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CMAJ Open

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https://www.readbyqxmd.com/read/28724726/costs-of-services-for-homeless-people-with-mental-illness-in-5-canadian-cities-a-large-prospective-follow-up-study
#1
Eric A Latimer, Daniel Rabouin, Zhirong Cao, Angela Ly, Guido Powell, Tim Aubry, Jino Distasio, Stephen W Hwang, Julian M Somers, Vicky Stergiopoulos, Scott Veldhuizen, Erica E M Moodie, Alain Lesage, Paula N Goering
BACKGROUND: Limited evidence on the costs of homelessness in Canada is available. We estimated the average annual costs, in total and by cost category, that homeless people with mental illness engender from the perspective of society. We also identified individual characteristics associated with higher costs. METHODS: As part of the At Home/Chez Soi trial of Housing First for homeless people with mental illness, 990 participants were assigned to the usual-treatment (control) group in 5 Canadian cities (Vancouver, Winnipeg, Toronto, Montréal and Moncton) between October 2009 and June 2011...
July 18, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28720597/accuracy-of-administrative-claims-data-for-cerebral-palsy-diagnosis-a-retrospective-cohort-study
#2
Maryam Oskoui, Pamela Ng, Marc Dorais, Nicole Pigeon, Louise Koclas, Céline Lamarre, Francine Malouin, Carol L Richards, Michael Shevell, Lawrence Joseph
BACKGROUND: Cerebral palsy is the most common cause of childhood physical disability, with multiple associated comorbidities. Administrative claims data provide population-level prevalence estimates for cerebral palsy surveillance; however, their diagnostic accuracy has never been validated in Quebec. This study aimed to assess the accuracy of administrative claims data for the diagnosis of cerebral palsy. METHODS: We conducted a retrospective cohort study of children with cerebral palsy born between 1999 and 2002 within 6 health administrative regions of Quebec...
July 18, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28701374/hospital-admission-rates-and-emergency-department-use-in-relation-to-glycated-hemoglobin-in-people-with-diabetes-mellitus-a-linkage-study-using-electronic-medical-record-and-administrative-data-in-ontario
#3
Richard Birtwhistle, Michael E Green, Eliot Frymire, Simone Dahrouge, Marlo Whitehead, Shahriar Khan, Michelle Greiver, Richard H Glazier
BACKGROUND: The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) collects extensive data on primary care patients but it currently does not gather reliable information on outcomes in other settings. The objectives of this study were to link electronic medical record (EMR) data from Ontario patients in the CPCSSN with administrative data from the Institute for Clinical Evaluative Sciences (ICES), to assess the representativeness of the CPCSSN population, and to identify people with diabetes in the CPCSSN data and describe their emergency department (ED) visits and hospital admissions over a 2-year period (2010-2012) by HbA1c level...
July 11, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28698181/risk-factors-for-surgical-site-infection-following-cesarean-delivery-a-retrospective-cohort-study
#4
Felicia Ketcheson, Christy Woolcott, Victoria Allen, Joanne M Langley
BACKGROUND: The rate of cesarean delivery is increasing in North America. Surgical site infection following this operation can make it difficult to recover, care for a baby and return home. We aimed to determine the incidence of surgical site infection to 30 days following cesarean delivery, associated risk factors and whether risk factors differed for predischarge versus postdischarge infection. METHODS: We identified a retrospective cohort in Nova Scotia by linking the provincial perinatal database to hospital admissions and physician billings databases to follow women for 30 days after they had given birth by cesarean delivery between Jan...
July 11, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28687643/cancer-incidence-attributable-to-lifestyle-and-environmental-factors-in-alberta-in-2012-summary-of-results
#5
Anne Grundy, Abbey E Poirier, Farah Khandwala, Xin Grevers, Christine M Friedenreich, Darren R Brenner
BACKGROUND: Estimates of the proportion of cancer cases that can be attributed to modifiable risk factors are not available for Canada and, more specifically, Alberta. The purpose of this study was to estimate the total proportion of cancer cases in Alberta in 2012 that could be attributed to a set of 24 modifiable lifestyle and environmental risk factors. METHODS: We estimated summary population attributable risk estimates for 24 risk factors (smoking [both passive and active], overweight and obesity, inadequate physical activity, diet [inadequate fruit and vegetable consumption, inadequate fibre intake, excess red and processed meat consumption, salt consumption, inadequate calcium and vitamin D intake], alcohol, hormones [oral contraceptives and hormone therapy], infections [Epstein-Barr virus, hepatitis B and C viruses, human papillomavirus, Helicobacter pylori], air pollution, natural and artificial ultraviolet radiation, radon and water disinfection by-products) by combining population attributable risk estimates for each of the 24 factors that had been previously estimated...
July 7, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28676535/outcomes-in-a-nurse-led-peripherally-inserted-central-catheter-program-a-retrospective-cohort-study
#6
Sheryl McDiarmid, Nicholas Scrivens, Marc Carrier, Elham Sabri, Baldwin Toye, Lothar Huebsch, Dean Fergusson
BACKGROUND: Peripherally inserted central catheters (PICCs) provide enormous benefit to patients. However, recent publications have highlighted relatively high PICC-associated complication rates. We report on patient and device outcomes from a nurse-led program. METHODS: We performed a retrospective analysis of a prospective cohort of consecutive patients undergoing PICC insertion at The Ottawa Hospital between Jan. 1, 2013 and Dec. 31, 2014. Of the 8314 BioFlo PASV PICCs inserted, we randomly selected a sample of 700 and obtained a complete data set for 656...
June 30, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28663187/lung-cancer-incidence-attributable-to-residential-radon-exposure-in-alberta-in-2012
#7
Anne Grundy, Kevin Brand, Farah Khandwala, Abbey Poirier, Sierra Tamminen, Christine M Friedenreich, Darren R Brenner
BACKGROUND: Radon is carcinogenic, and exposure to radon has been shown to increase the risk of lung cancer. The objective of this study was to quantify the proportion and number of lung cancer cases in Alberta in 2012 that could be attributed to residential radon exposure. METHODS: We estimated the population attributable risk of lung cancer for residential radon using radon exposure data from the Cross-Canada Survey of Radon Concentrations in Homes from 2009-2011 and data on all-cause and lung cancer mortality from Statistics Canada from 2008-2012...
June 28, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28659352/cancer-incidence-attributable-to-air-pollution-in-alberta-in-2012
#8
Abbey E Poirier, Anne Grundy, Farah Khandwala, Christine M Friedenreich, Darren R Brenner
BACKGROUND: The International Agency for Research on Cancer has classified outdoor air pollution (fine particulate matter [PM2.5]) as a Group 1 lung carcinogen in humans. We aimed to estimate the proportion of lung cancer cases attributable to PM2.5 exposure in Alberta in 2012. METHODS: Annual average concentrations of PM2.5 in 2011 for 22 communities across Alberta were extracted from the Clean Air Strategic Alliance Data Warehouse and were population-weighted across the province...
June 28, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28655728/opioid-use-during-pregnancy-a-population-based-cohort-study
#9
Jamie Falk, Matthew Dahl, Colette B Raymond, Dan Chateau, Alan Katz, Christine Leong, Shawn Bugden
BACKGROUND: Opioid use has increased dramatically in North America. The safety of opioids in pregnancy is uncertain, but they are associated with several fetal abnormalities and contribute to rising rates of neonatal abstinence syndrome. We examined opioid use before and during pregnancy in a complete population-based cohort. METHODS: We examined opioid use in a cohort of all pregnant women in Manitoba, Canada, from 2001 to 2013. Opioid use was defined by prescriptions for opioids, converted to oral morphine equivalents (MEQ), during the 3 months before pregnancy and for each trimester...
June 26, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28646095/estimated-reductions-in-provider-initiated-preterm-births-and-hospital-length-of-stay-under-a-universal-acetylsalicylic-acid-prophylaxis-strategy-a-retrospective-cohort-study
#10
Joel G Ray, Emily Bartsch, Alison L Park, Prakesh S Shah, Susie Dzakpasu
BACKGROUND: Hypertensive disorders, especially preeclampsia, are the leading reason for provider-initiated preterm birth. We estimated how universal acetylsalicylic acid (ASA) prophylaxis might reduce rates of provider-initiated preterm birth associated with preeclampsia and intrauterine growth restriction, which are related conditions. METHODS: We performed a cohort study of singleton hospital births in 2013 in Canada, excluding Quebec. We estimated the proportion of term births and provider-initiated preterm births affected by preeclampsia and/or intrauterine growth restriction, and the corresponding mean maternal and newborn hospital length of stay...
June 23, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28642253/military-related-sexual-assault-in-canada-a-cross-sectional-survey
#11
Kimberley Watkins, Rachel Bennett, Mark A Zamorski, Isabelle Richer
BACKGROUND: Most research on military-related sexual assault is based on the United States military and has important limitations, such as low response rates. We sought to estimate the lifetime prevalence of sexual assault, assess its relation to military service and identify the circumstances, correlates and associations with mental disorders of military-related sexual assault among Canadian military personnel. METHODS: We used the 2013 Canadian Forces Mental Health Survey, a cross-sectional representative survey of Canadian Regular Force personnel (n = 6696)...
June 22, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28637683/an-environmental-scan-of-quality-indicators-in-critical-care
#12
Sabira Valiani, Romain Rigal, Henry T Stelfox, John Muscedere, Claudio M Martin, Peter Dodek, François Lamontagne, Robert Fowler, Afshan Gheshmy, Deborah J Cook, Alan J Forster, Paul C Hébert
BACKGROUND: We performed a directed environmental scan to identify and categorize quality indicators unique to critical care that are reported by key stakeholder organizations. METHODS: We convened a panel of experts (n = 9) to identify key organizations that are focused on quality improvement or critical care, and reviewed their online publications and website content for quality indicators. We identified quality indicators specific to the care of critically ill adult patients and then categorized them according to the Donabedian and the Institute of Medicine frameworks...
June 21, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28641275/a-case-series-of-surgically-diagnosed-idiopathic-aortitis-in-a-canadian-centre-a-retrospective-study
#13
Diane L Murzin, Eric C Belanger, John P Veinot, Nataliya Milman
BACKGROUND: Idiopathic aortitis became recognized relatively recently, and the body of knowledge concerning this condition is scarce. We aimed to determine the frequency of idiopathic aortitis in aortic specimens, the clinical, laboratory and radiologic characteristics at diagnosis and during follow-up, and the approach to investigation, treatment and monitoring taken by the treating physicians. METHODS: We identified cases of aortitis diagnosed on pathological specimens of the aorta between Jan...
June 19, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28630258/realization-of-entry-to-practice-milestones-by-canadians-who-studied-medicine-abroad-and-other-international-medical-graduates-a-retrospective-cohort-study
#14
Maria Mathews, Rima Kandar, Steve Slade, Yanqing Yi, Sue Beardall, Ivy Bourgeault
BACKGROUND: International medical graduates must realize a series of milestones to obtain full licensure. We examined the realization of milestones by Canadian and non-Canadian graduates of Western or Caribbean medical schools, and Canadian and non-Canadian graduates from other medical schools. METHODS: Using the National IMG Database (data available for 2005-2011), we created 2 cohorts: 1) international medical graduates who had passed the Medical Council of Canada Qualifying Examination Part I between 2005 and 2010 and 2) those who had first entered a family medicine postgraduate program between 2005 and 2009, or had first entered a specialty postgraduate program in 2005 or 2006...
June 19, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28625973/prevalence-and-correlates-of-electronic-cigarette-use-among-canadian-students-cross-sectional-findings-from-the-2014-15-canadian-student-tobacco-alcohol-and-drugs-survey
#15
Annie Montreuil, Marjorie MacDonald, Mark Asbridge, T Cameron Wild, David Hammond, Steve Manske, Erin Rutherford
BACKGROUND: Over the past decade, youth tobacco use has declined, and electronic cigarettes (e-cigarettes) have entered the market. The aims of this study were to describe the prevalence of e-cigarette use among youth in Canada, by province, across sociodemographic variables and smoking-related correlates; and to examine associations among e-cigarette use, sociodemographic variables and smoking-related correlates, with adjustment for other factors. METHODS: The 2014/15 Canadian Student Tobacco, Alcohol and Drugs Survey, a biennial, school-based survey, was administered to students in grades 6-12 in all Canadian provinces...
June 14, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28619746/informal-regionalization-of-pediatric-fracture-care-in-the-greater-toronto-area-a-retrospective-cross-sectional-study
#16
Daniel Pincus, Steven Morrison, Martin F Gargan, Mark W Camp
BACKGROUND: Operative management of pediatric fractures is an expected competency in the specialty of Orthopedic Surgery. However, specialized pediatric centres may be providing care for increasing numbers of patients with fractures previously treated at community hospitals. The primary objective of this study was to examine trends in presentation of children with fractures to a specialized pediatric centre. METHODS: We performed a detailed chart review to examine trends in presentation of children aged 14 years or less with supracondylar humerus or femur fractures to a specialized pediatric centre (Hospital for Sick Children, Toronto) from anywhere in the Greater Toronto Area between Apr...
June 14, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28615192/access-to-hyperacute-stroke-services-across-canadian-provinces-a-geospatial-analysis
#17
Prasanna Venkatesan Eswaradass, Richard H Swartz, Jamey Rosen, Michael D Hill, M Patrice Lindsay
BACKGROUND: Canada's vast geography creates challenges for ensuring prompt transport to hospital of patients who have had a stroke. We sought to determine the proportion of people across various Canadian provinces for whom hyperacute stroke services are accessible within evidence-based time targets. METHODS: We calculated, for the 8 provinces with available data, drive-time polygons on a map of Canada that delineated the area around stroke centres and emergency medical services (EMS) base centres to which one can drive in 3...
June 14, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28611156/clinical-prediction-rule-for-delayed-hemothorax-after-minor-thoracic-injury-a-multicentre-derivation-and-validation-study
#18
Marcel Émond, Chantal Guimont, Jean-Marc Chauny, Raoul Daoust, Éric Bergeron, Laurent Vanier, Lynne Moore, Miville Plourde, Batomen Kuimi, Valérie Boucher, Nadine Allain-Boulé, Natalie Le Sage
BACKGROUND: About 75% of patients with minor thoracic injury are discharged after an emergency department visit. However, complications such as delayed hemothorax can occur. We sought to derive and validate a clinical decision rule to predict hemothorax in patients discharged from the emergency department. METHODS: We conducted a 6-year prospective cohort study in 4 university-affiliated emergency departments. Patients aged 16 years or older presenting with a minor thoracic injury were assessed at 5 time points (initial visit and 7, 14, 30 and 90 d after the injury)...
June 12, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28600449/regional-differences-in-use-of-endoscopic-ultrasonography-in-ontario-a-population-based-retrospective-cohort-study
#19
Paul D James, Mae Hegagi, Lilia Antonova, Jill Tinmouth, Steven J Heitman, Carmine Simone, Elaine Yeung, Elaine Yong
BACKGROUND: Endoscopic ultrasonography is a safe and accurate modality for evaluating and managing hepatobiliary and gastrointestinal conditions (malignant and nonmalignant); its use is increasing. The aim of this study was to describe regional trends in the use of endoscopic ultrasonography in Ontario. METHODS: We conducted a population-based retrospective cohort study using health administrative databases. We identified all patients who underwent an endoscopic ultrasound procedure in Ontario from 2003 to 2011 using physician billing data...
June 7, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28592406/factors-influencing-practice-variation-in-the-management-of-nephrotic-syndrome-a-qualitative-study-of-pediatric-nephrology-care-providers
#20
Susan M Samuel, Rachel Flynn, Michael Zappitelli, Allison Dart, Rulan Parekh, Maury Pinsk, Cherry Mammen, Andrew Wade, Shannon D Scott
BACKGROUND: Treatment protocols for childhood nephrotic syndrome are highly variable between providers and care centres. We conducted a qualitative study to understand the complex multilevel processes that lead to practice variation and influence provider management of nephrotic syndrome. METHODS: Focus groups with multidisciplinary pediatric nephrology care providers (n = 67) from 10 Canadian pediatric nephrology centres that had more than 1 pediatric nephrologist were conducted between September 2013 and April 2015...
June 7, 2017: CMAJ Open
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