Peggy Ng

The case for a cause‐effect linkage between environmental contamination and development in eggs of the common snapping turtle (Chelydra s.serpentina) from Ontario, Canada

Concentrations of polychlorinated biphenyls (PCBs), dibenzo-p-dioxins, and dibenzofurans, organochlorine pesticides, and their metabolites were measured in eggs of the common snapping turtle (Chelydra s.serpentina) collected from four wetlands on the shorelines of Lakes Ontario, and Erie, and one control location in central Ontario, Canada. Snapping turtle eggs from these sites were also artificially incubated to determine hatching success, and incidence of deformities in embryo and hatchling turtles. The hypothesis that elevated incidences of egg death and/or deformities of hatchling turtles would occur in populations with high concentrations of organochlorine contaminants in eggs was tested. The results were elevated using epidemiological criteria. Unhatched eggs and deformities occurred at significantly higher rates in eggs from Lake Ontario wetlands. Two of three sites from Lake Ontario had substantially higher levels of PCBs, dioxins, and furans compared to eggs from Lake Erie and the control site. It could not be shown that contamination of eggs preceded the occurrence of poor development of eggs, although excellent hatching success and low numbers of deformities in eggs from the control site were considered representative of development in healthy eggs. The statistical association between contaminant levels in eggs and poor development of these eggs supported the hypothesis that eggs from sites with the greatest contamination had the highest rates of abnormalities. PCBs were the most strongly associated chemicals, although possible effects due to the presence of other chemicals in eggs was a confounding factor. The deformities and rates of unhatched eggs were similar to those occurring in other vertebrates collected from highly contaminated areas of the Great Lakes. There were several chemicals present in the eggs that can cause similar reproductive effects in other species; therefore a specific chemical effect was not identified. Results were coherent with known statistical and biological information. Theoretical and factual evidence of PCB contamination in wild-caught snapping turtles supported and hypothesis. However, lack of controlled studies of reproductive effects of polychlorinated hydrocarbons upon this species hindered the agreement of all factual and theoretical evidence with the hypothesis.

Anuran Development, Density and Diversity in Relation to Agricultural Activity in the Holland River Watershed, Ontario, Canada (1990–1992)

Significantly lower anuran species diversity and density was recorded in a vegetable growing area relative to upstream and downstream sites in the Holland River watershed, Ontario, Canada. Egg hatching success and tadpole deformity rates of American toads (Bufo americanus americanus), green frogs (Rana clamitans melanota) and northern leopard frogs (Rana pipiens) eggs in water from field sites and control water were assessed. Compared to the control and the upstream site, the total abnormality rate (unhatched eggs plus deformed tadpoles) was higher for American toads in water from the agricultural and downstream sites. Total abnormality was higher in green frog eggs in water from the agricultural site and a downstream site. Trace concentrations of organophosphorus pesticides were detected most often in agricultural zone water and sediments than in upstream and downstream sites. Organochlorine pesticide residues, especially in agricultural zone samples, exceeded the no effect level guidelines for the protection of aquatic life. Ammonia, phosphorus, particulates, BOD and TKN were highest in the agricultural zone. Significant correlations between these parameters and anuran development suggest nutrient run-off as a causal or contributing factor in lower anuran diversity, density and reproductive success of American toads and green frogs in the site dominated by agriculture.

Physicians' perspective on quality of life: An exploratory study of oncologists

There is an implicit assumption that physicians incorporate quality of life (QOL) information in clinical decision-making. However, very limited data exists on how physicians view QOL information and how they actually use it. To explore this issue, an in-depth study was conducted using a semistructured interview guide, with 60 oncologists in Canada and the USA. While the majority of respondents perceived QOL as important they reported a tendency to use it informally and not in all situations. Key findings include the belief expressed by 88% of respondents that the term QOL could be defined, although they differed in their definitions. Although 85% stated that QOL can be formally measured, only a third perceived that the current instruments provide valid and reliable data. Respondents noted a number of significant benefits and drawbacks of using QOL data in their clinical practice that had not been previously noted in the literature. For example, its use as an endpoint in clinical trials was generally perceived to enhance both physician and patient participation. A drawback noted was that including QOL might adversely affect the decision-making process. These findings have been used to develop a self-administered questionnaire (MD-QOL) which will test the generalizability of these findings.

The Relationship between Organizational Leadership for Safety and Learning from Patient Safety Events

OBJECTIVE To examine the relationship between organizational leadership for patient safety and five types of learning from patient safety events (PSEs). STUDY SETTING Forty-nine general acute care hospitals in Ontario, Canada. STUDY DESIGN A nonexperimental design using cross-sectional surveys of hospital patient safety officers (PSOs) and patient care managers (PCMs). PSOs provided data on organization-level learning from (a) minor events, (b) moderate events, (c) major near misses, (d) major event analysis, and (e) major event dissemination/communication. PCMs provided data on organizational leadership (formal and informal) for patient safety. EXTRACTION METHODS Hospitals were the unit of analysis. Seemingly unrelated regression was used to examine the influence of formal and informal leadership for safety on the five types of learning from PSEs. The interaction between leadership and hospital size was also examined. PRINCIPAL FINDINGS Formal organizational leadership for patient safety is an important predictor of learning from minor, moderate, and major near-miss events, and major event dissemination. This relationship is significantly stronger for small hospitals (<100 beds). CONCLUSIONS We find support for the relationship between patient safety leadership and patient safety behaviors such as learning from safety events. Formal leadership support for safety is of particular importance in small organizations where the economic burden of safety programs is disproportionately large and formal leadership is closer to the front lines.

Environmental Contaminants in Eggs of the Common Snapping Turtle (Chelydra serpentina serpentina) from the Great Lakes-St. Lawrence River Basin of Ontario, Canada (1981, 1984)

Abstract Common snapping turtle eggs were collected at nesting sites from two locations in 1981 and eight locations in 1984 in Ontario, Canada, and analyzed for chlorinated hydrocarbons. Nine locations were within the Great Lakes-St. Lawrence River basin and one location, Algonquin Provincial Park, served as a control site outside the basin. Total PCBs ranged from 0.057 to 4.76 mg/kg (wet wt.) among the Great Lakes-St. Lawrence River samples. Mean total PCB concentration at Algonquin Park was 0.187 mg/kg. Eggs from Hamilton Harbour, Port Franks, Bay of Quinte/Murray Canal, and Lake St. Clair were the most contaminated among the ten sample locations. There was statistically significant variation in concentrations of all organochlorine compounds among sites. In some locations, there was high variation in contamination among clutches. A pool of eggs from Hamilton Harbour contained 67 ng/kg of 2378-tetrachlorodibenzo-p-dioxin and 14.0 ng/kg of23478-pentachlorodibenzofuran. Some dioxin congeners were present in turtle eggs at concentrations higher or equal to that in herring gull eggs from Hamilton Harbour. Comprehensive GC/MS analysis of the Hamilton Harbour eggs also revealed the presence of trace amounts of o,p-dicofol, octachlorostyrene, and toxaphene. Geographic variation in contaminant levels in snapping turtle eggs from wetlands is similar to that in spottail shiners and herring gull eggs collected in the pelagic zone of the Great Lakes. This may be due to the consumption of migrant fish by snapping turtles in nearshore wetlands.

Market exchanges, hierarchical exchanges or relational exchanges in export channels into emerging markets

This study draws from relational contracting paradigm, transaction cost paradigm, and internationalization process paradigm and evaluates market exchanges, hierarchical exchanges, and relational exchanges between Western manufacturers and their foreign intermediaries in emerging markets. The study suggests that choices of exchange governance be determined by various factors in combination, including experiential knowledge, market conditions, activity complementarity, brand power, and trust. Choices of exchange governance depend on the interaction among these factors.

A soft approach for hard continuous optimization

Abstract This paper is to introduce a soft approach for solving continuous optimizations models where seeking an optimal solution is theoretically or practically impossible. We first review methods for solving continuous optimization models, and argue that only a few optimization models with some good structure are solved. To solve a larger class of optimization problems, we suggest a soft approach by softening the goal in solving a model, and propose a two-stage process for implementing the soft approach. Furthermore, we offer an algorithm for solving optimization models with a convex feasible set, and verify the validity of the soft approach with numerical experiments.

Development of a Measure of Patient Safety Event Learning Responses

OBJECTIVE To define patient safety event (PSE) learning response and to provide preliminary validation of a measure of PSE learning response. DATA SOURCES Ten focus groups with front-line staff and managers, an expert panel, and cross-sectional survey data from patient safety officers in 54 general acute hospitals. STUDY DESIGN A mixed methods study to define a measure of learning responses to patient safety failures that is rooted in theory, expert knowledge, and organizational practice realities. EXTRACTION METHODS Learning response items developed from the literature were modified and validated in front-line staff and manager focus groups and by an expert panel and second group of external experts. Actual learning responses gleaned from survey data were examined using exploratory factor analyses and reliability analysis. PRINCIPAL FINDINGS Unique learning response items were identified for minor, moderate, major events, and major near misses by an expert panel. A two-factor model of major event learning response was identified (factor 1=event analysis, factor 2=dissemination/communication of learnings). Organizations engage in greater learning responses following major events than less severe events and, for major events, organizations engage in more factor 1 responses than factor 2 learning responses. CONCLUSIONS Eleven to 13 items can measure learning responses to PSEs of differing severity. The items are feasible, grounded in theory, and reflect expert opinion as well as practice setting realities. The items have the potential for use to assess current practice in organizations and set future improvement goals.

A Health Virtual Community Perspective for Peripheral Arterial Disease

This paper summarizes the result of a survey conducted on 239 subject in Toronto to gauge their awareness of Peripheral Arterial Disease (PAD) and educate them about it. The results show that awareness of PAD is scarce and that the campaign resulted in a significant increase in awareness. This intervention suggest that an e-education tool is of paramount importance to address the lack of awareness. The paper argues that a PAD Virtual Community might play a pivotal role in educating the public about PAD and providing a platform for awareness and prevention.

TECHNOLOGY ENHANCED LEARNING IN AN EDUCATIONAL ENVIRONMENT

This paper is a primer for the instructor who wishes to employ TEL in the classroom in an institutional environment which has not adopted TEL on a global scale. The judicious use of TEL can lead to something we call the virtual classroom, superior to the traditional classroom and not restricted by physical or geographic boundaries. The paper also provides a checklist of do’s and don’ts for TEL development that the authors have found useful.