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Québec NOT Canada

Simon Deslauriers, Marie-Hélène Raymond, Maude Laliberté, Amélie Lavoie, François Desmeules, Debbie E Feldman, Kadija Perreault
PURPOSE: Problems with access to outpatient physiotherapy services have been reported in publicly funded healthcare systems worldwide. A few studies have reported management strategies aimed at reducing extensive waiting lists, but their association with waiting times is not fully understood. The purpose of this study was to document access to public outpatient physiotherapy services for persons with musculoskeletal disorders in hospitals and explore organizational factors associated with waiting time...
October 19, 2016: Disability and Rehabilitation
Lynne Moore, Henry Thomas Stelfox, David Evans, Sayed Morad Hameed, Natalie L Yanchar, Richard Simons, John Kortbeek, Gilles Bourgeois, Julien Clément, François Lauzier, Alexis F Turgeon
OBJECTIVE: To assess the variation in hospital and intensive care unit (ICU) length of stay (LOS) for injury admissions across Canadian provinces and to evaluate the relative contribution of patient case mix and treatment-related factors (intensity of care, complications, and discharge delays) to explaining observed variations. BACKGROUND: Identifying unjustified interprovider variations in resource use and the determinants of such variations is an important step towards optimizing health care...
October 4, 2016: Annals of Surgery
Géraldine Layani, Richard Fleet, Renée Dallaire, Fatoumata K Tounkara, Julien Poitras, Patrick Archambault, Jean-Marc Chauny, Mathieu Ouimet, Josée Gauthier, Gilles Dupuis, Alain Tanguay, Jean-Frédéric Lévesque, Geneviève Simard-Racine, Jeannie Haggerty, France Légaré
BACKGROUND: Evidence-based indicators of quality of care have been developed to improve care and performance in Canadian emergency departments. The feasibility of measuring these indicators has been assessed mainly in urban and academic emergency departments. We sought to assess the feasibility of measuring quality-of-care indicators in rural emergency departments in Quebec. METHODS: We previously identified rural emergency departments in Quebec that offered medical coverage with hospital beds 24 hours a day, 7 days a week and were located in rural areas or small towns as defined by Statistics Canada...
July 2016: CMAJ Open
Michelle Gurvitz, Raluca Ionescu-Ittu, Liming Guo, Mark J Eisenberg, Michal Abrahamowicz, Louise Pilote, Ariane J Marelli
The prevalence rate of cancer among adult patients with congenital heart disease (CHD) in North America has not been previously described. The Quebec adult CHD database was used to determine the prevalence rate of cancer among adult patients with CHD measured as the number of adults with CHD and cancer alive in 2005 per 1,000 adults with CHD. This prevalence rate was compared with the prevalence rate of cancer in the general population of adults in Canada. Types of cancer among the CHD group were described by gender and age...
August 31, 2016: American Journal of Cardiology
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
Gisele Ferreira Paris, Francine de Montigny, Sandra Marisa Pelloso
OBJECTIVE: To verify the association between complicated grief and sociodemographic, reproductive, mental, marital satisfaction, and professional support characteristics in women after stillbirth. METHOD: Cross-sectional study with 26 women who had stillbirth in 2013, living in the city of Maringá, Brazil, and eight women who attended the Centre d'Études et de Rechercheen Intervention Familiale at the University of Quebec en Outaouais, in Canada. The instrument was administered as an interview to a small number of mothers of infants up to three months (n=50), who did not participate in the validation study...
July 2016: Revista da Escola de Enfermagem da U S P
Didier Saey
With more than 700,000 patients, chronic obstructive pulmonary disease (COPD), a sickness characterized by a progressive alteration of lungs function, presents a major burden in Canada. Even though COPD is primarily a respiratory system disease, progressive sedentary lifestyle, reduced exercise capacity and a restricted participation in daily life activities, which all contribute to a poor health-related quality of life are common consequences of the disease progression. Cornerstone of the COPD management, there is unequivocal evidence that pulmonary rehabilitation is the most effective treatment to improve shortness of breath, exercise tolerance and quality of life of patients with COPD...
September 2016: Annals of Physical and Rehabilitation Medicine
Ziad Samir Nasreddine, Bhavini Bhovan Patel
UNLABELLED: Objective background: The Montreal Cognitive Assessment (MoCA) is a questionnaire that has been developed to help physicians around the world diagnose a patient's cognitive ability. Available in multiple languages and for use in multiple countries worldwide, the goal of this study was to validate the alternate versions 2 and 3 of the French MoCA test to assist physicians in the detection of mild cognitive impairment (MCI), while decreasing the learning effect upon frequent testing...
September 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Ahmed Kayssi, Steven Dilkas, Derry L Dance, Charles de Mestral, Thomas L Forbes, Graham Roche-Nagle
BACKGROUND: The heterogeneity of medical complications that lead to amputation has resulted in a diverse patient population with differing rehabilitation needs; however, the rehabilitation trends for patients with lower extremity amputations across Canada have not been studied previously. OBJECTIVE: To describe trends in rehabilitation after lower extremity amputations and the factors affecting rehabilitation length of stay in Canada. DESIGN: Retrospective cohort analysis...
September 21, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Raphaël Bondu, Vincent Cloutier, Eric Rosa, Mostafa Benzaazoua
High arsenic concentrations occur in groundwater collected from a fractured crystalline bedrock aquifer in western Quebec (Canada). Sampling and analysis of water from 59 private wells reveal that more than half of the bedrock wells exceed the Canadian guideline value of 10μg/l for arsenic, whereas shallow wells in unconsolidated surficial deposits are not affected by the contamination. The weathering of arsenic-bearing sulfides present along the mineralized fault zone is considered to be the primary source of arsenic in groundwater...
September 17, 2016: Science of the Total Environment
Isabelle Laforest-Lapointe, Christian Messier, Steven W Kembel
BACKGROUND: The diversity and composition of the microbial community of tree leaves (the phyllosphere) varies among trees and host species and along spatial, temporal, and environmental gradients. Phyllosphere community variation within the canopy of an individual tree exists but the importance of this variation relative to among-tree and among-species variation is poorly understood. Sampling techniques employed for phyllosphere studies include picking leaves from one canopy location to mixing randomly selected leaves from throughout the canopy...
2016: PeerJ
Amy Metcalfe, Matthews Mathai, Shiliang Liu, Juan Andres Leon, K S Joseph
OBJECTIVE: Most literature on length of stay (LOS) for childbirth focuses on 'early' discharge as opposed to 'optimal' time of discharge and has conflicting results due to heterogeneous definitions of 'early' discharge and differing eligibility criteria for these programmes. We aimed to determine the LOS associated with the lowest neonatal readmission rate following childbirth by examining the incidence pattern of neonatal readmission for different LOS using the Kitagawa decomposition...
September 14, 2016: BMJ Open
Alex Carignan, Sébastien Poulin, Philippe Martin, Annie-Claude Labbé, Louis Valiquette, Hamed Al-Bachari, Louis-Philippe Montpetit, Jacques Pépin
OBJECTIVES: Patients with Clostridium difficile infection (CDI) who are re-exposed to antibiotics have a high likelihood of recurrence. We aimed to determine whether oral vancomycin as secondary prophylaxis reduces the risk of recurrence in patients recently diagnosed with CDI who undergo subsequent antibiotic exposure (CDI-AE). METHODS: We conducted a retrospective cohort study of patients diagnosed with CDI (initial episode or recurrence) between 2003 and 2011 in two tertiary care centers in Quebec, Canada and who received antibiotics not targeted against CDI within 90 days after their CDI diagnosis...
September 13, 2016: American Journal of Gastroenterology
Y Chiu, F Chebana, B Abdous, D Bélanger, P Gosselin
Hospitalizations and deaths belong to the most studied health variables in public health. Those variables are usually analyzed through mean events and trends, based on the whole dataset. However, this approach is not appropriate to comprehend health outcome peaks which are unusual events that strongly impact the health care network (e.g. overflow in hospital emergency rooms). Peaks can also be of interest in etiological research, for instance when analyzing relationships with extreme exposures (meteorological conditions, air pollution, social stress, etc...
September 1, 2016: Statistical Methods in Medical Research
Renee Carter, Jean-Frédéric Lévesque, Sam Harper, Amélie Quesnel-Vallée
The Family Medicine Group (FMG) model of primary care in Quebec, Canada, was driven by the voluntary implementation of family physicians. Our main objective was to measure the effect of FMG enrolment on avoidable use of the emergency department (ED) by diabetic patients. We also sought to determine if effects differed according to whether patients were infrequent or frequent users of the ED and according to high- versus low-regional levels of enrolment. We used data from provincial health administrative databases to identify the diabetic patient population over the age of 20 years for each fiscal year between 2003-2004 and 2011-2012...
August 30, 2016: Journal of Evaluation in Clinical Practice
Shiliang Liu, K S Joseph, Wei Luo, Juan Andrés León, Sarka Lisonkova, Michiel Van den Hof, Jane Evans, Ken Lim, Julian Little, Reg Sauve, Michael S Kramer
BACKGROUND: Previous studies have yielded inconsistent results for the effects of periconceptional multivitamins containing folic acid and of folic acid food fortification on congenital heart defects (CHDs). METHODS: We carried out a population-based cohort study (N=5 901 701) of all live births and stillbirths (including late-pregnancy terminations) delivered at ≥20 weeks' gestation in Canada (except Québec and Manitoba) from 1990 to 2011. CHD cases were diagnosed at birth and in infancy (n=72 591)...
August 30, 2016: Circulation
Marie-Hélène Guertin, Isabelle Théberge, Hervé Tchala Vignon Zomahoun, Michel-Pierre Dufresne, Éric Pelletier, Jacques Brisson
RATIONALE AND OBJECTIVES: This study evaluates to what extent technologists' experience, training, or practice in mammography are associated with screening mammography positioning quality. MATERIALS AND METHODS: Positioning quality of a random sample of 1278 mammograms drawn from the 394,190 screening examinations performed in 2004-2005 in the Breast Cancer Screening Program of Quebec (Canada) was evaluated by an expert radiologist. Information on technologists' experience, training, and practice was obtained by mailed questionnaire...
August 24, 2016: Academic Radiology
P Lehoux, F A Miller, G Daudelin
While health policy scholars wish to encourage the creation of technologies that bring more value to healthcare, they may not fully understand the mandate of venture capitalists and how they operate. This paper aims to clarify how venture capital operates and to illustrate its influence over the kinds of technologies that make their way into healthcare systems. The paper draws on the international innovation policy scholarship and the lessons our research team learned throughout a 5-year fieldwork conducted in Quebec (Canada)...
July 2016: BMJ Innovations
Nicole Roberts, Virginia Lee, Bethsheba Ananng, Annett Körner
PURPOSE/OBJECTIVES: To determine the acceptability of a self-help workbook, Mastering the Art of Coping in Good Times and Bad, for patients with cancer.
. RESEARCH APPROACH: Descriptive, qualitative.
. SETTING: Participants were recruited from the psychosocial support cancer centers of two tertiary care teaching hospitals in Montreal, Quebec, Canada.
. PARTICIPANTS: 18 individuals diagnosed with cancer.
. METHODOLOGIC APPROACH: A semistructured interview guide with open-ended questions was used to gather feedback from participants about the workbook...
September 1, 2016: Oncology Nursing Forum
Mehdi Pourabadehei, Catherine N Mulligan
Harbours, as strategic places in tourism and transportation, are exposed to many sources of contamination. Assessing the quality of harbours sediment by guidelines and regulations does not reflect the actual level of contamination and the risk posed to aquatic ecosystems. Selection of an appropriate management technique for contaminated sediments in those strategic locations is crucial for the aquatic environment. The purpose of this study is to show that insufficient information, provided by sediment quality guidelines (SQGs) to identify the actual contaminants, could lead to a destructive or potentially ineffective decision for risk reduction in contaminated harbours...
August 15, 2016: Environmental Pollution
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