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https://www.readbyqxmd.com/read/27920416/re-evaluating-the-inhibition-of-stress-erosions-revise-a-protocol-for-pilot-randomized-controlled-trial
#1
Waleed Alhazzani, Gordon Guyatt, John C Marshall, Richard Hall, John Muscedere, Francois Lauzier, Lehana Thabane, Mohammed Alshahrani, Shane W English, Yaseen M Arabi, Adam M Deane, Tim Karachi, Bram Rochwerg, Simon Finfer, Nick Daneman, Nicole Zytaruk, Diane Heel-Ansdell, Deborah Cook, On Behalf Of
INTRODUCTION: Clinicians routinely administer stress ulcer prophylaxis to mechanically ventilated patients in the intensive care unit (ICU), most commonly prescribing proton pump inhibitors (PPIs). However, the incidence of gastrointestinal (GI) bleeding from stress ulceration is low and recent observational studies suggest these agents may increase infections. Therefore, a large randomized clinical trial (RCT) is needed to inform modern practice. The aim of this multicenter pilot trial is to determine the feasibility of performing a large RCT to investigate the efficacy and safety of withholding intravenous pantoprazole...
November 2016: Annals of Saudi Medicine
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
#2
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/27896940/empowering-women-to-breastfeed-does-the-baby-friendly-initiative-make-a-difference
#3
Danielle Groleau, Katherine W Pizarro, Luisa Molino, Katherine Gray-Donald, Sonia Semenic
The Baby-Friendly Hospital Initiative (BFI) is currently presented worldwide as the gold standard model of care for promoting and supporting breastfeeding. However, there is a lack of understanding about the ways in which health services, including the BFI, address the cultural change from a disembodied practice (formula feeding) to an embodied one (breastfeeding) in contexts where formula feeding is the norm. We used a qualitative case study methodology to compare the embodied experience of breastfeeding and the maternal experience of breastfeeding promotion and support services between mothers receiving care from institutions with low and high levels of BFI implementation in Québec, Canada...
November 29, 2016: Maternal & Child Nutrition
https://www.readbyqxmd.com/read/27893998/influenza-and-rhinovirus-viral-load-and-disease-severity-in-upper-respiratory-tract-infections
#4
Andrea Granados, Adriana Peci, Allison McGeer, Jonathan B Gubbay
BACKGROUND: The role of viral load in respiratory viral infection is unclear. It is proposed that the viral load of some, but not all respiratory viruses correlate with disease severity. OBJECTIVES: We aimed to determine if an association exists between viral loads among patients in ambulatory settings, compared to those requiring hospitalization/intensive care unit (ICU) admission with influenza A/H3N2, influenza B, or human rhinovirus (HRV); we also explored the impact of age, gender and co-detection of Streptococcus pneumoniae on patient setting...
November 22, 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/27892855/application-of-ethnobotanical-repellents-and-acaricides-in-prevention-control-and-management-of-livestock-ticks-a-review
#5
REVIEW
Roman Pavela, Angelo Canale, Heinz Mehlhorn, Giovanni Benelli
Ticks transmit at least the same number or even more pathogens than any other group of blood-feeding arthropods worldwide affecting humans and animals. The eco-friendly control and management of tick vectors in a constantly changing environment is a crucial challenge. Besides the development of vaccines against ticks, IPM practices aimed at reducing tick interactions with livestock, emerging pheromone-based control tools, and few biological control agents, the extensive employment of acaricides and tick repellents still remain the most effective and ready-to-use strategies...
September 9, 2016: Research in Veterinary Science
https://www.readbyqxmd.com/read/27882997/development-of-a-validated-algorithm-for-the-diagnosis-of-paediatric-asthma-in-electronic-medical-records
#6
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/27834180/exploring-beliefs-around-physical-activity-among-older-adults-in-rural-canada
#7
Laurie Schmidt, Gwen Rempel, Terra C Murray, Tara-Leigh McHugh, Jeff K Vallance
OBJECTIVE: As physical activity can improve health and reduce the risk of chronic disease, it is important to understand the contributing factors to physical activity engagement among older adults, particularly those living in rural communities to assist in remaining active and healthy as long as possible. The purpose of this study was to gain a deeper understanding of the socio-ecological factors that influence or contribute to physical activity among rural-dwelling older adults in rural Saskatchewan, Canada...
2016: International Journal of Qualitative Studies on Health and Well-being
https://www.readbyqxmd.com/read/27799802/bringing-patient-centricity-to-diabetes-medication-access-in-canada
#8
REVIEW
Judith L Glennie, Katharina Kovacs Burns, Paul Oh
Canada must become proactive in addressing type 2 diabetes. With the second highest rate of diabetes prevalence in the developed world, the number of Canadians living with diabetes will soon reach epidemic levels. Against international comparisons, Canada also performs poorly with respect to diabetes-related hospitalizations, mortality rates, and access to medications. Diabetes and its comorbidities pose a significant burden on people with diabetes (PWD) and their families, through out-of-pocket expenses for medications, devices, supplies, and the support needed to manage their illness...
2016: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/27774739/physician-agreement-regarding-the-expansion-of-pharmacist-professional-activities-in-the-management-of-patients-with-asthma
#9
Audrey Tilly-Gratton, Alexandrine Lamontagne, Lucie Blais, Simon L Bacon, Pierre Ernst, Roland Grad, Kim L Lavoie, Martha L McKinney, Eve Desplats, Francine M Ducharme
BACKGROUND: Asthma control remains suboptimal in Canada. Expansion of pharmacist's professional activities offers the opportunity to improve the interdisciplinary management of patients with asthma. OBJECTIVE: The aim of this study was to determine the level of agreement of physicians regarding the expansion of pharmacists' professional activities in the management of asthma patients. METHODS: We conducted a survey of randomly selected Quebec physicians in family medicine, paediatrics and emergency medicine...
October 24, 2016: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27763434/tikanga-m%C3%A4-ori-m%C3%A4-ori-customary-practices-in-oral-health-research
#10
John R Broughton, Herenia P Lawrence, Lisa Jamieson
: Early childhood caries is a global health issue for Indigenous populations. The study, "Reducing disease burden and health inequalities arising from chronic dental disease among Indigenous children: an early childhood caries intervention," is being conducted in Australia, Canada, and Aotearoa/New Zealand. OBJECTIVE: To conduct the research in New Zealand using a kaupapa Māori (Māori philosophy) approach. METHODS: This is a mixed-method study incorporating quantitative and qualitative data whilst acknowledging Māori cultural practices by the utilization of Te Whare Tapa Whā, a model for Māori health and well-being...
2016: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/27760535/the-haiti-medical-education-project-development-and-analysis-of-a-competency-based-continuing-medical-education-course-in-haiti-through-distance-learning
#11
Robert Battat, Marc Jhonson, Lorne Wiseblatt, Cruff Renard, Laura Habib, Manouchka Normil, Brian Remillard, Timothy F Brewer, Galit Sacajiu
BACKGROUND: Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti...
October 19, 2016: BMC Medical Education
https://www.readbyqxmd.com/read/27749355/moving-in-and-out-of-the-what-ifs-the-experiences-of-unaffected-women-living-in-families-where-a-breast-cancer-1-or-2-genetic-mutation-was-not-found
#12
Dawn Schroeder, Wendy Duggleby, Brenda L Cameron
BACKGROUND: In families where genetic testing for the breast cancer 1 and 2 genes (BRCA1/2) has not identified a deleterious mutation, the risk for hereditary breast cancer (HBC) can still be high when there is a strong family history. Little is known about how an awareness of risk for HBC impacts the everyday lives of unaffected women (no personal history for breast and/or ovarian cancer) in these families. OBJECTIVE: The aim of this study is to explore how unaffected women, living in BRCA1/2-negative families, experience living with risk for HBC...
October 4, 2016: Cancer Nursing
https://www.readbyqxmd.com/read/27738255/feasibility-of-conducting-prospective-observational-research-on-critically-ill-dying-patients-in-the-intensive-care-unit
#13
Amanda van Beinum, Laura Hornby, Sonny Dhanani, Roxanne Ward, Jane Chambers-Evans, Kusum Menon
Studying patients during the end of life is important, as it has the potential to lead to improvements in care for the dying. For patients who die after a controlled withdrawal of life-sustaining therapies in the intensive care unit, information about the natural history of death and the process of removing life support has additionally led to advances in practice for deceased organ donation. However, this unique population of severely critically ill and imminently dying patients has been difficult to study, largely due to assumptions made by research teams and ethics boards alike about the logistical difficulties of obtaining consent and completing research procedures before or during the process of withdrawal of life-sustaining therapies...
October 13, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27716238/international-changes-in-end-of-life-practices-over-time-a-systematic-review
#14
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
#15
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
#16
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
#17
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/27660558/recognition-and-management-of-perinatal-depression-and-anxiety-by-general-practitioners-a-systematic-review
#18
Elizabeth Ford, Judy Shakespeare, Fatin Elias, Susan Ayers
BACKGROUND: Perinatal anxiety and depression are widespread, with up to 20% of women affected during pregnancy and after birth. In the UK, management of perinatal mental health falls under the remit of general practitioners (GPs). We reviewed the literature on GPs' routine recognition, diagnosis and management of anxiety and depression in the perinatal period. METHOD: A systematic search of Embase, Medline, PsycInfo, Pubmed, Scopus and Web of Science was conducted...
September 22, 2016: Family Practice
https://www.readbyqxmd.com/read/27620166/a-qualitative-study-of-perceived-needs-and-factors-associated-with-the-quality-of-care-for-common-mental-disorders-in-patients-with-chronic-diseases-the-perspective-of-primary-care-clinicians-and-patients
#19
Pasquale Roberge, Catherine Hudon, Alan Pavilanis, Marie-Claude Beaulieu, Annie Benoit, Hélène Brouillet, Isabelle Boulianne, Anna De Pauw, Serge Frigon, Isabelle Gaboury, Martine Gaudreault, Ariane Girard, Marie Giroux, Élyse Grégoire, Line Langlois, Martin Lemieux, Christine Loignon, Alain Vanasse
BACKGROUND: The prevalence of comorbid anxiety and depressive disorders is high among patients with chronic diseases in primary care, and is associated with increased morbidity and mortality rates. The detection and treatment of common mental disorders in patients with chronic diseases can be challenging in the primary care setting. This study aims to explore the perceived needs, barriers and facilitators for the delivery of mental health care for patients with coexisting common mental disorders and chronic diseases in primary care from the clinician and patient perspectives...
2016: BMC Family Practice
https://www.readbyqxmd.com/read/27611609/development-and-validation-of-quality-criteria-for-providing-patient-and-family-centered-injury-care
#20
Jamie M Boyd, Rachael Burton, Barb L Butler, Dianne Dyer, David C Evans, Melissa Felteau, Russell L Gruen, Kenneth M Jaffe, John Kortbeek, Eddy Lang, Val Lougheed, Lynne Moore, Michelle Narciso, Peter Oxland, Frederick P Rivara, Derek Roberts, Diana Sarakbi, Karen Vine, Henry T Stelfox
OBJECTIVE: The aim of this study was to develop and evaluate the content validity of quality criteria for providing patient- and family-centered injury care. BACKGROUND: Quality criteria have been developed for clinical injury care, but not patient- and family-centered injury care. METHODS: Using a modified Research AND Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Methodology, a panel of 16 patients, family members, injury and quality of care experts serially rated and revised criteria for patient- and family-centered injury care identified from patient and family focus groups...
September 8, 2016: Annals of Surgery
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