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https://www.readbyqxmd.com/read/28430754/biomarkers-for-early-acute-kidney-injury-diagnosis-and-severity-prediction-a-pilot-multicenter-canadian-study-of-children-admitted-to-the-icu
#1
Jennifer Palermo, Allison B Dart, Alanna De Mello, Prasad Devarajan, Ronald Gottesman, Gonzalo Garcia Guerra, Greg Hansen, Ari R Joffe, Cherry Mammen, Nick Majesic, Catherine Morgan, Peter Skippen, Michael Pizzi, Ana Palijan, Michael Zappitelli
OBJECTIVE: Acute kidney injury occurs early in PICU admission and increases risks for poor outcomes. We evaluated the feasibility of a multicenter acute kidney injury biomarker urine collection protocol and measured diagnostic characteristics of urine neutrophil gelatinase-associated lipocalin, interleukin-18, and liver fatty acid binding protein to predict acute kidney injury and prolonged acute kidney injury. DESIGN: Prospective observational pilot cohort study...
April 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28423164/triple-aim-in-canada-developing-capacity-to-lead-to-better-health-care-and-cost
#2
Elina Farmanova, Christine Kirvan, Jennifer Verma, Geetha Mukerji, Nurdin Akunov, Kaye Phillips, Stephen Samis
Quality problem: Many modern health systems strive for 'Triple Aim' (TA)-better health for populations, improved experience of care for patients and lower costs of the system, but note challenges in implementation. Outcomes of applying TA as a quality improvement framework (QI) have started to be realized with early lessons as to why some systems make progress while others do not. Initial assessment: Limited evidence is available as to how organizations create the capacity and infrastructure required to design, implement, evaluate and sustain TA systems...
December 1, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28412641/the-gap-between-entitlement-and-access-to-healthcare-an-analysis-of-candidacy-in-the-help-seeking-trajectories-of-asylum-seekers-in-montreal
#3
Liana E Chase, Janet Cleveland, Jesse Beatson, Cécile Rousseau
In 2012 the Canadian government made significant cuts to its historically strong federal refugee health coverage plan. While this policy had negligible effects on the level of coverage provided to asylum seekers in Quebec, there is evidence that this group nonetheless experienced reduced healthcare access during the period of polarized national debate that ensued. This study engaged the "candidacy" model of healthcare access to illuminate factors contributing to the observed gap between entitlement and access...
March 21, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28396854/a-hepatitis-c-educational-needs-assessment-of-canadian-healthcare-providers
#4
Reza Naghdi, Karen Seto, Carolyn Klassen, Didi Emokpare, Brian Conway, Melissa Kelley, Eric Yoshida, Hemant A Shah
Background and Aim. Despite advances in the treatment of chronic hepatitis C infection (CHC), it remains a major public health problem in Canada and globally. The knowledge of healthcare providers (HCPs) is critical to improve the care of CHC in Canada. To assess the current knowledge and educational needs of healthcare providers (HCPs) in the area of CHC management a national online survey was conducted. Method. An interprofessional steering committee designed a 29-question survey distributed through various direct and electronic routes...
2017: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28367724/sexual-hiv-risk-among-gay-bisexual-and-queer-transgender-men-findings-from-interviews-in-vancouver-canada
#5
Ashleigh Rich, Kai Scott, Caitlin Johnston, Everett Blackwell, Nathan Lachowsky, Zishan Cui, Paul Sereda, David Moore, Robert Hogg, Eric Roth
Gay, bisexual, queer and other men who have sex with men are disproportionately affected by HIV in Canada. While up to 63% of transgender men identify as gay, bisexual or queer and report a variety of HIV sexual risk behaviours, transgender men are often overlooked within epidemiological HIV surveillance and research. While a growing body of research has begun to examine sexual risk for transgender gay, bisexual and queer men, most studies have been conducted in the USA. This study explored sexual HIV risk for this population in the Canadian context, specifically in British Columbia, in an environment of publically funded universal access to healthcare, including HIV testing and treatment...
April 3, 2017: Culture, Health & Sexuality
https://www.readbyqxmd.com/read/28367684/traumatic-spinal-cord-injury-care-in-canada-a-survey-of-canadian-centres
#6
Vanessa K Noonan, Elaine Chan, Argelio Santos, Lesley Soril, Rachel Lewis, Anoushka Singh, Christiana L Cheng, Colleen O'Connell, Catherine Truchon, Jérôme Paquet, Sean Christie, Karen Ethans, Eve Tsai, Michael H Ford, Brian Drew, Gary Linassi, Christopher Bailey, Michael G Fehlings
Specialized centres of care for persons sustaining a traumatic spinal cord injury (tSCI) have been established in many countries, but the ideal system of care has not been defined. The objective of this study was to describe care delivery, with a focus on structures and services, for persons with tSCI in Canada. A survey was sent to 26 facilities (12 acute, 11 rehabilitation and 3 integrated) from 8 provinces participating in the Access to Care and Timing project. The survey included questions about: 1) care provision; 2) structural attributes and; 3) service availability...
April 1, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28364118/enablers-and-determinants-of-the-provision-of-written-action-plans-to-patients-with-asthma-a-stratified-survey-of-canadian-physicians
#7
Fabienne Djandji, Alexandrine J Lamontagne, Lucie Blais, Simon L Bacon, Pierre Ernst, Roland Grad, Kim L Lavoie, Martha L McKinney, Eve Desplats, Francine M Ducharme
Despite national recommendations, most patients with asthma are not given a written action plan . The objectives were to ascertain physicians' endorsement of potential enablers to providing a written action plan, and the determinants and proportion, of physician-reported use of a written action plan. We surveyed 838 family physicians, paediatricians, and emergency physicians in Quebec. The mailed questionnaire comprised 102 questions on asthma management, 11 of which pertained to written action plan and promising enablers...
March 31, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28363615/retrospective-comparison-of-the-low-risk-ankle-rules-and-the-ottawa-ankle-rules-in-a-pediatric-population
#8
Amy L Ellenbogen, Amy L Rice, Pranav Vyas
BACKGROUND: A recent multicenter prospective Canadian study presented prospective evidence supporting the Low Risk Ankle Rules (LRAR) as a means of reducing the number of ankle radiographs ordered for children presenting with an ankle injury while maintaining nearly 100% sensitivity. This is in contrast to a previous prospective study which showed that this rule yielded only 87% sensitivity. OBJECTIVE: It is important to further investigate the LRAR and compare them with the already validated Ottawa Ankle Rules (OAR) to potentially curb healthcare costs and decrease unnecessary radiation exposure without compromising diagnostic accuracy...
March 22, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28363120/awareness-and-understanding-of-hiv-non-disclosure-case-law-among-people-living-with-hiv-who-use-illicit-drugs-in-a-canadian-setting
#9
Sophie Patterson, Angela Kaida, Gina Ogilvie, Robert Hogg, Valerie Nicholson, Sabina Dobrer, Thomas Kerr, Jean Shoveller, Julio Montaner, M-J Milloy
BACKGROUND: In 2012, the Supreme Court of Canada (SCC) ruled that people living with HIV (PLWH) could face criminal charges if they did not disclose their serostatus before sex posing a "realistic possibility" of HIV transmission. Condom-protected vaginal sex with a low (i.e., <1500copies/mL) HIV viral load (VL) incurs no duty to disclose. Awareness and understanding of this ruling remain uncharacterized, particularly among marginalized PLWH. METHODS: We used data from ACCESS, a community-recruited cohort of PLWH who use illicit drugs in Vancouver...
March 28, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28360248/transfusion-of-red-blood-cells-in-patients-with-traumatic-brain-injuries-admitted-to-canadian-trauma-health-centres-a-multicentre-cohort-study
#10
Amélie Boutin, Lynne Moore, François Lauzier, Michaël Chassé, Shane English, Ryan Zarychanski, Lauralyn McIntyre, Donald Griesdale, Dean A Fergusson, Alexis F Turgeon
BACKGROUND: Optimisation of healthcare practices in patients sustaining a traumatic brain injury is of major concern given the high incidence of death and long-term disabilities. Considering the brain's susceptibility to ischaemia, strategies to optimise oxygenation to brain are needed. While red blood cell (RBC) transfusion is one such strategy, specific RBC strategies are debated. We aimed to evaluate RBC transfusion frequency, determinants of transfusions and associated clinical outcomes...
March 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28360247/economic-evaluation-of-aerobic-exercise-training-in-older-adults-with-vascular-cognitive-impairment-promote-trial
#11
Jennifer C Davis, Ging-Yuek Robin Hsiung, Stirling Bryan, John R Best, Janice J Eng, Michelle Munkacsy, Winnie Cheung, Bryan Chiu, Claudia Jacova, Philip Lee, Teresa Liu-Ambrose
BACKGROUND/OBJECTIVES: Evidence suggests that aerobic exercise may slow the progression of subcortical ischaemic vascular cognitive impairment (SIVCI) by modifying cardiovascular risk factors. Yet the economic consequences relating to aerobic training (AT) remain unknown. Therefore, our primary objective was to estimate the incremental cost per quality-adjusted life years (QALYs) gained of a thrice weekly AT intervention compared with usual care. DESIGN: Cost-utility analysis alongside a randomised trial...
March 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28346282/screening-tools-to-assess-risk-of-opioid-abuse-in-the-canadian-primary-healthcare-setting
#12
Hollie Muir, Fran Seymour
Opioid therapy for patients with chronic pain is increasing in frequency along with rates of opioid abuse. Many screening tools are available to assess for the risk of opioid abuse. NPs should use screening tools that are cross-validated for use in chronic pain patients in the Canadian primary healthcare setting.
March 24, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28344704/decolonization-in-health-professions-education-reflections-on-teaching-through-a-transgressive-pedagogy
#13
Ruth Rodney
BACKGROUND: Canadian health educators travel to the global south to provide expertise in health education. Considering the history of relations between the north and south, educators and healthcare providers from Canada should critically examine their practices and consider non-colonizing ways to relate to their Southern colleagues. METHODS: Using her experience as a teacher with the Toronto Addis Ababa Academic Collaboration in Nursing, the author explored issues of identity and representation as a registered nurse and PhD candidate teaching in Ethiopia...
December 2016: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/28333089/south-asian-ethnicity-is-related-to-the-highest-risk-of-vitamin-b12-deficiency-in-pregnant-canadian-women
#14
Marta Jeruszka-Bielak, Carly Isman, Theresa H Schroder, Wangyang Li, Tim J Green, Yvonne Lamers
Vitamin B12 (B12) adequacy during pregnancy is crucial for maternal health and optimal fetal development; however, suboptimal B12 status has been reported in pregnant Canadian women. Methylmalonic acid (MMA) is a sensitive indicator of B12 status. Since few studies have measured MMA during pregnancy in Canadian women, the objective of this study was to evaluate B12 status in pregnant women living in Metro Vancouver, using both plasma total B12 and MMA. We recruited a convenience sample of 320 pregnant women between 20 and 35 gestational weeks from local healthcare facilities...
March 23, 2017: Nutrients
https://www.readbyqxmd.com/read/28299786/changing-nurse-licensing-examinations-media-analysis-and-implications-of-the-canadian-experience
#15
L McGillis Hall, M Lalonde, J Kashin, C Yoo, J Moran
AIM: This study examines perceptions of the implementation of National Council Licensing Examination in Canada through a content analysis of articles in the media. BACKGROUND: Public opinions of nursing in the media have been acknowledged as important for the profession, specifically in relation to their portrayal of nursing. INTRODUCTION: The Canadian Council of Registered Nurse Regulators began using the US-based National Council Licensing Examination as entry examination (also known widely as NCLEX) for Canada's registered nurses, discontinuing the previous Canadian Registered Nurse Examination in 2015...
March 15, 2017: International Nursing Review
https://www.readbyqxmd.com/read/28298129/a-rural-shelter-in-ontario-adapting-to-address-the-changing-needs-of-women-who-have-experienced-intimate-partner-violence-a-qualitative-case-study
#16
Tara Mantler, Barat Wolfe
INTRODUCTION: Intimate partner violence is a significant public health problem, with shelters offering the predominant community-based solution. Shelters in Canada are mandated to provide a safe place, protection planning, advocacy and counseling among other services. Recently it has been noted the role of the shelter was shifting from an inpatient to outpatient model with a focus on increased integration of health and social services. This changing role of the shelter is amplified within the rural context where resources and cultural norms may be limited or incompatible with help-seeking behaviors...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28286993/clinical-and-economic-impact-of-mirabegron-compared-with-antimuscarinics-for-the-treatment-of-overactive-bladder-in-canada
#17
Zalmai Hakimi, Jameel Nazir, Charles McCrea, Malin Berling, Francis Fatoye, Barbara Ramos, Adrian Wagg
BACKGROUND: The β3-adrenoceptor agonist, mirabegron, and antimuscarinic agents provide similar efficacy for the treatment of overactive bladder (OAB), but mirabegron appears to be associated with better persistence, perhaps due to an absence of anticholinergic side-effects. This study estimated the expected costs associated with the management of OAB in Canada from a societal perspective by utilizing real-world evidence. METHODS: An economic model with monthly cycles and a 1-year time horizon was developed to depict a treatment pathway for a hypothetical cohort of 100 patients with OAB...
March 12, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28280970/belimumab-use-clinical-outcomes-and-glucocorticoid-reduction-in-patients-with-systemic-lupus-erythematosus-receiving-belimumab-in-clinical-practice-settings-results-from-the-observe-canada-study
#18
Zahi Touma, Amyn Sayani, Christian A Pineau, Isabelle Fortin, Mark Matsos, George A Ecker, Andrew Chow, Sandra Iczkovitz
To describe the characteristics of patients receiving belimumab, overall patterns of systemic lupus erythematosus (SLE) care, clinical outcomes, and changes in glucocorticoid dose following 6 months of therapy with belimumab, and healthcare resource utilization in belimumab users in Canadian clinical practice settings. Retrospective multicenter medical chart review study of adult patients with SLE who were prescribed belimumab as part of usual care and who received ≥8 infusions or 6 months of treatment...
March 9, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28277207/estimating-the-cost-of-cancer-care-in-british-columbia-and-ontario-a-canadian-inter-provincial-comparison
#19
Claire De Oliveira, Reka Pataky, Karen E Bremner, Jagadish Rangrej, Kelvin K W Chan, Winson Y Cheung, Jeffrey S Hoch, Stuart Peacock, Murray D Krahn
BACKGROUND: Costing studies are useful to measure the economic burden of cancer. Comparing costs between healthcare systems can inform evaluation, development or modification of cancer care policies. OBJECTIVES: To estimate and compare cancer costs in British Columbia and Ontario from the payers' perspectives. METHODS: Using linked cancer registry and administrative data, and standardized costing methodology and analyses, we estimated costs for 21 cancer sites by phase of care to determine potential differences between provinces...
February 2017: Healthcare Policy, Politiques de Santé
https://www.readbyqxmd.com/read/28275838/economic-evaluation-of-a-population-based-osteoporosis-intervention-for-outpatients-with-non-traumatic-non-hip-fractures-the-catch-a-break-1i-type-c-fls
#20
S R Majumdar, D A Lier, D A Hanley, A G Juby, L A Beaupre
Fracture liaison services (FLS) are advocated to improve osteoporosis treatment after fragility fracture, but there are few economic analyses of different models. A population-based 1i [=type C] FLS for non-hip fractures was implemented and it costs $44 per patient and it was very cost-effective ($9200 per QALY gained). Small operational changes would convert it from cost-effective to cost-saving. INTRODUCTION: After fragility fracture, <20% of patients receive osteoporosis treatment...
March 9, 2017: Osteoporosis International
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