoff, 1976). Although urinary excretion followed second-order kinetics in rats (Larsen et al., 1972; Braun et al., 1977) except in females receiving a single high dose (100 mg/kg) of pentachlorophenol, urinary excretion of pentachlorophenol in humans and monkeys followed first-order kinetics (Braun and Sauerhoff, 1976; Braun et al., 1978). Enterohepatic circulation played an importation role in the pharmacokinetics of pen tachlorophenol. The half-life of pentachlorophenol in the plasma is longer in female rats and monkeys than it is in male rats and monkeys (Braun et al. , 1978; Braun and Sauerhoff, 1976). Because many preparations of pentachlorophenol are contaminated with small but measurable amounts of highly toxic substances, such as dibenzodioxins, special attention must be paid to the composition of the pentachlorophenol solution tested. In studies where technical and purified pentachlorophenol have been evaluated (Schwetz et al., 1974; Goldstein et al., 1977; Kimbrough and Linder, 1978; Knudsen et al., 1974; Johnson et al., 1973; Kerkvliet et al., 1982), only the results of the experiments using purified pentachlorophenol were reported in detail. Oral exposure to pentachlorophenol was not carcinogenic in mice (BRL, 1968; Innes et al., 1969) or rats (Schwetz et al., 1977), regardless of the composition of the pentachlorophenol solution tested. Although there are a few studies that suggest pentachlorophenol may be mutagenic in B. subtilis (Waters et al., 1982; Shirasu, 1976), in yeast, Saccharomyces cerevisiae (Fahrig et al., 1977) and in mice, as evidenced by the coat-color spot test (Fahrig et al., 1977), no evidence of mutagenicity was reported in S. typhimurium (Anderson et al. , 1972; Simmon et al., 1977; Lemma and Ames, 1975; Moriya et al. , 1983; Waters et al., 1982; Buselmaier et al., 1973) or in E. coli (Simmon et al., 1977; Fahrig, 1974; Moriya et al., 1983; Waters et al., 1982) with or without metabolic activation. Three teratogenicitylreproductive toxicity studies (Schwetz et al., 1974, 1977; Courtney et al., 1976) indicate that pentachlorophenol is fetotoxic in rats at oral dose levels ≥5 mg/kg/day. At the highest dose tested (500 ppm) in a fourth teratogenicity/reproductive toxicity study (Exon and Koller, 1982), there was a statistically nonsignificant decrease in litter size. The lowest dose tested (5 mg/kg/day) by Schwetz et al. (1977) was the lowest dose at which any evidence offetotoxicity, as indicated by delayed ossification, was observed. No adverse fetal or reproductive effects were reported at ≤3 mg/kg/day (Schwetz et al., 1977; Exon and Koller, 1982). In subchronic and chronic toxicity studies, adverse effects occurred primarily in the liver (Kerkvliet et al., 1982; Johnson et al., 1973; Knudsen et al. , 1974; Goldstein et al. , 1977; Kimbrough and Linder, 1978; Schwetz et al., 1977), the kidney (Johnson et al., 1973; Kimbrough and Linder, 1978; Schwetz et al., 1977) and the immune system (Kerkvliet et al., 1982). Knudsen et al. (1974) reported increased liver weights in female rats and centrilobu lar vacuolization in male rats exposed to diets containing ≧50 ppm commercial pentachlorophenol, which contained 282 ppm dioxins. In the remaining studies, increased liver weight (Johnson et al., 1973) and increased pigmentation of hepatocytes (Schwetz et al., 1977) were observed at oral doses of≥10 mg/kg/day (∼90%), and SGPT levels significantly increased in rats ingesting 30 mg/kg/day pentachloro phenol (∼90%) for 2 years (Schwetz et al., 1977). Increased kidney weight unaccompanied by renal histopathology was reported in rats exposed to dietary concentration ≧20 ppm of pentachlorophenol (>99%) for 8 months (Kimbrough and Linder, 1978) and in rats ingesting 30 mg/kg/day (∼90%) for 90 days (Johnson et al., 1973). Increased pigmentation of the renal tubular epithelial cells was re ported in rats ingesting 10 or 30 mg/kg/day pentachlorophenol for 2 years (Schwetz et al., 1977). Although decreased immunocompetence was reported in mice exposed to dietary levels of 50 or 500 ppm of pentachlorophenol (>99%) for 34 weeks (Kerkvliet et al., 1982), the decrease was statistically significant only at the higher dose. An ADI of 0.03 mg/kg/day or 2.1 mg/day for a 70 kg human was derivedfrom the NOAEL of 3 mg/kg/day in rats in the chronic dietary study by Schwetz et al. (1977). An uncertainty factor of 100 was used. An RQ of 100 was derived based on the fetotoxic effects of pen tachlorophenol in rats in the study by Schwetz et al. (1974). Based on guidelines for carcinogen risk assessment (U.S. EPA, 1984b) and inadequate evidence for animal carcinogenicity or absence of human cancer data, pentachlorophenol is classified as Group D, meaning that it is not classified as a human carcinogen.

This article discusses findings from a study of a 22-year campaign to change special education assessment policy in Ontario by the advocacy organization People for Education (P4E) and explains how dominant discourses enabled the government to leave the issue unresolved. Based on a rhetorical analysis of 58 documents, the article identifies strategies used by P4E to persuade Ontario’s government and citizens to view students’ uneven access to educational assessments as a problem. Further, since this problem differently impacts children by class and geographical location, it perpetuates inequities. Despite using strategies deemed effective in other change efforts, arguments mobilized by P4E have not been persuasive in a neoliberal context that champions responsibilized individualism, meritocracy, human capital development, and reduced funding of public services.

Amherst Island is an internationally renowned sanctuary for raptors and is home to 34 avian species at risk. In addition to providing critical habitat for migrating birds, Amherst Island also supports a variety of other taxa including reptiles, amphibians, bats, and butterflies, some of which are endangered. Located in eastern Ontario, the island has been ranked second in biodiversity significance by Islands of Life and has been internationally recognized as an Important Bird Area. Amherst Island gained attention in recent months following a proposal by Windlectric Inc. to install and operate up to 36 wind turbines on Amherst Island as part of the Government of Ontario’s renewable energy initiatives. Despite clear energy and economic benefits, negative impacts of wind turbine installation have also been well documented. Risks associated with wind farming include habitat fragmentation and destruction, increased road traffic, and bird and bat strikes.With the help of contacts at the Association to Protect Amherst Island, Kingston Field Naturalists, and Windlectric Inc., we plan to develop an unbiased risk assessment using data from primary literature and existing wind farms as case studies. We will place special focus on species of concern while weighing potential environmental disturbance against benefits of the green energy movement in Ontario. Our project is intended to act as a holistic, nonpartisan assessment of the benefits and potential concerns involved with the wind turbine project, and where appropriate, we hope to provide recommendations for mitigating damages associated with installation and operation.

IntroductionChildren with special educational needs (SEN) often struggle academically. Previous studies found that children’s abilities in kindergarten are predictive of their future SEN status. It is currently unknown whether these predictors differ in children with and without an early identification of a special need in kindergarten (SN-K). Objectives and ApproachWe investigated early predictors of SEN in Grade 3, in a cohort of Ontario children, with and without SN-K (1,824 and 62,842, respectively), who attended kindergarten between 2003/04 and 2005/06. Early Development Instrument data, a teacher-completed checklist of children’s development, were linked to Grade 3 standardized reading, writing, and mathematics test scores. Controlling for children’s demographics, multivariate binary logistic regressions were conducted examining the association between children’s developmental outcomes, their functional impairments, the necessity for further assessment (all reported by their kindergarten teacher) and their SEN status in Grade 3. ResultsOverall, 69.8% of children with SN-K had SEN in Grade 3, while 11.6% of children without SN-K had SEN. Our analyses revealed that, for children with SN-K, having a functional impairment was the most significant predictor of having SEN in Grade 3 (Odds Ratio=3.61, 2.59-5.02 95% confidence interval). For children without SN-K, teachers reporting the need for further assessment was the strongest predictor of having SEN in Grade 3 in children without SN-K (Odds Ratio=2.70, 2.49-2.93). Conclusion / ImplicationsEarly predictors of SEN in Grade 3 differ for children who receive an early identification (SN-K) compared to those who don’t. How children with SN-K function in a classroom is the best predictor of SEN in Grade 3, while teachers’ observation that a child needs further assessment is the strongest predictor of SEN in Grade 3 for those without SN-K. Addressing these areas early on may help reduce the number of children with SEN in later grades and may positively impact their future academic success.

Background: Congenital anomalies (CAs) are a major cause of infant morbidity and mortality in Canada. Reliably identifying CAs is essential for CA surveillance and research. The main objective of this study was to assess the agreement of eight sentinel anomalies including: neural tube defects (NTD), orofacial clefts, limb deficiency defects (LDD), Down syndrome (DS), tetralogy of Fallot (TOF), gastroschisis (GS), hypoplastic left heart syndrome (HLHS) and transposition of great vessels (TGA) captured in the BORN Information System (BIS) database and the Canadian Institute for Health Information (CIHI) Discharge Abstract Database (DAD).Methods: Live birth and stillbirth records between the BIS and CIHI-DAD in the fiscal years of 2012–2013 to 2015–2016 were linked using 10 digit infant Ontario Health Insurance Plan (OHIP) numbers. Percent agreement and Kappa statistics were performed to assess the reliability (agreement) of CAs identified in the linked BIS and CIHI-DAD birth records. Then, further investigations were conducted on those CA cases identified in the CIHI-DAD only.Results: Kappa coefficients of the eight selected CAs between BIS (“Confirmed” or “Suspected” cases) and CIHI-DAD were 0.96 (95% CI: 0.93–0.98) for GS; 0.81 (95% CI: 0.78–0.83) for Orofacial clefts; 0.75 (95% CI: 0.72–0.77) for DS; 0.71 (95% CI: 0.65–0.77) for TOF; 0.62 (95% CI: 0.55–0.68) for TGA; 0.59 (95% CI: 0.49–0.68) for HLHS, 0.53 (95% CI: 0.46–0.60) for NTD-all; and 0.30 (95% CI: 0.23–0.37) for LDD.Conclusions: The degree of agreement varied among sentinel CAs identified between the BIS and CIHI. The potential reasons for discrepancies include incompleteness of capturing CAs using existing picklist values, especially for certain sub-types, incomplete neonatal special care data in the BIS, and differences between clinical diagnosis in the BIS and ICD-10-CA classification in the DAD. A future data abstraction study will be conducted to investigate the potential reasons for discrepancies of CA capture between two databases. This project helps quantify the quality of CA data collection in the BIS, enhances understanding of CA prevalence in Ontario and provides direction for future data quality improvement activities.

This special issue of the International Journal of Education Policy & Leadership (IJEPL), Research in the Canadian Context, marks a significant milestone for the journal. Throughout our twelve-year history, we have sought to publish the best research in leadership, policy, and research use, allowing authors to decide the topics by dint of their research. While this model still serves as the foundation for IJEPL content, we decided to give researchers a chance to engage in deeper conversations by introducing special issues. In our first special issue, researchers discuss their work within the scope of education policy, leadership, and research use within the Canadian context. While many aspects of leadership, teaching, and learning can be seen as similar across contexts, there are also issues of particular concern within national, regional, provincial, or local spheres, particularly when looking at policy and system changes. The researchers featured in this issue provide an important look into education in Canada.PolicyIn the policy realm, Sue Winton and Lauren Jervis examine a 22-year campaign to change special education assessment policy in Ontario, examining how discourses dominant in the province enabled the government to leave the issue unresolved for decades. Issues of access and equity play out within a neoliberal context focused on individualism, meritocracy, and the reduced funding of public services. While Winton and Jervis highlight the tension between policy goals and ideological contexts, Jean-Vianney Auclair considers the place of policy dialogues within governmental frames, and the challenge of engaging in broadly applicable work within vertically structured governmental agencies. One often-touted way to move beyondResearch useWithin the scope of research use, Sarah L. Patten examines how socioeconomic status (SES) is defined and measured in Canada, the challenges in defining SES, and potential solutions specific to the Canadian context. In looking at knowledge mobilization, Joelle Rodway considers how formal coaches and informal social networks nserve to connect research, policy, and practice in Ontario’s Child and Youth Mental Health program.LeadershipTurning to leadership, contributing researchers explored the challenges involved in staff development, administrator preparation, and student outcomes. Keith Walker and Benjamin Kutsyuruba explore how educational administrators can support early career teachers to increase retention, and the somewhat haphazard policies and supports in place across Canada to bring administrators and new teachers together. Gregory Rodney MacKinnon, David Young, Sophie Paish, and Sue LeBel look at how one program in Nova Scotia conceptualizes professional growth, instructional leadership, and administrative effectiveness and the emerging needs of administrators to respond to issues of poverty, socioemotional health, and mental health, while also building community. This complex environment may mean expanding leadership preparation to include a broader consideration of well-being and community. Finally, Victoria Handford and Kenneth Leithwood look at the role school leaders play in improving student achievement in British Columbia, and the school district characteristics associated with improving student achievement.Taken together, the research in this special issue touches on many of the challenges in policy development, application, and leadership practice, and the myriad ways that research can be used to address these challenges. We hope you enjoy this first special issue of IJEPL!

The Spotted Turtle (Clemmy guttata), a small freshwater turtle species, prefer shallow wetland habitats, and are restricted to eastern North America, predominantly in southern Ontario along the southern shores of the Great Lakes. However, the Spotted Turtle has been classified as ‘vulnerable’ (a species of special concern) by COSEWIC since 1991, owing to the 35% decline of the population throughout the past century. This is primarily of concern regarding reductions of ecosystem biodiversity, and further anthropogenic pressures will drive the species towards further endangerment. High rates of road mortality are considered a key actor in facilitating a decline in the Spotted Turtle population. A study by Ashley and Robinson (1996) found that approximately 25% of annual Spotted Turtle deaths are a direct result of roadway incidents, around the Long Point Causeway, bordering Lake Erie. By utilizing data from Long Point, the extent of road mortality of the Spotted Turtle will be characterized by analyzing the proportions of deaths in high-density versus low-density roadways. There is varied response to the effectiveness of various solutions to minimize road mortality, including a vegetation management approach boarding roadways, subterranean passages, barriers along roadsides, and influencing and informing in decision-making processes. With the Sandy Pines Wildlife Center, Napanee, reductions in roadway mortality rates will decline along the 401 by increasing both public and private sector awareness regarding the issue of Spotted Turtle road mortality. Recommendations to communities and government entities will be made to facilitate the improvement of the status of Spotted Turtle.

PURPOSE: Timely care for patients with lung cancer (LC) is associated with improved clinical outcomes. In Southeastern Ontario, Canada, we identified delays in the diagnostic process for patients undergoing evaluation for suspected LC through a rapid assessment clinic. We developed improvement initiatives with an aim of reducing the time from referral to diagnosis. METHODS: A Standardized Triage Process (STP) was implemented for patients referred with suspected LC, including routine interdisciplinary triage, standardized pathways with preordered staging tests, and a new Small Nodule Clinic. We retrospectively analyzed all patients referred pre-STP (January to April 2018) and prospectively for improvement (May 2018 to March 2019). Process measures included STP compliance and time to completion of staging investigations (positron emission tomography [PET] and computed tomography/magnetic resonance imaging of brain). Data are reported as means; significance was determined by special-cause variation using Statistical Process Control charts; unpaired t tests were compared between groups. RESULTS: We reviewed 833 referrals (207 baseline and 626 post-STP). STP compliance improved monthly to 99.4%. Post-STP, time from referral to PET decreased (from 38.5 to 15.7 days), time from referral to brain imaging decreased (from 33.4 to 13.1 days), and time from referral to diagnosis decreased (from 38.0 to 22.7 days), all demonstrating special-cause variation. Patients completing preordered staging tests experienced significantly faster care than those without preordered tests, including time to PET (23.0 v 35.9 days), computed tomography/magnetic resonance imaging of brain (16.2 v 29.9 days), and diagnosis (39.9 v 28.1 days), all P < .001. CONCLUSION: An STP significantly improved timeliness of diagnosis and staging for patients with suspected LC undergoing evaluation in a rapid assessment clinic.

IntroductionPatient–clinician communication in the Emergency Department (ED) faces challenges of time and interruptions, resulting in negative effects on patient satisfaction with communication and failure to relieve anxiety. Our aim was to improve patient satisfaction with communication and to decrease related patient anxiety.MethodsA multistage quality improvement (QI) initiative was conducted in the ED of Toronto General Hospital, a quaternary care centre in Ontario, Canada, from January to May 2018. We engaged stakeholders widely including clinicians, allied health and patients. We developed a 5-point Likert scale survey to measure patient and clinician rating of their communication experience, along with open-ended questions, and a patient focus group. Inductive analyses yielded interventions that were introduced through three Plan-Do-Study-Act (PDSA) cycles: (1) a clinician communication tool called Acknowledge-Empathize-Inform; (2) patient information pamphlets; and (3) a multimedia solution displaying patient-directed material. Our primary outcome was to improve patient satisfaction with communication and decrease anxiety by at least one Likert scale point over 6 months. Our secondary outcome was clinician-perceived interruptions by patients. We used statistical process control (SPC) charts to identify special cause variation and two-tailed Mann-Whitney U tests to compare means (statistical significance p<0.05).ResultsA total of 232 patients and 104 clinicians were surveyed over baseline and three PDSA cycles. Communication about wait times, ED process, timing of next steps and directions to patient areas were the most frequently identified gaps, which informed our interventions. Measurements at baseline and during PDSA 3 showed: patient satisfaction increased from 3.28 (5 being best; n=65) to 4.15 (n=59, p<0.0001). Patient anxiety decreased from 2.96 (1 being best; n=65) to 2.31 (n=59, p<0.001). Clinician-perceived interruptions by patients changed from 4.33 (5 being highest; n=30) to 4.18 (n=11, p=0.98) and did not meet significance. SPC charts showed special cause variation temporally associated with our interventions.ConclusionsOur pragmatic low-cost QI initiative led to statistically significant improvement in patient satisfaction with communication and decreased patient anxiety while narrowly missing our a priori improvement aim of one full Likert scale point.

Objectives To investigate the effect of prolonged low-level laser therapy application combined with exercise on pain and disability in patients with osteoarthritis of the knee. Design A randomized controlled trial. Setting Special rehabilitation services. Subjects Forty-three participants with knee osteoarthritis. Intervention Following initial assessment, participants were randomly allocated to the Laser group (n = 22, 44 knees) and received low-level laser therapy while the Placebo group (n = 21, 42 knees) received placebo therapy three times a week for 3 weeks. Both groups then received low-level laser therapy combined with exercise three times a week for the following 8 weeks. Main outcome measures The primary outcome was change in knee pain and disability (Lequesne). Secondary outcomes included change in mobility (Timed Up and Go test), range of motion (goniometer), muscular strength (dynamometer), activity (Western Ontario and McMaster Universities Osteoarthritis questionnaire), and medication intake and relief. Results Mean (SD) age of participants was 63.02 (9.9) years. Pain scores at baseline, 3 weeks, 11 weeks, and 6 months follow-up were 9.1 (1.3), 2.6 (2.3), 0.2 (0.9), and 0.2 (0.8) for the Laser group and 9.5 (8.0), 7.7 (5.3), 5.6 (2.4), and 7.4 (5.0) for the Placebo group, respectively. Disability scores at baseline, 3 weeks, 11 weeks, and 6 months follow-up were 14.9 (4.7), 7.6 (4.8), 3.9 (4.2), and 3.5 (4.1) for the Laser group and 17.8 (14.7), 15.2 (11.5), 11.6 (6.4), and 15.8 (11.9) for the Placebo Group, respectively. Conclusion In participants with osteoarthritis of the knee, the isolated application of low-level laser therapy in the initial 3 weeks and combined with exercises in the final 8 weeks reduced pain, disability, and intake of medication over a 6-month period.

Abstract Background Posterior tibial slope (PTS) increases after medial open-wedge high tibial osteotomy (OWHTO) is challenging for patients. This study aims to determine whether use of a suspended and straightened knee joint position during the fixing of steel plates can prevent an increase in the PTS after OWHTO. Methods This study retrospectively analyzed 112 subjects (122 knees) [34 males, 78 females; mean age 59.1 ± 6.6 (range 48–76) years; mean body mass index 28.06 ± 3.61 kg/m2] who underwent OWHTO. A total of 78 knees that were suspended and extended by placing a sterile cloth ball under the ipsilateral ankle during the fixing of steel plates comprised the suspended and straightened knee joint position (SSP) group, and 44 knees that were kept naturally straightened without placing a sterile cloth ball under the ipsilateral ankle during the fixing of steel plates comprised the naturally straightened knee joint position (NSP) group. Patients were clinically assessed according to the visual analog pain scale (VAS), the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index, the Knee Society Scores (KSS) knee and function scores, the Hospital for Special Surgery (HSS) knee scores and the Lysholm knee scores. Radiological assessment was performed according to the changes in the PTS between preoperation, 1-day postoperation, and the final follow-up periods. Ultimately, the difference in postoperative PTS changes between the two groups was statistically analyzed. The median follow-up period was 2.2 years (range 1.6–3.7 years). Results In the final follow-up period, significant improvements were observed in the clinical VAS scores, WOMAC scores, KSS knee and function scores, HSS scores and the Lysholm knee scores in both groups (P < 0.001), and no difference was found between the two groups. Radiological assessment showed that there was no statistical difference in the preoperative PTS between the two groups. The 1-day postoperative PTS and the most recent follow-up PTS were significantly greater than the preoperative PTS in the NSP group (t = − 3.213, − 6.406, all P < 0.001), but no significant increase was seen in the SSP group (P > 0.05). The increase in PTS in the NSP group was significantly greater than that in the SSP group at the 1-day postoperative (t = 2.243, P = 0.030) and final follow-up periods (t = 6.501, P < 0.001). Conclusions For OWHTO, the use of a suspended and straightened knee joint position rather than a naturally straightened knee joint position during the fixing of steel plates could effectively prevent the increase in postoperative PTS. Level of Evidence: Retrospective Study Level III.