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The objectives of this study were to describe the characteristics, management, and outcomes of patients treated by paramedics for hypoglycemia, and to determine the predictors of hospital admission for these patients within 72 hours of the initial hypoglycemia event. We performed a health record review of paramedic call reports and emergency department records over a 12-month period. We queried prehospital databases to identify cases, which included all patients ⩾18 years with prehospital glucose readings of <72 mg/dl (<4.0 mmol/L) and excluded terminally ill and cardiac arrest patients. We developed and piloted a standardized data collection tool and obtained consensus on all data definitions before initiation of data extraction by trained investigators. Data analyses included descriptive statistics univariate and logistic regression presented as adjusted odds ratios (aOR) with 95% confidence intervals (95%CI). There were 791 patients with the following characteristics: mean age 56.2, male 52.3%, type 1 diabetes 11.6%, on insulin 43.3%, median initial glucose 54.0 mg/dl (3.0 mmol/L), from home 56.4%. They were treated by advanced care paramedics 80.1%, received intravenous D50 37.8%, intramuscular glucagon 17.8%, oral complex carbs/protein 25.7%, and accepted transport to hospital 70.2%. Among those transported, 134 (24.3%) were initially admitted and four more were admitted within 72 hours. One patient was admitted, discharged, and admitted again within 72 hours. Patients without documented histories of diabetes (aOR 2.35, CI 1.13–4.86), with cardiovascular disease (aOR 1.81, CI 1.10–3.00), on corticosteroids (aOR 4.63, CI 2.15–9.96), on oral hypoglycemic agent(s) (aOR 1.92, CI 1.02–3.62), or those given glucagon (aOR 1.77, CI 1.07–2.93) on scene were more likely to be admitted to hospital, whereas patients on insulin (aOR 0.49, CI 0.27–0.91), able to tolerate complex oral carbs/protein (aOR 0.22, CI 0.10–0.48), with final GCS scores of 15 (aOR 0.53, CI 0.34–0.83), or from public locations (aOR 0.40, CI 0.21–0.75) were less likely to be admitted. There are several patient and prehospital management characteristics which, in combination, could be incorporated into a safe clinical decision tool for patients who present with hypoglycemia. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Education / Revue Canadienne de l'Éducation is the property of Canadian Society for the Study of Education and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

With the increasing use of genetic testing in pediatric epilepsy, it is important to describe the diagnostic outcomes as they relate to clinical care. The goal of this study was to assess the diagnostic yield and impact on patient care of genetic epilepsy panel testing. We conducted a retrospective chart review of patients at the Children's Hospital of Eastern Ontario (CHEO) who had genetic testing between the years of 2013–2020. We identified 227 patients that met criteria for inclusion. The majority of patients had their testing performed as "out-of-province" tests since province-based testing during this period was limited. The diagnostic yield for multi-gene epilepsy panel testing was 17% (39/227) and consistent with the literature. Variants of unknown significance (VUS) were reported in a significant number of undiagnosed individuals (77%; 128/163). A higher diagnostic rate was observed in patients with a younger age of onset of seizures (before one year of age; 32%; 29/90). A genetic diagnosis informed prognosis, recurrence risk counselling and expedited access to resources in all those with a diagnosis. A direct change in clinical management as a result of the molecular diagnosis was evident for 9% (20/227) of patients. The information gathered in this study provides evidence of the clinical benefits of genetic testing in epilepsy and serves as a benchmark for comparison with the current provincial Ontario Epilepsy Genetic Testing Program (OEGTP) that began in 2020. [ABSTRACT FROM AUTHOR]

Background: When a family member resides in long term care facility (LTC), family carers continue caregiving and have been found to have decreases in mental health. The aim of My Tools 4 Care - In Care (an online intervention) is to support carers of persons living with dementia residing in LTC through transitions and increase their self-efficacy, hope, social support and mental health. This article comprises the protocol for a study to evaluate My Tools 4 Care-In Care (MT4C-In Care) by asking the following research questions: 1) Is there a 2 month (immediately post-intervention) and 4 month (2 months post-intervention) increase in mental health, general self-efficacy, social support and hope, and decrease in grief and loneliness, in carers of a person living with dementia residing in LTC using MT4C-In CARE compared to an educational control group? 2) Do carers of persons living with dementia residing in LTC perceive My Tools 4 Care- In Care helps them with the transitions they experience?Methods: This study is a single blinded pragmatic mixed methods randomized controlled trial. Approximately 280 family carers of older persons (65 years of age and older) with dementia residing in LTC will be recruited for this study. Data will be collected at three time points: baseline, 2 month, and 4 months. Based on the feasibility study, we hypothesize that participants using MT4C-In Care will report significant increases in hope, general self-efficacy, social support and mental health quality of life, and significant decreases in grief and loneliness from baseline, as compared to an educational control group. To determine differences between groups and over time, generalized estimating equations analysis will be used. Qualitative descriptive analysis will be used to further evaluate MT4C-In Care and if it supports carers through transitions.Discussion: Data collection will begin in four Canadian provinces (Alberta, Manitoba, Ontario and Saskatchewan) in February 2020 and is expected to be completed in June 2021. The results will inform policy and practice as MT4C-In Care can be revised for local contexts and posted on websites such as those hosted by the Alzheimer Society of Canada.Trial Registration: NCT04226872 ClinicalTrials.gov Registered 09 January 2020 Protocol Version #2 Feb 19, 2020. [ABSTRACT FROM AUTHOR]

What does Heron teach about our time of turbulent multi-scalar issues like species extinctions, climate change, and related social injustices? In this article, I consider this question by engaging the changing presence of various Herons in the wetlands of southern Ontario, Canada, in a context of colonial and modern urbanizing processes that continue to have impacts. The teachings Heron offers goes beyond critical reflections on external ecological changes, for I also symbolically relate with its wetland home as a place in midst of the Kaswén:ta or Two Row Wampum. This early treaty between Indigenous Canoe and Colonial Ship was meant to situate us on our Common Waters in a way that can honor diverse ways. Though the subsequent colonial focus on conversion of people and creation would manifest an array of impacts, I am guided back to the Two Row as a model for bringing into dialogue Indigenous and conservationist understandings. It is in the still presence of Heron that different understandings and acts emerge on what it will take to sustainably respond to those colonizing ways that continue to fuel global scale issues like extinction and climate change. [ABSTRACT FROM AUTHOR]

Fluvial systems in southern Ontario are regularly affected by widespread early-spring flood events primarily caused by rain-on-snow events. Recent studies have shown an increase in winter floods in this region due to increasing winter temperature and precipitation. Streamflow simulations are associated with uncertainties mainly due to the different scenarios of greenhouse gas emissions, global climate models (GCMs) or the choice of the hydrological model. The internal variability of climate, defined as the chaotic variability of atmospheric circulation due to natural internal processes within the climate system, is also a source of uncertainties to consider. Uncertainties of internal variability can be assessed using hydrological models fed by downscaled data of a global climate model large ensemble (GCM-LE), but GCM outputs have too coarse of a scale to be used in hydrological modeling. The Canadian Regional Climate Model Large Ensemble (CRCM5-LE), a 50-member ensemble downscaled from the Canadian Earth System Model version 2 Large Ensemble (CanESM2-LE), was developed to simulate local climate variability over northeastern North America under different future climate scenarios. In this study, CRCM5-LE temperature and precipitation projections under an RCP8.5 scenario were used as input in the Precipitation Runoff Modeling System (PRMS) to simulate streamflow at a near-future horizon (2026–2055) for four watersheds in southern Ontario. To investigate the role of the internal variability of climate in the modulation of streamflow, the 50 members were first grouped in classes of similar projected change in January–February streamflow and temperature and precipitation between 1961–1990 and 2026–2055. Then, the regional change in geopotential height (Z500) from CanESM2-LE was calculated for each class. Model simulations showed an average January–February increase in streamflow of 18 % (±8.7) in Big Creek, 30.5 % (±10.8) in Grand River, 29.8 % (±10.4) in Thames River and 31.2 % (±13.3) in Credit River. A total of 14 % of all ensemble members projected positive Z500 anomalies in North America's eastern coast enhancing rain, snowmelt and streamflow volume in January–February. For these members the increase of streamflow is expected to be as high as 31.6 % (±8.1) in Big Creek, 48.3 % (±11.1) in Grand River, 47 % (±9.6) in Thames River and 53.7 % (±15) in Credit River. Conversely, 14 % of the ensemble projected negative Z500 anomalies in North America's eastern coast and were associated with a much lower increase in streamflow: 8.3 % (±7.8) in Big Creek, 18.8 % (±5.8) in Grand River, 17.8 % (±6.4) in Thames River and 18.6 % (±6.5) in Credit River. These results provide important information to researchers, managers, policymakers and society about the expected ranges of increase in winter streamflow in a highly populated region of Canada, and they will help to explain how the internal variability of climate is expected to modulate the future streamflow in this region. [ABSTRACT FROM AUTHOR]

Extreme events are widely studied across the world because of their major implications for many aspects of society and especially floods. These events are generally studied in terms of precipitation or temperature extreme indices that are often not adapted for regions affected by floods caused by snowmelt. The rain on snow index has been widely used, but it neglects rain-only events which are expected to be more frequent in the future. In this study, we identified a new winter compound index and assessed how large-scale atmospheric circulation controls the past and future evolution of these events in the Great Lakes region. The future evolution of this index was projected using temperature and precipitation from the Canadian Regional Climate Model large ensemble (CRCM5-LE). These climate data were used as input in Precipitation Runoff Modelling System (PRMS) hydrological model to simulate the future evolution of high flows in three watersheds in southern Ontario. We also used five recurrent large-scale atmospheric circulation patterns in north-eastern North America and identified how they control the past and future variability of the newly created index and high flows. The results show that daily precipitation higher than 10 mm and temperature higher than 5 ∘ C were necessary historical conditions to produce high flows in these three watersheds. In the historical period, the occurrences of these heavy rain and warm events as well as high flows were associated with two main patterns characterized by high Z500 anomalies centred on eastern Great Lakes (HP regime) and the Atlantic Ocean (South regime). These hydrometeorological extreme events will still be associated with the same atmospheric patterns in the near future. The future evolution of the index will be modulated by the internal variability of the climate system, as higher Z500 on the east coast will amplify the increase in the number of events, especially the warm events. The relationship between the extreme weather index and high flows will be modified in the future as the snowpack reduces and rain becomes the main component of high-flow generation. This study shows the value of the CRCM5-LE dataset in simulating hydrometeorological extreme events in eastern Canada and better understanding the uncertainties associated with internal variability of climate. [ABSTRACT FROM AUTHOR]

Background: As the population ages, older hospitalized patients are at increased risk for hospital-acquired morbidity. The Mobilization of Vulnerable Elders (MOVE) program is an evidence-informed early mobilization intervention that was previously evaluated in Ontario, Canada. The program was effective at improving mobilization rates and decreasing length of stay in academic hospitals. The aim of this study was to scale-up the program and conduct a replication study evaluating the impact of the evidence-informed mobilization intervention on various units in community hospitals within a different Canadian province.Methods: The MOVE program was tailored to the local context at four community hospitals in Alberta, Canada. The study population was patients aged 65 years and older who were admitted to medicine, surgery, rehabilitation and intensive care units between July 2015 and July 2016. The primary outcome was patient mobilization measured by conducting visual audits twice a week, three times a day. The secondary outcomes included hospital length of stay obtained from hospital administrative data, and perceptions of the intervention assessed through a qualitative assessment. Using an interrupted time series design, the intervention was evaluated over three time periods (pre-intervention, during, and post-intervention).Results: A total of 3601 patients [mean age 80.1 years (SD = 8.4 years)] were included in the overall analysis. There was a significant increase in mobilization at the end of the intervention period compared to pre-intervention, with 6% more patients out of bed (95% confidence interval (CI) 1, 11; p-value = 0.0173). A decreasing trend in median length of stay was observed, where patients on average stayed an estimated 3.59 fewer days (95%CI -15.06, 7.88) during the intervention compared to pre-intervention period.Conclusions: MOVE is a low-cost, effective and adaptable intervention that improves mobilization in older hospitalized patients. This intervention has been replicated and scaled up across various units and hospital settings. [ABSTRACT FROM AUTHOR]

Extreme events are widely studied across the world because of their major implications for many aspects of society and especially floods. These events are generally studied in term of precipitation or temperature extreme indices that are often not adapted for regions affected by floods caused by snowmelt. Rain on Snow index has been widely used but it neglects rain only events which are expected to be more frequent in the future. In this study we identified a new winter compound index and assessed how large-scale atmospheric circulation controls the past and future evolution of these events in the Great Lakes region. The future evolution of this index was projected using temperature and precipitation from the Canadian Regional Climate Model Large Ensemble (CRCM5-LE). These climate data were used as input in PRMS hydrological model to simulate the future evolution of high flows in three watersheds in Southern Ontario. We also used five recurrent large-scale atmospheric circulation patterns in northeastern North America and identified how they control the past and future variability of the newly created index and high flows. The results show that daily precipitation higher than 10 mm and temperature higher than 5 °C were a necessary historical condition to produce high flows in these three watersheds. In the historical period, the occurrences of these heavy rain and warm events as well as high flows were associated to two main patterns characterized by high Z500 anomalies centred on eastern Great Lakes (HP) and the Atlantic Ocean (South). These hydrometeorological extreme events will be more frequent in the near future and will still be associated to the same atmospheric patterns. The future evolution of the index will be modulated by the internal variability of the climate system as higher Z500 in the east coast will amplify the increase in the number of events, especially the warm events. The relationship between the extreme weather index and high flows will be modified in the future as the snowpack reduces and rain becomes the main component of high flows generation. This study shows the values of CRCM5-LE dataset to simulate hydrometeorological extreme events in Eastern Canada and to better understand the uncertainties associated to internal variability of climate. [ABSTRACT FROM AUTHOR]

Social work is being challenged to situate its theories and practice within the lands it finds itself on in North America. This article considers the Canadian Truth and Reconciliation Commission’s calls for change from the perspective of how social workers are educated in relation to land, from Indigenous views on its colonial conversions to the land’s role in healing. The discussion is grounded in a course I teach on Reconciliation and Indigenous-Social Work Relations on the Haudenosaunee lands of the Grand River in Ontario. Social work students consider their vocation in relation to a truth-telling process that is a first step for reconciling with Indigenous nations and land. The article concludes with general implications for social work educators. [ABSTRACT FROM AUTHOR]

Appropriate and optimal use of medication and polypharmacy are especially relevant to the care of older Canadians living with frailty, often impacting their health outcomes and quality of life. A majority (two thirds) of older adults (65 or older) are prescribed five or more drug classes and over one-quarter are prescribed 10 or more drugs. The risk of adverse drug-induced events is even greater for those aged 85 or older where 40% are estimated to take drugs from 10 or more drug classes. The Canadian Frailty Network (CFN), a pan-Canadian non-for-profit organization funded by the Government of Canada through the Networks of Centres of Excellence Program (NCE), is dedicated to improving the care of older Canadian living with frailty and, as part of its mandate, convened a meeting of stakeholders from across Canada to seek their perspectives on appropriate medication prescription. The CFN Medication Optimization Summit identified priorities to help inform the design of future research and knowledge mobilization efforts to facilitate optimal medication prescribing in older adults living with frailty. The priorities were developed and selected through a modified Delphi process commencing before and concluding during the summit. Herein we describe the overall approach/process to the summit, a summary of all the presentations and discussions, and the top ten priorities selected by the participants. [ABSTRACT FROM AUTHOR]

Accelerometry is the gold standard for field-based physical activity assessment in children; however, the plethora of devices, data reduction procedures, and cut-points available limits comparability between studies. This study aimed to compare physical activity variables from the ActiGraph GT3X+ and Actical accelerometers in children under free-living conditions. A cross-sectional study of 379 children aged 9–11 years from Ottawa (Canada) was conducted. Children wore the ActiGraph GT3X+ and Actical accelerometers on the hip simultaneously for 7 consecutive days (24-h protocol). Moderate-to-vigorous (MVPA), vigorous (VPA), moderate (MPA), and light (LPA) physical activity, as well as sedentary time, (SED) were derived using established data reduction protocols. Excellent agreement between devices was observed for MVPA (ICC = 0.73–0.80), with fair to good agreement for MPA, LPA and SED, and poor agreement for VPA. Bland-Altman plots showed excellent agreement for MVPA, LPA, and SED, adequate agreement for MPA, and poor agreement for VPA. MVPA derived from the Actical was 11.7% lower than the ActiGraph GT3X+. The ActiGraph GT3X+ and Actical are comparable for measuring children’s MVPA. However, comparison between devices for VPA, MPA, LPA, and SED are highly dependent on data reduction procedures and cut-points, and should be interpreted with caution. [ABSTRACT FROM PUBLISHER]

Background: Having a TV in the bedroom is associated with adiposity in children. It is not known how lifestyle behaviours (television viewing time, diet patterns, physical activity, and sleep duration) mediate this association. The objective of this study was to examine the mediating role of these lifestyle behaviours in the association between TV in the bedroom and percent body fat (% BF). Methods: Cross-sectional data from 1 201 children (57.3 % female; mean age = 9.8 years) from Ottawa, Canada and Baton Rouge, USA were examined. % BF was directly measured. Accelerometers were used to determine physical activity and sleep duration (24-h, 7-day protocol). Questionnaires were used to assess TV viewing time and healthy/unhealthy diet patterns (derived using factor analysis from food frequency questionnaire data). Results: Canadian boys and girls with a TV in their bedroom had a higher % BF, watched more TV and had unhealthier diets. American boys and girls with a TV in their bedroom watched more TV, while boys had a higher % BF and a more unhealthy diet, and girls had less MVPA. In Canadian girls, TV viewing time mediated the association between having a TV in the bedroom and adiposity, independent of diet patterns, MVPA, and sleep duration. Other lifestyle mediators were not significant in Canadian boys or in US children. Conclusion: TV viewing is a mediating lifestyle behaviour in the association between TV in the bedroom and adiposity in Canadian girls. Future research is needed to identify lifestyle behaviours as intermediate mediators. [ABSTRACT FROM AUTHOR]

Background: Demographic, family, and home characteristics play an important role in determining childhood sedentary behaviour. The objective of this paper was to identify correlates of total sedentary time (SED) and correlates of self-reported screen time (ST) in Canadian children. Methods: Child- and parent-reported household, socio-demographic, behavioural, and diet related data were collected; directly measured anthropometric and accelerometer data were also collected for each child. Participants with complete demographic, anthropometric, and either SED (n=524, 41% boys) or ST (n=567, 42% boys) data from the Canadian site of the International Study of Childhood Obesity Lifestyle and the Environment (ISCOLE) were included in analysis. Sixteen potential correlates of SED and ST were examined using multilevel general linear models, adjusting for sex, ethnicity, number of siblings, and socio-economic status. All explanatory variables moderately associated (p<0.10) with SED and/or ST in univariate analyses were included in the final, fully-adjusted models. Variables that remained significant in the final models (p<0.05) were considered correlates of SED and/or ST. Results: Children averaged 8.5hours of daily SED; no differences in total SED, or total ST were seen between girls and boys, but boys reported significantly more video game/computer usage than girls. Boys also had higher waist circumference and BMI z-scores than girls. In the final models, waist circumference and number of TVs in the home were the only common correlates of both SED and ST. SED was also negatively associated with sleep duration. ST was also positively associated with mother's weight status, father's education, and unhealthy eating pattern score and negatively associated with healthy eating pattern score, and weekend breakfast consumption. Few common correlates existed between boys and girls. Conclusion: Several factors were identified as correlates of SED and/or of ST in Canadian children; however, few correlates were common for both SED and ST, and for both boys and girls. This suggests that a single strategy to reduce SED and ST is unlikely to be effective. Future work should examine a variety of other, non-screen based sedentary behaviours and their potential correlates in the hopes of creating tailored public health messages to reduce SED and ST in both boys, and girls. [ABSTRACT FROM AUTHOR]

Copyright of Applied Physiology, Nutrition & Metabolism is the property of Canadian Science Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Workers who stand on platforms or equipment that vibrate are exposed to foot-transmitted vibration (FTV). Exposure to FTV can lead to vibration white feet/toes resulting in blanching of the toes, and tingling and numbness in the feet and toes. OBJECTIVES: The objectives are 1) to review the current state of knowledge of the health risks associated with foot-transmitted vibration (FTV), and 2) to identify the characteristics of FTV and discuss the associated risk of vibration-induced injury. PARTICIPANTS: Workers who operated locomotives (n=3), bolting platforms (n=10), jumbo drills (n=7), raise drilling platforms (n=4), and crushers (n=3), participated. METHODS: A tri-axial accelerometer was used to measure FTV in accordance with ISO 2631-1 guidelines. Frequency-weighted root-mean-square acceleration and the dominant frequency are reported. Participants were also asked to report pain/ache/discomfort in the hands and/or feet. RESULTS: Reports of pain/discomfort/ache were highest in raise platform workers and jumbo drill operators who were exposed to FTV in the 40 Hz and 28 Hz range respectively. Reports of discomfort/ache/pain were lowest in the locomotive and crusher operators who were exposed to FTV below 10 Hz. These findings are consistent with animal studies that have shown vascular and neural damage in exposed appendages occurs at frequencies above 40 Hz. CONCLUSIONS: Operators exposed to FTV at 40 Hz appear to be at greater risk of experiencing vibration induced injury. Future research is required to document the characteristics of FTV and epidemiological evidence is required to link exposure with injury. [ABSTRACT FROM AUTHOR]

Copyright of Ecoscience (Ecoscience) is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Citizens can be involved directly in the electoral reform process. In some jurisdictions, constitutional requirements or political necessity requires a referendum. There are also instances in which a proposal originates through such means as a popular initiative or reference to a citizens' assembly. When a vote occurs, additional barriers to success are created. This article examines particularly the referendum which took place in the Canadian province of Ontario on a reform proposal that had been recommended by a citizens' assembly. The analysis examines the campaign and discusses some of the factors that ultimately led to the defeat of the proposal. [ABSTRACT FROM AUTHOR]

A polarimetric melting-layer detection algorithm developed for an S-band radar has been modified for use by the King City C-band radar in southern Ontario, Canada. The technique ingests radar scan volume data to determine the melting-layer top and bottom and to diagnose temporal and spatial variations of the melting-layer heights. The thickness of the melting layer is also derived from the algorithm. Detailed case studies of two frontal systems over this region are described, comparing the radar-derived melting-layer height with aircraft measurement of the height of the 0°C isotherm. The analysis demonstrated the ability to detect rapidly changing melting-layer heights during frontal passages in the region. A range of melting-layer heights for a 3-yr period was investigated and produced detections from close to the ground up to about 5.0 km. Comparison of algorithm results to output from a numerical weather prediction model over the 3-yr period showed good agreement. The correlation coefficient of the heights of the 0°C wet-bulb temperature with the radar-derived melting-layer tops was 0.96. The time series of the algorithm output was used to detect frontal passages and showed that the algorithm should be useful for approximately 19 frontal passages per year in this region. [ABSTRACT FROM AUTHOR]

Geostationary Operational Environmental Satellite (GOES) imagery is used to demonstrate the development of lake-breeze boundaries in southern Ontario under different synoptic conditions. The orientation of the gradient wind with respect to the shorelines is important in determining the location of such lines. When moderate winds (5–10 m s[sup -1] ) are parallel to straight sections of coastlines, cloud lines can extend well inland. In the region between Lakes Huron and Erie lake-breeze lines merge frequently, sometimes resulting in long-lasting stationary storms and attendant heavy rain and flooding. The influence of the lakes is apparent in the tornado climatology for the region: tornadoes appear to be suppressed in regions visited by lake-modified air and enhanced in regions favored by lake-breeze convergence lines. The cloud patterns in the case of a cold front interacting with merging lake-breeze boundaries are shown to be similar to those on a major tornado outbreak day. Two of the cases discussed are used as conceptual models to explain many of the features in the patterns of tornado touchdown locations. In general, it appears that the lakes suppress tornadoes in southern Ontario, compared with neighboring states and in particular in areas where southwest winds are onshore, but enhance tornado likelihood locally in areas of frequent lake-breeze activity. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to assess the sleep quality, quantity, and fatigue levels of Canadian wildland firefighters while on deployment. Methods: Objective and subjective sleep and fatigue measures were collected using actigraphy and questionnaires during non-fire (Base) and fire (Initial Attack and Project) deployments. Results: Suboptimal sleep quality and quantity were more frequently observed during high-intensity, Initial Attack fire deployments. Suboptimal sleep was also exhibited during nonfire (Base) work periods, which increases the risk of prefire deployment sleep debt. Self-reported, morning fatigue scores were low-to-moderate and highest for Initial Attack fire deployments. Conclusions: The study highlights the incidence of suboptimal sleep patterns in wildland firefighters during non-fire and fire suppression work periods. These results have implications for the health and safety practices of firefighters given the link between sleep and fatigue, in a characteristically hazardous occupation. [ABSTRACT FROM AUTHOR]