154 research outputs found

    Impact Assessment in the Ring of Fire: Contested Authorities, Competing Visions and a Clash of Legal Orders

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    In 2007, a significant mineral deposit dubbed the ‚ÄúRing of Fire‚ÄĚ was discovered in the boreal peatlands in Treaty No.9 territory in the far north of Ontario. The original project proposal submitted to the Canadian Environmental Assessment Agency was for a chromite mine and an associated infrastructure corridor to connect the remote location to the provincial high-way system. As years went by without progress on the regulatory approvals, the proponent sold its claims at a loss. In the period that followed, Ontario negotiated with the Matawa First Nations (the nine most proximate First Nations) who were, as a united block, claiming to hold inherent jurisdiction and governing authority over their homelands in the Ring of Fire region, an area exclusively occupied by Indigenous peoples. Those negotiations soon broke down and Ontario pivoted to bilateral negotiations with individual ‚Äúmining-ready‚ÄĚ First Nations. Deal-making from that approach has produced two First Nations willing to act as proponents for all-season roads along the same corridor as the mining road originally proposed. Three road segments became subject to both provincial and federal environmental/impact assessments. The Impact Assessment Agency of Canada also initiated a Regional Assessment for the Ring of Fire region, which was intended to examine the cumulative impacts of all the expected changes in the region brought about by opening up the far north. Each of these assessments is now mired in controversy about who holds jurisdiction, who can provide or withhold their consent to major projects in the region, and whose law applies when environmental/impact assessments are conducted. This case study illustrates how difficult it can be to apply a term such as ‚ÄúIndigenous-led impact assessment‚ÄĚ in a context of overlapping territories, competing authorities, and multiple legal orders

    Impact Assessment in the Ring of Fire: Contested Authorities, Competing Visions and a Clash of Legal Orders

    No full text
    In 2007, a significant mineral deposit dubbed the ‚ÄúRing of Fire‚ÄĚ was discovered in the boreal peatlands in Treaty No.9 territory in the far north of Ontario. The original project proposal submitted to the Canadian Environmental Assessment Agency was for a chromite mine and an associated infrastructure corridor to connect the remote location to the provincial high-way system. As years went by without progress on the regulatory approvals, the proponent sold its claims at a loss. In the period that followed, Ontario negotiated with the Matawa First Nations (the nine most proximate First Nations) who were, as a united block, claiming to hold inherent jurisdiction and governing authority over their homelands in the Ring of Fire region, an area exclusively occupied by Indigenous peoples. Those negotiations soon broke down and Ontario pivoted to bilateral negotiations with individual ‚Äúmining-ready‚ÄĚ First Nations. Deal-making from that approach has produced two First Nations willing to act as proponents for all-season roads along the same corridor as the mining road originally proposed. Three road segments became subject to both provincial and federal environmental/impact assessments. The Impact Assessment Agency of Canada also initiated a Regional Assessment for the Ring of Fire region, which was intended to examine the cumulative impacts of all the expected changes in the region brought about by opening up the far north. Each of these assessments is now mired in controversy about who holds jurisdiction, who can provide or withhold their consent to major projects in the region, and whose law applies when environmental/impact assessments are conducted. This case study illustrates how difficult it can be to apply a term such as ‚ÄúIndigenous-led impact assessment‚ÄĚ in a context of overlapping territories, competing authorities, and multiple legal orders

    Non-Malignant Etiologies for Cystectomy: Trends from 2013-2020

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    Introduction: Simple cystectomy (SC) may be performed for a variety of non-malignant bladder conditions. However, SC can involve many complications. We seek to characterize the indications for SC including neurogenic bladder, interstitial cystitis, radiation cystitis, and fistulae. We aim to provide an updated analysis of the temporal and demographic trends from 2013-2020. Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was reviewed for patients undergoing SC. The non-malignant etiologies for SC were separated into 9 subgroups: anatomical, autoimmune, benign neoplasm, bladder outlet obstruction/ lower urinary tract symptoms / reflux, fistula, infectious, neurogenic, vascular, and other. ANOVA analysis was performed to assess for significant changes in indication frequency. A two-sided Z-test comparing frequencies of SC in 2013 vs 2020 for each subgroup. Statistical significance was accepted at alpha of 0.05. Results A total of 1,516 patients met inclusion criteria. Neurogenic bladder, fistula, and vascular were the most common indications with 376 (25%), 259 (17%), and 227 (15%) of patients, respectively (Table 1). The average length of stay (LOS) for neurogenic etiologies was 11.05 days. The trends of neurogenic (p\u3c0.01), other (p=0.003), autoimmune (p=0.011), and fistula (p=0.025) etiologies had a statistically significant decrease from 2013 to 2020 (Table 1). Discussion From 2013-2020, the most common indication for SC was neurogenic bladder though there has been a statistically significant decrease in SC from 2013 to 2020. We observed that while cystectomy continues to have long LOS and with high rates of complication, there has been a decrease in frequency with which SC is performed as more conservative management is pursued. While performing cystectomy for non-malignant conditions remains relatively rare, it is important to retrospectively look at the diagnoses that warrant this procedure. This information is of interest to urologists as they consider surgical versus non-surgical management of these benign diseases. The trends identified in this study will help define the prevalence of SC in treating non-malignant disease and the need for future research in this area

    Law, Labour and Landscape in a Just Transition

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    Taking conflicts over new solar energy projects on the agricultural landscape in the global North as its backdrop, the chapter demonstrates how work and labour (including that performed in the North by workers from the global South) are erased both by the opponents and the proponents of such projects. The erasure is consistent with prevailing ways of knowing the human-environment nexus, shaped by an underlying political economy derivative of how international law has constructed and maintained the foundational liberal mythology that separates labour from land. Grounded in our commitment to pursuing a ‚Äėjust transition‚Äô to decarbonisation ‚Äď that is to say, a transition that attends to the distributional effects and disproportionate impacts of decarbonisation on workers and communities ‚Äď we strive to reconceptualise work and labour as embodied practices of working and living on the land. Everyday socio-spatial practices structured by law implicate ordinary people in the making of landscapes and continuing relations of settler capitalism, shaping how ‚Äėwe‚Äô live together on the land, including who belongs and who gets to decide

    Ottawa steps into ‚ÄėRing of Fire‚Äô debate with Doug Ford

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    The struggle over the mineral deposits in Ontario’s Ring of Fire has taken a surprising turn. With all eyes on British Columbia as events unfold in Unist\u27ot\u27en, the federal minister of environment and climate change has said the agency will establish a major regional assessment process for the Ring of Fire

    Therapeutic Anticoagulation with Heparin in Critically Ill Patients with Covid-19.

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    BACKGROUND: Thrombosis and inflammation may contribute to morbidity and mortality among patients with coronavirus disease 2019 (Covid-19). We hypothesized that therapeutic-dose anticoagulation would improve outcomes in critically ill patients with Covid-19. METHODS: In an open-label, adaptive, multiplatform, randomized clinical trial, critically ill patients with severe Covid-19 were randomly assigned to a pragmatically defined regimen of either therapeutic-dose anticoagulation with heparin or pharmacologic thromboprophylaxis in accordance with local usual care. The primary outcome was organ support-free days, evaluated on an ordinal scale that combined in-hospital death (assigned a value of -1) and the number of days free of cardiovascular or respiratory organ support up to day 21 among patients who survived to hospital discharge. RESULTS: The trial was stopped when the prespecified criterion for futility was met for therapeutic-dose anticoagulation. Data on the primary outcome were available for 1098 patients (534 assigned to therapeutic-dose anticoagulation and 564 assigned to usual-care thromboprophylaxis). The median value for organ support-free days was 1 (interquartile range, -1 to 16) among the patients assigned to therapeutic-dose anticoagulation and was 4 (interquartile range, -1 to 16) among the patients assigned to usual-care thromboprophylaxis (adjusted proportional odds ratio, 0.83; 95% credible interval, 0.67 to 1.03; posterior probability of futility [defined as an odds ratio <1.2], 99.9%). The percentage of patients who survived to hospital discharge was similar in the two groups (62.7% and 64.5%, respectively; adjusted odds ratio, 0.84; 95% credible interval, 0.64 to 1.11). Major bleeding occurred in 3.8% of the patients assigned to therapeutic-dose anticoagulation and in 2.3% of those assigned to usual-care pharmacologic thromboprophylaxis. CONCLUSIONS: In critically ill patients with Covid-19, an initial strategy of therapeutic-dose anticoagulation with heparin did not result in a greater probability of survival to hospital discharge or a greater number of days free of cardiovascular or respiratory organ support than did usual-care pharmacologic thromboprophylaxis. (REMAP-CAP, ACTIV-4a, and ATTACC ClinicalTrials.gov numbers, NCT02735707, NCT04505774, NCT04359277, and NCT04372589.)

    Energy without Injustice?: Indigenous Participation in Renewable Energy Generation

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    There is growing involvement of Indigenous communities in renewable energy development across their traditional territories in what is now called Canada. Here, we explore Indigenous participation in large-scale ‚Äúgreen‚ÄĚ energy generation as a response to encroachment, displacement, and dispossession wrought by the extractivist orientation of contemporary settler capitalism

    Therapeutic anticoagulation with heparin in noncritically Ill patients with Covid-19

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