Collaboration between infection control and occupational health in three continents: a success story with international impact

Globalization has been accompanied by the rapid spread of infectious diseases, and further strain on working conditions for health workers globally. Post-SARS, Canadian occupational health and infection control researchers got together to study how to better protect health workers, and found that training was indeed perceived as key to a positive safety culture. This led to developing information and communication technology (ICT) tools. The research conducted also showed the need for better workplace inspections, so a workplace audit tool was also developed to supplement worker questionnaires and the ICT. When invited to join Ecuadorean colleagues to promote occupational health and infection control, these tools were collectively adapted and improved, including face-to-face as well as on-line problem-based learning scenarios. The South African government then invited the team to work with local colleagues to improve occupational health and infection control, resulting in an improved web-based health information system to track incidents, exposures, and occupational injury and diseases. As the H1N1 pandemic struck, the online infection control course was adapted and translated into Spanish, as was a novel skill-building learning tool that permits health workers to practice selecting personal protective equipment. This tool was originally developed in collaboration with the countries from the Caribbean region and the Pan American Health Organization (PAHO). Research from these experiences led to strengthened focus on building capacity of health and safety committees, and new modules are thus being created, informed by that work. The products developed have been widely heralded as innovative and interactive, leading to their inclusion into “toolkits” used internationally. The tools used in Canada were substantially improved from the collaborative adaptation process for South and Central America and South Africa. This international collaboration between occupational health and infection control researchers led to the improvement of the research framework and development of tools, guidelines and information systems. Furthermore, the research and knowledge-transfer experience highlighted the value of partnership amongst Northern and Southern researchers in terms of sharing resources, experiences and knowledge.

Relationships between Duck and Grassland Bird Relative Abundance and Species Richness in Southern Saskatchewan

Digital map products that integrate long-term duck population and land-use data are currently being used to guide conservation program delivery on the Canadian Prairies. However, understanding the inter-relationships between ducks and other grassland bird species would greatly enhance program planning and delivery. We hypothesized that ducks, and Northern Pintail (Anas acuta) in particular, may function as an umbrella guild for the overall breeding habitat quality for other grassland bird species. We compared grassland bird species richness and relative abundance among areas of low, moderate, and high predicted waterfowl breeding densities (i.e., duck density strata) in the southern Missouri Coteau, Saskatchewan. We conducted roadside point counts and delineated habitats within a 400 m radius of each point. The duck high-density stratum supported greater avian species richness and abundance than did the duck low-density stratum. Overall, duck and other grassland bird species richness and abundance were moderately correlated, with all r between 0.37 and 0.69 (all P < 0.05). Although the habitat requirements of Northern Pintail may overlap with those of other grassland endemics, priority grassland bird species richness was only moderately correlated with total pintail abundance in both years, and the abundances of pintail and grassland songbirds listed by the Committee on the Status of Endangered Wildlife in Canada were not correlated. No differences in the mean number of priority grassland species were detected among the strata. Adequate critical habitat for several priority species may not be protected if conservation is focused only in areas of moderate to high wetland density because large tracts of contiguous, dry grassland habitat (e.g., pasture) occur infrequently in high-quality duck habitat.

Estimated Mortality of Selected Migratory Bird Species from Mowing and Other Mechanical Operations in Canadian Agriculture

Mechanical operations such as mowing, tilling, seeding, and harvesting are well-known sources of direct avian mortality in agricultural fields. However, there are currently no mortality rate estimates available for any species group or larger jurisdiction. Even reviews of sources of mortality in birds have failed to address mechanical disturbance in farm fields. To overcome this information gap we provide estimates of total mortality rates by mechanical operations for five selected species across Canada. In our step-by-step modeling approach we (i) quantified the amount of various types of agricultural land in each Bird Conservation Region (BCR) in Canada, (ii) estimated population densities by region and agricultural habitat type for each selected species, (iii) estimated the average timing of mechanical agricultural activities, egg laying, and fledging, (iv) and used these values and additional demographical parameters to derive estimates of total mortality by species within each BCR. Based on our calculations the total annual estimated incidental take of young ranged from ~138,000 for Horned Lark (Eremophila alpestris) to as much as ~941,000 for Savannah Sparrow (Passerculus sandwichensis). Net losses to the fall flight of birds, i.e., those birds that would have fledged successfully in the absence of mechanical disturbance, were, for example ~321,000 for Bobolink (Dolichonyx oryzivorus) and ~483,000 for Savannah Sparrow. Although our estimates are subject to an unknown degree of uncertainty, this assessment is a very important first step because it provides a broad estimate of incidental take for a set of species that may be particularly vulnerable to mechanical operations and a starting point for future refinements of model parameters if and when they become available.

Comparing the results of recall surveys and standardized searches in understanding bird-window collisions at houses

Every year a large number of birds die when they collide with windows. The actual number is difficult to ascertain. Previous attempts to estimate bird-window collision rates in Canada relied heavily on a prior citizen-science study that used memory-based surveys. Such an approach to data collection has many potential biases. We built upon this study and its recommendations for future research by creating a citizen-science program that actively searched for collision evidence at houses and apartments for an extended period with the objective to see how standardized approaches to data collection compared with memory recall. Absolute collision estimates as well as relative differences were compared between residence types in the two studies, and we found considerable differences in absolute values for collisions but similar rankings of collision rates between residence types. Collision recall rates in our study (56.5%) were very similar those in the prior 2012 study, where 50.5% of participants remembered a bird colliding with a window at some time in the past. Fatality estimates, however, were 1.4 times higher in the 2012 study than in our study based on standardized searches. Rural houses with a bird feeder consistently had the highest number of collisions. This suggests that memory recall surveys may be a useful tool for understanding the relative importance of different risk factors causing bird-window collisions.

A comparison of greenhouse gas emissions in the residential sector of major Canadian cities

One of the most significant sources of greenhouse gas (GHG) emissions in Canada is the buildings sector, with over 30% of national energy end-use occurring in buildings. Energy use must be addressed to reduce emissions from the buildings sector, as nearly 70% of all Canada���s energy used in the residential sector comes from fossil sources. An analysis of GHG emissions from the existing residential building stock for the year 2010 has been conducted for six Canadian cities with different climates and development histories: Vancouver, Edmonton, Winnipeg, Toronto, Montreal, and Halifax. Variation across these cities is seen in their 2010 GHG emissions, due to climate, characteristics of the building stock, and energy conversion technologies, with Halifax having the highest per capita emissions at 5.55 tCO2e/capita and Montreal having the lowest at 0.32 tCO2e/capita. The importance of the provincial electricity grid’s carbon intensity is emphasized, along with era of construction, occupancy, floor area, and climate. Approaches to achieving deep emissions reductions include innovative retrofit financing and city level residential energy conservation by-laws; each region should seek location-appropriate measures to reduce energy demand within its residential housing stock, as well as associated GHG emissions.

Tapping into Floor Staff: Using the knowledge of floor staff to conduct formative evaluations of exhibits in a Canadian science centre

Most science centres in Canada employ science-educated floor staff to motivate visitorsto have fun while enhancing the educational reach of the exhibits. Although bright andsensitive to visitors’ needs, floor staff are rarely consulted in the planning,implementation, and modification phases of an exhibit. Instead, many developmentteams rely on costly third-party evaluations or skip the front-end and formativeevaluations all together, leading to costly errors that could have been avoided. This studywill seek to reveal a correlation between floor staff’s perception of visitors’ interactionswith an exhibit and visitors’ actual experiences. If a correlation exists, a recommendationcould be made to encourage planning teams to include floor staff in the formative andsummative evaluations of an exhibit. This is especially relevant to science centres withlimited budgets and for whom a divide exists between floor staff and management.In this study, a formative evaluation of one exhibit was conducted, measuring both floorstaff’s perceptions of the visitor experience and visitors’ own perceptions of the exhibit.Floor staff were then trained on visitor evaluation methods. A week later, floor staff andvisitors were surveyed a second time on a different exhibit to determine whether anincrease in accuracy existed.The training session increased the specificity of the motivation and comprehensionresponses and the enthusiasm of the staff, but not their ability to predict observedbehaviours with respect to ergonomics, learning indicators, holding power, and successrates. The results revealed that although floor staff underestimated visitors’ success ratesat the exhibits, staff accurately predicted visitors’ behaviours with respect to holdingpower, ergonomics, learning indicators, motivation and comprehension, both before andafter the staff training.

Detecting migrants in populations of Rhizoctonia solani anastomosis group 3 from potato in North Carolina using multilocus genotype probabilities

The relative contribution of migration of Rhizoctonia solani anastomosis group 3 (AG-3) on infested potato seed tubers originating from production areas in Canada, Maine, and Wisconsin (source population) to the genetic diversity and structure of populations of R. solani AG-3 in North Carolina (NC) soil (recipient population) was examined. The frequency of alleles detected by multilocus polymerase chain reaction-restriction fragment length polymorphisms, heterozygosity at individual loci, and gametic phase disequilibrium between all pairs of loci were determined for subpopulations of R. solani AG-3 from eight sources of potato seed tubers and from five soils in NC. Analysis of molecular variation revealed little variation between seed source and NC recipient soil populations or between subpopulations within each region. Analysis of population data with a Bayesian-based statistical method previously developed for detecting migration in human populations suggested that six multilocus genotypes from the NC soil population had a statistically significant probability of being migrants from the northern source population. The one-way (unidirectional) migration of genotypes of R. solani AG-3 into NC on infested potato seed tubers from Canada, Maine, and Wisconsin provides a plausible explanation for the lack of genetic subdivision (differentiation) between populations of the pathogen in NC soils or between the northern source and the NC recipient soil populations.

MicroRNA Signature Obtained From the Comparison of Aggressive With Indolent Non-Hodgkin Lymphomas: Potential Prognostic Value in Mantle-Cell Lymphoma

Purpose Mantle-cell lymphoma (MCL) has a variable natural history but is incurable with current therapies. MicroRNAs (miRs) are useful in prognostic assessment of cancer. We determined an miR signature defining aggressiveness in B-cell non-Hodgkin lymphomas (NHL) and assessed whether this signature aids in MCL prognosis.MethodsWe assessed miR expression in a training set of 43 NHL cases. The miR signature was validated in 44 additional cases and examined on a training set of 119 MCL cases from four institutions in Canada. miRs significantly associated with overall survival were examined in an independent cohort of 114 MCL cases to determine association with patient outcome. miR expression was combined with current clinical prognostic factors to develop an enhanced prognostic model in patients with MCL.ResultsFourteen miRs were differentially expressed between aggressive and indolent NHL; 11 of 14 were validated in an independent set of NHL (excluding MCL). miR-127-3p and miR-615-3p were significantly associated with overall survival in the MCL training set. Their expression was validated in an independent MCL patient set. In comparison with Ki-67, expression of these miRs was more significantly associated with overall survival among patients with MCL. miR-127-3p was combined with Ki-67 to create a new prognostic model for MCL. A similar model was created with miR-615-3p and Mantle Cell Lymphoma International Prognostic Index scores.ConclusionEleven miRs are differentially expressed between aggressive and indolent NHL. Two novel miRs were associated with overall survival in MCL and were combined with clinical prognostic models to generate novel prognostic data for patients with MCL. (C) 2013 by American Society of Clinical Oncology

Hydatid Disease in Boreal Regions

It is the purpose of this paper to review the status of hydatid disease (caused by Echinococcus spp.) in the boreal regions of the world. Its importance has long been recognized in Eurasian countries, but only during recent years have investigators added anything significant to the knowledge of hydatid disease in North America. There is need to disseminate up-to-date information among medical workers in Canada and Alaska, where the disease is endemic in northern regions having a large aboriginal population. Therefore, particular emphasis will be placed on the situation in boreal North America.

'Työmies?': Finnish Canadians in the Economy: A Historiographic Overview

Finnish immigrants are often seen as labor activists, even “radicals,” and key players in the “left-right” political divide, thus indicating a real presence on the “other” side of the economy. How did successive historians build these now-standard views? This paper takes a sweeping tour of writing on Finnish Canadian workers, tracing the evolution of these assessments. Archives and histories provided basic notions of “the” Finnish Canadian and were key sources as professional scholars – many Finns themselves – began their work. In Canada, new academics – Varpu Lindstrom most prominently – wrote about women, arts and culture, intellectual activity, and the impact of Finns as “exceptional” historical actors in socioeconomic terms. But, have historians of Finnish Canadian workers built a convincing case? Examination of Finnish Canadian “economic” historiography offers insights into the Finnish Canadian “story,” and the nature of generalization in immigrant and ethnic history.

A meta-analysis of cambium phenology and growth: linear and non-linear patterns in conifers of the northern hemisphere

Background and Aims Ongoing global warming has been implicated in shifting phenological patterns such as the timing and duration of the growing season across a wide variety of ecosystems. Linear models are routinely used to extrapolate these observed shifts in phenology into the future and to estimate changes in associated ecosystem properties such as net primary productivity. Yet, in nature, linear relationships may be special cases. Biological processes frequently follow more complex, non-linear patterns according to limiting factors that generate shifts and discontinuities, or contain thresholds beyond which responses change abruptly. This study investigates to what extent cambium phenology is associated with xylem growth and differentiation across conifer species of the northern hemisphere. Methods Xylem cell production is compared with the periods of cambial activity and cell differentiation assessed on a weekly time scale on histological sections of cambium and wood tissue collected from the stems of nine species in Canada and Europe over 1–9 years per site from 1998 to 2011. Key Results The dynamics of xylogenesis were surprisingly homogeneous among conifer species, although dispersions from the average were obviously observed. Within the range analysed, the relationships between the phenological timings were linear, with several slopes showing values close to or not statistically different from 1. The relationships between the phenological timings and cell production were distinctly non-linear, and involved an exponential pattern. Conclusions The trees adjust their phenological timings according to linear patterns. Thus, shifts of one phenological phase are associated with synchronous and comparable shifts of the successive phases. However, small increases in the duration of xylogenesis could correspond to a substantial increase in cell production. The findings suggest that the length of the growing season and the resulting amount of growth could respond differently to changes in environmental conditions.

Sex- and gender-related risk factor burden in patients with premature acute coronary syndrome

BACKGROUND Few contemporary data exist on traditional (TRF) and non-TRF (NTRF) burden in patients with premature acute coronary syndrome (ACS). METHODS Prevalence of TRFs and NTRFs were measured in 1015 young (55 years old or younger) ACS patients recruited from 26 centres in Canada, the United States, and Switzerland. Risk factors were compared across sex and family history categories, and against a sample of the general Canadian population based on the 2000-2001 Canadian Community Health Survey. The 10- and 30-year risks of cardiovascular disease (CVD) were estimated using Framingham Risk Scores. RESULTS Risk factors were more prevalent in premature ACS patients compared with the general population. Young women with a family history of coronary artery disease showed the greatest risk factor burden including TRFs of hypertension (67%), dyslipidemia (67%), obesity (53%), smoking (42%), and diabetes (33%), and NTRFs of anxiety (55%), low household income (44%), and depression (37%). The estimated median 10-year risk of CVD was 7% (interquartile range [IQR], 3%-9%) in women and 13% (IQR, 7%-17%) in men, whereas the 30-year risk of CVD was 36% (IQR, 22%-49%) in women and 44% (IQR, 31%-57%) in men. CONCLUSIONS Patients with premature ACS, especially women with a positive family history, are characterized by a very high risk factor burden that is poorly captured by 10-year risk estimates but better captured by 30-year estimates. Consideration of NTRFs and use of 30-year risk estimates might better estimate risk in young individuals and improve the prevention of premature ACS.

Depression and disease severity in patients with premature acute coronary syndrome

OBJECTIVES The association between depression and cardiovascular disease severity in younger patients has not been assessed, and sex differences are unknown. We assessed whether major depression and depressive symptoms were associated with worse cardiovascular disease severity in patients with premature acute coronary syndrome, and we assessed sex differences in these relationships. METHODS We enrolled 1023 patients (aged ≤ 55 years) hospitalized with acute coronary syndrome from 26 centers in Canada, the United States, and Switzerland, through the GENdEr and Sex determInantS of cardiovascular disease: From bench to beyond-Premature Acute Coronary Syndrome study. Left ventricular ejection fraction, Killip class, cardiac troponin I, and Global Registry of Acute Coronary Events score data were collected through chart review. RESULTS The sample comprised 248 patients with major depression and 302 women. In univariate analyses, major depression was associated with a lower likelihood of having an abnormal left ventricular ejection fraction (odds ratio, 0.70; 95% confidence interval, 0.51-0.97; P = .03) and lower troponin I levels (estimate, -4.04; 95% confidence interval, -8.01 to -0.06; P = .05). After adjustment for sociodemographic and clinical characteristics, neither major depression nor depressive symptoms were associated with disease severity indices, and there were no sex differences. CONCLUSION The increased risk of adverse events in depressed patients with premature acute coronary syndrome is not explained by disease severity.

Using Informatics and the Electronic Medical Record to Describe Antimicrobial Use in the Clinical Management of Diarrhea Cases at 12 Companion Animal Practices

Antimicrobial drugs may be used to treat diarrheal illness in companion animals. It is important to monitor antimicrobial use to better understand trends and patterns in antimicrobial resistance. There is no monitoring of antimicrobial use in companion animals in Canada. To explore how the use of electronic medical records could contribute to the ongoing, systematic collection of antimicrobial use data in companion animals, anonymized electronic medical records were extracted from 12 participating companion animal practices and warehoused at the University of Calgary. We used the pre-diagnostic, clinical features of diarrhea as the case definition in this study. Using text-mining technologies, cases of diarrhea were described by each of the following variables: diagnostic laboratory tests performed, the etiological diagnosis and antimicrobial therapies. The ability of the text miner to accurately describe the cases for each of the variables was evaluated. It could not reliably classify cases in terms of diagnostic tests or etiological diagnosis; a manual review of a random sample of 500 diarrhea cases determined that 88/500 (17.6%) of the target cases underwent diagnostic testing of which 36/88 (40.9%) had an etiological diagnosis. Text mining, compared to a human reviewer, could accurately identify cases that had been treated with antimicrobials with high sensitivity (92%, 95% confidence interval, 88.1%-95.4%) and specificity (85%, 95% confidence interval, 80.2%-89.1%). Overall, 7400/15,928 (46.5%) of pets presenting with diarrhea were treated with antimicrobials. Some temporal trends and patterns of the antimicrobial use are described. The results from this study suggest that informatics and the electronic medical records could be useful for monitoring trends in antimicrobial use.

Completion and Publication Rates of Randomized Controlled Trials in Surgery: An Empirical Study.

OBJECTIVE: To investigate the prevalence of discontinuation and nonpublication of surgical versus medical randomized controlled trials (RCTs) and to explore risk factors for discontinuation and nonpublication of surgical RCTs. BACKGROUND: Trial discontinuation has significant scientific, ethical, and economic implications. To date, the prevalence of discontinuation of surgical RCTs is unknown. METHODS: All RCT protocols approved between 2000 and 2003 by 6 ethics committees in Canada, Germany, and Switzerland were screened. Baseline characteristics were collected and, if published, full reports retrieved. Risk factors for early discontinuation for slow recruitment and nonpublication were explored using multivariable logistic regression analyses. RESULTS: In total, 863 RCT protocols involving adult patients were identified, 127 in surgery (15%) and 736 in medicine (85%). Surgical trials were discontinued for any reason more often than medical trials [43% vs 27%, risk difference 16% (95% confidence interval [CI]: 5%-26%); P = 0.001] and more often discontinued for slow recruitment [18% vs 11%, risk difference 8% (95% CI: 0.1%-16%); P = 0.020]. The percentage of trials not published as full journal article was similar in surgical and medical trials (44% vs 40%, risk difference 4% (95% CI: -5% to 14%); P = 0.373). Discontinuation of surgical trials was a strong risk factor for nonpublication (odds ratio = 4.18, 95% CI: 1.45-12.06; P = 0.008). CONCLUSIONS: Discontinuation and nonpublication rates were substantial in surgical RCTs and trial discontinuation was strongly associated with nonpublication. These findings need to be taken into account when interpreting surgical literature. Surgical trialists should consider feasibility studies before embarking on full-scale trials.