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https://www.readbyqxmd.com/read/27917532/do-women-have-a-choice-care-providers-and-decision-makers-perspectives-on-barriers-to-access-of-health-services-for-birth-after-a-previous-cesarean
#1
Sarah Munro, Jude Kornelsen, Kitty Corbett, Elizabeth Wilcox, Nick Bansback, Patricia Janssen
BACKGROUND: Repeat cesarean delivery is the single largest contributor to the escalating cesarean rate worldwide. Approximately 80 percent of women with a past cesarean are candidates for vaginal birth after a cesarean (VBAC), but in Canada less than one-third plan VBAC. Emerging evidence suggests that these trends may be due in part to nonclinical factors, including care provider practice patterns and delays in access to surgical and anesthesia services. This study sought to explore maternity care providers' and decision makers' attitudes toward and experiences with providing and planning services for women with a previous cesarean...
December 5, 2016: Birth
https://www.readbyqxmd.com/read/27908559/influence-of-a-pay-for-performance-program-on-glycemic-control-in-patients-living-with-diabetes-by-family-physicians-in-a-canadian-province
#2
Emilie LeBlanc, Mathieu Bélanger, Véronique Thibault, Lise Babin, Beverly Greene, Stuart Halpine, Michelina Mancuso
OBJECTIVES: We evaluated the influence of the introduction of a pay-for-performance program implemented in 2010 for family physicians on the glycemic control of patients with diabetes. METHODS: Administrative data for all 583 eligible family physicians and 83,580 adult patients with diabetes in New Brunswick over 10 years were used. We compared the probability of receiving at least 2 tests for glycated hemoglobin (A1C) levels and achieving glycemic control before (2005-2009) and after (2010-2014) the implementation of the program and between patients divided based on whether a physician claimed the incentive or did not...
November 29, 2016: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/27882997/development-of-a-validated-algorithm-for-the-diagnosis-of-paediatric-asthma-in-electronic-medical-records
#3
Andrew J Cave, Christina Davey, Elaheh Ahmadi, Neil Drummond, Sonia Fuentes, Seyyed Mohammad Reza Kazemi-Bajestani, Heather Sharpe, Matt Taylor
An accurate estimation of the prevalence of paediatric asthma in Alberta and elsewhere is hampered by uncertainty regarding disease definition and diagnosis. Electronic medical records (EMRs) provide a rich source of clinical data from primary-care practices that can be used in better understanding the occurrence of the disease. The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) database includes cleaned data extracted from the EMRs of primary-care practitioners. The purpose of the study was to develop and validate a case definition of asthma in children 1-17 who consult family physicians, in order to provide primary-care estimates of childhood asthma in Alberta as accurately as possible...
November 24, 2016: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/27874189/incapacity-of-the-mind-secondary-to-medication-misuse-as-a-not-criminally-responsible-defense
#4
Sebastien S Prat, Bruno J Losier, Heather M Moulden, Gary A Chaimowitz
The manifestations of disorders of the mind may play a role in the occurrence of criminal behavior. In the majority of the cases, the presence of a psychiatric disorder is cited as the reason that an individual was not fully aware of his behavior. However, other conditions, such as seizure disorders or hypoglycemia, have also been linked to an inability to understand the nature and consequences of one's actions. On occasion, these situations can be explained by a state of automatism that may be described as insane or noninsane...
November 22, 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27869051/money-is-brain-financial-barriers-and-consequences-for-canadian-stroke-patients
#5
Aravind Ganesh, Kathryn King-Shier, Braden J Manns, Michael D Hill, David J T Campbell
BACKGROUND: Stroke patients of lower socioeconomic status have worse outcomes. It remains poorly understood whether this is due to illness severity or personal or health system barriers. We explored the experiences of stroke patients with financial barriers in a qualitative descriptive pilot study, seeking to capture perceived challenges that interfere with their poststroke health and recovery. METHODS: We interviewed six adults with a history of stroke and financial barriers in Alberta, Canada, inquiring about their: (1) experiences after stroke; (2) experience of financial barriers; (3) perceived reasons for financial barriers; (4) health consequences of financial barriers; and (5) mechanisms for coping with financial barriers...
November 21, 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/27832752/more-primary-care-patients-regret-health-decisions-if-they-experienced-decisional-conflict-in-the-consultation-a-secondary-analysis-of-a-multicenter-descriptive-study
#6
Maria-Margarita Becerra-Perez, Matthew Menear, Stephane Turcotte, Michel Labrecque, France Légaré
BACKGROUND: We sought to estimate the extent of decision regret among primary care patients and identify risk factors associated with regret. METHODS: Secondary analysis of an observational descriptive study conducted in two Canadian provinces. Unique patient-physician dyads were recruited from 17 primary care clinics and data on patient, physician and consultation characteristics were collected before, during and immediately after consultations, as well as two weeks post-consultation, when patients completed the Decision Regret Scale (DRS)...
November 10, 2016: BMC Family Practice
https://www.readbyqxmd.com/read/27776575/understanding-the-use-of-emergency-department-and-urgent-care-services-by-diabetic-patients-of-a-family-medicine-health-team-a-retrospective-observational-study
#7
Matthew Ward
: Aim To understand the frequency, urgency, and rationale of emergency department and urgent care (ED/UC) use by diabetic patients of a Family Medicine Health Team (FHT). METHODS: A retrospective, observational study with comparison control groups was conducted from 1 January 2013 to 31 December 2014. A total of 693 diabetic patients were compared with two, age-standardized non-diabetic groups: one with a higher disease burden based on International Classification of Diseases 9 diagnoses and the other from a randomized patient pool...
October 25, 2016: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/27748332/implementation-of-a-pediatric-emergency-triage-system-in-xiamen-china
#8
Gang-Xi Lin, Yin-Ling Yang, Denise Kudirka, Colleen Church, Collin K K Yong, Fiona Reilly, Qi-Yi Zeng
BACKGROUND: Pediatric emergency rooms (PERs) in Chinese hospitals are perpetually full of sick and injured children because of the lack of sufficiently developed community hospitals and low access to family physicians. The aim of this study was to evaluate the clinical value of a new five-level Chinese pediatric emergency triage system (CPETS), modeled after the Canadian Triage System and Acuity Scale. METHODS: In this study, we compared CPETS outcomes in our PER relative to those of the prior two-level system...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27737996/coordination-of-cancer-care-between-family-physicians-and-cancer-specialists-importance-of-communication
#9
Julie Easley, Baukje Miedema, June C Carroll, Donna P Manca, Mary Ann O'Brien, Fiona Webster, Eva Grunfeld
OBJECTIVE: To explore health care provider (HCP) perspectives on the coordination of cancer care between FPs and cancer specialists. DESIGN: Qualitative study using semistructured telephone interviews. SETTING: Canada. PARTICIPANTS: A total of 58 HCPs, comprising 21 FPs, 15 surgeons, 12 medical oncologists, 6 radiation oncologists, and 4 GPs in oncology. METHODS: This qualitative study is nested within a larger mixed-methods program of research, CanIMPACT (Canadian Team to Improve Community-Based Cancer Care along the Continuum), focused on improving the coordination of cancer care between FPs and cancer specialists...
October 2016: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/27734788/transforming-regions-into-high-performing-health-systems-toward-the-triple-aim-of-better-health-better-care-and-better-value-for-canadians
#10
Yves Bergevin, Bettina Habib, Keesa Elicksen-Jensen, Stephen Samis, Jean Rochon, Jean-Louis Denis, Denis Roy
A study on the impact of regionalization on the Triple Aim of Better Health, Better Care and Better Value across Canada in 2015 identified major findings including: (a) with regard to the Triple Aim, the Canadian situation is better than before but variable and partial, and Canada continues to underperform compared with other industrialized countries, especially in primary healthcare where it matters most; (b) provinces are converging toward a two-level health system (provincial/regional); (c) optimal size of regions is probably around 350,000-500,000 population; d) citizen and physician engagement remains weak...
2016: HealthcarePapers
https://www.readbyqxmd.com/read/27730112/influenza-immunization-among-canadian-health-care-personnel-a-cross-sectional-study
#11
Sarah A Buchan, Jeffrey C Kwong
BACKGROUND: Influenza immunization coverage among Canadian health care personnel remains below national targets. Targeting this group is of particular importance given their elevated risk of influenza infection, role in transmission and influence on patients' immunization status. We examined influenza immunization coverage in health care personnel in Canada, reasons for not being immunized and the impact of "vaccinate-or-mask" influenza prevention policies. METHODS: In this national cross-sectional study, we pooled data from the 2007 to 2014 cycles of the Canadian Community Health Survey and restricted it to respondents who reported a health care occupation...
July 2016: CMAJ Open
https://www.readbyqxmd.com/read/27730100/developing-canadian-oncology-education-goals-and-objectives-for-medical-students-a-national-modified-delphi-study
#12
Vincent C Tam, Paris-Ann Ingledew, Scott Berry, Sunil Verma, Meredith E Giuliani
BACKGROUND: Studies have shown that there is a deficiency in focused oncology teaching during medical school in Canada. This study aimed to develop oncology education goals and objectives for medical students through consensus of oncology educators from across Canada. METHODS: In 2014 we created a comprehensive list of oncology education objectives using existing resources. Experts in oncology education and undergraduate medical education from all 17 Canadian medical schools were invited to participate in a 3-round modified Delphi process...
July 2016: CMAJ Open
https://www.readbyqxmd.com/read/27716238/international-changes-in-end-of-life-practices-over-time-a-systematic-review
#13
Yi-Sheng Chao, Antoine Boivin, Isabelle Marcoux, Geneviève Garnon, Nicholas Mays, Pascale Lehoux, Marie-Claude Prémont, Evert van Leeuwen, Raynald Pineault
BACKGROUND: End-of-life policies are hotly debated in many countries, with international evidence frequently used to support or oppose legal reforms. Existing reviews are limited by their focus on specific practices or selected jurisdictions. The objective is to review international time trends in end-of-life practices. METHODS: We conducted a systematic review of empirical studies on medical end-of-life practices, including treatment withdrawal, the use of drugs for symptom management, and the intentional use of lethal drugs...
October 3, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27714588/cancer-screening-among-patients-who-self-identify-as-muslim-combining-self-reported-data-with-medical-records-in-a-family-practice-setting
#14
A K Lofters, M Slater, M Vahabi
Cancer screening is a core component of family medicine but screening inequalities are well documented in Canada for foreign-born persons. Although people of Muslim faith and culture are the fastest growing immigrant population in Canada, there is little information in the literature about their cancer screening practices. Determining screening gaps could inform practice-based quality improvement initiatives. We conducted a retrospective chart review combining patient-level medical record data with self-reported religious affiliation to examine the relationship between religion and cancer screening in a large multi-site urban family practice...
October 6, 2016: Journal of Immigrant and Minority Health
https://www.readbyqxmd.com/read/27685758/physician-driven-variation-in-the-care-of-children-with-spinal-muscular-atrophy-type-1
#15
Maryam Oskoui, Pamela Ng, Stephen Liben, David Zielinski
BACKGROUND: Increasing numbers of families are requesting active supportive management for their child with spinal muscular atrophy type 1 (SMA1), leading to longer survival and greater prevalence of affected children. Strong opinions exist among physicians for and against the provision of care measures prolonging life. OBJECTIVE: To describe current practice in the care of SMA1 in Canada, and explore the factors underlying inter-physician variability. METHODS: A cross-sectional survey of Canadian hospital-based pediatric neurologists and pediatric respirologists was performed in 2015...
September 29, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27673401/an-assessment-of-how-nurse-practitioners-create-access-to-primary-care-in-canadian-residential-long-term-care-settings
#16
Nancy Carter, Esther Sangster-Gormley, Jenny Ploeg, Ruth Martin-Misener, Faith Donald, Abigail Wickson-Griffiths, Sharon Kaasalainen, Carrie McAiney, Kevin Brazil, Alan Taniguchi, Lori Schindel Martin
The aim of this paper is to explore the role and activities of nurse practitioners (NPs) working in long-term care (LTC) to understand concepts of access to primary care for residents. Utilizing the "FIT" framework developed by Penchanksy and Thomas, we used a directed content analysis method to analyze data from a pan-Canadian study of NPs in LTC. Individual and focus group interviews were conducted at four sites in western, central and eastern regions of Canada with 143 participants, including NPs, RNs, regulated and unregulated nursing staff, allied health professionals, physicians, administrators and directors and residents and family members...
2016: Nursing Leadership
https://www.readbyqxmd.com/read/27666084/primary-health-care-providers-perspectives-facilitating-older-patients-access-to-community-support-services
#17
Jenny Ploeg, Margaret Denton, Brian Hutchison, Carrie McAiney, Ainsley Moore, Kevin Brazil, Joseph Tindale, Amina Wu, Annie Lam
The purpose of the study examined in this article was to understand how non-physician health care professionals working in Canadian primary health care settings facilitate older persons' access to community support services (CSSs). The use of CSSs has positive impacts for clients, yet they are underused from lack of awareness. Using a qualitative description approach, we interviewed 20 health care professionals from various disciplines and primary health care models about the processes they use to link older patients to CSSs...
September 26, 2016: Canadian Journal on Aging, la Revue Canadienne du Vieillissement
https://www.readbyqxmd.com/read/27629690/helicobacter-pylori-status-among-patients-undergoing-gastroscopy-in-rural-northern-alberta
#18
Isabelle N Colmers-Gray, Ben Vandermeer, Robert I Greidanus, Michael R Kolber
OBJECTIVE: To determine the Helicobacter pylori status of patients who underwent gastroscopy. DESIGN: Retrospective chart review. SETTING: Peace River Community Health Centre in rural northwestern Alberta. PARTICIPANTS: Data were collected from patients who had a gastroscopy performed by either of 2 family physicians between January 1, 2011, and December 31, 2012. MAIN OUTCOME MEASURES: The proportion of patients who had positive test results for H pylori overall and among first-time gastroscopy patients...
September 2016: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/27629666/approach-to-preventive-care-in-the-elderly
#19
REVIEW
Bachir Tazkarji, Robert Lam, Shawn Lee, Soumia Meiyappan
OBJECTIVE: To guide family physicians in creating preventive screening and treatment plans for their elderly patients. SOURCES OF INFORMATION: The MEDLINE database was searched for Canadian guidelines on primary health care and the elderly; guidelines or meta-analyses or practice guidelines or systematic reviews related to mass screening in those aged 80 and older and the frail elderly, limited to between 2006 and July 2016; and articles on preventive health services for the elderly related to family practice or family physicians, limited to English-language publications between 2012 and July 2016...
September 2016: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/27614869/patient-and-family-centered-care-a-qualitative-exploration-of-oncologist-perspectives
#20
Timothy K Nguyen, Glenn S Bauman, Christopher J Watling, Karin Hahn
PURPOSE: Increasingly, patient- and family-centered care (PFCC) is recognized as a valuable component of healthcare reform with rich opportunities for improvement within oncology. Shifting toward PFCC requires physician buy-in; however, research examining their perspectives on PFCC is lacking. We sought to explore oncologists' perspectives on PFCC to identify factors that influence their ability to practice PFCC. METHODS: We conducted semi-structured interviews with 18 oncologists (8 radiation, 4 medical, 4 surgical, 2 hematologist-oncologists) at a single Canadian academic cancer institution...
January 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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