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Can you stand segregation? These researchers are using virtual reality to let hospital staff see through their patients’ eyes

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HAMILTON—Think virtual reality and you might picture a fantasy world to be explored and enjoyed. But researchers and staff at a Hamilton hospital are using the technology to better understand what it feels like to be in a seclusion room, the health-care equivalent of a jail segregation cell.

“We wanted to see what it was like to be on the other side of the door,” said Gary Chaimowitz, head of the forensic psychiatry program at St. Joseph’s Healthcare and a professor at McMaster University. “I think many of us can imagine, or recall times when you’ve been in places by yourself, when you didn’t want to be by yourself, left alone, but this puts you, as a staff person, in our rooms.”

A virtual reality prison solitary confinement room in a training scenario created by Ottawa-based company SimWave for the forensic psychiatry program at St. Joseph’s Healthcare in Hamilton.
A virtual reality prison solitary confinement room in a training scenario created by Ottawa-based company SimWave for the forensic psychiatry program at St. Joseph’s Healthcare in Hamilton.  (Courtesy of SimWave)

Using a VR headset and hand controllers, staff are transported into a room modelled after real seclusion rooms at the hospital, and another set in a jail cell.

SimWave, an Ottawa-based company, used photographs to recreate the experience.

In two of three VR training modules being used at the program, you try to get the attention of virtual staff on the other side of the door. The seclusion room has no bathroom, and your bladder is full. You can ask for help, pace the room and knock or even pound on the door.

Your call for help returns one of 10 programmed responses, ranging from, a polite, “Yes, we’ll get you something,” to “Hold on a sec, we’re a little bit busy right now,” to a little more pointed response, Chaimowitz said.

“The tone, if you’re on the receiving end of that, obviously it makes a hell of a big difference,” he said.

Sometimes, there is no response, or the “patient” hears laughter. In another scenario, you actually get to use the bathroom.

“We’re looking at how long you can be in there before you get anxious,” Chaimowitz said, “and what it’s like to have a different staff response, the idea being that we are going to try to sensitize staff to what it’s like to be on the inside, which might change the way they interact with patients, both in terms of their tone and also a recognition of what it’s like to be there.”

Some staff have had to remove the headset after a while because they feel so enclosed by being in the room, Chaimowitz said, adding no one has found the experience to feel fake. “People have acknowledged that this is very different than being on the other side of the door,” he said.

The artists and developers at SimWave paid close attention to the finest of details. “If you press your virtual nose against the walls you can really see the details,” said Matt Thomas, SimWave’s head of business development.

Many of the hospital’s patients come from jails and return after treatment. Chaimowitz said the hospital hopes to share this training experience with provincial and federal corrections systems, where the use of segregation is under intense scrutiny.

In federal and provincial jails, inmates are being held in segregation for great lengths of time, and often exceeding 15 consecutive days, a point beyond which the United Nations has called to be banned because of the proven psychological harm it can cause.

This fall, as part of a human rights case settlement, Ontario’s Ministry of Community Safety and Correctional Services released two months’ worth of data on inmates either awaiting trial or serving short sentences who had spent time in segregation.

Of 3,998 placements in segregation, 778 were for periods longer than 15 consecutive days, the data revealed.

Gary Chaimowitz, second from right, is the head of the forensic psychiatry program, at St. Joseph's Healthcare in Hamilton. He and his team, including Brandon Sunstrum, left, Sebastien Prat and Heather Dunlop-Witt, are using virtual reality scenarios to help staff understand what it feels like to be in a seclusion room, the hospital equivalent of a jail segregation cell.
Gary Chaimowitz, second from right, is the head of the forensic psychiatry program, at St. Joseph’s Healthcare in Hamilton. He and his team, including Brandon Sunstrum, left, Sebastien Prat and Heather Dunlop-Witt, are using virtual reality scenarios to help staff understand what it feels like to be in a seclusion room, the hospital equivalent of a jail segregation cell.  (Jim Rankin/Toronto Star)

Half of the inmates had mental health alerts on their files and more than a third had a suicide alert.

“The correctional system is behind,” says Chaimowitz, who gave expert testimony at the coroner’s inquest into the 2007 death of Ashley Smith, who spent more than three years in segregation.

He recalls his first visit, decades ago, to a Hamilton jail. “I could hear people screaming and recognized there were mentally unwell people.”

“I don’t think anybody there is being cruel,” he said. “But it is frightening, and it is one of those sort of things that I can’t believe, in our cities, that we house people like this.”

The VR training can’t replicate everything in a seclusion or segregation setting, such as the degree of noise, the clanging and the smells, but the idea is that “if we can walk in someone’s shoes, even if it’s the way you deal with people, that it will be a little bit more humane,” he said.

Another training module simulates a search for contraband in a psychiatry patient room complete with a full bathroom. A more complex simulation still in the works involves an educational night-shift scenario that begins with hearing a noise and escalates into a hostage-taking situation.

The hospital’s forensic psychiatry unit has 114 beds and will be adding four correctional beds, as part of a pilot project with the provincial ministry that overseas corrections. Those beds should cut down visits by mentally ill inmates to hospital emergency rooms, where staff are “uncomfortable” with corrections patients who are shackled and handcuffed, Chaimowitz said.

“We’ll be in a better position to treat them and get their mental illness under control,” Chaimowitz said. “The idea is to bring them in here and get them well enough” to return to the general jail population, he says. “I think it the potential for making a big difference is very, very high.”

As for more the potential for virtual reality, Chaimowitz and his team would like to see patients given the opportunity to use the technology to escape their rooms and units and explore.

“They are basically stuck in their unit and the perimeter around St. Joe’s and Hamilton. So, they can’t do a lot,” said psychiatrist Sébastien Prat. “We want to develop that kind of project, in order to make them able to travel to a beach or somewhere they want to go, so they can enjoy something.”

Jim Rankin is a reporter based in Toronto. Follow him on Twitter: @Jleerankin

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Anglais

‘Business as usual’ for Dorel Industries after terminating go-private deal

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MONTREAL — Dorel Industries Inc. says it will continue to pursue its business strategy going forward after terminating an agreement to go private after discussions with shareholders.

« Moving ahead. Business as usual, » a spokesman for the company said in an email on Monday.

A group led by Cerberus Capital Management had previously agreed to buy outstanding shares of Dorel for $16 apiece, except for shares owned by the family that controls the company’s multiple-voting shares.

But Dorel chief executive Martin Schwartz said the Montreal-based maker of car seats, strollers, bicycles and home furniture pulled the plug on a deal on the eve of Tuesday’s special meeting after reviewing votes from shareholders.

“Independent shareholders have clearly expressed their confidence in Dorel’s future and the greater potential for Dorel as a public entity, » he said in a news release.

Dorel’s board of directors, with Martin Schwartz, Alan Schwartz, Jeffrey Schwartz and Jeff Segel recused, unanimously approved the deal’s termination upon the recommendation of a special committee.

The transaction required approval by two-thirds of the votes cast, and more than 50 per cent of the votes cast by non-family shareholders.

Schwartz said enhancing shareholder value remains a top priority while it stays focused on growing its brands, which include Schwinn and Mongoose bikes, Safety 1st-brand car seats and DHP Furniture.

Dorel said the move to end the go-private deal was mutual, despite the funds’ increased purchase price offer earlier this year.

It said there is no break fee applicable in this case.

Montreal-based investment firm Letko, Brosseau & Associates Inc. and San Diego’s Brandes Investment Partners LP, which together control more than 19 per cent of Dorel’s outstanding class B subordinate shares voiced their opposition to the amended offer, which was increased from the initial Nov. 2 offer of $14.50 per share.

« We believe that several minority shareholders shared our opinion, » said Letko vice-president Stephane Lebrun, during a phone interview.

« We are confident of the long-term potential of the company and we have confidence in the managers in place.”

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Anglais

Pandemic funds helping Montreal businesses build for a better tomorrow

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Many entrepreneurs have had to tap into government loans during the pandemic, at first just to survive, but now some are using the money to better prepare their businesses for the post-COVID future.

One of those businesses is Del Friscos, a popular family restaurant in Dollard-des-Ormeaux that, like many Montreal-area restaurants, has had to adapt from a sit-down establishment to one that takes orders online for takeout or delivery.

“It was hard going from totally in-house seating,” said Del Friscos co-owner Terry Konstas. “We didn’t have an in-house delivery system, which we quickly added. There were so many of our employees that were laid off that wanted to work so we adapted to a delivery system and added platforms like Uber and DoorDash.”

Helping them through the transition were emergency grants and low-interest loans from the federal and provincial governments, some of which are directly administered by PME MTL, a non-profit business-development organization established to assist the island’s small and medium-sized businesses.

Konstas said he had never even heard of PME MTL until a customer told him about them and when he got in touch, he discovered there were many government programs available to help his business get through the downturn and build for the future. “They’ve been very helpful right from day one,” said Konstas.

“We used some of the funds to catch up on our suppliers and our rents, the part that wasn’t covered from the federal side, and we used some of it for our new virtual concepts,” he said, referring to a virtual kitchen model which the restaurant has since adopted.

The virtual kitchen lets them create completely different menu items from the casual American Italian dishes that Del Friscos is known for and market them under different restaurant brand names. Under the Prasinó Soup & Salad banner, they sell healthy Greek options and their Stallone’s Sub Shop brand offers hearty sandwiches, yet the food from both is created in the same Del Friscos kitchen.

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Anglais

Downtown Montreal office, retail vacancies continue to rise

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Some of downtown Montreal’s key economic indicators are heading in the wrong direction.

Office and retail vacancies in the city’s central core continued to climb in the fourth quarter of 2020, according to a quarterly report released Thursday by the Urban Development Institute of Quebec and the Montréal Centre-Ville merchants association. The report, whose first edition was published in October, aims to paint a socio-economic picture of the downtown area.

The survey also found office space available for sublet had increased during the fourth quarter, which may foreshadow even more vacancies when leases expire. On the residential front, condo sales fell as new listings soared — a sign that the downtown area may be losing some of its appeal to homeowners.

“It’s impossible not to be preoccupied by the rapid increase in office vacancies,” Jean-Marc Fournier, the former Quebec politician who now heads the UDI, said Thursday in an interview.

Still, with COVID-19 vaccinations set to accelerate in the coming months, “the economic picture is bound to improve,” he said. “People will start returning downtown. It’s much too early to say the office market is going to disappear.”

Public health measures implemented since the start of the pandemic almost a year ago — such as caps on office capacity — have deprived downtown Montreal of more than 500,000 workers and students. A mere 4,163 university and CEGEP students attended in-person classes in the second quarter, the most recent period for which figures are available. Border closures and travel restrictions have also brought tourism to a standstill, hurting hotels and thousands of local businesses.

Seventy per cent of downtown workers carried out their professional activities at home more than three days a week during the fourth quarter, the report said, citing an online survey of 1,000 Montreal-area residents conducted last month.

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