Development and current use of parenteral nutrition in critical care - an opinion paper.

Critically ill patients depend on artificial nutrition for the maintenance of their metabolic functions and lean body mass, as well as for limiting underfeeding-related complications. Current guidelines recommend enteral nutrition (EN), possibly within the first 48 hours, as the best way to provide the nutrients and prevent infections. EN may be difficult to realize or may be contraindicated in some patients, such as those presenting anatomic intestinal continuity problems or splanchnic ischemia. A series of contradictory trials regarding the best route and timing for feeding have left the medical community with great uncertainty regarding the place of parenteral nutrition (PN) in critically ill patients. Many of the deleterious effects attributed to PN result from inadequate indications, or from overfeeding. The latter is due firstly to the easier delivery of nutrients by PN compared with EN increasing the risk of overfeeding, and secondly to the use of approximate energy targets, generally based on predictive equations: these equations are static and inaccurate in about 70% of patients. Such high uncertainty about requirements compromises attempts at conducting nutrition trials without indirect calorimetry support because the results cannot be trusted; indeed, both underfeeding and overfeeding are equally deleterious. An individualized therapy is required. A pragmatic approach to feeding is proposed: at first to attempt EN whenever and as early as possible, then to use indirect calorimetry if available, and to monitor delivery and response to feeding, and finally to consider the option of combining EN with PN in case of insufficient EN from day 4 onwards.

Paper 2: EUROCAT public health indicators for congenital anomalies in Europe.

OBJECTIVE: The purpose of this article is to present the specific public health indicators recently developed by EUROCAT that aim to summarize important aspects of the public health impact of congenital anomalies in a few quantitative measures. METHODS: The six indicators are: (1) congenital anomaly perinatal mortality, (2) congenital anomaly prenatal diagnosis prevalence, (3) congenital anomaly termination of pregnancy, (4) Down syndrome livebirth prevalence, (5) congenital anomaly pediatric surgery, and (6) neural tube defects (NTD) total prevalence. Data presented for this report pertained to all cases (livebirths, fetal deaths, or stillbirths after 20 weeks of gestation and terminations of pregnancy for fetal anomaly [TOPFA]) of congenital anomaly from 27 full member registries of EUROCAT that could provide data for at least 3 years during the period 2004 to 2008. Prevalence of anomalies, prenatal diagnosis, TOPFA, pediatric surgery, and perinatal mortality were calculated per 1000 births. RESULTS: The overall perinatal mortality was approximately 1.0 per 1000 births for EUROCAT registries with almost half due to fetal and the other half due to first week deaths. There were wide variations in perinatal mortality across the registries with the highest rates observed in Dublin and Malta, registries in countries where TOPFA are illegal, and in Ukraine. The overall perinatal mortality across EUROCAT registries slightly decreased between 2004 and 2008 due to a decrease in first week deaths. The prevalence of TOPFA was fairly stable at about 4 per 1000 births. There were variations in livebirth prevalence of cases typically requiring surgery across the registries; however, for most registries this prevalence was between 3 and 5 per 1000 births. Prevalence of NTD decreased by about 10% from 1.05 in 2004 to 0.94 per 1000 in 2008. CONCLUSION: It is hoped that by publishing the data on EUROCAT indicators, the public health importance of congenital anomalies can be clearly summarized to policy makers, the need for accurate data from registries emphasized, the need for primary prevention and treatment services highlighted, and the impact of current services measured.

Key Account Management in Paper and Board Industry- Identification of Key Accounts for Stora Enso Graphical Boards

Tutkimuksen tarkoituksena oli tunnistaa nykyiset sekä potentiaaliset avainasiakkaat case yritykselle. Avainasiakkaat tunnistettiin Chevertonin tunnistamis- ja valintamatriisin avulla, jossa asiakkaan sijoittumista matriisiin arvioidaan asiakkaan houkuttelevuuden sekä toimittajan suhteellisten vahvuuksien avulla. Kriteereiksi avainasiakkaiden tunnistamiseen valittiin asiakkaan vuotuinen ostovolyymi, asiakkaan business-potentiaali sekä case-yrityksen toimittajaosuus. Asiakkaat luokiteltiin avainasiakkaisiin, kehitettäviin avainasiakkaisiin, ylläpidettäviin asiakkaisiin sekä satunnaisiin asiakkaisiin. Tutkimus tarjosi lähtökohdan case-yrityksen uusille avainasiakaspäälliköille sekä osoitti suunnan tulevaisuuden tutkimustarpeille. Aktiivisen tiedonvaihdannan kautta eri myyntikonttoreiden johtohenkilöstön sekä myös yrityksen eri funktionaalisten divisioonien välillä voidaan saavuttaa kilpailuetua kun lähestytään asiakasta toimintojaan järkiperäisesti koordinoineena toimittajana samalla kun asiakkaat keskittävät ostojaan. Jotta yrityksen tavoitteet, markkinamahdollisuudet sekä resurssit olisivat hyvin tasapainossa, tulisi myös asiakaskannattavuutta sekä asiakkaiden strategista merkittävyyttä arvioida ja mitata säännöllisesti tässä tutkimuksessa käytettyjen tunnistuskriteereiden lisäksi.

Market Potential and Demand Drivers for a Special Laminating Paper: Implementation of Market Research

Tutkimuksen tavoitteena oli selvittää raaka-aineena käytettävän paloa hidastavan laminaattipaperin markkinapotentiaali sekä kysyntä Euroopassa. Näiden kehitystä arvioitiin analysoimalla kysyntään vaikuttavia tekijöitä. Tutkimusmetodologiassa yhdistyivät useat lähestymistavat, pääasiassa käytettiin kuvailevaa ja ennustavaa tutkimusotetta. Tutkimus perustui sekä primaari että sekundaaritietoon. Primaaritietoa hankittiin tuotteen käyttäjiltä, myyntiedustajilta sekä haastattelemalla tuottajayrityksen henkilökuntaa. Sekundaaritietoa kerättiin myös, mutta tutkimuksen tavoitteisiin liittyviä lähteitä ei ollut runsaasti saatavilla. Tästä syystä primaaritiedolla oli tutkimuksessa hieman tärkeämpi rooli kuin sekundaaritiedolla, mikä on yleistä teollisessa markkinatutkimuksessa. Tuotteen tulevaisuuden näkymät vaikuttavat melko hyviltä. Teoreettinen markkinapotentiaali on suuri verrattuna nykyiseen myyntimäärään, myyntimäärän kasvattaminen vaatii kuitenkin tiettyjä toimenpiteitä. Tulevaisuudessa huomiota tulisi kiinnittää tuotekuvaan, hinnoitteluun ja laadun kokonaisvaltaiseen maksimointiin. Tutkimuksessa havaittiin suuntauksia kysynnän kasvusta tulevien parin vuoden aikana. Myös teoreettinen markkinapotentiaali voisi kasvaa, koska paloa hidastavien laminaattien kysyntä vaikuttaa kasvavan Euroopassa erityisesti rakennusalalla.

The claim of Amasa Stetson, of Massachusetts, on the United States, for money advanced, in fulfilling the orders of the Government while discharging the duties of Commissary General of Purchases, in time of the late war with Great Britain ; and for services rendered. --

Claim relating to the War of 1812.

Ontario Paper Company Limited

On February 29, 1912 The Ontario Paper Company Limited was incorporated under the leadership of Col. Robert R. McCormick. Four months later construction began in Thorold, Ontario as this location was best for the abundance of power and water and water transportation. The first machine was started at the mill on September 5, 1913. The mill was one of the most advanced of its era, using electricity instead of water power. The mill was also the first of its kind as it combined pulp and paper making instead of separating the two operations.

Quebec North Shore Paper Company Limited fonds

The Q.N.S. [Quebec North Shore Paper Company] newsprint mill started in 1937 at Baie Comeau in Quebec. Being the first major industry in that area at the time, harbour facilities, a power station and an entire community was built around the mill. In 1952, a power station was built at the first falls of the Manicouagan River. The station generated much more power than necessary for the mill, but attracted an aluminum smelter a few years later in 1958.

Pleasant Hours: A Paper for Young Folk, Vol. III No. 20- October 6, 1863

This issue of Pleasant Hours: a paper for young folk contains an article titled "The Story of Queenston Heights".

Independent Chronicle Vol. XLVI No. 2476- August 4, 1814

A semi-weekly paper that was published from 1801 to 1817. It was previously called the Independent chronicle and the universal advertiser, and was later the Independent chronicle and Boston patriot (Semiweekly). Publishers were Abijah Adams and Ebenezer Rhoades. Topics of interest in this issue include: Page 1: Proclamation from James Madison pardoning military deserters if they return to military service; announcement to officers and soldiers in the military offering reward for the return of military deserters; U.S. General W. Scott's account of the battle of Chippewa; U.S. General P. B. Porter's account of the battle of Chippewa; Major J. Hindman's account of the battle of Chippewa; news of British war ships attacking and capturing U.S. cargo ships; Page 2: news of a soldier shot for desertion; military news from Erie, Pennsylvania; New York appropriates money to pay troops and build two encampments; James Madison issues orders for state of Rhode Island to raise a militia of 500 troops; U.S. military news from Bermuda; report of the death of Capt. Parker of the U.S. ship Syren; account of the battle of Chippewa and a list of important officers wounded; report of a raft captured that was taking supplies to the British; report of U.S. General Brown being wounded in battle; list of further details of the battle of Chippewa; report of Indian attack near Champlain; news of prisoner exchange and announcement that exchanged prisoners should return to their regiments; listing of the total number of British forces in the U.S.; report of British shipwrecks; Naval news for the Port of Boston; news of various U.S. war ships; Page 4: Marshal's notice announcing a trial for members of a private American ship accused of supplying the British with provisions;

Buried Treasure: The Economics of Leak Detection and Water Loss Prevention in Ontario

On average approximately 13% of the water that is withdrawn by Canadian municipal water suppliers is lost before it reaches final users. This is an important topic for several reasons: water losses cost money, losses force water agencies to draw more water from lakes and streams thereby putting more stress on aquatic ecosystems, leaks reduce system reliability, leaks may contribute to future pipe failures, and leaks may allow contaminants to enter water systems thereby reducing water quality and threatening the health of water users. Some benefits of leak detection fall outside water agencies’ accounting purview (e.g. reduced health risks to households connected to public water supply systems) and, as a result, may not be considered adequately in water agency decision-making. Because of the regulatory environment in which Canadian water agencies operate, some of these benefits-especially those external to the agency or those that may accrue to the agency in future time periods- may not be fully counted when agencies decide on leak detection efforts. Our analysis suggests potential reforms to promote increased efforts for leak detection: adoption of a Canada-wide goal of universal water metering; development of full-cost accounting and, pricing for water supplies; and co-operation amongst the provinces to promulgate standards for leak detection efforts and provide incentives to promote improved efficiency and rational investment decision-making.

Letter - The Ontario Paper Co. Limited to Mr. Arthur A. Schmon, 1949

A letter from The Ontario Paper Co., Limited of Thorold, Ontario. The letter, dated 15 August 1949, celebrates the Thirtieth Anniversary of association between Arthur A. Schmon and the paper company. The letter praises the work of Mr. Schmon, "a leader of progressive thinking and action, a man with a true sense of values, sound judgement and a deep sense of justice". There are ten signatures at the bottom of the letter.

Photograph - Baie Comeau, Paper Store House Construction

A photograph at Baie Comeau with the caption "Cement hoist at work on paper store house construction".

Canadian Society for Exercise Physiology Position Paper: Resistance Training in Children and Adolescents

Many position stands and review papers have refuted the myths associated with resistance training (RT) in children and adolescents. With proper training methods, RT for children and adolescents can be relatively safe and improve overall health. The objective of this position paper and review is to highlight research and provide recommendations in aspects of RT that have not been extensively reported in the pediatric literature. In addition to the well-documented increases in muscular strength and endurance, RT has been used to improve function in pediatric patients with cystic fibrosis, cerebral palsy and burn victims. Increases in children’s muscular strength have been attributed primarily to neurological adaptations due to the disproportionately higher increase in muscle strength than in muscle size. Although most studies using anthropometric measures have not shown significant muscle hypertrophy in children, more sensitive measures such as magnetic resonance imaging and ultrasound have suggested hypertrophy may occur. There is no minimum age for RT for children. However the training and instruction must be appropriate for children and adolescents involving a proper warm-up, cool-down and an appropriate choice of exercises. It is recommended that low-to-moderate intensity resistance should be utilized 2-3 times per week on non-consecutive days, with 1-2 sets initially, progressing to 4 sets of 8-15 repetitions for 8-12 exercises. These exercises can include more advanced movements such as Olympic style lifting, plyometrics and balance training, which can enhance strength, power, co-ordination and balance. However specific guidelines for these more advanced techniques need to be established for youth. In conclusion, a RT program that is within a child’s or adolescent’s capacity, involves gradual progression under qualified instruction and supervision with appropriately sized equipment can involve more advanced or intense RT exercises which can lead to functional (i.e. muscular strength, endurance, power, balance and co-ordination) and health benefits.