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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/28596186/hepatitis-b-virus-testing-and-linkage-to-care-in-a-canadian-urban-tertiary-referral-centre-a-retrospective-cohort-study
#12
Keith C K Lau, Abdel Aziz Shaheen, Alexander A Aspinall, Tazuko Ricento Ba, Kamran Qureshi Mba, Stephen E Congly, Meredith A Borman, Saumya Jayakumar, Bertus Eksteen, Samuel S Lee, Laura Stinton, Mark G Swain, Kelly W Burak, Carla S Coffin
BACKGROUND: Despite universal vaccination, chronic hepatitis B virus (HBV) infection remains a public health concern in North America owing to immigration. We aimed to characterize the number of people with a positive result of testing for HBV surface antigen (HBsAg) in Calgary, a large urban Canadian health care region, and to assess whether recommended laboratory tests and specialist consultation were done for those identified as HBsAg-positive. METHODS: Based on laboratory and Alberta Health Services administrative data, we identified all adults (age > 18 yr) with a positive HBsAg test result from Jan...
June 6, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28559388/stress-testing-after-percutaneous-coronary-interventions-a-population-based-study
#13
Simina R Luca, Maria Koh, Feng Qiu, David A Alter, Akshay Bagai, R Sacha Bhatia, Andrew Czarnecki, Shaun G Goodman, Ching Lau, Harindra C Wijeysundera, Dennis T Ko
BACKGROUND: Routine stress testing is commonly used after percutaneous coronary intervention (PCI) to detect in-stent restenosis or suboptimal procedure results; however, recent studies suggest that such testing is rarely indicated. Our main objectives were to assess temporal trends in utilization of stress testing and to determine factors associated with its use. METHODS: We conducted an observational study involving all patients who had undergone PCI in Ontario, Canada, from Apr...
May 26, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28526704/elder-women-s-perceptions-around-optimal-perinatal-health-a-constructivist-grounded-theory-study-with-an-indigenous-community-in-southern-ontario
#14
Sujane Kandasamy, Meredith Vanstone, Mark Oremus, Trista Hill, Gita Wahi, Julie Wilson, A Darlene Davis, Ruby Jacobs, Rebecca Anglin, Sonia Savitri Anand
BACKGROUND: Women play important roles in translating health knowledge, particularly around pregnancy and birth, in Indigenous societies. We investigated elder Indigenous women's perceptions around optimal perinatal health. METHODS: Using a methodological framework that integrated a constructivist grounded-theory approach with an Indigenous epistemology, we conducted and analyzed in-depth interviews and focus groups with women from the Six Nations community in southern Ontario who self-identified as grandmothers...
May 18, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28522680/geographic-clustering-of-emergency-department-presentations-for-acute-coronary-syndromes-and-heart-failure-in-alberta-a-population-based-study
#15
Rhonda J Rosychuk, Brian H Rowe, Finlay A McAlister
BACKGROUND: Collectively, the most common acute cardiac presentations to emergency departments are acute coronary syndromes (ACSs) and heart failure. We examined geographic variation and clustering in emergency department presentations by adults for ACS or heart failure in Alberta in 2010/11. METHODS: All emergency department presentations for ACS or heart failure made by Alberta residents aged 35 years or more during 2010/11 were extracted from 5 linked population-based Alberta administrative health databases...
May 18, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28506972/career-and-research-outcomes-of-the-physician-scientist-training-program-at-the-university-of-calgary-a-retrospective-cohort-study
#16
Jason T Bau, Alexandra D Frolkis, Nabeela Nathoo, Bryan G Yipp, Morley D Hollenberg, Paul L Beck
BACKGROUND: Physician-scientists are integral to medical research, with medical programs throughout Canada invested in training hybrid physician-scientists. Few data exist as to whether these programs are generating the diversity, gender equity and numbers of trainees essential for the future of medical research and teaching. We aimed to identify factors that contribute to research productivity, diversity and retention of individuals as physician-scientists. METHODS: We completed a retrospective cohort study, for the period 1973 to 2015, of the University of Calgary Leaders in Medicine Program in Calgary, Alberta...
May 15, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28515137/under-the-influence-examination-of-prevalence-and-correlates-of-alcohol-and-marijuana-consumption-in-relation-to-youth-driving-and-passenger-behaviours-in-canada-a-cross-sectional-study
#17
Leia M Minaker, Aaron Bonham, Tara Elton-Marshall, Cesar Leos-Toro, T Cameron Wild, David Hammond
BACKGROUND: Consequences of alcohol- and drug-impaired driving affect youth disproportionately. We describe individual- and area-level characteristics associated with risky driving and passenger behaviours among grade 9-12 students in Canada. METHODS: The 2014-2015 Canadian Student Tobacco, Alcohol and Drug Survey was administered to 24 650 students in provincially generalizable samples. Dichotomous outcomes included ever and last-30-day driving after drinking alcohol, ever and last-30-day driving after using marijuana, and ever and last-30-day reporting of being a passenger with a driver who had been drinking or using marijuana...
May 12, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28495938/allergen-immunotherapy-for-the-treatment-of-allergic-rhinitis-and-or-asthma-an-umbrella-review
#18
Jesse Elliott, Shannon E Kelly, Amy Johnston, Becky Skidmore, Tara Gomes, George A Wells
BACKGROUND: Allergic rhinitis and asthma are important public health concerns, yet there is no consensus about the benefits and harms of allergen-specific immunotherapy to treat these conditions. We performed an umbrella review of systematic reviews summarizing the current evidence for the benefits and harms of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). METHODS: We searched MEDLINE, Embase, the Cochrane Library and the grey literature from Jan...
May 10, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28487349/patient-centred-innovations-for-persons-with-multimorbidity-funded-evaluation-protocol
#19
Moira Stewart, Martin Fortin
BACKGROUND: The high prevalence of multimorbidity necessitates rethinking of the health care system. The overarching goal of the Patient-Centred Innovations for Persons with Multimorbidity program is to build on existing structures and find and evaluate patient-centred innovations relevant to multimorbidity. METHODS: We describe the protocol for a proposed multijurisdictional (Quebec and Ontario) concurrent triangulation mixed-methods study. In both provinces, a qualitative descriptive study will be used to explore innovations in patient-centred multimorbidity care...
May 9, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28483785/association-between-interpersonal-continuity-of-care-and-medication-adherence-in-type-2-diabetes-an-observational-cohort-study
#20
Anara Richi Dossa, Jocelyne Moisan, Line Guénette, Sophie Lauzier, Jean-Pierre Grégoire
BACKGROUND: Prior studies have shown that, compared to patients with a low level of interpersonal continuity of care, patients with a high level of continuity of care have a lower likelihood of hospital admission and emergency department visits, and a higher likelihood of patient satisfaction. We sought to determine whether higher levels of continuity of care are associated with medication persistence and compliance among new users of oral antidiabetic treatment. METHODS: We conducted a medicoadministrative cohort study of new users of oral antidiabetics aged 18 years or more among people covered by the Quebec public drug plan...
May 8, 2017: CMAJ Open
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