Hidden plastics of Lake Ontario, Canada and their potential preservation in the sediment record.

Microplastics are a source of environmental pollution resulting from degradation of plastic products and spillage of resin pellets. We report the amounts of microplastics from various sites of Lake Ontario and evaluate their potential for preservation in the sediment record. A total of 4635 pellets were sampled from the Humber Bay shoreline on three sampling dates. Pellet colours were similar to those from the Humber River bank, suggesting that the river is a pathway for plastics transport into Lake Ontario. Once in the lake, high density microplastics, including mineral-polyethylene and mineral-polypropylene mixtures, sink to the bottom. The minerals may be fillers that were combined with plastics during production, or may have adsorbed to the surfaces of the polymers in the water column or on the lake bottom. Based on sediment depths and accumulation rates, microplastics have accumulated in the offshore region for less than 38 years. Their burial increases the chance of microplastics preservation. Shoreline pellets may not be preserved because they are mingled with organic debris that is reworked during storm events.

Improving transitions in inpatient and outpatient care using a paper or web-based journal.

OBJECTIVE: To develop a 'Transitions Journal' for inter-unit and inter-setting communication for improving quality and safety of care and patient satisfaction with timely, reliable and meaningful information for all stakeholders. DESIGN: Front-line staff were targeted in a series of four team meetings through which this 'Journal' was developed iteratively; initially as a paper-based and subsequently as an IT-based tool. Goals were to: (1) develop a standardized tool based on SBAR format (Situation, Background, Assessment, Recommendation); (2) facilitate improved communication at the points of care; (3) use a bottom-up approach; (4) create situational awareness and facilitate team formation; and (5) create visual workflow models to help inculcate a culture of safety. SETTING: A 183-bed community-hospital and its Primary Care Center, in an urban area in western New York State. PARTICIPANTS: Ten nurses and 12 physicians representing both the hospital and primary care center participated voluntarily. MAIN OUTCOME MEASURES: (1) Successful development of the 'Transitions Journal'; and (2) identification of its potential uses. RESULTS: (1) DEVELOPMENT: the journal was successfully developed in both paper and web-based formats; (2) identification of uses: participants recommended using the tool as a checklist to verify appropriate communication at both the sending and receiving ends; as an audit tool for retrospective review of handoffs; and as a teaching tool. CONCLUSIONS: A journal developed by and for front-line staff has the potential to provide opportunities for improvement, instill a systems approach, improve care continuity, improve compliance with safety goals, improve patient and staff satisfaction, reduce duplication and costs, inculcate teamwork, and provide mutual emotional and intellectual support. Further work to evaluate and disseminate this tool is in progress.