Simcoe County Research Articles

Multimorbidity in Older Adult Acute Care Hospital Patients: Impacts on Patient Flow, Medical Management, Care Transitions and Cost.

The healthcare system is wrestling with the impact of demographics on demand for care. We hear anecdotally of heightened patient acuity and increased prevalence of chronic disease. Southlake is a leading healthcare organization serving the northern York Region and southern Simcoe County. We have analyzed all in-patient data over the last four years and observed massive increases in multi-comorbidity levels in older in-patient cohorts. This article will review the analysis and highlight the impact of this phenomenon on critical areas of hospital operations such as patient flow, care transitions and cost. It will also review the medical management implications of increased chronic disease prevalence in this patient population. Finally, we share a series of initiatives that have been successful in helping the hospital respond to these challenges. We believe these are relevant for acute hospitals and their community-based partners across Canada.

The Importance of Minimally Invasive Remote Sensing Methods in Huron-Wendat Archaeology

AbstractThe Huron-Wendat have had their ancestors’ villages and burial sites investigated archaeologically for over 170 years. Past and ongoing land disturbance and invasive archaeological excavation have erased dozens of Huron-Wendat village sites in Ontario, hindering Huron-Wendat duty to care for their ancestors. Consequently, over the last 20 years, in addition to large-scale repatriation of ancestral remains, the Huron-Wendat have requested that archaeologists make every effort to avoid any further excavation of ancestral sites. This poses a new challenge for archaeologists about how to learn about the Huron-Wendat past with minimal disturbance to ancestral sites. Honoring the cultural responsibilities of the Huron-Wendat, the authors have employed minimally invasive remote sensing methods of investigation on Ahatsistari, a forested early seventeenth-century Huron-Wendat village site in Simcoe County, Ontario. Remote sensing methods (e.g., magnetic susceptibility survey, high-resolution soil chemistry sampling, and metal detector survey) have revealed village limits and the possible location and orientation of longhouses, providing essential information in support of the Huron-Wendat imperative to find, assess, and preserve as many of their archaeological sites as possible. This is to protect the ancestors, learn from the ancestors, and preserve ancestral sites and related landscapes for future generations.

The Armstrongs of Manorhamilton and West Gwillimbury: A Study of Settlement and Migration Patterns of Irish Immigrants to Upper Canada

This article considers the land transactions, occupations, and last known residence of three brothers, Protestant landed gentry from Manorhamilton, Leitrim County, Ireland, who arrived in West Gwillimbury, Simcoe County, Upper Canada (Ontario) in 1819, 1822, and 1825, and of their sons, sons-in-law, and grandchildren. At least one aspired to a large estate, but none acquired more land than they needed for themselves and their sons. Most of their children (all born in Ireland) or their husbands farmed in Ontario, most in Simcoe County, but their grandchildren dispersed widely across North America and less than half remained in farming.

The pre-Late Wisconsin stratigraphy of southern Simcoe County, Ontario: implications for ice sheet buildup, decay, and Great Lakes drainage evolution

Recent three-dimensional mapping investigations in southern Simcoe County, Ontario, allow refinement of the existing regional stratigraphic framework. Analysis of 25 continuously cored boreholes has revealed a complex but consistent sediment succession that provides a record of the last two glacial cycles (Marine Isotope Stages 1–6). Five stratigraphic units (SU1–SU5) comprise the pre-Late Wisconsin record. The stratigraphy is floored by a presumed Illinoian glacial complex consisting of a lower, coarse-grained till (SU1), locally overlain by stratified glaciolacustrine and glaciofluvial sediments (SU2), but more commonly capped by a stone-poor, fine-grained till (SU3) of the Georgian Bay lobe. A widespread subaerial unconformity developed on the upper surface of SU3 contains organic-bearing, nonglacial deposits (SU4) ranging between 54 800 ± 3000 years BP (considered beyond the limits of radiocarbon dating) and 37 450 ± 590 14C years BP. SU4 is abruptly overlain by a thick succession of rhythmically laminated lacustrine muds graded upwards into glaciolacustrine silts and clays interrupted by regionally continuous sand bodies (SU5). The succession is capped (and locally truncated) by Late Wisconsin Newmarket Till. The sedimentary record of southern Simcoe County is correlated with other well-studied reference sections in southern Ontario and contains information that informs reconstructions of former ice extents in the lower Great Lakes region following the Illinoian glaciation. Several sediment units host aquifers, but limited thickness and spatial extent, as well as issues with naturally occurring dissolved gases and solids, restrict their use for groundwater supply.

Stratigraphic analysis of Late Wisconsin and Holocene glaciolacustrine deposits exposed along the Nottawasaga River, southern Ontario, Canada

Analysis of 56 outcrop exposures in cut banks along the Nottawasaga River in southern Simcoe County, Ontario, Canada, has led to the identification of eight stratigraphic units (SU1–SU8) that represent a record of changing environmental conditions during deglaciation and exhibit strong controls on shallow groundwater flow in the region. The stratigraphic succession is floored by the Late Wisconsin Newmarket Till (SU1), which is locally overlain by ice-proximal debris flow deposits (SU2). These glacial sediments are overlain by glaciolacustrine silt rhythmites (SU3) that pass upwards into deltaic sand (SU4) and channelized fluviodeltaic sand and gravel (SU5). Lying above the fluvial deposits are widespread interbedded glaciolacustrine sands and silt (SU6), which coarsen up-section toward the ground surface. The succession is locally capped by fluviodeltaic (SU7) and younger fluvial (SU8) deposits. These SUs record sedimentary environments that existed during deglaciation of the region and provide insight into the evolution of glacial lakes Schomberg and Algonquin and the Nipissing phase of the upper Great Lakes. The environmental changes described from sediments along the Nottawasaga River provide insights into basin-scale events that occurred throughout the upper Great Lakes during deglaciation. Qualitative observations of groundwater discharge from sediments at outcrop faces are used to characterize the hydraulic function of the stratigraphic units as well as possible preferential groundwater flow pathways in the shallow subsurface.

Ontario Ministry of Natural Resources South-Central Region Bobwhite Quail Rehabilitation Program

Archaeological and historical evidence on status of northern bobwhites (Colinus virginianus) in southern Ontario prior to European settlement is not clear. The bird was documented on the Essex and Kent County prairies at the time of European settlement in the early l700's. Early farmsteading increased available habitat space for quail. That landscape, combined with mild winters in the l 840's, enabled bobwhites to expand their ranges. By the mid-l 850's, bobwhites ranged generally throughout Ontario's tallgrass prairie and savannah communities extending from the Detroit River approximately 300 miles north into Simcoe County, the southeast limit of Georgian Bay, and 400 miles east to Kingston, the eastern limit of Lake Ontario. Bobwhites became a valued upland bird in pioneer Ontario for hunting, viewing and controlling farm garden weed seeds and insects. The detrimental impacts of harsh winters were a major contributor to quail declines from the late l 850's to the l 980's. Additionally, more subtle factors which also contributed detrimental stresses were loss of tallgrass prairie and savannah, intensive agriculture, continued deforestation, urbanization, pesticide use, the taking of wild stock for pen-rearing and the low survival rates of introduced cultured stocks into the wild. In summary, bobwhites in Ontario declined due to the destruction, impairment and fragmentation of wildlife habitat. The population stabilized at low numbers during the early l 980's. Recreational harvesting of the species continued into the l 970's. Gun harvests probably at no time exerted a controlling influence on the quail populations. The harvest diminished to non-existence in the 1980's. The hunting seasons for wild populations were eliminated in the l 990's. People continued to appreciate the bird for recreational viewing and dog training opportunities. In spite of agricultural trends towards less intensive land uses, new emphases on resource and environmental conservation and rehabilitation, as well as milder winters in the l 980's and l 990's, bobwhite numbers have not rebounded in southwest Ontario. Approximately 185 birds in 16 coveys throughout Elgin, Lambton and Middlesex counties were documented in 1990. Although large areas of suitable land are unoccupied by bobwhites, populations remain small, disjunct and isolated. Ontario Ministry of Natural Resources formed partnerships with a number of other governmental agencies, non-governmental organizations and landowners, to initiate the rehabilitation of bobwhite quail in southern Ontario. The Ontario Federation of Anglers and Hunters, their affiliate and individual members, are a key sponsor to this rehabilitation initiative. These groups have participated in an advisory committee, raised funds, and offered volunteer labor, predator control services adjacent to release sites, and professional services. The committee recommended the transfer of wild bobwhites from other North American populations as a means of rehabilitating Ontario populations. The program's goal is to reestablish larger, sustainable populations of quail in southern Ontario to provide recreational viewing and hunting opportunities. It is anticipated that large numbers of urban and rural Ontarians will be pleased with the reestablishment of northern bobwhites and the recreational viewing and hunting benefits they provide. Restoration of quail hunting opportunities will generate economic benefits in Ontario and may be a suitable method for monitoring the grass-shrubland ecotone. Healthy quail populations also have the potential to function as natural control agents for some crop pests.

Delineation of Paleowind Direction from Dunes in Simcoe County, Ontario

Dune fields that developed along paleolake shorelines in Ontario are a product of paleoenvironmental conditions, which developed as a result of glacially influenced geological processes. In Simcoe County, Ontario, many dune fields were created between 3 and 12 ka, when this area was covered by a series of lakes, bordered by thick sandy beaches. Coastal sediments of the glacial Lake Algonquin and the Nipissing phase of the upper Great Lakes were reworked primarily by paleowind activity and intense periodic storms once lake levels had decreased. This formed dunes, which are now common along the south-eastern coast of Georgian Bay in Simcoe County. Dunes that developed earlier (8–10 ka) have a different average orientation than dunes that developed later (3–5 ka). Various geomorphometric techniques are tested to construct a replicable methodology for determining paleowind direction. Through identification of parabolic dunes, azimuth angles were determined and used to infer the dominant paleowind directions. Dunes on the paleolake Algonquin plain commonly have a north-east to south-west orientation, whereas dunes associated with Nipissing phase shorelines formed via north-westerly winds. These data may suggest changing prevailing winds in the Great Lakes region during deglaciation.

Quantifying Eroded Sediment Volume during Drumlin Formation in Simcoe County

Drumlins, despite being well studied, are still incredibly enigmatic in terms of their formation processes. Theories on their origin vary widely, and the evidence presented in this study seeks to assist in this debate. To support an erosional theory for the formation of drumlins, large volumes of sediment would have undergone transport and deposition. The volume of sediment that would have eroded from part of the Peterborough Drumlin Field in Simcoe County was calculated using two methods in a GIS. The limitations of both methods and the geological composition of potential sediment sinks were analysed. The range of eroded sediment volume was calculated to be 3.5–8.3 km3, which could fill between 30.2% and 71.6% of the Lake Simcoe basin. The high volume of sediment that was estimated in this study will have future implications in the drumlin debate and for the feasibility of an erosional process of formation.

A sensitivity analysis of the Children's Treatment Network trial: a randomized controlled trial of integrated services versus usual care for children with special health care needs

BackgroundThe value of integrated care through comprehensive, coordinated, and family-centered services has been increasingly recognized for improving health outcomes of children with special health care needs (CSHCN). In a randomized controlled trial (RCT), the integrated care provided through the Children’s Treatment Network (CTN) was compared with usual care in improving the psychosocial health of target CSHCN. In this paper, we aimed to estimate the effect of CTN care by conducting multiple analyses to handle noncompliance in the trial.MethodsThe trial recruited target children in Simcoe County and York Region, ON, Canada. Children were randomized to receive CTN or usual care and were followed for 2 years. The CTN group received integrated services through multiple providers to address their specific needs while the usual care group continued to receive care directed by their parents. The outcome was change in psychosocial quality of life at 2 years. We conducted intention-to-treat, as-treated, per-protocol, and instrumental variable analyses to analyze the outcome.ResultsThe trial randomized 445 children, with 229 in the intervention group and 216 in the control group. During follow-up, 52% of children in the intervention group did not receive complete CTN care for various reasons. At 2 years, we did not find a significant improvement in psychosocial quality of life among the children receiving CTN care compared with usual care (intention-to-treat mean difference 1.50, 95% confidence interval −1.49 to 4.50; P = 0.32). Other methods of analysis yielded similar results.ConclusionAlthough the effect of CTN care was not significant, there was evidence showing benefits of integrated care for CSHCN. More RCTs are needed to demonstrate the magnitude of such an effect. The CTN study highlights the key challenges in RCTs when assessing interventions involving integrated care, and informs further RCTs including similar evaluations.

System Integration and Its Influence on the Quality of Life of Children with Complex Needs

Purpose. To explore the interactions between child and parents psychosocial factors and team integration variables that may explain improvements in physical dimensions of the PEDS QL quality of life of children with complex needs after 2 years. Methods. In this 2-year study, parents were identified by the Children's Treatment Network. Families were eligible if the child was aged 0–19 years, had physical limitations, resided in either Simcoe County or the Region of York, Ontario, and there were multiple other family needs. Regression analysis used to explore associations and interactions; n = 110. Results. A child's physical quality of life was affected by interacting factors including child's behavior, parenting, and integrated care. Statistically significant interactions between team integration, processes of care, and child/parent variables highlight the complexity of the rehabilitation approach in real-life situations. Conclusions. Rehabilitation providers working with children with complex needs and their families should also address child and parent problematic behaviors. When this was the case in high integrated teams, the child's physical quality of life improved after two years.

Trace elements in recent groundwater of an artesian flow system and comparison with snow: enrichments, depletions, and chemical evolution of the water

Snow samples collected from hand-dug pits at two sites in Simcoe County, Ontario, Canada were analysed for major and trace elements using the clean lab methods established for polar ice. Potentially toxic, chalcophile elements are highly enriched in snow, relative to their natural abundance in crustal rocks, with enrichment factor (EF) values (calculated using Sc) in the range 107 to 1081 for Ag, As, Bi, Cd, Cu, Mo, Pb, Sb, Te, and Zn. Relative to M/Sc ratios in snow, water samples collected at two artesian flows in this area are significantly depleted in Ag, Al, Be, Bi, Cd, Cr, Cu, Ni, Pb, Sb, Tl, V, and Zn at both sites, and in Co, Th and Tl at one of the sites. The removal from the waters of these elements is presumably due to such processes as physical retention (filtration) of metal-bearing atmospheric aerosols by organic and mineral soil components as well as adsorption and surface complexation of ionic species onto organic, metal oxyhydroxide and clay mineral surfaces. In the case of Pb, the removal processes are so effective that apparently "natural" ratios of Pb to Sc are found in the groundwaters. Tritium measurements show that the groundwater at one of the sites is modern (ie not more than 30 years old) meaning that the inputs of Pb and other trace elements to the groundwaters may originally have been much higher than they are today; the M/Sc ratios measured in the groundwaters today, therefore, represent a conservative estimate of the extent of metal removal along the flow path.Lithogenic elements significantly enriched in the groundwaters at both sites include Ba, Ca, Li, Mg, Mn, Na, Rb, S, Si, Sr, and Ti. The abundance of these elements can largely be explained in terms of weathering of the dominant silicate (plagioclase, potassium feldspar, amphibole and biotite) and carbonate minerals (calcite, dolomite and ankerite) in the soils and sediments of the watershed. Arsenic, Mo, Te, and especially U are also highly enriched in the groundwaters, due to chemical weathering: these could easily be explained if there are small amounts of sulfides (As, Mo, Te) and apatite (U) in the soils of the source area. Elements neither significantly enriched nor depleted at both sites include Fe, Ga, Ge, and P.

A Decision Tool for Negotiating Home Care Funding Levels in Ontario

ABSTRACT This paper describes a decision tool created for the Sim-coe County Community Care Access Center (SCCCAC) in Ontario. The tool allows the SCCCAC to quantitatively assess the trade-offs between cost, quality, and waiting time of their home care patients. This information can then be used to negotiate reasonable funding levels with the Ontario government and to appropriately allocate this funding among the various patient groups at the SCCCAC. This work can be expanded to other health care organizations that use prioritized waiting lists.

Nesting Behavior, Ecology, Seasonal and Geographic Distribution of the Sand Wasp, <em>Stictiella emarginata</em> (Hymenoptera: Sphecidae)

The nesting behavior and ecology of Stictiella emarginata are documented for the first time based on field studies made mainly at Canadian Forces Base Borden, Simcoe County, Ontario. Type of soil, natural community, temporary closure, mound leveling, orientation flight, prey transport, nest structure and dimensions, and kind and number of prey per cell are defined. Museum and field collection records support a geographic bridge from northern Michigan to the Atlantic Coast and dispel the previously held notion of a disjunct distribution for this species. A late June-July-early August flight season is inferred from observations and collections made in Ontario, New York and Michigan. The nesting behavior and ecology of S. emarginata and several other Stictiella species from the western United States, Mexico and Florida are compared.

Responding to the severe acute respiratory syndrome (SARS) outbreak: Lessons learned in a Toronto emergency department

Responding to the severe acute respiratory syndrome (SARS) outbreak: Lessons learned in a Toronto emergency department

Mosses of Simcoe County, Ontario

Mosses of Simcoe County, Ontario

The functions of aggression by male teenagers.

The functions of aggression by male teenagers.

Urban Stormwater Management Strategy for the Severn Sound Remedial Action Plan

Abstract Urban Stormwater has been identified as a significant source of phosphorus to Severn Sound and a potential source of bacterial contamination which can affect recreational bathing areas within the Sound. In order to develop an effective remedial action plan, a cooperative study of urban Stormwater impacts was initiated in the Severn Sound Area of Concern (AOC) through a joint partnership that included Environment Canada (Great Lakes 2000 Cleanup Fund), the Ontario Ministry of the Environment, the Simcoe County District Health Unit, and various municipalities in the Sound. The study objectives were (1) characterization of dry weather and runoff quantity and quality; (2) monitoring effects of Stormwater runoff on the bacterial concentrations at an urban bathing area; and (3) development of pollution control plans for the participating urban municipalities in the Severn Sound watershed with an overall goal of a 20% reduction of Stormwater phosphorus loads. In general, the event mean concentrations of most runoff pollutants lie either within the range or below ranges reported by previous storm-water studies in Canada and the U.S., while some runoff pollutant concentrations (e.g., E. coli, heavy metals and nutrients) exceed the Ontario provincial water quality objectives. The bathing area sampling program recorded E. coli concentrations exceeding 600 organisms/100 mL at an outfall right after storm events started. Based on the limited sampling, it appears that rain events of approximately 20 mm or more may result in impingement of water with elevated E. coli counts on this bathing area within 6 hours of the onset of a rain event In order to update pollution loading estimates and develop pollution control plans, a retrofit Stormwater management model was applied. The planning model estimates an annual phosphorus loading of 1083 kg/year and a 20% reduction of phosporus loading, using source controls such as downspout disconnections and oil/water interceptors, drainage system controls such as grassed ditches and exfiltration systems, and downstream control such as water quality ponds. Pollution control plans were developed for each participating municipality based on the retrofit opportunities identified through the modelling exercise. The estimated cost is about $4 million. These plans provide specific recommendations regarding the implementation of various Stormwater retrofit measures and their financial requirements. A water quality pond identified by the pollution control plan for the Town of Penetanguishene has since been implemented.

Footprints in Stone and Biology Teaching

H. Murray Lang is Professor, Science Education Department, University of Toronto, Canada M5S 2R7. He holds a B.A. in honour biology, McMaster University, and an M.Ed. in curriculum, Ontario Institute for Studies in Education. He served as chairman of the Science Education Department at the University of Toronto during the years 1976-81, and currently teaches methods in science and biology. He has also taught science and biology at three collegiate (high) schools in Canada and biology methods at Althouse College of Education, University of Western Ontario, London. Mr. Lang is the author or coauthor of several articles and books, including Life Probe -A Study of Biology (with Galbraith, Finucane, and Tallevi, 1981, John Wiley & Sons Canada, Ltd.). He is especially interested in the teaching of evolution and biology by inquiry, gardening, and traveling and photographing Nature. Biology teachers are often faced with strange, seemingly unanswerable arguments from creationists. Sometimes the facts needed to answer these incongruities are difficult to uncover. A letter from a biology teacher set me on a trail of research that turned up some apparently deliberate deception on the part of certain creationists. The letter came from a school in Simcoe County, Ontario in February 1981:

Plant-parasitic nematodes associated with potatoes (Solatium tuberosum L.) in Simcoe County, Ontario

(1982). Plant-parasitic nematodes associated with potatoes (Solatium tuberosum L.) in Simcoe County, Ontario. Canadian Journal of Plant Pathology: Vol. 4, No. 4, pp. 389-391.

: Folsom Tools and Technology at the Hanson Site, Wyoming . George C. Frison, Bruce A. Bradley. ; A Report on the Banting and Hussey Sites. Two Paleo-Indian Campsites in Simcoe County, Southern Ontario . P. L. Storck. ; Pleistocene Bone Technology in the Beringian Refugium . Robson Bonnichsen. ; Early Man in America from a Circum-Pacific Perspective . Alan

American AnthropologistVolume 84, Issue 2 p. 447-449 Free Access Archeology: Folsom Tools and Technology at the Hanson Site, Wyoming, George C. Frison and Bruce A. Bradley.: A Report on the Banting and Hussey Sites. Two Paleo-Indian Campsites in Simcoe County, Southern Ontario. P. L. Storck.: Pleistocene Bone Technology in the Beringian Refugium. Robson Bonnichsen.: Early Man in America From a Circum-Pacific Perspective. Alan Lyle Bryan, ed Dennis Stanford, Dennis Stanford Smithsonian InstitutionSearch for more papers by this author Dennis Stanford, Dennis Stanford Smithsonian InstitutionSearch for more papers by this author First published: June 1982 https://doi.org/10.1525/aa.1982.84.2.02a00400AboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume84, Issue2June 1982Pages 447-449 RelatedInformation