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BACKGROUND: Cancer Care Ontario's Systemic Therapy Task Force recently reviewed the medical oncology system in the province. There has been growing concern about anecdotal reports of burnout, high levels of stress and staff leaving or decreasing their work hours. However, no research has systematically determined whether there is evidence to support or refute these reports. To this end, a confidential survey was undertaken. METHODS: A questionnaire was mailed to all 1016 personnel of the major providers of medical oncology services in Ontario. The questionnaire consisted of the Maslach Burnout Inventory, the 12-item General Health Questionnaire, a questionnaire to determine job satisfaction and stress, and questions to obtain demographic characteristics and to measure the staff's consideration of alternative work situations. RESULTS: The overall response rate was 70.9% (681 of 961 eligible subjects): by group it was 63.3% (131/207) for physicians, 80.9% (314/388) for allied health professionals and 64.5% (236/366) for support staff. The prevalence of emotional exhaustion were significantly higher among the physicians (53.3%) than among the allied health professionals (37.1%) and the support staff (30.5%) (p < or = 0.003); the same was true for feelings of depersonalization (22.1% v. 4.3% and 5.5% respectively) (p < or = 0.003). Feelings of low personal accomplishment were significantly higher among physicians (48.4%) and allied health professionals (54.0%) than among support staff (31.4%) (p < or = 0.002). About one-third of the respondents in each group reported that they have considered leaving for a job outside the cancer care system. Significantly more physicians (42.6%) than allied health professionals (7.6%) or support staff (4.5%) stated that they have considered leaving for a job outside the province. INTERPRETATION: The findings support the concern that medical oncology personnel are experiencing burnout and high levels of stress and that large numbers are considering leaving or decreasing their work hours. This is an important finding for the cancer care system, where highly trained and experienced health care workers are already in short supply.

OBJECTIVE: To estimate the point prevalence of fibromyalgia syndrome (FM) among noninstitutionalized Canadian adults; and to assess the effect of demographic variables on the odds of having FM. METHODS: A screening questionnaire was administered via telephone to a random community sample of 3395 noninstitutionalized adults residing in London, Ontario. Individuals screening positive were invited to be examined by a rheumatologist to confirm or exclude FM using the 1990 American College of Rheumatology classification criteria. RESULTS: One hundred confirmed cases of FM were identified, of whom 86 were women. Mean age among FM cases was 49.2 years among women, 39.3 years among men (p < 0.02). FM affects an estimated 4.9% (95% CI 4.7%, 5.1%) of adult women and 1.6% (1.3%, 1.9%) of adult men in London, for a female to male ratio of roughly 3 to one. In women, prevalence rises steadily with age from < 1% in women aged 18-30 to almost 8% in women 55-64. Thereafter, it declines. The peak prevalence in men also appears to be in middle age (2.5%; 1.1%, 5.7%). FM affects 3.3% (3.2%, 3.4%) of noninstitutionalized adults in London. Female sex, middle age, less education, lower household income, being divorced, and being disabled are associated with increased odds of having FM. CONCLUSION: FM is a common musculoskeletal disorder among Canadian adults, especially among women and persons of lower socioeconomic status.

Importance: Medical imaging increased rapidly from 2000 to 2006, but trends in recent years have not been analyzed. Objective: To evaluate recent trends in medical imaging. Design, Setting, and Participants: Retrospective cohort study of patterns of medical imaging between 2000 and 2016 among 16 million to 21 million patients enrolled annually in 7 US integrated and mixed-model insurance health care systems and for individuals receiving care in Ontario, Canada. Exposures: Calendar year and country (United States vs Canada). Main Outcomes and Measures: Use of computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and nuclear medicine imaging. Annual and relative imaging rates by imaging modality, country, and age (children [<18 years], adults [18-64 years], and older adults [≥65 years]). Results: Overall, 135 774 532 imaging examinations were included; 5 439 874 (4%) in children, 89 635 312 (66%) in adults, and 40 699 346 (30%) in older adults. Among adults and older adults, imaging rates were significantly higher in 2016 vs 2000 for all imaging modalities other than nuclear medicine. For example, among older adults, CT imaging rates were 428 per 1000 person-years in 2016 vs 204 per 1000 in 2000 in US health care systems and 409 per 1000 vs 161 per 1000 in Ontario; for MRI, 139 per 1000 vs 62 per 1000 in the United States and 89 per 1000 vs 13 per 1000 in Ontario; and for ultrasound, 495 per 1000 vs 324 per 1000 in the United States and 580 per 1000 vs 332 per 1000 in Ontario. Annual growth in imaging rates among US adults and older adults slowed over time for CT (from an 11.6% annual percentage increase among adults and 9.5% among older adults in 2000-2006 to 3.7% among adults in 2013-2016 and 5.2% among older adults in 2014-2016) and for MRI (from 11.4% in 2000-2004 in adults and 11.3% in 2000-2005 in older adults to 1.3% in 2007-2016 in adults and 2.2% in 2005-2016 in older adults). Patterns in Ontario were similar. Among children, annual growth for CT stabilized or declined (United States: from 10.1% in 2000-2005 to 0.8% in 2013-2016; Ontario: from 3.3% in 2000-2006 to -5.3% in 2006-2016), but patterns for MRI were similar to adults. Changes in annual growth in ultrasound were smaller among adults and children in the United States and Ontario compared with CT and MRI. Nuclear medicine imaging declined in adults and children after 2006. Conclusions and Relevance: From 2000 to 2016 in 7 US integrated and mixed-model health care systems and in Ontario, rates of CT and MRI use continued to increase among adults, but at a slower pace in more recent years. In children, imaging rates continued to increase except for CT, which stabilized or declined in more recent periods. Whether the observed imaging utilization was appropriate or was associated with improved patient outcomes is unknown.

Research Article| March 01, 1973 Archean Ultramafic Flows in Munro Township, Ontario D. R. PYKE; D. R. PYKE 1Ontario Division of Mines, Geological Branch, Whitney Block, Queen's Park, Toronto, Ontario, Canada Search for other works by this author on: GSW Google Scholar A. J. NALDRETT; A. J. NALDRETT 2Department of Geology, University of Toronto, Toronto, Ontario, Canada Search for other works by this author on: GSW Google Scholar O. R. ECKSTRAND O. R. ECKSTRAND 3Geological Survey of Canada, 601 Booth Street, Ottawa, Ontario, Canada Search for other works by this author on: GSW Google Scholar GSA Bulletin (1973) 84 (3): 955–978. https://doi.org/10.1130/0016-7606(1973)84<955:AUFIMT>2.0.CO;2 Article history first online: 01 Jun 2017 Cite View This Citation Add to Citation Manager Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Search Site Citation D. R. PYKE, A. J. NALDRETT, O. R. ECKSTRAND; Archean Ultramafic Flows in Munro Township, Ontario. GSA Bulletin 1973;; 84 (3): 955–978. doi: https://doi.org/10.1130/0016-7606(1973)84<955:AUFIMT>2.0.CO;2 Download citation file: Ris (Zotero) Refmanager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentBy SocietyGSA Bulletin Search Advanced Search Abstract A unique exposure within the Abitibi orogenic belt of northeastern Ontario provides an exceptionally clear view of early Precambrian (Archean) ultramafic volcanic rocks. Approximately 60 ultramafic flow units are exposed over a stratigraphic thickness of 125 m. Individual flow units range in thickness from 0.5 to 15 m, average about 3 m, and display remarkable strike lengths and internal structure, which suggest extreme fluidity.The upper margin of the flow units (0.1 to 1.0 m) is thicker than the lower margin (about 1 cm), and the upper margin is highly fractured, thereby providing an easily recognizable top determinator. Many flow units contain a zone of spinifex, ranging in width from zero to 5 m, which underlies and is gradational with the flow top. Spinifex is a textural term to describe an array of criss-crossing sheafs or booklets characterized by numerous closely spaced and parallel blade- or plate-like crystals of olivine. The texture is generally accepted as having formed by rapid cooling of a crystal-free ultramafic liquid in situ. The variation in size of bladed olivine crystals within a spinifex zone is always from coarse (up to 1 m long) at the bottom to fine at the top, thereby providing a primary top determination. In flow units not containing a spinifex zone the chilled and fractured flow top grades downward into a zone of moderately foliated peridotite which generally constitutes the remaining part of a flow unit.Chemically, the flow units resemble similar ultramafic rocks described from northeastern Ontario, western Australia, and the Barberton area of South Africa; one unique feature is the exceptionally high alumina content of the clinopyroxene This content is PDF only. Please click on the PDF icon to access. First Page Preview Close Modal You do not have access to this content, please speak to your institutional administrator if you feel you should have access.

BACKGROUND: BRCA1 and BRCA2 mutations in general populations and in various types of cancers have not been well characterized. We investigated the presence of these mutations in unselected patients with newly diagnosed incident ovarian cancer in Ontario, Canada, with respect to cancers reported among their relatives. METHODS: A population series of 1171 unselected patients with incident ovarian cancer diagnosed between January 1, 1995, and December 31, 1999, in Ontario, Canada, was screened for germline mutations throughout the BRCA1 and BRCA2 genes. Screening involved testing for common variants, then protein truncation testing of long exons, and then denaturing gradient gel electrophoresis or denaturing high-performance liquid chromatography for the remainder of BRCA1 and BRCA2, respectively. Cox regression analysis was used to examine cancer outcomes reported by the case probands for their 8680 first-degree relatives. Population allele frequencies and relative risks (RRs) were derived from the regression results by an extension of Saunders-Begg methods. Age-specific Ontario cancer incidence rates were used to estimate cumulative incidence of cancer to age 80 years by mutation status. RESULTS: Among 977 patients with invasive ovarian cancer, 75 had BRCA1 mutations and 54 had BRCA2 mutations, for a total mutation frequency of 13.2% (95% confidence interval [CI] = 11.2% to 15.5%). Higher risks for various cancer types in the general Ontario population were associated with BRCA1 mutation carriage than with noncarriage, including ovarian (RR = 21, 95% CI = 12 to 36), female breast (RR = 11, 95% CI = 7.5 to 15), and testis (RR = 17, 95% CI = 1.3 to 230) cancers. Higher risks were also associated with BRCA2 mutation carriage than with noncarriage, particularly for ovarian (RR = 7.0, 95% CI = 3.1 to 16), female and male breast (RR = 4.6, 95% CI = 2.7 to 7.8, and RR = 102, 95% CI = 9.9 to 1050, respectively), and pancreatic (RR = 6.6, 95% CI = 1.9 to 23) cancers. Cancer risks differed according to the mutation's position in the gene. Estimated cumulative incidence to age 80 years among women carrying BRCA1 mutations was 24% for ovarian cancer and 90% for breast cancer and among women carrying BRCA2 mutations was 8.4% for ovarian cancer and 41% for breast cancer. For the general Ontario population, estimated carrier frequencies of BRCA1 and BRCA2 mutations, respectively, were 0.32% (95% CI = 0.23% to 0.45%) and 0.69% (95% CI = 0.43% to 1.10%). CONCLUSIONS: BRCA1 and BRCA2 mutations may be more frequent in general populations than previously thought and may be associated with various types of cancers.

OBJECTIVES: To present the 6-month prevalence and sociodemographic correlates of mental disorders and mental health-related service contacts in a sample of children (4 to 11 years) and youth (12 to 17 years) in Ontario. METHODS: The 2014 Ontario Child Health Study is a provincially representative survey of 6537 families with children aged 4 to 17 years in Ontario. DSM-IV-TR mental disorders were assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) and included mood (major depressive episode), anxiety (generalized anxiety, separation anxiety, social phobia, specific phobia), and behaviour disorders (attention-deficit/hyperactivity disorder, oppositional-defiant disorder, conduct disorder).The MINI-KID was administered independently to the primary caregiver and youth aged 12 to 17 years in the family's home. RESULTS: Past 6-month prevalence of any mental disorder ranged from 18.2% to 21.8% depending on age and informant. Behaviour disorders were the most common among children, and anxiety disorders were the most common among youth. Among children and youth with a parent-identified mental disorder, 25.6% of children and 33.7% of youth had contact with a mental health provider. However, 60% had contact with one or more of the providers or service settings assessed, most often through schools. CONCLUSIONS: Between 18% and 22% of children and youth in Ontario met criteria for a mental disorder but less than one-third had contact with a mental health provider. These findings provide support for strengthening prevention and early intervention efforts and enhancing service capacity to meet the mental health needs of children and youth in Ontario.

Superior crop cultivars must be identified through multi-environment trials (MET) and on the basis of multiple traits. The objectives of this paper were to describe two types of biplots, the GGE biplot and the GT biplot, which graphically display genotype by environment data and genotype by trait data, respectively, and hence facilitate cultivar evaluation on the basis of MET data and multiple traits. Genotype main effect plus genotype by environment interaction effect (GGE) biplot analysis of the soybean [Glycine max (L.) Merr.] yield data for the 2800 crop heat unit area of Ontario for MET in the period 1994-1999 revealed yearly crossover genotype by site interactions. The eastern Ontario site Winchester showed a different genotype response pattern from the three southwestern Ontario sites in four of the six years. The interactions were not large enough to divide the area into different mega-environments as when analyzed over years, a single cultivar yielded the best in all four sites. The southwestern site, St. Pauls, was found to always group together with at least one of the other three sites; it did not provide unique information on genotype performance. Therefore, in future cultivar evaluations, Winchester should always be used but St. Pauls can be dismissed. Applying GT biplot to the 1994-1999 multiple trait data illustrated that GT biplots graphically displayed the interrelationships among seed yield, oil content, protein content, plant height, and days to maturity, among other traits, and facilitated visual cultivar comparisons and selection. It was found that selection for seed yield alone was not only the simplest, but also the most effective strategy in the early stages of soybean breeding.