Accountability: Understanding the effect of governance structures on land ambulance services in Ontario, connected by Consolidated Municipal Services Management (CMSM) agreements

Ontario has seen significant changes across the municipal landscape, including the realignment of service responsibilities. One of the products of this realignment was the introduction of the CMSM program in 1998, which saw local municipalities take on the responsibilities for many services, including land ambulance. Land ambulance is an important life-saving service (Aringhieri et al. 2017). Decision-makers must ensure that such services must be delivered with optimal performance. As a public service in Ontario, this includes democratic performance. Crucial to the anchorage of democratic performance is accountability. Accountability is a transaction of information, dialogue, and rewards/sanctions (Brandsma and Schillemans 2012). It is an important component of democracy. While much attention has been paid to accountability at the provincial and federal levels, there is a growing body of research into accountability at the local level (Spicer 2017; Arnbuckle 2018). This study aims to contribute to this growing body of literature by considering the vital service of land ambulance and the unique institutions of city-county separation along with the imposed CMSM program. By asking the question “In areas where city-county institutions are established, to what extent is the accountability gap in land ambulance services agreements effected by the governance model of the service provider”, this study contributes to the empirical data around accountability, inter-municipal agreements, and SPBs. Through a quantitative test and description, this paper first quantifies the extent of accountability in 13 city-county services, confirming that while land-ambulance services generally perform well, governance structures do correlate with improved performance. Additionally, using a comparative case study, this study qualitatively describes the findings in two similar municipalities with different governance structures, supporting the GAT findings and describing how municipalities can improve their accountability. In sum, this paper finds that in the 13 agreements/services studied, SPB governance structures have superior performance to direct and contract delivery. However, partnerships that have or can produce annual reports, create clear complaints processes, establish joint committees (or boards) with representation from all partner municipalities, do correlate with a strong performance in accountability

Navigating Human Cytomegalovirus (hcmv) Envelopment And Egress

Human cytomegalovirus (HCMV) is a ubiquitous viral pathogen. In individuals with fully functioning and mature immune systems, HCMV is associated with mild symptoms prior to establishing latency. In individuals with naïve or compromised immune systems, HCMV is capable of causing severe organ damage. HCMV is the leading infectious cause of congenital birth defects and a major non-genetic cause of hearing loss. Unfortunately, antiviral treatment options lack diversity due to limited knowledge of virion replication. If HCMV replication were better understood, new antiviral treatments could be developed. In this work, we describe the development and implementation of new tools to study HCMV replication with a focus on envelopment and egress. We generated a novel HCMV bacterial artificial chromosome (BAC) expression system for characterizing the effects of exogenous proteins in the context of HCMV replication. While demonstrating the new BAC, TB40/E/Cre, we are also able to draw conclusions relating HCMV genome size to replication efficiency. In addition, we characterize the transcriptional profile of cellular proteins during HCMV infection. We found that HCMV causes significant alteration in host mRNA expression and targets a number of transcripts related to vesicle-mediated trafficking. By tracing the effects of HCMV on cellular trafficking, we propose a model of virion envelopment and egress. Through this work, we now have the capability to test our predictions and determine the route of viral maturation and exocytosis in host cells. By constructing a map of HCMV replication, we provide critical control points for use in developing novel antiviral therapies

Monolithic narrow-linewidth InGaAsP semiconductor laser for coherent optical communications

A design for a monolithic narrow-linewidth InGaAsP diode laser has been developed using a multiple-quantum-well (MQW) extended-passive-cavity distributed-Bragg-reflector (DBR) laser design. Theoretical results indicate that this structure has the potential for a linewidth of 100 kHz or less. To realize this device, a number of the fabrication techniques required to integrate low-loss passive waveguides with active regions have been developed using a DBR laser structure. In addition, the MOCVD growth of InGaAs MQW laser structures has been developed, and threshold current densities as low as 1.6 kA/sq cm have been obtained from broad-stripe InGaAs/InGaAsP separate-confinement-heterostructure MQW lasers

A theoretical study of nitrososilane and six isomers of SiH3NO

Article on a theoretical study of nitrososilane and six isomers of SiH2NO

WO2: “Teaching Tokens” for effective, efficient, and enjoyable clinical precepting

Clinical preceptors of medical students often work under significant time constraints, limiting time for teaching and pre-empting participation in formal didactics to learn more efficient teaching techniques. As such, both enjoyment and efficiency in precepting can be negatively affected. We identified a teaching intervention to be used throughout the clinical day itself to positively reinforce effective, efficient precepting techniques. Medical students are provided printed cards, Teaching Tokens, which contain listed observable precepting techniques. When the student sees a technique performed the medical student gives the card to their preceptor, reinforcing the behavior and empowering the student in the teaching process. In the initial pilot study, we found increased feelings of useful engagement in early clinical learners. Further, the featured teaching techniques were reported as useful reminders or lessons for the preceptors, especially among less experienced preceptors. We are currently expanding the Teaching Tokens into a Residents as Teachers curriculum. We hope to observe changes in precepting enjoyment, confidence, and proficiency among the resident participants