Northern Ontario

Atmospheric deposition of polycyclic aromatic hydrocarbons (PAHs) has increased in northern Alberta, Canada, due to industrial development in the Athabasca oil sands region (AOSR). However, the sources, summertime deposition fluxes and associated spatial patterns are poorly characterized, and the magnitude of contamination has not been directly contrasted with comparable measurements around large Canadian cities. PAHs were measured in Sphagnum moss collected from 30 bogs in the AOSR and compared with reference moss collected from various remote, rural and near-urban sites in Alberta and Ontario...

Northern boreal forests are a strong sink for mercury (Hg), a global contaminant of significant concern to wildlife and human health. Mercury stored in forest soils can be mobilized via runoff and erosion, and under suitable conditions can be methylated to its much more bioaccumulative form, methylmercury. Forest harvesting can affect the mobilization and methylation of Hg, though the direction and magnitude of the impact is unclear or conflicting across previous studies. This study examined 5 harvested and 2 reference watersheds in northwestern Ontario, Canada, before, during, and after harvest to quantify changes in stream total and methylmercury concentration and loads and identified potential landscape and management factors that contribute to differences in stream response...

Background Pediatric out-of-hospital cardiac arrest (POHCA) is associated with significant mortality and poor neurological outcomes. We aimed to describe the association between sociodemographic factors and POHCA risk in Ontario, Canada. Methods and Results We conducted a province-wide case-control study at ICES, where patient records are linked across administrative databases. The case group included children (1 day to 17 years of age) who experienced an OHCA between 2004 and 2020. Controls were matched up to 1:4 on age, sex, index date, and key comorbidities...

INTRODUCTION: Enhanced recovery after surgery (ERAS) programmes include pre-operative, intraoperative and post-operative clinical pathways to improve quality of patient care while reducing length of stay (LOS) and readmission. This study assessed the feasibility and outcomes of an ERAS protocol for colorectal surgery implemented over 2 years in a small, resource-challenged rural hospital. METHODS: A prospective cohort study used retrospectively matched controls to assess the effect of ERAS on LOS in patients undergoing colorectal surgery in a small rural hospital in northern Ontario, Canada...

Overdoses are increasing in the province of Ontario, Canada, where northern communities such as Sudbury have witnessed disproportionately elevated rates, with opioid-related deaths double that of the provincial average. To address this issue, governments have implemented supervised consumption services (SCS) where people who use drugs (PWUD) can use their pre-obtained substances onsite under trained supervision. In September 2022, the city of Sudbury opened its first SCS, 'The Spot', but the site's sustainability is contingent on demonstrating benefit to PWUD and the neighboring community...

BACKGROUND: All learners at the Northern Ontario School of Medicine University complete a longitudinal integrated clerkship experience in their third year, which serves to improve learner experience with community and clinical acute and chronic health needs. Early in the program, Muskoka faculty (two of the 15 LIC sites of NOSM U) became aware that learners never had the occasion to complete a full history and physical exam on a real patient with complex needs. Recognizing this as a critical experience, a program was initiated to provide learners with this opportunity...

The views of community Elders and health care providers in a rural remote First Nation community in Ontario, Canada on their health care landscape and adapting the Community Paramedicine at Clinic (CP@clinic) Program to their community are presented. Key informant interviews took place between September 2020 and March 2021, and were thematically analysed using the Framework Hierarchical Analysis. There were seven themes that emerged with many subthemes: available services in the community, health care access, health challenges in community, causes of frailty, health care and community appreciations, community-specific benefits of CP@clinic, and CP@clinic program considerations for adaptation...

Canada has extensive petroleum hydrocarbon (PHC) contamination in northern areas and the boreal forest region from historical oil and gas activities. Since the 2013 standardization of boreal forest species for plant toxicity testing in Canada, there has been a need to build the primary literature of the toxicity of weathered PHCs to these species. A series of toxicity experiments were carried out using fine-grained (<0.005-0.425 mm) background (100 total mg/kg total PHCs) and weathered contaminated soil (11,900 mg/kg total PHCs) collected from a contaminated site in northern Ontario, Canada...

OBJECTIVES: Social accountability is an equity-oriented health policy strategy that requires institutions to focus on local population needs. This strategy is well established in health professional education, but there is limited understanding of its application in healthcare service delivery. Building on what is known in the education setting, this study aimed to explore the development of a framework of comprehensive, evidence-based social accountability standards for healthcare service delivery institutions...

Recent research suggests that children and youth are at increased risk of anxiety and depression due to the indirect effects of the COVID-19 pandemic. In Canada, children and youths may face additional hurdles in accessing mental health services in rural areas due to socioeconomic disadvantages and healthcare provider shortages worsened by the pandemic. Our study aimed to assess changes in primary healthcare utilization related to depression and anxiety among children and youth aged 10-25 years in Northern Ontario, Canada...

The effects of farm management practices and seasonal variation on the microbial community and chemical composition of corn and grass-legume silage are largely understudied due to the advantages of controlled mini-silo experiments. This study aims to investigate the effects that some key farm factors (use of an inoculant, farm region, and bunker or tower silo) and seasonal variations have on corn and grass-legume silage from farms across Ontario, Quebec, and New York. The silage was either treated with a commercial inoculant (Lallemand Biotal Buchneri 500® or Chr Hansen SiloSolve FC®) or left untreated...

BACKGROUND: Chronic pain is a complex condition that poses challenges in assessment and treatment. Primary care teams, especially in rural areas, may have a role in managing this population, providing interprofessional care to optimize patient outcomes. Tools are needed to aid these clinicians in assessing chronic pain. AIMS: The aim of this article is to present the case application of a clinical reasoning framework proposed by Walton and Elliott, which is used to identify drivers of chronic pain in a 61-year-old male patient with a remote history of spinal injury...

Unique properties of biochar render it appealing for revegetating and decontaminating historic, barren, and chemically complex mine tailings. Bottom ash from bioenergy facilities can contain high levels of charcoal residue, and thus qualify as a type of biochar; the wide availability of this material at low cost makes it of particular interest in the context of tailings remediation. Nevertheless, bottom ash is variable and often contains residual toxic metal/loids that could be phytoabsorbed into plant tissues...

Introduction The challenges of delivering cardiac arrest (CA) courses in rural and remote (R&R) locations worldwide have been further exacerbated by the COVID-19 pandemic. However, it is important to note that this problem has always existed. The implementation of social distancing measures to combat the pandemic has had a significant impact on healthcare and medical education, particularly in relation to the training of students, laypeople (LP), and healthcare professionals (HCPs) in CA care. The combination of pandemic restrictions and pre-existing difficulties faced in R&R locations and large cities has disrupted the provision of comprehensive medical education...

PURPOSE: To examine changes to primary care practice for transgender clients resulting from government mandated public health measures in response to COVID-19 in Northern Ontario. DESIGN: Secondary analysis of qualitative data using interview transcripts from a dataset that included 15 interviews conducted between October 2020 and April 2021. METHODS: The dataset came from a convergent mixed method study exploring the delivery of primary care services to transgender individuals in Northern Ontario...

The outcomes of species interactions can vary by life stage, year, and surrounding environmental conditions. Amphibian species are expected to compete most strongly during their tadpole stage when they exist in the highest densities. Changes in arrival timing, surrounding aquatic communities, and yearly conditions could all affect the outcome of larval competition. In Long Point, Ontario, the Fowler's toad ( Anaxyrus fowleri ) is at the northern edge of its range and overlaps with the more common American toad ( Anaxyrus americanus )...

BACKGROUND: Eligible patients with kidney failure should have equal access to kidney transplantation. Transplant referral is the first crucial step toward receiving a kidney transplant; however, studies suggest substantial variation in the rate of kidney transplant referral across regions. The province of Ontario, Canada, has a public, single-payer health care system with 27 regional chronic kidney disease (CKD) programs. The probability of being referred for kidney transplant may not be equal across CKD programs...

BACKGROUND: The novel coronavirus, COVID-19, emerged in December 2019. Shortly after, vaccines against the virus were distributed in Canada for public use, but the remoteness of many northern Indigenous communities in Ontario posed a challenge for vaccine distribution and dissemination. The Ministry of Health partnered with the Northern Ontario School of Medicine University (NOSMU) and the air ambulance service, Ornge, to assist in delivering the vaccination doses to 31 fly-in communities in the Nishnawbe Aski Nation and Moosonee, all within Ontario...

BACKGROUND: Culicoides Latreille (Diptera: Ceratopogonidae) is a genus of hematophagous midges feeding on various vertebrate hosts and serving as a vector for numerous pathogens important to livestock and wildlife health. North American pathogens include bluetongue (BT) and epizootic hemorrhagic disease (EHD) viruses. Little is known about Culicoides spp. distribution and abundance and species composition in Ontario, Canada, despite bordering numerous U.S. states with documented Culicoides spp...

Purpose: To examine the factors associated with females attending a fertility consultation within 30 days of cancer diagnosis. Methods: This is a retrospective cohort study, including females, 15 to 39 years of age, diagnosed with cancer in Ontario, Canada. Administrative data were used from the Institute of Clinical and Evaluative Sciences for the period 2006 to 2019. A backward selection multivariate logistic regression was performed, with a primary outcome of fertility consultation within 30 days of diagnosis...