A healthcare-associated group A Streptococcus outbreak involving six patients, four healthcare workers, and one household contact occurred in the labor and delivery unit of an academic medical center. Isolates were highly related by whole genome sequencing. Infection prevention measures, healthcare worker screening, and chemoprophylaxis of those colonized halted further transmission.

It is widely agreed that there is a crisis in labour/employment standards enforcement. A key issue is the role of deterrence measures that penalise violations. Employment standards enforcement in Ontario, like in most jurisdictions, is based mainly on a compliance framework promoting voluntary resolution of complaints and, if that fails, ordering restitution. Deterrence measures that penalise violations are rarely invoked. However, the Ontario government has recently increased the role of proactive inspections and tickets, a low-level deterrence measure which imposes fines of CAD295 plus victim surcharges. In examining the effectiveness of the use of tickets in inspections, we begin by looking at this development in the broader context of employment standards enforcement and its historical trajectory. Then, using administrative data from the Ministry of Labour, we examine when and why tickets are issued in the course of workplace inspections. After demonstrating that even when ticketable violations are detected, tickets are issued only rarely, we explore factors associated with an increased likelihood of an inspector issuing a ticket. Finally, we consider how the overall deterrent effect of workplace inspections is influenced by the use or non-use of deterrence tools.

ABSTRACT IMPACT: This study is providing a telehealth intervention for the first time in patients with sickle cell disease with the goal of improving cognitive functioning and preparing adolescents for successful transition of care to adult healthcare providers. OBJECTIVES/GOALS: There is a high prevalence of cognitive impairment in adolescents with sickle cell disease (SCD). The purpose of this study is to test the efficacy of an individualized cognitive remediation program designed to promote not just cognitive function, but also adaptive and self-management skills necessary for successful transition to independence. METHODS/STUDY POPULATION: 12 participants with SCD (5 males, ages 10-16) participated in an individualized program, Cognitive-Remediation of Executive and Adaptive Deficits in Youth [C-READY], consisting of three main components: individual goal-based therapy, parent training sessions, and home skill practice. C-READY sessions occur one-on-one with a trained therapist for 8 sessions conducted over 4 weeks. Weekly parent training sessions are also conducted as part of the C-READY program. All of these sessions occurred via telehealth video-calling between the therapist and the adolescent/parent. Participants were evaluated before and after the C-READY program using neuropsychological assessment measures and transition readiness questionnaires. Parents also completed ratings on telehealth delivery, content, and timing. RESULTS/ANTICIPATED RESULTS: Repeated measures ANOVA indicated significant improvement in transition readiness behaviors as rated by parents, including improved independence in medication management (p = 0.029) and in talking with their healthcare providers (p = 0.019). Significant improvement was also demonstrated on a neuropsychological measure related to executive function skills, specifically inhibition and switching (p = 0.012). Results from telehealth surveys (rated on a 5-point Likert scale) indicated overall satisfaction with services (4.2/5), including visual (4/5) and voice quality (4.3/5) of telehealth equipment. Ratings also indicated feeling that their privacy was respected (4/5) and that their interactions with their therapist were appropriate and sensitive (4.5/5). DISCUSSION/SIGNIFICANCE OF FINDINGS: These results provide support for interventions that focus on cognitive skills to improve behaviors necessary for successful transition of care in youth with SCD. Results are also promising for delivery via telehealth in order to address barriers related to access to care. Future results will continue to be reported, as this study is currently ongoing.

Capitalist society seems particularly disorderly of late, a disorder contributing to the beginnings of what we hope will be a renewal of Marxist legal scholarship. This essay reviews some key developments in Marxist analysis of law from the 1970s to the present. Over all, our essay traces a back and forth between Marxists’ emphasis on theoretical inquiry on the one hand and empirical and historical work inquiry on the other. We argue that Christopher Tomlins’s 1993 book, Law, Labor, and Ideology in the Early American Republic, remains salient for thinking about ways to combine Marxist theoretic and historical work to understand the role of law in capitalist social formations and that Nancy Fraser and Rahel Jaeggi’s recent book Capitalism: A Conversation in Critical Theory offers complementary resources for a renewal in Marxist legal thought. We conclude that further development of Marxist legal thought will require a mix of both empirical and theoretical innovations, and we identify political questions that Marxists will need to address.

Whether monozygotic (MZ) and dizygotic (DZ) twins differ from each other in a variety of phenotypes is important for genetic twin modeling and for inferences made from twin studies in general. We analyzed whether there were differences in individual, maternal and paternal education between MZ and DZ twins in a large pooled dataset. Information was gathered on individual education for 218,362 adult twins from 27 twin cohorts (53% females; 39% MZ twins), and on maternal and paternal education for 147,315 and 143,056 twins respectively, from 28 twin cohorts (52% females; 38% MZ twins). Together, we had information on individual or parental education from 42 twin cohorts representing 19 countries. The original education classifications were transformed to education years and analyzed using linear regression models. Overall, MZ males had 0.26 (95% CI [0.21, 0.31]) years and MZ females 0.17 (95% CI [0.12, 0.21]) years longer education than DZ twins. The zygosity difference became smaller in more recent birth cohorts for both males and females. Parental education was somewhat longer for fathers of DZ twins in cohorts born in 1990–1999 (0.16 years, 95% CI [0.08, 0.25]) and 2000 or later (0.11 years, 95% CI [0.00, 0.22]), compared with fathers of MZ twins. The results show that the years of both individual and parental education are largely similar in MZ and DZ twins. We suggest that the socio-economic differences between MZ and DZ twins are so small that inferences based upon genetic modeling of twin data are not affected.

The purpose of this paper is to advance an approach to analyzing decision-making by front line public officials. The notion of discretion in front line decision-making has been examined widely in the law and society literature. However, it has often failed to capture the different kinds and levels of decisions that enforcement officials make. Taking an interdisciplinary approach that draws on political, sociological, and legal analysis, we propose a new conceptual framework, one that draws a sharper distinction between discretion and judgment and teases out distinct levels in the scope and depth of decision-making. We then use this framework to create a conceptual map of the decision-making process of front-line officials charged with enforcing the Employment Standards Act (ESA) of Ontario, demonstrating that a deeper, more precise analysis of discretion and judgment can contribute to a richer understanding of front line decision-making and its social, political, and legal implications.

Causation analysis is densely political in at least three ways. First, because causation is crucial to our system of attributing moral, legal and political responsibility, causation arguments are advanced for purely instrumental purposes. They do political work. Second, because any particular occurrence is the outcome of an almost infinite number of antecedent events, “but for” causation analysis produces trivial results. A judgement about causal significance is required and will depend, in part, on the goals of the analysis. The choice of goals is political, but unstated goals and hidden assumptions often exclude consideration of some possible causes as significant. These politics of causation need to be made explicit. Third, the institutional setting in which official determinations of causation are made influence the outcome. Hence, it is necessary to explore these as well. Each of these three dimensions of the politics of causation is explored through an analysis of the 1992 Westray mine disaster which killed 29 miners in Nova Scotia, and the official responses to it. It is argued that if the goal is to protect workers and nothing else, then the political-economic context that promotes the creation of hazardous conditions must be considered a significant cause of harmful occurrences. It is unlikely, however, that any of the official responses to the disaster will take this approach.

Street railway strikes in the late nineteenth and early twentieth centuries were frequently the occasion for large‐scale collective violence in North American cities and challenged the capacity of local authorities to maintain civic order. However, this was only the most visible manifestation of the challenge that street railway workers' collective action posed to the order of liberal capitalism, an order constructed on several intersecting dimensions. Using the example of Canadian street railway workers from 1886 to 1914, a period of rapid urbanization and industrialization, this article explores the ways the collective action by workers and their community sympathizers challenged the workplace, marketplace, and “streetplace” orders of liberal capitalism. It discusses how those challenges were met through political and legal processes of resistance and accommodation, taking into account the fragmentation of state power, hostile public opinion toward the street railways, and conflicting views over the legitimate scope for workers' collective action.

The essence of the contract of employment is the performance of service in exchange for wages. As such, labor assumes a commodity form—a capacity that is bought and sold in labor markets. But because labor cannot be separated from its bearer, and is not produced for the market, it has been widely recognized as a special or fictive commodity that has been the subject of a distinct legal regime. Historically, that distinct regime—here referred to as employment law—has served both disciplinary and protective functions. On the one hand, it assists employers to extract from the worker the value of the labor they have purchased, while on the other it protects workers against unacceptable exploitation. While these functions are a constant, the scope and techniques of legal discipline and protection vary over time and place, as does the balance between them, depending on such factors as the development of social relations of production, the balance of power between workers and employers, dominant ideologies, etc. In the fulfillment of these functions, law has encountered a series of recurring dilemmas that stem structurally from labor's special commodity status and socially and politically from conflicts between workers' and employers' interests.

An analytical model is presented for the deformation of an ellipsoidal Newtonian droplet, suspended in another Newtonian fluid with different viscosity and zero interfacial tension. The theory is exact for any linear velocity field, and is not limited to small deformations. It encompasses some well-known special cases, such as Jeffery's equation for solid axisymmetric particles and Taylor's small-deformation theory for droplets. Example calculations exhibit droplet stretching, reorientation, and tumbling, and provide a reasonable match to available experimental data on transient and steady droplet shapes. The corresponding rheological theory for dilute dispersions is also derived, in a form that explicitly includes the effects of microstructure on dispersion rheology.

Until recently, North American labor law historiography has been dominated by the view that the legal regime regulating trade unions and collective bargaining has passed through three stages of development: repression, toleration, and promotion. This evolutionary narrative served the function of justifying current collective bargaining schemes by showing them to be the progressive realization of political and industrial pluralism. Confidence in the narrative, however, is eroding. In part, this is fuelled by the crisis of the current collective bargaining regime. It no longer appears to be able to deliver the goods. Not coincidentally, critical scholars have also chosen this moment to scrutinize the Whiggish history produced by writers committed to the Wagner Act model and have found it wanting.