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Morgan DG, Kosteniuk J, Bayly M. Perceptions and outcomes of an embedded Alzheimer Society First Link Coordinator in rural primary health care memory clinics. BMC Health Serv Res 2024; 24:607. [PMID: 38724975 PMCID: PMC11080231 DOI: 10.1186/s12913-024-11066-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Primary health care has a central role in dementia detection, diagnosis, and management, especially in low-resource rural areas. Care navigation is a strategy to improve integration and access to care, but little is known about how navigators can collaborate with rural primary care teams to support dementia care. In Saskatchewan, Canada, the RaDAR (Rural Dementia Action Research) team partnered with rural primary health care teams to implement interprofessional memory clinics that included an Alzheimer Society First Link Coordinator (FLC) in a navigator role. Study objectives were to examine FLC and clinic team member perspectives of the impact of FLC involvement, and analysis of Alzheimer Society data comparing outcomes associated with three types of navigator-client contacts. METHODS This study used a mixed-method design. Individual semi-structured interviews were conducted with FLC (n = 3) and clinic team members (n = 6) involved in five clinics. Data were analyzed using thematic inductive analysis. A longitudinal retrospective analysis was conducted with previously collected Alzheimer Society First Link database records. Memory clinic clients were compared to self- and direct-referred clients in the geographic area of the clinics on time to first contact, duration, and number of contacts. RESULTS Three key themes were identified in both FLC and team interviews: perceived benefits to patients and families of FLC involvement, benefits to memory clinic team members, and impact of rural location. Whereas other team members assessed the patient, only FLC focused on caregivers, providing emotional and psychological support, connection to services, and symptom management. Face-to-face contact helped FLC establish a relationship with caregivers that facilitated future contacts. Team members were relieved knowing caregiver needs were addressed and learned about dementia subtypes and available services they could recommend to non-clinic clients with dementia. Although challenges of rural location included fewer available services and travel challenges in winter, the FLC role was even more important because it may be the only support available. CONCLUSIONS FLC and team members identified perceived benefits of an embedded FLC for patients, caregivers, and themselves, many of which were linked to the FLC being in person.
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Affiliation(s)
- Debra G Morgan
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Box 23, Saskatoon, SK, S7N 5E5, Canada.
| | - Julie Kosteniuk
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Box 23, Saskatoon, SK, S7N 5E5, Canada
| | - Melanie Bayly
- Research Ethics Office, Human Ethics, University of Saskatchewan, 2nd Floor, Thorvaldson Building, 110 Science Place, Saskatoon, SK, S7N 5C9, Canada
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2
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Jansen EB, Ostadgavahi AT, Hewins B, Buchanan R, Thivierge BM, Sganzerla Martinez G, Goncin U, Francis ME, Swan CL, Scruten E, Bell J, Darbellay J, Facciuolo A, Falzarano D, Gerdts V, Fenton ME, Hedlin P, Kelvin DJ, Kelvin AA. PASC (Post Acute Sequelae of COVID-19) is associated with decreased neutralizing antibody titers in both biological sexes and increased ANG-2 and GM-CSF in females. Sci Rep 2024; 14:9854. [PMID: 38684819 PMCID: PMC11058778 DOI: 10.1038/s41598-024-60089-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 04/18/2024] [Indexed: 05/02/2024] Open
Abstract
Post-acute sequelae of COVID-19 (PASC) or the continuation of COVID-19 (Coronavirus disease 2019) symptoms past 12 weeks may affect as many as 30% of people recovering from a SARS-CoV-2 (severe acute respiratory coronavirus 2) infection. The mechanisms regulating the development of PASC are currently not known; however, hypotheses include virus reservoirs, pre-existing conditions, microblood clots, immune dysregulation, as well as poor antibody responses. Importantly, virus neutralizing antibodies are essential for COVID-19 recovery and protection from reinfection but there is currently limited information on these immune regulators and associated cytokines in PASC patients. Understanding the key drivers of general and specific symptoms associated with Long COVID and the presence of virus neutralizing antibodies in PASC will aid in the development of therapeutics, diagnostics, and vaccines which currently do not exist. We designed a cross-sectional study to investigate systemic antibody and cytokine responses during COVID-19 recovery and PASC. In total, 195 participants were recruited in one of four groups: (1) Those who never had COVID-19 (No COVID); (2) Those in acute COVID-19 recovery (Acute Recovery) (4-12 weeks post infection); (3) Those who recovered from COVID-19 (Recovered) (+ 12 weeks from infection); and (4) those who had PASC (PASC) (+ 12 weeks from infection). Participants completed a questionnaire on health history, sex, gender, demographics, experiences with COVID-19 acute and COVID-19 recovery/continuing symptoms. Serum samples collected were evaluated for antibody binding to viral proteins, virus neutralizing antibody titers, and serum cytokine levels using Ella SimplePlex Immunoassay™ panels. We found participants with PASC reported more pre-existing conditions (e.g. such as hypertension, asthma, and obesity), and PASC symptoms (e.g. fatigue, brain fog, headaches, and shortness of breath) following COVID-19 than COVID-19 Recovered individuals. Importantly, we found PASC individuals to have significantly decreased levels of neutralizing antibodies toward both SARS-CoV-2 and the Omicron BA.1 variant. Sex analysis indicated that female PASC study participants had sustained antibody levels as well as levels of the inflammatory cytokines GM-CSF and ANG-2 over time following COVID-19. Our study reports people experiencing PASC had lower levels of virus neutralizing antibodies; however, the results are limited by the collection time post-COVID-19 and post-vaccination. Moreover, we found females experiencing PASC had sustained levels of GM-CSF and ANG-2. With lower levels of virus neutralizing antibodies, this data suggests that PASC individuals not only have had a suboptimal antibody response during acute SARS-CoV-2 infection but may also have increased susceptibility to subsequent infections which may exacerbate or prolong current PASC illnesses. We also provide evidence suggesting GM-CSF and ANG-2 to play a role in the sex-bias of PASC. Taken together, our findings maybe important for understanding immune molecular drivers of PASC and PASC subgroups.
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Affiliation(s)
- Ethan B Jansen
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
- Department of Biochemistry, Microbiology, and Immunology, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Benjamin Hewins
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
| | - Rachelle Buchanan
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
| | - Brittany M Thivierge
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Una Goncin
- Department of Anesthesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Magen E Francis
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
- Department of Biochemistry, Microbiology, and Immunology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Cynthia L Swan
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
| | - Erin Scruten
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
| | - Jack Bell
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
- Department of Biochemistry, Microbiology, and Immunology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Joseph Darbellay
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
| | - Antonio Facciuolo
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
- Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Darryl Falzarano
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
- Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Volker Gerdts
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
- Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Mark E Fenton
- Division of Respirology, Critical Care, and Sleep Medicine, Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Peter Hedlin
- Department of Anesthesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - David J Kelvin
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
| | - Alyson A Kelvin
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada.
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3
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Sapkota RP, Lozinski T, Wilhems A, Nugent M, Schaub MP, Keough MT, Sundström C, Hadjistavropoulos HD. Internet-delivered therapy for alcohol misuse: engagement, satisfaction, and outcomes when patients select their preference for therapist- or self-guided treatment. Addict Sci Clin Pract 2024; 19:30. [PMID: 38643242 PMCID: PMC11032586 DOI: 10.1186/s13722-024-00456-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 03/19/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Alcohol misuse is common and causes substantial harm. Internet-delivered cognitive behaviour therapy (ICBT) is effective in reducing alcohol misuse; however, the literature investigating how treatment outcomes are impacted by patients' preferences for therapist- versus self-guided ICBT for alcohol misuse is sparse. METHODS In this preference trial, 74 eligible patients (who reported ≥ 14 drinks in the previous week and obtained scores suggesting hazardous or harmful drinking) chose between enrolling in either therapist- or self-guided ICBT for alcohol misuse. We investigated whether those who chose therapist- versus self-guided ICBT differed in their (a) drinking outcomes-as measured by Timeline Follow-Back (TLFB) and heavy drinking days (HDD) at post-treatment and 3-month follow-up-and (b) post-treatment ICBT engagement and satisfaction. RESULTS The majority (81.1%) of eligible patients chose therapist-guided ICBT. These patients reported higher psychotropic medication use, drinking difficulties, and anxiety symptoms. For both the therapist- and self-guided patients, a modified intention-to-treat analysis revealed large within-group treatment effects for TLFB (β = - 2.64, SE 0.66; p < 0.001) and HDD (β = - 0.34, SE 0.07; p < 0.001), with large pre-to-post-treatment Cohen's effect sizes of d = 0.97 (95% CI [0.49, 1.45]) for TLFB and d = 1.19 (95% CI [0.69, 1.68]) for HDD. The interaction comparing the effects of therapist- to self-guided ICBT over time was not significant for TLFB (p = 0.34) or HDD (p = 0.06). With treatment, for both therapist- and self-guided patients, there was a significant improvement in drinking difficulties, cravings, and confidence with controlling cravings, as well as in anxiety, depression, and functional impairment. Further, the majority (75.7%) of patients completed five or more lessons, as well as reported overall satisfaction with the treatment (88.9%) and increased confidence in managing their symptoms (86.7%); these outcomes also did not differ between therapist- and self-guided patients. CONCLUSIONS The current study shows that ICBT for alcohol misuse is associated with reduced drinking and comorbid mental health difficulties over time, irrespective of whether patients chose to complete the course on their own or with therapist guidance. TRIAL REGISTRATION NUMBER NCT04611854 ( https://clinicaltrials.gov/ct2/show/NCT04611854 ).
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Affiliation(s)
- Ram P Sapkota
- Online Therapy Unit, Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - Tristen Lozinski
- Online Therapy Unit, Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - Andrew Wilhems
- Online Therapy Unit, Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - Marcie Nugent
- Online Therapy Unit, Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - Michael P Schaub
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Konradstrasse 32, 8005, Zurich, Switzerland
| | - Matthew T Keough
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Christopher Sundström
- Department of Psychology, Stockholm University, 106 91, Stockholm, Sweden
- Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Norra Stationsgatan 69, 113 64, Stockholm, Sweden
| | - Heather D Hadjistavropoulos
- Online Therapy Unit, Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada.
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4
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Alford H, Anvari N, Lengyel C, Wickson-Griffiths A, Hunter P, Yakiwchuk E, Cammer A. Resources to Support Decision-Making Regarding End-of-Life Nutrition Care in Long-Term Care: A Scoping Review. Nutrients 2024; 16:1163. [PMID: 38674853 PMCID: PMC11054792 DOI: 10.3390/nu16081163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Resources are needed to aid healthcare providers and families in making end-of-life nutrition care decisions for residents living in long-term care settings. This scoping review aimed to explore what is reported in the literature about resources to support decision-making at the end of life in long-term care. Four databases were searched for research published from 2003 to June 2023. Articles included peer-reviewed human studies published in the English language that reported resources to support decision-making about end-of-life nutrition in long-term care settings. In total, 15 articles were included. Thematic analysis of the articles generated five themes: conversations about care, evidence-based decision-making, a need for multidisciplinary perspectives, honouring residents' goals of care, and cultural considerations for adapting resources. Multidisciplinary care teams supporting residents and their families during the end of life can benefit from resources to support discussion and facilitate decision-making.
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Affiliation(s)
- Heather Alford
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada; (H.A.); (N.A.); (E.Y.)
| | - Nadia Anvari
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada; (H.A.); (N.A.); (E.Y.)
| | - Christina Lengyel
- Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada;
| | | | - Paulette Hunter
- St. Thomas More College, University of Saskatchewan, Saskatoon, SK S7N 0W6, Canada;
| | - Erin Yakiwchuk
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada; (H.A.); (N.A.); (E.Y.)
| | - Allison Cammer
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada; (H.A.); (N.A.); (E.Y.)
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5
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Rose G, McCarron M, Reid M, Fayant-McLeod T, Gulka E, Young J, Clark M, Madill SJ. Using focus groups to inform a peer health navigator service for people who are transgender and gender diverse in Saskatchewan, Canada. Health Expect 2024; 27:e14022. [PMID: 38528661 DOI: 10.1111/hex.14022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/07/2024] [Accepted: 03/10/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND This study investigated healthcare access and quality for people who are transgender and gender-diverse (PTGD) in Saskatchewan (SK), Canada, to inform a larger project that was piloting two peer health navigators for PTGD. METHODS Two online focus groups were held. Nineteen participants were recruited to represent a broad range in age, gender and location in SK. Transcripts of the focus groups were analyzed using a thematic approach. RESULTS The core theme that was identified was participants' desire for culturally safe healthcare. This core theme had two component themes: (1) systemic healthcare factors and (2) individual healthcare provider (HCP) factors. The healthcare system primarily acted as a barrier to culturally safe healthcare. HCPs could be either barriers or facilitators of culturally safe care; however, negative experiences outweighed positive ones. CONCLUSIONS PTGD in SK face discrimination, with delays and barriers to care at all levels of the healthcare system. Peer health navigators can address some of these discrepancies; however, greater support is required for PTGD to be able to access culturally safe healthcare. PATIENT OR PUBLIC CONTRIBUTION People with lived experience/PTGD were involved in all stages of this project. They were included on the team as community researchers and co-developed the research project, conducted the focus groups, participated in the analyses and are co-authors. As well, both navigators and all the participants in the focus groups were also PTGD.
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Affiliation(s)
- Gwen Rose
- School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | | | - Mel Reid
- School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | | | - Emily Gulka
- School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | | | - Megan Clark
- Academic Family Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Stéphanie J Madill
- School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Saskatoon, Canada
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6
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Kuwornu JP, Maldonado F, Groot G, Cooper EJ, Penz E, Sommer L, Reid A, Marciniuk DD. An economic evaluation of chronic obstructive pulmonary disease clinical pathway in Saskatchewan, Canada: Data-driven techniques to identify cost-effectiveness among patient subgroups. PLoS One 2024; 19:e0301334. [PMID: 38557914 PMCID: PMC10984414 DOI: 10.1371/journal.pone.0301334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Saskatchewan has implemented care pathways for several common health conditions. To date, there has not been any cost-effectiveness evaluation of care pathways in the province. The objective of this study was to evaluate the real-world cost-effectiveness of a chronic obstructive pulmonary disease (COPD) care pathway program in Saskatchewan. METHODS Using patient-level administrative health data, we identified adults (35+ years) with COPD diagnosis recruited into the care pathway program in Regina between April 1, 2018, and March 31, 2019 (N = 759). The control group comprised adults (35+ years) with COPD who lived in Saskatoon during the same period (N = 759). The control group was matched to the intervention group using propensity scores. Costs were calculated at the patient level. The outcome measure was the number of days patients remained without experiencing COPD exacerbation within 1-year follow-up. Both manual and data-driven policy learning approaches were used to assess heterogeneity in the cost-effectiveness by patient demographic and disease characteristics. Bootstrapping was used to quantify uncertainty in the results. RESULTS In the overall sample, the estimates indicate that the COPD care pathway was not cost-effective using the willingness to pay (WTP) threshold values in the range of $1,000 and $5,000/exacerbation day averted. The manual subgroup analyses show the COPD care pathway was dominant among patients with comorbidities and among patients aged 65 years or younger at the WTP threshold of $2000/exacerbation day averted. Although similar profiles as those identified in the manual subgroup analyses were confirmed, the data-driven policy learning approach suggests more nuanced demographic and disease profiles that the care pathway would be most appropriate for. CONCLUSIONS Both manual subgroup analysis and data-driven policy learning approach showed that the COPD care pathway consistently produced cost savings and better health outcomes among patients with comorbidities or among those relatively younger. The care pathway was not cost-effective in the entire sample.
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Affiliation(s)
- John Paul Kuwornu
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Gary Groot
- Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Elizabeth J. Cooper
- Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Erika Penz
- Respirology, Critical Care & Sleep Medicine, The Respiratory Research Centre, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Leland Sommer
- Stewardship and Clinical Appropriateness, Saskatchewan Health Authority, Regina, Saskatchewan, Canada
| | - Amy Reid
- Clinical Integration Unit, Saskatchewan Health Authority, Regina, Saskatchewan, Canada
| | - Darcy D. Marciniuk
- Respirology, Critical Care & Sleep Medicine, The Respiratory Research Centre, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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7
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Moura CS, Morrison LJ, Hohl CM, Grant L, Pilote L, Neville A, Hau JP, Bernatsky S. Administrative data ICD-10 diagnostic codes identifies most lab-confirmed SARS-CoV-2 admissions but misses many discharged from the Emergency Department. Sci Rep 2024; 14:6008. [PMID: 38472258 PMCID: PMC10933440 DOI: 10.1038/s41598-023-49501-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 12/08/2023] [Indexed: 03/14/2024] Open
Abstract
We estimated the operating characteristics of ICD-10 code U07.1, introduced by the World Health Organization in 2020, to identify lab-confirmed SARS-CoV-2. CCEDRRN is a national research registry of adults (March 2020-August 2021) with suspected/confirmed SARS-CoV-2 identified in Canadian emergency departments (EDs) using chart review (symptoms, clinical information, and lab test results including SARS-CoV-2 polymerase chain reaction, PCR results). CCEDRRN data were linked to administrative hospitalization discharge and ED ICD-10 diagnostic codes (accessed centrally via the Canadian Institute for Health Information). We identified ICD-10 diagnostic codes in CCEDRRN participants. We defined lab-confirmed SARS-CoV-2 based on at least one positive PCR in the 0-14 days before the ED presentation and/or during hospitalization (in those admitted from ED). We performed separate analyses for CCEDRRN participants discharged from ED and those hospitalized from the ED. Additional analyses were stratified by province, sex, age, and (for hospitalized patients) timing of the first PCR test. The sensitivity of ICD-10 code U07.1 for a positive SARS-CoV-2 test was 93.6% (95% CI 93.0-94.1%) in those hospitalized from ED and 83.0% (95% CI 82.1-83.9%) in those discharged from the ED. Sensitivity was similar across provinces and demographics, but in each stratified analysis, values were higher in those hospitalized versus those discharged from ED. The ICD-10 diagnostic code for U07.1 within administrative data identified most lab-confirmed SARS-CoV-2 within persons hospitalized from ED, although a significant number of cases discharged from ED were missed. This should be considered when using administrative data for research and public health planning.
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Affiliation(s)
| | - Laurie J Morrison
- Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | | | | | | | - Autumn Neville
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Jeffrey P Hau
- University of British Columbia, Vancouver, BC, Canada
| | - Sasha Bernatsky
- McGill University, Montreal, QC, Canada.
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
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Hopkins L, Carey M, Brown L, McCrea S, Milne M, Tokaryk D, Stacey D. The Development and Testing of a Patient Decision Aid for Individuals with Homologous Recombinant Proficient Ovarian Cancer Who Are Considering Niraparib Maintenance Therapy. Curr Oncol 2024; 31:1416-1425. [PMID: 38534940 PMCID: PMC10969309 DOI: 10.3390/curroncol31030107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 05/26/2024] Open
Abstract
New treatments for ovarian cancer are available that require trade-offs between progression-free survival and quality of life. The aim of this study was to develop a decision aid for patients with homologous recombinant proficient (HRP) tumors, as the benefit-harm ratio of niraparib needs consideration. This decision aid was created with a systematic and iterative development process based on the Ottawa Decision Support Framework. The decision aid was user-tested for acceptability, usability, and comprehensibility using a survey completed by a sample of patients with ovarian cancer and oncologists. This decision aid follows the International Patient Decision Aids Standards (IPDAS) criteria in its development. User-test respondents (n = 13 patients; 13 physicians) reported that the decision aid used language that was easy to follow (69% patients; 85% physicians), was an appropriate length (69% patients; 62% physicians) and provided the right amount of information (54% patients; 54% physicians). Most respondents (92% patients; 62% physicians) would recommend this decision aid for HRP patients considering niraparib. This is the first decision aid for patients with HRP ovarian cancers who are considering niraparib maintenance therapy. It is available on-line and is being further evaluated in a pragmatic clinical trial in Saskatchewan.
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Affiliation(s)
- Laura Hopkins
- Division of Oncology, University of Saskatchewan, Saskatoon, SK S7V 4H4, Canada
| | - Mark Carey
- Division of Gynecologic Oncology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
| | - Linda Brown
- Ovarian Cancer Canada, Toronto, ON M5A 1E3, Canada
| | - Sabryna McCrea
- Research Facilitators, University of Saskatchewan, Saskatoon, SK S7N 5A2, Canada; (S.M.); (M.M.)
| | - Mark Milne
- Research Facilitators, University of Saskatchewan, Saskatoon, SK S7N 5A2, Canada; (S.M.); (M.M.)
| | - Dawne Tokaryk
- Saskatchewan Cancer Agency Patient and Family Advisory Council, Saskatoon, SK S7V 4H4, Canada;
| | - Dawn Stacey
- School of Nursing Science, University of Ottawa, Ottawa, ON K1H 8M5, Canada;
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada
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9
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Rohatinsky N, Russell B, Peña-Sánchez JN, Boklaschuk S, Bhasin S, Fowler S, Guzowski T, Wicks K, Wicks M. Exploring the Experiences of Virtual Inflammatory Bowel Disease Care in Saskatchewan. Can J Nurs Res 2024; 56:95-108. [PMID: 38062657 PMCID: PMC10804685 DOI: 10.1177/08445621231219299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Individuals with inflammatory bowel disease (IBD) require life-long interactions with the healthcare system. Virtual care (VC) technologies are becoming increasingly utilized for accessing healthcare services. Research related to the use of VC technology for the management of IBD in Canada is limited. This study aimed to examine the VC experiences from the perspectives of individuals with IBD and gastroenterology care providers (GCPs). METHODS A patient-oriented, qualitative descriptive approach was used. Semi-structured interviews were completed with individuals with IBD and GCPs. Data were analyzed using an inductive content analysis approach. RESULTS A total of 25 individuals with IBD and five GCPs were interviewed. Three categories were identified: benefits of virtual IBD care delivery, challenges of virtual IBD care delivery, and optimizing IBD care delivery. Individuals with IBD and GCPs were satisfied with the use of VC technology for appointments. Participants believed VC was convenient and allowed enhanced access to care. However, VC was not considered ideal in some instances, such as during disease flares or first appointments. Thus, a blended use of virtual and in-person appointments was suggested for individualized care. CONCLUSIONS The virtual method of connecting patients and providers is deemed useful for routine appointments and for persons living in rural areas. VC is becoming more common in the IBD care environment. Nurses are in a key position to facilitate and enhance virtual IBD care delivery for the benefit of both individuals living with IBD and providers.
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Affiliation(s)
- Noelle Rohatinsky
- College of Nursing, University of Saskatchewan, Saskatoon, Sask., Canada
| | - Brooke Russell
- College of Nursing, University of Saskatchewan, Saskatoon, Sask., Canada
| | - Juan Nicolás Peña-Sánchez
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Canada
| | | | - Sanchit Bhasin
- Division of Gastroenterology, Department of Medicine, Saskatchewan Health Authority, Regina General Hospital, Canada
- Division of Gastroenterology and Hepatology, Department of Medicine, College of Medicine, University of Saskatchewan, Canada
| | - Sharyle Fowler
- Division of Gastroenterology and Hepatology, Department of Medicine, College of Medicine, University of Saskatchewan, Canada
| | - Tomasz Guzowski
- Division of Gastroenterology and Hepatology, Department of Medicine, College of Medicine, University of Saskatchewan, Canada
| | | | - Mike Wicks
- Patient and Family Partner, Saskatchewan, Canada
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Koosha E, Brenna CTA, Ashique AM, Jain N, Ovens K, Koike T, Kitagawa H, Eames BF. Proteoglycan inhibition of canonical BMP-dependent cartilage maturation delays endochondral ossification. Development 2024; 151:dev201716. [PMID: 38117077 PMCID: PMC10820745 DOI: 10.1242/dev.201716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 11/28/2023] [Indexed: 12/21/2023]
Abstract
During endochondral ossification, chondrocytes secrete a proteoglycan (PG)-rich extracellular matrix that can inhibit the process of cartilage maturation, including expression of Ihh and Col10a1. Because bone morphogenetic proteins (BMPs) can promote cartilage maturation, we hypothesized that cartilage PGs normally inhibit BMP signalling. Accordingly, BMP signalling was evaluated in chondrocytes of wild-type and PG mutant (fam20b-/-) zebrafish and inhibited with temporal control using the drug DMH1 or an inducible dominant-negative BMP receptor transgene (dnBMPR). Compared with wild type, phospho-Smad1/5/9, but not phospho-p38, was increased in fam20b-/- chondrocytes, but only after they secreted PGs. Phospho-Smad1/5/9 was decreased in DMH1-treated or dnBMPR-activated wild-type chondrocytes, and DMH1 also decreased phospho-p38 levels. ihha and col10a1a were decreased in DMH1-treated or dnBMPR-activated chondrocytes, and less perichondral bone formed. Finally, early ihha and col10a1a expression and early perichondral bone formation of fam20b mutants were rescued with DMH1 treatment or dnBMPR activation. Therefore, PG inhibition of canonical BMP-dependent cartilage maturation delays endochondral ossification, and these results offer hope for the development of growth factor therapies for skeletal defects of PG diseases.
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Affiliation(s)
- Elham Koosha
- Department of Anatomy, Physiology, and Pharmacology, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Connor T. A. Brenna
- Department of Anatomy, Physiology, and Pharmacology, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Amir M. Ashique
- Department of Anatomy, Physiology, and Pharmacology, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Niteesh Jain
- Department of Anatomy, Physiology, and Pharmacology, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Katie Ovens
- Department of Computer Science, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Toshiyasu Koike
- Department of Biochemistry, Kobe Pharmaceutical University, Higashinada-ku, Kobe 658-0003, Japan
| | - Hiroshi Kitagawa
- Department of Biochemistry, Kobe Pharmaceutical University, Higashinada-ku, Kobe 658-0003, Japan
| | - B. Frank Eames
- Department of Anatomy, Physiology, and Pharmacology, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
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11
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Rose G, Goalen S, Clark M, Madill S. Identifying a Cohort of People Who Are Transgender and Gender-Diverse Within Saskatchewan's Administrative Health Databases. Health Serv Insights 2024; 17:11786329231222122. [PMID: 38223213 PMCID: PMC10785721 DOI: 10.1177/11786329231222122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 10/11/2023] [Indexed: 01/16/2024] Open
Abstract
This was a retrospective cohort study. Algorithms were developed to identify a cohort of people who were trans and gender diverse (PTGD) among provincial-level administrative health databases (physician, hospital, emergency department, and pharmacy) from April 1, 2012 to September 30, 2020. Then, healthcare usage was compared between the identified cohort and the general population. There were 6466 unique individuals identified in the cohort, out of a total population of 1.2 million Saskatchewan residents (~0.5%). They had a mean age of 42.5 (SD 17.7) years. 1946 (30.1%) had a female sex marker and 4560 (69.9%) had a male sex marker, which may not indicate their lived gender. The cohort had increased healthcare usage 2 years prior to their index date, compared to the general population, which continued to rise to 1 year past their index date across physician, emergency department visits, and hospitalizations. The results for drugs were mixed. The percentage of PTGD identified in Saskatchewan was comparable to other studies. Healthcare utilization among the cohort was higher than the general population. Further research could use external data sources to validate and improve the cohort identification methods. The large majority of individuals with a male sex marker deserves further investigation.
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Affiliation(s)
- Gwen Rose
- College of Rehabilitation Sciences, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Megan Clark
- Academic Family Medicine, University of Saskatchewan, Regina, SK, Canada
| | - Stéphanie Madill
- College of Rehabilitation Sciences, University of Saskatchewan, Saskatoon, SK, Canada
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12
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Kuwornu JP, Maldonado F, Groot G, Penz E, Cooper EJ, Reid A, Marciniuk DD. Real-World Cost-Consequence Analysis of an Integrated Chronic Disease Management Program in Saskatchewan, Canada. Health Serv Insights 2024; 17:11786329231224621. [PMID: 38223214 PMCID: PMC10785729 DOI: 10.1177/11786329231224621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/28/2023] [Indexed: 01/16/2024] Open
Abstract
An integrated disease management program otherwise called a clinical pathway was recently implemented in Saskatchewan, Canada for patients living with chronic obstructive pulmonary disease (COPD). This study compared the real-world costs and consequences of the COPD clinical pathway program with 2 control treatment programs. The study comprised adult COPD patients in Regina (clinical pathway group, N = 759) matched on propensity scores to 2 independent control groups of similar adults in (1) Regina (historical controls, N = 759) and (2) Saskatoon (contemporaneous controls, N = 759). The study measures included patient-level healthcare costs and acute COPD exacerbation outcomes, both tracked in population-based administrative health data over a one-year follow-up period. Analyses included Cox proportional hazards models and differences in means between groups. The bias-corrected and accelerated bootstrap method was used to calculate 95% confidence intervals (CI). The COPD pathway patients had lower risks of moderate (hazard ratio [HR] =0.57, 95% CI [0.40-0.83]) and severe (HR = 0.43, 95% CI [0.28-0.66]) exacerbations compared to the historical control group, but similar risks compared with the contemporaneous control group. The COPD pathway patients experienced fewer episodes of exacerbations compared with the historical control group (mean difference = -0.30, 95% CI [-0.40, -0.20]) and the contemporaneous control group (mean difference = -0.12, 95% CI [-0.20, -0.03]). Average annual healthcare costs in Canadian dollars were marginally higher among patients in the COPD clinical pathway (mean = $10 549, standard deviation [SD] =$18 149) than those in the contemporaneous control group ($8841, SD = $17 120), but comparable to the historical control group ($10 677, SD = $21 201). The COPD pathway provides better outcomes at about the same costs when compared to the historical controls, but only slightly better outcomes and at a marginally higher cost when compared to the contemporaneous controls.
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Affiliation(s)
- John Paul Kuwornu
- Research Department, Saskatchewan Health Authority, Regina, SK, Canada
| | | | - Gary Groot
- Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Erika Penz
- Respirology, Critical Care & Sleep Medicine, The Respiratory Research Centre, University of Saskatchewan, Saskatoon, SK, Canada
| | - Elizabeth J Cooper
- Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - Amy Reid
- Clinical Integration Unit, Saskatchewan Health Authority, Regina, SK, Canada
| | - Darcy D Marciniuk
- Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
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13
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Moslemi Z, Toledo-Aldana EA, Baldwin B, Donkers SJ, Eng JJ, Mondal P, de Zepetnek JOT, Buttigieg J, Levin MC, Mang CS. Task-oriented exercise effects on walking and corticospinal excitability in multiple sclerosis: protocol for a randomized controlled trial. BMC Sports Sci Med Rehabil 2023; 15:175. [PMID: 38129896 PMCID: PMC10734154 DOI: 10.1186/s13102-023-00790-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is a degenerative disease of the central nervous system (CNS) that disrupts walking function and results in other debilitating symptoms. This study compares the effects of 'task-oriented exercise' against 'generalized resistance and aerobic exercise' and a 'stretching control' on walking and CNS function in people with MS (PwMS). We hypothesize that task-oriented exercise will enhance walking speed and related neural changes to a greater extent than other exercise approaches. METHODS This study is a single-blinded, three-arm randomized controlled trial conducted in Saskatchewan, Canada. Eligible participants are those older than 18 years of age with a diagnosis of MS and an expanded Patient-Determined Disease Steps (PDDS) score between 3 ('gait disability') and 6 ('bilateral support'). Exercise interventions are delivered for 12 weeks (3 × 60-min per week) in-person under the supervision of a qualified exercise professional. Interventions differ in exercise approach, such that task-oriented exercise involves weight-bearing, walking-specific activities, while generalized resistance and aerobic exercise uses seated machine-based resistance training of major upper and lower body muscle groups and recumbent cycling, and the stretching control exercise involves seated flexibility and relaxation activities. Participants are allocated to interventions using blocked randomization that stratifies by PDDS (mild: 3-4; moderate: 5-6). Assessments are conducted at baseline, post-intervention, and at a six-week retention time point. The primary and secondary outcome measures are the Timed 25-Foot Walk Test and corticospinal excitability for the tibialis anterior muscles determined using transcranial magnetic stimulation (TMS), respectively. Tertiary outcomes include assessments of balance, additional TMS measures, blood biomarkers of neural health and inflammation, and measures of cardiorespiratory and musculoskeletal fitness. DISCUSSION A paradigm shift in MS healthcare towards the use of "exercise as medicine" was recently proposed to improve outcomes and alleviate the economic burden of MS. Findings will support this shift by informing the development of specialized exercise programming that targets walking and changes in corticospinal excitability in PwMS. TRIAL REGISTRATION ClinicalTrials.gov, NCT05496881, Registered August 11, 2022. https://classic. CLINICALTRIALS gov/ct2/show/NCT05496881 . Protocol amendment number: 01; Issue date: August 1, 2023; Primary reason for amendment: Expand eligibility to include people with all forms of MS rather than progressive forms of MS only.
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Affiliation(s)
- Zahra Moslemi
- Faculty of Kinesiology and Health Studies, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A1, Canada
| | - Eduardo A Toledo-Aldana
- Faculty of Kinesiology and Health Studies, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A1, Canada
| | - Bruce Baldwin
- Faculty of Kinesiology and Health Studies, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A1, Canada
| | - Sarah J Donkers
- School of Rehabilitation Sciences, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | - Janice J Eng
- Centre for Aging SMART at Vancouver Coastal Health, Department of Physical Therapy, University of British Columbia, 2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Prosanta Mondal
- Clinical Research Support Unit, University of Saskatchewan, 3200 Health Science E-wing, Saskatoon, SK, S7N 5B5, Canada
| | - Julia O Totosy de Zepetnek
- Faculty of Kinesiology and Health Studies, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A1, Canada
| | - Josef Buttigieg
- Department of Biology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A1, Canada
| | - Michael C Levin
- Department of Neurology and Anatomy and Cell Biology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Cameron S Mang
- Faculty of Kinesiology and Health Studies, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A1, Canada.
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14
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Walker S, Kannan P, Bhawra J, Katapally TR. Evaluation of a longitudinal digital citizen science initiative to understand the impact of culture on Indigenous youth mental health: Findings from a quasi-experimental qualitative study. PLoS One 2023; 18:e0294234. [PMID: 38127846 PMCID: PMC10735025 DOI: 10.1371/journal.pone.0294234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 10/29/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Indigenous youth in settler nations are susceptible to poor mental health due to complex intergenerational systemic inequities. Research has shown benefits of cultural connectedness for improving mental health; however, there are few studies which have evaluated the impact of culturally relevant mental health interventions, particularly among Indigenous youth. The purpose of this study is to assess the impact of a culturally-responsive, land-based, active living initiative on the mental health of Indigenous youth. METHODS This quasi-experimental qualitative study is part of Smart Indigenous Youth (SIY), a mixed-methods 5-year longitudinal digital citizen science initiative. SIY embeds culturally responsive, land-based active living programs into the curricula of high schools in rural Indigenous communities in the western Canadian province of Saskatchewan. In year-1 (Winter 2019), 76 Indigenous youth citizen scientists (13-18 years) from 2 schools participated in the study. At the beginning of the term, each school initiated separate 4-month land-based active living programs specific to their culture, community, geography, and language (Cree and Saulteaux). Before and after the term, focus groups were conducted with the 2 Youth Citizen Scientist Councils, which included students from both participating schools. This study includes data from focus groups of one participating school, with 11 youth citizen scientists (5 boys, 6 girls). Focus group data were transcribed and analyzed by two independent reviewers using Nvivo to identify themes and subthemes. Both reviewers discussed their thematic analysis to reach consensus about final findings. RESULTS Baseline focus group analyses (before land-based programming) revealed themes demonstrating the importance of Indigenous culture, identity, history, and language. Youth emphasized the impact of loss of language and culture, the importance of being a helper, and the necessity of intergenerational knowledge transfer. Follow-up focus group analyses (post land-based programming) indicated that cultural school programming led to students expressing positive mental health benefits, increased interest in ceremonies, increased participation in physical activity, and greater knowledge of culture, identity, and ceremonial protocol. CONCLUSIONS This novel qualitative quasi-experimental study offers a window into the future of upstream interventions in partnership with Indigenous communities, where Indigenous youth can be engaged in real-time via their digital devices, while participating in culturally-sensitive, land-based school programming that promotes culture, identity, and mental health.
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Affiliation(s)
- Susannah Walker
- Johnson Shoyama Graduate School of Public Policy, University of Regina, Regina, Canada
| | - Prasanna Kannan
- Johnson Shoyama Graduate School of Public Policy, University of Regina, Regina, Canada
| | - Jasmin Bhawra
- CHANGE Research Lab, School of Occupational and Public Health, Faculty of Community Services, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Tarun Reddy Katapally
- DEPtH Lab, School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Children’s Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada
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15
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Acuna E, Ndlovu E, Molaeitabari A, Shahina Z, Dahms TES. Carvacrol-Induced Vacuole Dysfunction and Morphological Consequences in Nakaseomyces glabratus and Candida albicans. Microorganisms 2023; 11:2915. [PMID: 38138059 PMCID: PMC10745442 DOI: 10.3390/microorganisms11122915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
With the prevalence of systemic fungal infections caused by Candida albicans and non-albicans species and their resistance to classical antifungals, there is an urgent need to explore alternatives. Herein, we evaluate the impact of the monoterpene carvacrol, a major component of oregano and thyme oils, on clinical and laboratory strains of C. albicans and Nakaseomyces glabratus. Carvacrol induces a wide range of antifungal effects, including the inhibition of growth and hyphal and biofilm formation. Using biochemical and microscopic approaches, we elucidate carvacrol-induced hyphal inhibition. The significantly reduced survival rates following exposure to carvacrol were accompanied by dose-dependent vacuolar acidification, disrupted membrane integrity, and aberrant morphology. Germ tube assays, used to elucidate the relationship between vacuolar dysfunction and hyphal inhibition, showed that carvacrol significantly reduced hyphal formation, which was accompanied by a defective C. albicans morphology. Thus, we show a link between vacuolar acidification/disrupted vacuole membrane integrity and compromised candidal morphology/morphogenesis, demonstrating that carvacrol exerts its anti-hyphal activity by altering vacuole integrity.
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Affiliation(s)
| | | | | | - Zinnat Shahina
- Department of Chemistry and Biochemistry, University of Regina, Regina, SK S4S 1P4, Canada; (E.A.)
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16
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Buitrago JM, Kolbe RJ, Siqueira MF. Dental unit waterline testing practices: an 11-Year retrospective study. BMC Oral Health 2023; 23:867. [PMID: 37968643 PMCID: PMC10652605 DOI: 10.1186/s12903-023-03590-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/27/2023] [Indexed: 11/17/2023] Open
Abstract
OBJECTIVES This retrospective study examined the dental unit waterline (DUWL) testing practices of Saskatchewan dental clinics over a period of 11 years, with an emphasis on their responses after identification of high microbial levels. MATERIALS AND METHODS Dental clinics (n = 137) aseptically collected samples of output water from their air/water syringes, handpieces, and ultrasonic scaler lines using Sigma-Aldrich® waterline test kits and delivered them to a quality assurance laboratory. Tests were incubated for seven days at room temperature, and those with heterotrophic plate counts > 500 CFU/mL were reported as failures. Statistical analyses were performed on a database containing 4,093 test results. RESULTS Participating clinics submitted an average of 11 DUWL tests per year. Overall, 21% of tests failed, and a moderate positive association (rs=.52, p < 0.001) was found between clinics' DUWL testing frequency and failure rate. Only 7% of failed DUWL tests were followed up by collection of a subsequent test within two weeks, of which 47% still exceeded the 500 CFU/mL threshold. CONCLUSIONS Our findings demonstrate an association between DUWL testing frequency and detection of unacceptable microbial levels, along with infrequent retesting and often-inadequate intervention after a failed test. This suggests the need for further efforts at the regulatory and educational levels to maintain adequate water quality during dental treatment. CLINICAL RELEVANCE Procedural water can become contaminated in DUWLs and endanger patients. Regular DUWL monitoring and evidence-based interventions to treat contaminated systems are necessary to safeguard patient health.
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Affiliation(s)
- Juan M Buitrago
- College of Dentistry, University of Saskatchewan, Saskatoon, SK, Canada
| | - Rob J Kolbe
- College of Dentistry, University of Saskatchewan, Saskatoon, SK, Canada
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17
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Bairagi S, Abdollahifar MA, Atake OJ, Dust W, Wiebe S, Belev G, Chapman LD, Webb MA, Zhu N, Cooper DML, Eames BF. MRI overestimates articular cartilage thickness and volume compared to synchrotron radiation phase-contrast imaging. PLoS One 2023; 18:e0291757. [PMID: 37788257 PMCID: PMC10547194 DOI: 10.1371/journal.pone.0291757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 09/05/2023] [Indexed: 10/05/2023] Open
Abstract
Accurate evaluation of morphological changes in articular cartilage are necessary for early detection of osteoarthritis (OA). 3T magnetic resonance imaging (MRI) has highly sensitive contrast resolution and is widely used clinically to detect OA. However, synchrotron radiation phase-contrast imaging computed tomography (SR-PCI) can also provide contrast to tissue interfaces that do not have sufficient absorption differences, with the added benefit of very high spatial resolution. Here, MRI was compared with SR-PCI for quantitative evaluation of human articular cartilage. Medial tibial condyles were harvested from non-OA donors and from OA patients receiving knee replacement surgery. Both imaging methods revealed that average cartilage thickness and cartilage volume were significantly reduced in the OA group, compared to the non-OA group. When comparing modalities, the superior resolution of SR-PCI enabled more precise mapping of the cartilage surface relative to MRI. As a result, MRI showed significantly higher average cartilage thickness and cartilage volume, compared to SR-PCI. These data highlight the potential for high-resolution imaging of articular cartilage using SR-PCI as a solution for early OA diagnosis. Recognizing current limitations of using a synchrotron for clinical imaging, we discuss its nascent utility for preclinical models, particularly longitudinal studies of live animal models of OA.
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Affiliation(s)
- Suranjan Bairagi
- Department of Anatomy, Physiology, and Pharmacology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Mohammad-Amin Abdollahifar
- Department of Anatomy, Physiology, and Pharmacology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Oghenevwogaga J. Atake
- Department of Anatomy, Physiology, and Pharmacology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - William Dust
- Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Sheldon Wiebe
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - George Belev
- Canadian Light Source Inc., Saskatoon, Saskatchewan, Canada
| | - L. Dean Chapman
- Department of Anatomy, Physiology, and Pharmacology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - M. Adam Webb
- Canadian Light Source Inc., Saskatoon, Saskatchewan, Canada
| | - Ning Zhu
- Canadian Light Source Inc., Saskatoon, Saskatchewan, Canada
| | - David M. L. Cooper
- Department of Anatomy, Physiology, and Pharmacology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - B. Frank Eames
- Department of Anatomy, Physiology, and Pharmacology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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18
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Hohl CM, Cragg A, Purssel E, McAlister FA, Ting DK, Scheuermeyer F, Stachura M, Grant L, Taylor J, Kanu J, Hau JP, Cheng I, Atzema CL, Bola R, Morrison LJ, Landes M, Perry JJ, Rosychuk RJ. Comparing methods to classify admitted patients with SARS-CoV-2 as admitted for COVID-19 versus with incidental SARS-CoV-2: A cohort study. PLoS One 2023; 18:e0291580. [PMID: 37751455 PMCID: PMC10522023 DOI: 10.1371/journal.pone.0291580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023] Open
Abstract
INTRODUCTION Not all patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection develop symptomatic coronavirus disease 2019 (COVID-19), making it challenging to assess the burden of COVID-19-related hospitalizations and mortality. We aimed to determine the proportion, resource utilization, and outcomes of SARS-CoV-2 positive patients admitted for COVID-19, and assess the impact of using the Center for Disease Control's (CDC) discharge diagnosis-based algorithm and the Massachusetts state department's drug administration-based classification system on identifying admissions for COVID-19. METHODS In this retrospective cohort study, we enrolled consecutive SARS-CoV-2 positive patients admitted to one of five hospitals in British Columbia between December 19, 2021 and May 31,2022. We completed medical record reviews, and classified hospitalizations as being primarily for COVID-19 or with incidental SARS-CoV-2 infection. We applied the CDC algorithm and the Massachusetts classification to estimate the difference in hospital days, intensive care unit (ICU) days and in-hospital mortality and calculated sensitivity and specificity. RESULTS Of 42,505 Emergency Department patients, 1,651 were admitted and tested positive for SARS-CoV-2, with 858 (52.0%, 95% CI 49.6-54.4) admitted for COVID-19. Patients hospitalized for COVID-19 required ICU admission (14.0% versus 8.2%, p<0.001) and died (12.6% versus 6.4%, p<0.001) more frequently compared with patients with incidental SARS-CoV-2. Compared to case classification by clinicians, the CDC algorithm had a sensitivity of 82.9% (711/858, 95% CI 80.3%, 85.4%) and specificity of 98.1% (778/793, 95% CI 97.2%, 99.1%) for COVID-19-related admissions and underestimated COVID-19 attributable hospital days. The Massachusetts classification had a sensitivity of 60.5% (519/858, 95% CI 57.2%, 63.8%) and specificity of 78.6% (623/793, 95% CI 75.7%, 81.4%) for COVID-19-related admissions, underestimating total number of hospital and ICU bed days while overestimating COVID-19-related intubations, ICU admissions, and deaths. CONCLUSION Half of SARS-CoV-2 hospitalizations were for COVID-19 during the Omicron wave. The CDC algorithm was more specific and sensitive than the Massachusetts classification, but underestimated the burden of COVID-19 admissions. TRIAL REGISTRATION Clinicaltrials.gov, NCT04702945.
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Affiliation(s)
- Corinne M. Hohl
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Emergency Department, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Amber Cragg
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Elizabeth Purssel
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Emergency Department, Surrey Memorial Hospital, Surrey, British Columbia, Canada
| | - Finlay A. McAlister
- Division of General Internal Medicine, University of Alberta, Edmonton, Alberta, Canada
- Alberta Strategy for Patient Oriented Research Support Unit, Edmonton, Alberta, Canada
| | - Daniel K. Ting
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Emergency Department, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Frank Scheuermeyer
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Emergency Department, St. Paul’s & Mount Saint Joseph Hospitals, Vancouver, British Columbia, Canada
| | - Maja Stachura
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Emergency Department, Lions Gate Hospital, North Vancouver, British Columbia, Canada
| | - Lars Grant
- Department of Emergency Medicine, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute for Medical Research, Montreal, Quebec, Canada
| | - John Taylor
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Josephine Kanu
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jeffrey P. Hau
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ivy Cheng
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Clare L. Atzema
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Rajan Bola
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Laurie J. Morrison
- Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Megan Landes
- Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- University Health Network, Toronto, Ontario, Canada
| | - Jeffrey J. Perry
- Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Rhonda J. Rosychuk
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
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19
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Ibrahim ST, Hammami N, Katapally TR. Traditional surveys versus ecological momentary assessments: Digital citizen science approaches to improve ethical physical activity surveillance among youth. PLOS Digit Health 2023; 2:e0000294. [PMID: 37756285 PMCID: PMC10529555 DOI: 10.1371/journal.pdig.0000294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/08/2023] [Indexed: 09/29/2023]
Abstract
The role of physical activity (PA) in minimizing non-communicable diseases is well established. Measurement bias can be reduced via ecological momentary assessments (EMAs) deployed via citizen-owned smartphones. This study aims to engage citizen scientists to understand how PA reported digitally by retrospective and prospective measures varies within the same cohort. This study used the digital citizen science approach to collaborate with citizen scientists, aged 13-21 years over eight consecutive days via a custom-built app. Citizen scientists were recruited through schools in Regina, Saskatchewan, Canada in 2018 (August 31-December 31). Retrospective PA was assessed through a survey, which was adapted from three validated PA surveys to suit smartphone-based data collection, and prospective PA was assessed through time-triggered EMAs deployed consecutively every day, from day 1 to day 8, including weekdays and weekends. Data analyses included paired t-tests to understand the difference in PA reported retrospectively and prospectively, and linear regressions to assess contextual and demographic factors associated with PA reported retrospectively and prospectively. Findings showed a significant difference between PA reported retrospectively and prospectively (p = 0.001). Ethnicity (visible minorities: β = - 0.911, 95% C.I. = -1.677, -0.146), parental education (university: β = 0.978, 95% C.I. = 0.308, 1.649), and strength training (at least one day: β = 0.932, 95% C.I. = 0.108, 1.755) were associated with PA reported prospectively. In contrast, the number of active friends (at least one friend: β = 0.741, 95% C.I. = 0.026, 1.458) was associated with retrospective PA. Physical inactivity is the fourth leading cause of mortality globally, which requires accurate monitoring to inform population health interventions. In this digital age, where ubiquitous devices provide real-time engagement capabilities, digital citizen science can transform how we measure behaviours using citizen-owned ubiquitous digital tools to support prevention and treatment of non-communicable diseases.
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Affiliation(s)
- Sheriff Tolulope Ibrahim
- DEPtH Lab, School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Nour Hammami
- Department of Child and Youth Studies, Trent University Durham, 55 Thornton Road South, Oshawa, Ontario, Canada
| | - Tarun Reddy Katapally
- DEPtH Lab, School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Children’s Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada
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20
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Lynds ME, Arnold CM. Fall Risk Screening and Assessment for People Living With Dementia: A Scoping Review. J Appl Gerontol 2023; 42:2025-2035. [PMID: 37078271 PMCID: PMC10466966 DOI: 10.1177/07334648231168983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 02/17/2023] [Accepted: 03/15/2023] [Indexed: 04/21/2023] Open
Abstract
Falls are the leading cause of injury and hospitalization for older adults in Canada and the second leading cause of unintentional injury deaths worldwide. For people living with dementia (PLWD), falls have an even greater impact, but the standard testing methods for fall risk screening and assessment are often not practical for this population. The purpose of this scoping review is to identify and summarize recent research, practice guidelines and gray literature which have considered fall risk screening and assessment for PLWD. Database search results revealed a dearth in the literature that can support researchers and healthcare providers when considering which option/s are the most suitable for PLWD. Further primary studies into the validity of using the various tests with PLWD are needed if researchers and healthcare providers are to be empowered via the literature and clinical practice guidelines to provide the best possible fall risk care for PLWD.
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Affiliation(s)
- Michaela E. Lynds
- School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Saskatoon, SK, CA
| | - Catherine M. Arnold
- School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Saskatoon, SK, CA
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21
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Zinck CB, Raveendram Thampy P, Uhlemann EME, Adam H, Wachter J, Suchan D, Cameron ADS, Rego ROM, Brisson D, Bouchard C, Ogden NH, Voordouw MJ. Variation among strains of Borrelia burgdorferi in host tissue abundance and lifetime transmission determine the population strain structure in nature. PLoS Pathog 2023; 19:e1011572. [PMID: 37607182 PMCID: PMC10473547 DOI: 10.1371/journal.ppat.1011572] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 09/01/2023] [Accepted: 07/23/2023] [Indexed: 08/24/2023] Open
Abstract
Pathogen life history theory assumes a positive relationship between pathogen load in host tissues and pathogen transmission. Empirical evidence for this relationship is surprisingly rare due to the difficulty of measuring transmission for many pathogens. The comparative method, where a common host is experimentally infected with a set of pathogen strains, is a powerful approach for investigating the relationships between pathogen load and transmission. The validity of such experimental estimates of strain-specific transmission is greatly enhanced if they can predict the pathogen population strain structure in nature. Borrelia burgdorferi is a multi-strain, tick-borne spirochete that causes Lyme disease in North America. This study used 11 field-collected strains of B. burgdorferi, a rodent host (Mus musculus, C3H/HeJ) and its tick vector (Ixodes scapularis) to determine the relationship between pathogen load in host tissues and lifetime host-to-tick transmission (HTT). Mice were experimentally infected via tick bite with 1 of 11 strains. Lifetime HTT was measured by infesting mice with I. scapularis larval ticks on 3 separate occasions. The prevalence and abundance of the strains in the mouse tissues and the ticks were determined by qPCR. We used published databases to obtain estimates of the frequencies of these strains in wild I. scapularis tick populations. Spirochete loads in ticks and lifetime HTT varied significantly among the 11 strains of B. burgdorferi. Strains with higher spirochete loads in the host tissues were more likely to infect feeding larval ticks, which molted into nymphal ticks that had a higher probability of B. burgdorferi infection (i.e., higher HTT). Our laboratory-based estimates of lifetime HTT were predictive of the frequencies of these strains in wild I. scapularis populations. For B. burgdorferi, the strains that establish high abundance in host tissues and that have high lifetime transmission are the strains that are most common in nature.
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Affiliation(s)
- Christopher B. Zinck
- Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Prasobh Raveendram Thampy
- Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Eva-Maria E. Uhlemann
- Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Hesham Adam
- Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Jenny Wachter
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Danae Suchan
- Institute for Microbial Systems and Society, Faculty of Science, University of Regina, Regina, Saskatchewan, Canada
- Department of Biology, University of Regina, Regina, Saskatchewan, Canada
| | - Andrew D. S. Cameron
- Institute for Microbial Systems and Society, Faculty of Science, University of Regina, Regina, Saskatchewan, Canada
- Department of Biology, University of Regina, Regina, Saskatchewan, Canada
| | - Ryan O. M. Rego
- Biology Centre, Institute of Parasitology, Czech Academy of Sciences, České Budějovice, Czech Republic
- Faculty of Science, University of South Bohemia, České Budějovice, Czech Republic
| | - Dustin Brisson
- Department of Biology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Catherine Bouchard
- Public Health Risk Sciences, National Microbiology Laboratory, Public Health Agency of Canada, St Hyacinthe, Quebec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de Médecine Vétérinaire, Université de Montréal, Montreal, Canada
| | - Nicholas H. Ogden
- Public Health Risk Sciences, National Microbiology Laboratory, Public Health Agency of Canada, St Hyacinthe, Quebec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de Médecine Vétérinaire, Université de Montréal, Montreal, Canada
- Centre de recherche en santé publique (CReSP), Université de Montréal, Montreal, QC, Canada
| | - Maarten J. Voordouw
- Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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22
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O'Brien J, Barbour-Tuck E, Xia L, Campbell K, Reimche E, Valiani S, Pikaluk R, Clunie M. Introducing Cardiac Enhanced Recovery After Surgery best practices in Saskatchewan. Can J Anaesth 2023; 70:1409-1410. [PMID: 37253859 PMCID: PMC10228880 DOI: 10.1007/s12630-023-02483-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 06/01/2023] Open
Affiliation(s)
- Jennifer O'Brien
- Provincial Department of Anesthesiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Erin Barbour-Tuck
- Provincial Department of Anesthesiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Lei Xia
- Provincial Department of Anesthesiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Kathy Campbell
- Provincial Department of Anesthesiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Eileen Reimche
- Saskatchewan Center for Patient Oriented Research, University of Saskatchewan, Saskatoon, SK, Canada
| | - Sabira Valiani
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Ryan Pikaluk
- Provincial Department of Anesthesiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Michelle Clunie
- Provincial Department of Anesthesiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
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23
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Sapkota RP, Valli E, Wilhelms A, Adlam K, Bourgeault L, Heron V, Dickerson K, Nugent M, Hadjistavropoulos HD. Patient-Oriented Research to Improve Internet-Delivered Cognitive Behavioural Therapy for People of Diverse Ethnocultural Groups in Routine Practice. Healthcare (Basel) 2023; 11:2135. [PMID: 37570375 PMCID: PMC10418375 DOI: 10.3390/healthcare11152135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
There has been limited research on improving Internet-delivered Cognitive Behavioural Therapy (ICBT) in routine online therapy clinics that serve people from diverse ethnocultural groups (PDEGs). This article describes a patient-oriented adaptation approach used to address this gap in research. A working group consisting of people with lived experience, community representatives, ICBT clinicians, managers, and researchers was formed. The working group examined archival feedback on ICBT from past patients who self-identified as being from diverse ethnocultural backgrounds (N = 278) and the results of interviews with current patients (N = 16), community representatives (N = 6), and clinicians (N = 3). The archival data and interviews revealed the majority of the patients reported being satisfied with and benefitting from ICBT. Suggestions for improvement were not related to the cognitive-behavioural model and techniques, but rather to making treatment materials more inclusive. Consequently, the ICBT adaptation focused on adding content related to cultural influences on mental health, addressing stigma, diversifying case stories, examples, and imagery, adding audiovisual introductions, and replacing English idioms with more descriptive language. Moreover, further training was offered to clinicians, and efforts were made to improve community outreach. This study demonstrates a process for using patient-oriented research to improve ICBT within routine care serving patients of diverse backgrounds.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Heather D. Hadjistavropoulos
- Online Therapy Unit, Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada; (R.P.S.); (E.V.); (A.W.); (K.A.); (L.B.); (V.H.); (K.D.); (M.N.)
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24
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Salimuddin S, Beshai S, Iskric A, Watson L. Framing Effects of Cognitive Behavioural Therapy for Depression on Perceptions of Believability, Acceptability, and Credibility. Int J Environ Res Public Health 2023; 20:6330. [PMID: 37510563 PMCID: PMC10379820 DOI: 10.3390/ijerph20146330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023]
Abstract
While CBT is an effective treatment for depression, uptake can be low. This is largely due to attitudinal barriers. Accordingly, the goals of the current investigation were to (a) tailor and develop persuasive psychoeducational materials to match dominant cultural beliefs about the causes of depression and (b) examine the effectiveness of tailored CBT descriptions in improving CBT perceptions. We examined the believability of CBT mechanisms by invoking commonly endorsed etiological models of depression and investigated whether tailoring CBT descriptions to match etiological beliefs about depression influences perceptions of CBT. Participants were recruited using TurkPrime. In Study 1, participants (n = 425) read a CBT description that was generic or framed to match an etiological model of depression (biological, stress/environmental, or relationship/interpersonal). The participants indicated believability of each model as adopted by CBT. In study 2, the participants (n = 449) selected what they believed was the most important cause of depression. Subsequently, the participants were randomised to receive either a CBT description tailored to their endorsed model or a generic CBT description, and they provided ratings for CBT's acceptability, credibility, and expectancy. In Study 1, the believability of biological CBT mechanisms was low across conditions, but participants reported greater believability when receiving a biological description than when receiving other mechanistic descriptions. Participants who received the stress- and relationship-focused descriptions did not rate the respective models as more believable than those who received a generic description. In study 2, there were no differences in the perceptions of acceptability, credibility and expectancy between participants who received a tailored description and those who received a generic description. Our findings suggest that CBT is believed to be a psychologically appropriate treatment; however, the believability of biological mechanisms is improved by presenting a biology-focused description.
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Affiliation(s)
- Saba Salimuddin
- Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada
| | - Shadi Beshai
- Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada
| | - Adam Iskric
- Department of Psychology, Hofstra University, Hempstead, NY 11549, USA
| | - Lisa Watson
- Faculty of Business, Athabasca University, Athabasca, AB T9S 3A3, Canada
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25
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Sekar S, Zhang Y, Miranzadeh Mahabadi H, Buettner B, Taghibiglou C. Low-Field Magnetic Stimulation Alleviates MPTP-Induced Alterations in Motor Function and Dopaminergic Neurons in Male Mice. Int J Mol Sci 2023; 24:10328. [PMID: 37373475 DOI: 10.3390/ijms241210328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/06/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
Recent studies show that repetitive transcranial magnetic stimulation (rTMS) improves cognitive and motor functions in patients with Parkinson's Disease (PD). Gamma rhythm low-field magnetic stimulation (LFMS) is a new non-invasive rTMS technique that generates diffused and low-intensity magnetic stimulation to the deep cortical and subcortical areas. To investigate the potential therapeutic effects of LFMS in PD, we subjected an experimental mouse model to LFMS (as an early treatment). We examined the LFMS effect on motor functions as well as neuronal and glial activities in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated male C57BL/6J mice. Mice received MPTP injection (30 mg/kg, i.p., once daily for 5 days) followed by LFMS treatment, 20 min each day for 7 days. LFMS treatment improved motor functions compared with the sham-treated MPTP mice. Further, LFMS significantly improved tyrosine hydroxylase (TH) and decreased glial fibrillary acidic protein (GFAP) levels in substantia nigra pars compacta (SNpc) and non-significantly in striatal (ST) regions. LFMS treatment improved neuronal nuclei (NeuN) levels in SNpc. Our findings suggest that early LFMS treatment improves neuronal survival and, in turn, motor functions in MPTP-treated mice. Further investigation is required to clearly define the molecular mechanisms by which LFMS improves motor and cognitive function in PD patients.
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Affiliation(s)
- Sathiya Sekar
- Department of Anatomy, Physiology, Pharmacology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Yanbo Zhang
- Department of Psychiatry, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Hajar Miranzadeh Mahabadi
- Department of Anatomy, Physiology, Pharmacology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Benson Buettner
- Department of Anatomy, Physiology, Pharmacology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Changiz Taghibiglou
- Department of Anatomy, Physiology, Pharmacology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
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26
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Suleman S, O'Brien JM, McIlduff C, Benson B, Labine N, Khan S, Tse T, Kawchuk J, Kapur P, Abramyk C, Reimche E, Valiani S. Understanding equitable and affirming communication moments and relationship milestones during the intensive care unit journey: findings from stage 1 of a design thinking project. Can J Anaesth 2023; 70:995-1007. [PMID: 37188836 PMCID: PMC10184968 DOI: 10.1007/s12630-023-02456-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/21/2022] [Accepted: 07/06/2022] [Indexed: 05/17/2023] Open
Abstract
PURPOSE Communication is vital to facilitate patient and family-centred care (PFCC) and to build trusting relationships between intensive care unit (ICU) health care providers, the patient, and their loved ones in the ICU. The focus of this investigation was to identify, define, and refine key moments of communication, connection, and relationship building in the ICU through a lens of Equity, Diversity, Decolonization, and Inclusion (EDDI) to encourage meaningful communication and development of trusting relationships. METHODS We conducted 13 journey mapping interviews with ICU health care providers, patients, and their loved ones as the first stage in a design thinking project. We used directed content analysis to identify intersections where principles of EDDI directly or indirectly impacted communication, relationships, and trust throughout the ICU journey. To serve diverse patients and their loved ones, accessibility, inclusivity, and cultural safety were foundational pillars of the design thinking project. RESULTS Thirteen ICU health care providers, patients, and their loved ones participated in journey mapping interviews. We defined and refined 16 communication moments and relationship milestones in the journey of a patient through the ICU (e.g., admission, crises, stabilization, discharge), and intersections where EDDI directly or indirectly impacted communication and connection during the ICU journey. CONCLUSION Our findings highlight that diverse intersectional identities impact communication moments and relationship milestones during an ICU journey. To fully embrace a paradigm of PFCC, consideration should be given to creating an affirming and safe space for patients and their loved ones in the ICU.
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Affiliation(s)
- Salima Suleman
- Speech Language Pathologist, Independent Research Consultant, Edmonton, AB, Canada
| | - Jennifer M O'Brien
- Department of Anesthesiology, Perioperative Medicine and Pain Management, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
| | - Cari McIlduff
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Brittany Benson
- Department of Anesthesiology, Perioperative Medicine and Pain Management, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Nicole Labine
- Department of Surgery, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Sahar Khan
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Tiffanie Tse
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Joann Kawchuk
- Department of Anesthesiology, Perioperative Medicine and Pain Management, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Puneet Kapur
- Department of Emergency Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Candace Abramyk
- Patient and Family Partners, Saskatchewan Center for Patient Oriented Research, Saskatoon, SK, Canada
| | - Eileen Reimche
- Patient and Family Partners, Saskatchewan Center for Patient Oriented Research, Saskatoon, SK, Canada
| | - Sabira Valiani
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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27
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Pandey M, Smith L, MacZek N, Tomkins A, Sasakamoose J. Indigenous birth support worker (IBSW) program evaluation: a qualitative analysis of program workers and clients' perspectives. BMC Pregnancy Childbirth 2023; 23:367. [PMID: 37259049 DOI: 10.1186/s12884-023-05695-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 05/10/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND The Indigenous Birth Support Worker (IBSW) Program provides Indigenous women with respectful, culturally safe, and trauma-informed care and supports women and families during labor and delivery. Located in the Jim Pattison Children's Hospital (JPCH) Maternal Care Centre in Saskatoon, Saskatchewan, Canada, the program served 1023 clients between December 2019 and January 2021. METHODS The study objective was to explore the perspectives of the IBSWs and program clients one year post-implementation. The research plan was developed in collaboration with the IBSW program director and manager, IBSWs, and partners from the First Nation and Métis Health departments within the health region. A focus group with four IBSWs and individual interviews with ten clients who received services were conducted using a qualitative research design. RESULTS Thematic analysis revealed that clients greatly appreciated and respected the IBSWs' cultural support and their compassionate, nonjudgmental, and safe care. IBSWs emphasized the importance of culturally safe and client-centered treatment, more effective pain management solutions, and that relationships with Elders and community healthcare personnel should be built and strengthened to improve pregnancy and postnatal care delivery. IBSWs desire to work with community healthcare providers to provide prenatal care and build relationships before delivery. IBSWs advocated for collaborative cooperation with community healthcare professionals and rural healthcare teams to enable a smooth care flow to and from communities. CONCLUSION The Indigenous Birth Support Worker (IBSW) Program provides safe and client-centred care to Indigenous women during pregnancy, labour, and postpartum, consistent with the six principles proposed by BC perinatal services. IBSWs advocate for and assist Indigenous women in obtaining quality healthcare, provide traditional and cultural support, and positively affect mental health. However, the evaluation has revealed that healthcare provider insensitivity towards Indigenous clients persists. There is a need for greater role clarity and collaboration with healthcare practitioners to ensure evidence-based healthcare of the highest standard. This requires a commitment to addressing systemic issues and implementing broader calls to action and justice proposed by the Truth and Reconciliation Commission Calls to Action, the Missing and Murdered Indigenous Women and Girls Calls for Justice, and the United Nations Declaration on the Rights of Indigenous Peoples. The IBSW program offers vital support to Indigenous women during childbirth, but it must be viewed in the context of ongoing colonialism and the need for reconciliation and decolonization, requiring genuine collaboration with Indigenous peoples.
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Affiliation(s)
- Mamata Pandey
- Research Department, Saskatchewan Health Authority, Regina, SK, S4S 0A5, Canada
| | - Leanne Smith
- Maternal and Child Incentive Care Unit, Jim Pattison Children's Hospital, Saskatchewan Health Authority, Saskatoon, SK, S7K 0M7, Canada
| | - Nicole MacZek
- Maternal and Child Incentive Care Unit, Jim Pattison Children's Hospital, Saskatchewan Health Authority, Saskatoon, SK, S7K 0M7, Canada
| | - Angela Tomkins
- Maternal and Child Incentive Care Unit, Jim Pattison Children's Hospital, Saskatchewan Health Authority, Saskatoon, SK, S7K 0M7, Canada
| | - JoLee Sasakamoose
- Faculty of Education, University of Regina, 3737 Wascana Parkway 380 Education Building Regina, Saskatoon, SK, S4S 0A2, Canada.
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28
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Leeies M, Rosychuk RJ, Ismath M, Xu K, Archambault P, Fok PT, Audet T, Jelic T, Hayward J, Daoust R, Chandra K, Davis P, Yan JW, Hau JP, Welsford M, Brooks SC, Hohl CM. Intubation practices and outcomes for patients with suspected or confirmed COVID-19: a national observational study by the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN). CAN J EMERG MED 2023; 25:335-343. [PMID: 37017802 PMCID: PMC10075161 DOI: 10.1007/s43678-023-00487-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 03/09/2023] [Indexed: 04/06/2023]
Abstract
OBJECTIVE Intubation practices changed during the COVID-19 pandemic to protect healthcare workers from transmission of disease. Our objectives were to describe intubation characteristics and outcomes for patients tested for SARS CoV-2 infection. We compared outcomes between patients testing SARS COV-2 positive with those testing negative. METHODS We conducted a health records review using the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN) registry. We included consecutive eligible patients who presented to one of 47 EDs across Canada between March 1, 2020 and June 20, 2021, were tested for SARS-CoV-2 and intubated in the ED. The primary outcome was the proportion of patients experiencing a post-intubation adverse event during the ED stay. Secondary outcomes included first-pass success, intubation practices, and hospital mortality. We used descriptive statistics to summarize variables with subgroup differences examined using t tests, z tests, or chi-squared tests where appropriate with 95% CIs. RESULTS Of 1720 patients with suspected COVID-19 who were intubated in the ED during the study period, 337 (19.6%) tested SARS-CoV-2 positive and 1383 (80.4%) SARS-CoV-2 negative. SARS-CoV-2 positive patients presented to hospital with lower oxygen levels than SARS-CoV-2 negative patients (mean pulse oximeter SaO2 86 vs 94%, p < 0.001). In total, 8.5% of patients experienced an adverse event post-intubation. More patients in the SARS-CoV-2 positive subgroup experienced post-intubation hypoxemia (4.5 vs 2.2%, p = 0.019). In-hospital mortality was greater for patients who experienced intubation-related adverse events (43.2 vs 33.2%, p = 0.018). There was no significant difference in adverse event-associated mortality by SARS-CoV-2 status. First-pass success was achieved in 92.4% of all intubations, with no difference by SARS-CoV-2 status. CONCLUSIONS During the COVID-19 pandemic, we observed a low risk of adverse events associated with intubation, even though hypoxemia was common in patients with confirmed SARS-CoV-2. We observed high rates of first-pass success and low rates of inability to intubate. The limited number of adverse events precluded multivariate adjustments. Study findings should reassure emergency medicine practitioners that system modifications made to intubation processes in response to the COVID-19 pandemic do not appear to be associated with worse outcomes compared to pre-COVID-19 practices.
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Affiliation(s)
- Murdoch Leeies
- Department of Emergency Medicine, University of Manitoba, Winnipeg, MB, Canada.
- Rady Faculty of Health Sciences, Section of Critical Care Medicine, University of Manitoba, Winnipeg, MB, Canada.
| | - Rhonda J Rosychuk
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Muzeen Ismath
- Department of Emergency Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Ke Xu
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Patrick Archambault
- Department of Family Medicine and Emergency Medicine and Department of Anesthesiology and Intensive Care, Université Laval, Québec, QC, Canada
| | - Patrick T Fok
- Department of Emergency Medicine, Dalhousie University, Halifax, NS, Canada
| | - Thomas Audet
- Department of Internal Medicine, Université Laval, Québec, QC, Canada
| | - Tomislav Jelic
- Department of Emergency Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Jake Hayward
- Department of Emergency Medicine, University of Alberta, Edmonton, AB, Canada
| | - Raoul Daoust
- Department of Family and Emergency Medicine, University of Montreal, Montreal, QC, Canada
| | - Kavish Chandra
- Department of Emergency Medicine, Dalhousie University, Saint John, NB, Canada
| | - Phil Davis
- Department of Emergency Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Justin W Yan
- Division of Emergency Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, Western University and Lawson Health Research Institute, London Health Sciences Centre, London, ON, Canada
| | - Jeffrey P Hau
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Michelle Welsford
- Division of Emergency Medicine, McMaster University, Hamilton, ON, Canada
| | - Steven C Brooks
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada
| | - Corinne M Hohl
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
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Gallant NL, Hadjistavropoulos T, Stopyn RJN, Feere EK. Integrating Technology Adoption Models Into Implementation Science Methodologies: A Mixed-Methods Preimplementation Study. Gerontologist 2023; 63:416-427. [PMID: 35810405 PMCID: PMC10028232 DOI: 10.1093/geront/gnac098] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Sustainable implementation of patient-oriented technologies in health care settings is challenging. Preimplementation studies guided by the Consolidated Framework for Implementation Research (CFIR) can provide opportunities to address barriers and leverage facilitators that can maximize the likelihood of successful implementation. When looking to implement patient-oriented technologies, preimplementation studies may also benefit from guidance from a conceptual framework specific to technology adoption such as the Unified Theory of Acceptance and Use of Technology. This study was, therefore, aimed at identifying determinants for the successful implementation of a patient-oriented technology (i.e., automated pain behavior monitoring [APBM] system) within a health care setting (i.e., long-term care [LTC] facility). RESEARCH DESIGN AND METHODS Using a mixed-methods study design, 164 LTC nurses completed a set of questionnaires and 68 LTC staff participated in individual interviews involving their perceptions of an APBM system in LTC environments. Quantitative data were analyzed using a series of mediation analyses and narrative responses were examined using directed content analysis. RESULTS Performance expectancy and effort expectancy partially and fully mediated the influence of implementation, readiness for organizational change, and technology readiness constructs on behavioral intentions to use the APBM system in LTC environments. Findings from the qualitative portion of this study provide guidance for the development of an intervention that is grounded in the CFIR. DISCUSSION AND IMPLICATIONS Based on our results, we offer recommendations for the implementation of patient-oriented technologies in health care settings.
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Affiliation(s)
- Natasha L Gallant
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
- Centre on Aging and Health, University of Regina, Regina, Saskatchewan, Canada
| | - Thomas Hadjistavropoulos
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
- Centre on Aging and Health, University of Regina, Regina, Saskatchewan, Canada
| | - Rhonda J N Stopyn
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
- Centre on Aging and Health, University of Regina, Regina, Saskatchewan, Canada
| | - Emma K Feere
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
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Jagoda E, Marnetto D, Senevirathne G, Gonzalez V, Baid K, Montinaro F, Richard D, Falzarano D, LeBlanc EV, Colpitts CC, Banerjee A, Pagani L, Capellini TD. Regulatory dissection of the severe COVID-19 risk locus introgressed by Neanderthals. eLife 2023; 12:e71235. [PMID: 36763080 PMCID: PMC9917435 DOI: 10.7554/elife.71235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 01/26/2023] [Indexed: 02/11/2023] Open
Abstract
Individuals infected with the SARS-CoV-2 virus present with a wide variety of symptoms ranging from asymptomatic to severe and even lethal outcomes. Past research has revealed a genetic haplotype on chromosome 3 that entered the human population via introgression from Neanderthals as the strongest genetic risk factor for the severe response to COVID-19. However, the specific variants along this introgressed haplotype that contribute to this risk and the biological mechanisms that are involved remain unclear. Here, we assess the variants present on the risk haplotype for their likelihood of driving the genetic predisposition to severe COVID-19 outcomes. We do this by first exploring their impact on the regulation of genes involved in COVID-19 infection using a variety of population genetics and functional genomics tools. We then perform a locus-specific massively parallel reporter assay to individually assess the regulatory potential of each allele on the haplotype in a multipotent immune-related cell line. We ultimately reduce the set of over 600 linked genetic variants to identify four introgressed alleles that are strong functional candidates for driving the association between this locus and severe COVID-19. Using reporter assays in the presence/absence of SARS-CoV-2, we find evidence that these variants respond to viral infection. These variants likely drive the locus' impact on severity by modulating the regulation of two critical chemokine receptor genes: CCR1 and CCR5. These alleles are ideal targets for future functional investigations into the interaction between host genomics and COVID-19 outcomes.
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Affiliation(s)
- Evelyn Jagoda
- Department of Human Evolutionary Biology, Harvard UniversityCambridgeUnited States
| | - Davide Marnetto
- Estonian Biocentre, Institute of Genomics, University of TartuTartuEstonia
| | - Gayani Senevirathne
- Department of Human Evolutionary Biology, Harvard UniversityCambridgeUnited States
| | - Victoria Gonzalez
- Department of Veterinary Microbiology, University of SaskatchewanSaskatoonCanada
- Vaccine and Infectious Disease Organization, University of SaskatchewanSaskatoonCanada
| | - Kaushal Baid
- Vaccine and Infectious Disease Organization, University of SaskatchewanSaskatoonCanada
| | - Francesco Montinaro
- Estonian Biocentre, Institute of Genomics, University of TartuTartuEstonia
- Department of Biology, University of BariBariItaly
| | - Daniel Richard
- Department of Human Evolutionary Biology, Harvard UniversityCambridgeUnited States
| | - Darryl Falzarano
- Department of Veterinary Microbiology, University of SaskatchewanSaskatoonCanada
- Vaccine and Infectious Disease Organization, University of SaskatchewanSaskatoonCanada
| | - Emmanuelle V LeBlanc
- Department of Biomedical and Molecular Sciences, Queen’s UniversityKingstonCanada
| | - Che C Colpitts
- Department of Biomedical and Molecular Sciences, Queen’s UniversityKingstonCanada
| | - Arinjay Banerjee
- Department of Veterinary Microbiology, University of SaskatchewanSaskatoonCanada
- Vaccine and Infectious Disease Organization, University of SaskatchewanSaskatoonCanada
- Department of Biology, University of WaterlooWaterlooCanada
- Department of Laboratory Medicine and Pathobiology, University of TorontoTorontoCanada
| | - Luca Pagani
- Estonian Biocentre, Institute of Genomics, University of TartuTartuEstonia
- Department of Biology, University of PadovaPadovaItaly
| | - Terence D Capellini
- Department of Human Evolutionary Biology, Harvard UniversityCambridgeUnited States
- Broad Institute of MIT and HarvardCambridgeUnited States
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Kosteniuk J, Osman BA, Osman M, Quail JM, Islam N, O'Connell ME, Kirk A, Stewart NJ, Morgan D. Health service use before and after dementia diagnosis: a retrospective matched case-control study. BMJ Open 2022; 12:e067363. [PMID: 36428015 PMCID: PMC9703329 DOI: 10.1136/bmjopen-2022-067363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES This study investigated patterns in health service usage among older adults with dementia and matched controls over a 10-year span from 5 years before until 5 years after diagnosis. DESIGN Population-based retrospective matched case-control study. SETTING Administrative health data of individuals in Saskatchewan, Canada from 1 April 2008 to 31 March 2019. PARTICIPANTS The study included 2024 adults aged 65 years and older living in the community at the time of dementia diagnosis from 1 April 2013 to 31 March 2014, matched 1:1 to individuals without a dementia diagnosis on age group, sex, rural versus urban residence, geographical region and comorbidity. OUTCOME MEASURES For each 5-year period before and after diagnosis, we examined usage of health services each year including family physician (FP) visits, specialist visits, hospital admissions, all-type prescription drug dispensations and short-term care admissions. We used negative binomial regression to estimate the effect of dementia on yearly average health service utilisation adjusting for sex, age group, rural versus urban residence, geographical region, 1 year prior health service use and comorbidity. RESULTS Adjusted findings demonstrated that 5 years before diagnosis, usage of all health services except hospitalisation was lower among persons with dementia than persons without dementia (all p<0.001). After this point, differences in higher health service usage among persons with dementia compared to without dementia were greatest in the year before and year after diagnosis. In the year before diagnosis, specialist visits were 59.7% higher (p<0.001) and hospitalisations 90.5% higher (p<0.001). In the year after diagnosis, FP visits were 70.0% higher (p<0.001) and all-type drug prescriptions 29.1% higher (p<0.001). CONCLUSIONS Findings suggest the year before and year after diagnosis offer multiple opportunities to implement quality supports. FPs are integral to dementia care and require effective resources to properly serve this population.
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Affiliation(s)
- Julie Kosteniuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Beliz Açan Osman
- Saskatchewan Health Quality Council, Saskatoon, Saskatchewan, Canada
| | - Meric Osman
- Saskatchewan Medical Association, Saskatoon, Saskatchewan, Canada
| | | | - Naorin Islam
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Andrew Kirk
- Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Norma J Stewart
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Debra Morgan
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Davis P, Rosychuk R, Hau JP, Cheng I, McRae AD, Daoust R, Lang E, Turner J, Khangura J, Fok PT, Stachura M, Brar B, Hohl CM. Diagnostic yield of screening for SARS-CoV-2 among patients admitted to hospital for alternate diagnoses: an observational cohort study. BMJ Open 2022; 12:e057852. [PMID: 35948378 PMCID: PMC9378945 DOI: 10.1136/bmjopen-2021-057852] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To determine the diagnostic yield of screening patients for SARS-CoV-2 who were admitted with a diagnosis unrelated to COVID-19 and to identify risk factors for positive tests. DESIGN Cohort from the Canadian COVID-19 Emergency Department Rapid Response Network registry. SETTING 30 acute care hospitals across Canada. PARTICIPANTS Patients hospitalised for non-COVID-19-related diagnoses who were tested for SARS-CoV-2 between 1 March and 29 December 2020. MAIN OUTCOME Positive nucleic acid amplification test for SARS-CoV-2. OUTCOME MEASURE Diagnostic yield. RESULTS We enrolled 15 690 consecutive eligible adults who were admitted to hospital without clinically suspected COVID-19. Among these patients, 122 tested positive for COVID-19, resulting in a diagnostic yield of 0.8% (95% CI 0.64% to 0.92%). Factors associated with a positive test included presence of fever, being a healthcare worker, having a positive household contact or institutional exposure, and living in an area with higher 7-day average incident COVID-19 cases. CONCLUSIONS Universal screening of hospitalised patients for COVID-19 across two pandemic waves had a low diagnostic yield and should be informed by individual-level risk assessment in addition to regional COVID-19 prevalence. TRIAL REGISTRATION NUMBER NCT04702945.
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Affiliation(s)
- Philip Davis
- Department of Emergency Medicine, University of Saskatchewan, Saskatchewan, Saskatoon, Canada
| | - Rhonda Rosychuk
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Jeffrey P Hau
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- Department of Emergency Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Ivy Cheng
- Department of Emergency Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Emergency Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | - Andrew D McRae
- Department of Emergency Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Raoul Daoust
- Département Médecine de Famille et Médecine d'Urgence, Université de Montréal, Montreal, Quebec, Canada
| | - Eddy Lang
- Department of Emergency Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Joel Turner
- Department of Emergency Medicine, McGill University, Montreal, Quebec, Canada
| | - Jaspreet Khangura
- Department of Emergency Medicine, Northeast Community Health Centre, Edmonton, Alberta, Canada
| | - Patrick T Fok
- Department of Emergency Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Maja Stachura
- Department of Emergency Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Baljeet Brar
- Department of Emergency Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Corinne M Hohl
- Department of Emergency Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
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Hill JE, Peña-Sánchez JN, Fernando C, Freitas AC, Withana Gamage N, Fowler S. Composition and Stability of the Vaginal Microbiota of Pregnant Women With Inflammatory Bowel Disease. Inflamm Bowel Dis 2022; 28:905-911. [PMID: 34919692 PMCID: PMC9165555 DOI: 10.1093/ibd/izab314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is common in women of childbearing years, and active IBD during pregnancy is associated with increased rates of preterm delivery and low-birth-weight newborns. Changes in the vaginal microbiome have been associated with preterm delivery. We aimed to determine the taxonomic composition of the vaginal microbiota at 3 time points during pregnancy in a population of women with IBD. METHODS Participants were recruited from the patient registry of the Preconception and Pregnancy IBD Clinic at Royal University Hospital in Saskatoon, Canada. Self-collected vaginal swabs were obtained from patients at each trimester. Microbiota profiles were created by cpn60 amplicon sequencing. RESULTS We characterized the vaginal microbiota of 32 pregnant participants with IBD (33 pregnancies) during each trimester. A total of 32 of 33 pregnancies resulted in a live birth with 43.8% (n = 14 of 32, 2 missing) by caesarean section; 2 of 32 were preterm. Microbiota compositions corresponded to previously described community state types, with most participants having microbiota dominated by Lactobacillus crispatus. In 25 of 29 participants in which samples were available for more than 1 time point, there was no change in the community state type over time. Prevalence of Mollicutes (Mycoplasma and/or Ureaplasma) was significantly higher in pregnant participants with IBD than in a previously profiled cohort of 172 pregnant women without IBD who delivered at term. CONCLUSIONS The vaginal microbiome of participants with IBD was stable throughout pregnancy. Prevalence of Mollicutes, which has been associated with preterm delivery, warrants further study in this patient group.
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Affiliation(s)
- Janet E Hill
- Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Juan-Nicolás Peña-Sánchez
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Champika Fernando
- Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Aline C Freitas
- Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Niradha Withana Gamage
- Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- Grain Research Laboratory, Canadian Grain Commission, Winnipeg, Manitoba, Canada
| | - Sharyle Fowler
- Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Pushie MJ, Messmer M, Sylvain NJ, Heppner J, Newton JM, Hou H, Hackett MJ, Kelly ME, Peeling L. Multimodal imaging of hemorrhagic transformation biomarkers in an ischemic stroke model. Metallomics 2022; 14:mfac007. [PMID: 35254441 PMCID: PMC9056027 DOI: 10.1093/mtomcs/mfac007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 01/04/2022] [Indexed: 11/13/2022]
Abstract
Hemorrhagic transformation of ischemic stroke has devastating consequences, with high mortality and poor functional outcomes. Animal models of ischemic stroke also demonstrate the potential for hemorrhagic transformation, which complicates biochemical characterization, treatment studies, and hinders poststroke functional outcomes in affected subjects. The incidence of hemorrhagic transformation of ischemic stroke in animal model research is not commonly reported. The postmortem brain of such cases presents a complex milieu of biomarkers due to the presence of healthy cells, regions of varying degrees of ischemia, dead and dying cells, dysregulated metabolites, and blood components (especially reactive Fe species released from lysed erythrocytes). To improve the characterization of hemorrhage biomarkers on an ischemic stroke background, we have employed a combination of histology, X-ray fluorescence imaging (XFI), and Fourier transform infrared (FTIR) spectroscopic imaging to assess 122 photothrombotic (ischemic) stroke brains. Rapid freezing preserves brain biomarkers in situ and minimizes metabolic artifacts due to postmortem ischemia. Analysis revealed that 25% of the photothrombotic models had clear signs of hemorrhagic transformation. The XFI and FTIR metabolites provided a quantitative method to differentiate key metabolic regions in these models. Across all hemorrhage cases, it was possible to consistently differentiate otherwise healthy tissue from other metabolically distinct regions, including the ischemic infarct, the ischemic penumbra, blood vessels, sites of hemorrhage, and a region surrounding the hemorrhage core that contained elevated lipid oxidation. Chemical speciation of deposited Fe demonstrates the presence of heme-Fe and accumulation of ferritin.
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Affiliation(s)
- M J Pushie
- Department of Surgery, Division of Neurosurgery, College of Medicine, University of Saskatchewan, SK S7N 5E5, Canada
| | - M Messmer
- Department of Surgery, Division of Neurosurgery, College of Medicine, University of Saskatchewan, SK S7N 5E5, Canada
| | - N J Sylvain
- Clinical Trial Support Unit, College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 0W8, Canada
| | - J Heppner
- Department of Surgery, Division of Neurosurgery, College of Medicine, University of Saskatchewan, SK S7N 5E5, Canada
| | - J M Newton
- Department of Surgery, Division of Neurosurgery, College of Medicine, University of Saskatchewan, SK S7N 5E5, Canada
| | - H Hou
- Department of Surgery, Division of Neurosurgery, College of Medicine, University of Saskatchewan, SK S7N 5E5, Canada
| | - M J Hackett
- Curtin Health Innovation Research Institute, Curtin University, Perth, WA 6102, AUS
- School of Molecular and Life Sciences, Curtin University, Perth, WA 6845, AUS
| | - M E Kelly
- Department of Surgery, Division of Neurosurgery, College of Medicine, University of Saskatchewan, SK S7N 5E5, Canada
| | - L Peeling
- Department of Surgery, Division of Neurosurgery, College of Medicine, University of Saskatchewan, SK S7N 5E5, Canada
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Peña-Sánchez JN, Osei JA, Marques Santos JD, Jennings D, Andkhoie M, Brass C, Bukassa-Kazadi G, Lu X, Johnson-Jennings M, Porter L, Porter R, Quintin CL, Sanderson R, Teucher U, Fowler S. Increasing Prevalence and Stable Incidence Rates of Inflammatory Bowel Disease Among First Nations: Population-Based Evidence From a Western Canadian Province. Inflamm Bowel Dis 2022; 28:514-522. [PMID: 34037223 PMCID: PMC8972279 DOI: 10.1093/ibd/izab096] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND There is limited to no evidence of the prevalence and incidence rates of inflammatory bowel disease (IBD) among Indigenous peoples. In partnership with Indigenous patients and family advocates, we aimed to estimate the prevalence, incidence, and trends over time of IBD among First Nations (FNs) since 1999 in the Western Canadian province of Saskatchewan. METHODS We conducted a retrospective population-based study linking provincial administrative health data from the 1999-2000 to 2016-2017 fiscal years. An IBD case definition requiring multiple health care contacts was used. The prevalence and incidence data were modeled using generalized linear models and a negative binomial distribution. Models considered the effect of age groups, sex, diagnosis type (ulcerative colitis [UC], Crohn disease [CD]), and fiscal years to estimate prevalence and incidence rates and trends over time. RESULTS The prevalence of IBD among FNs increased from 64/100,000 (95% confidence interval [CI], 62-66) in 1999-2000 to 142/100,000 (95% CI, 140-144) people in 2016-2017, with an annual average increase of 4.2% (95% CI, 3.2%-5.2%). Similarly, the prevalence of UC and CD, respectively, increased by 3.4% (95% CI, 2.3%-4.6%) and 4.1% (95% CI, 3.3%-4.9%) per year. In contrast, the incidence rates of IBD, UC, and CD among FNs depicted stable trends over time; no statistically significant changes were observed in the annual change trend tests. The ratio of UC to CD was 1.71. CONCLUSIONS We provided population-based evidence of the increasing prevalence and stable incidence rates of IBD among FNs. Further studies are needed in other regions to continue understanding the patterns of IBD among Indigenous peoples.
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Affiliation(s)
- Juan Nicolás Peña-Sánchez
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Jessica Amankwah Osei
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Jose Diego Marques Santos
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Derek Jennings
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Mustafa Andkhoie
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Germain Bukassa-Kazadi
- Health Surveillance and Assessment Unit Service, Department of Indigenous Services Canada, Regina, Saskatchewan, Canada
| | - Xinya Lu
- Saskatchewan Health Quality Council, Saskatoon, Saskatchewan, Canada
| | - Michelle Johnson-Jennings
- Department of Indigenous Studies, College of Arts and Science, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Rob Porter
- York Factory First Nation, Manitoba, Canada
| | - Carol-Lynne Quintin
- Crohn’s and Colitis Canada, Saskatchewan Chapter, Saskatoon, Saskatchewan, Canada
| | | | - Ulrich Teucher
- Department of Psychology, College of Arts and Science, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Sharyle Fowler
- Division of Gastroenterology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Katapally TR. Cannabis use and suicidal ideation among youth: Can we democratize school policies using digital citizen science? PLoS One 2022; 17:e0263533. [PMID: 35157726 PMCID: PMC8843173 DOI: 10.1371/journal.pone.0263533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/20/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND School policies and programs are important in preventing Cannabis use among youth. This study uses an innovative digital citizen science approach to determine the association between Cannabis use and suicidal ideation among youth while investigating how school health policies mediate this association. METHODS The study engaged 818 youth (aged 13-18 years) and 27 educators as citizen scientists via their own smartphones. Youths responded to time-triggered validated surveys and ecological momentary assessments to report on a complex set of health behaviours and outcomes. Similarly, educators' reported on substance misuse and mental health school policies and programs. Multivariable logistic regression modeling and mediation analyses were employed. RESULTS 412 youth provided data on substance misuse and suicidal ideation. Cannabis use and other factors such as bullying, other illicit drug use, and youth who identified as females or other gender were associated with increased suicidal ideation. However, school policies and programs for substance misuse prevention did not mediate the association between Cannabis use and suicidal ideation. CONCLUSIONS In the digital age, it is critical to reimagine the role of schools in health policy interventions. Digital citizen science not only provides an opportunity to democratize school policymaking and implementation processes, but also provides a voice to vulnerable youth.
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Affiliation(s)
- Tarun Reddy Katapally
- Faculty of Health Sciences, Western University, London, United Kingdom
- Johnson Shoyama Graduate School of Public Policy, University of Regina, Regina, Saskatchewan, Canada
- College of Medicine, Health Science Building, University of Saskatchewan, Saskatoon, Canada
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Halleran M, Chernoff A, Gordon JL. Fertility Knowledge Among Women Struggling to Conceive Without Medical Intervention: A Brief Report. Front Glob Womens Health 2022; 3:828052. [PMID: 35224546 PMCID: PMC8873180 DOI: 10.3389/fgwh.2022.828052] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionApproximately 1 in 6 women experience infertility. Though medical treatments for infertility exist, they are very costly and highly burdensome for women. It is therefore desirable to optimize women's chances of conception without medical intervention by ensuring that they have adequate knowledge of the female menstrual cycle and the timing of the fertile window. The current study therefore aimed to assess the degree to which women struggling to conceive without medical intervention are knowledgeable about these topics.MethodsOne hundred and two women of reproductive age (18–45 years old) in Canada and the United States who had been struggling to conceive without medical intervention for ≥12 months completed an online survey including a questionnaire assessing knowledge related to reproduction and fertility.ResultsMean accuracy score on the Fertility Knowledge Questionnaire was 67%. Seventy-two women were not aware that the week before ovulation was associated with the highest chances of conception. Women using cervical mucus tracking to increase chances of conception were more knowledgeable (p = 0.02), as were women with more formal education (p = 0.01). Conversely, women who had been attempting to conceive for longer had lower fertility knowledge (p = 0.03). Age, number of children, and family income were unrelated to fertility knowledge (p > 0.05).DiscussionOur findings suggest that women who are struggling to conceive would benefit from education related to the timing and identification of the fertile window. Reproductive and primary healthcare providers can play an important role in assessing fertility knowledge and addressing knowledge gaps to improve chances of successful conception.
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Stoliker BE, Kerodal AG, Jewell LM, Brown K, Kent-Wilkinson A, Peacock S, O'Connell ME, Wormith JS. Older people in custody in a forensic psychiatric facility, prevalence of dementia, and community reintegration needs: an exploratory analysis. Health Justice 2022; 10:3. [PMID: 35072844 PMCID: PMC8785542 DOI: 10.1186/s40352-022-00168-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 01/11/2022] [Indexed: 05/23/2023]
Abstract
BACKGROUND Across much of the developed world, the number of older people in custody has been increasing, which presents challenges for correctional systems due to the complex social, medical and mental health needs of this subgroup, especially those living with dementia. The present study therefore aimed to increase insight into the extent to which older people in custody are (a) potentially living with dementia and (b) receiving appropriate supports/services (particularly, with respect to community reintegration). RESULTS Cross-sectional data were drawn from a sample of 29 older people in custody and 20 correctional health care professionals at a regional forensic psychiatric hospital in a medium-sized Canadian city. In general, analyses revealed that: (a) scores from a modified version of the Community Screening Instrument for Dementia (CSI'D') suggest that 45% of older individuals screened positive for dementia; (b) 35% of Social Workers and 25% of Primary Nurses (i.e., RNs/RPNs) suspected that at least one older individual on their caseload has dementia, and there was adequate agreement between health staffs' perception of the presence or absence of dementia and the CSI'D' assessment; (c) varying supports/services may be required for older individuals' successful community reintegration and living; and (d) Social Workers and Primary Nurses generally lack training/education to adequately support older people in custody. CONCLUSIONS A substantial number of older people in custody may experience age-related challenges, including dementia. This necessitates the development and implementation of programming to effectively address older individuals' needs during incarceration and community reintegration and living.
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Affiliation(s)
- Bryce E Stoliker
- Centre for Forensic Behavioural Science and Justice Studies, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5A5, Canada.
| | - Ashmini G Kerodal
- Centre for Forensic Behavioural Science and Justice Studies, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5A5, Canada
| | - Lisa M Jewell
- Centre for Forensic Behavioural Science and Justice Studies, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5A5, Canada
| | - Kelsey Brown
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5A5, Canada
| | - Arlene Kent-Wilkinson
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5E5, Canada
| | - Shelley Peacock
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5E5, Canada
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5A5, Canada
| | - J Stephen Wormith
- Centre for Forensic Behavioural Science and Justice Studies, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5A5, Canada
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Olszynski P, Marshall RA, Olver TD, Oleniuk T, Auser C, Wilson T, Atkinson P, Woods R. Performance of an automated ultrasound device in identifying and tracing the heart in porcine cardiac arrest. Ultrasound J 2022; 14:1. [PMID: 34978635 PMCID: PMC8724362 DOI: 10.1186/s13089-021-00251-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/16/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND While intra-arrest echocardiography can be used to guide and monitor chest compression quality, it is not currently feasible on the scene of out-of-hospital cardiac arrests. Rapid and automated sonographic localization of the heart may provide first-responders guidance to an optimal area of compression without requiring them to interpret ultrasound images. In this proof-of-concept porcine study, we sought to describe the performance of an automated ultrasound device in correctly identifying and tracing the borders of the heart in three distinct states: pre-arrest, arrest, and late arrest. METHODS An automated ultrasound device (bladder scanner) was placed on the chests of 7 swine, along the left sternal border (4th-8th intercostal spaces). Scanner-generated images were recorded for each space during pre-arrest, arrest, and finally late arrest. 828 images of the LV and LV outflow tract were randomized and 150 (50/state) selected for analysis. Scanner tracings of the heart were then digitally obscured to facilitate tracing by expert reviewers who were blinded to the physiologic state. Reviewer tracings were compared to bladder scanner tracings; with concordance between these images determined via Sørensen-Dice index (SDI). RESULTS When compared to human reviewers, the bladder scanner was able to identify and trace the borders during cardiac arrest. The bladder scanner performed best at the time of arrest (SDI 0.900 ± 0.059). As resuscitation efforts continued and time from initial arrest increased, the scanner's performance decreased dramatically (SDI 0.597 ± 0.241 in late arrest). CONCLUSION An automated ultrasound device (bladder scanner) reliably traced porcine hearts during cardiac arrest. It is possible a device could be developed to indicate where compressions should be performed without requiring the operator to interpret ultrasound images. Further investigation into rapid, automated, sonographic localization of the heart to identify the area of compression in out-of-hospital cardiac arrest is warranted.
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Affiliation(s)
- Paul Olszynski
- Department of Emergency Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada.
| | - Rory A Marshall
- Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada
| | - T Dylan Olver
- Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Trevor Oleniuk
- College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Cameron Auser
- College of Arts and Sciences, University of Saskatchewan, Saskatoon, Canada
| | - Tracy Wilson
- Department of Emergency Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - Paul Atkinson
- Department of Emergency Medicine, Dalhousie, Saint John, Canada
| | - Rob Woods
- Department of Emergency Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
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Peña-Sánchez JN, Osei JA, Rohatinsky N, Lu X, Risling T, Boyd I, Wicks K, Wicks, M, Quintin CL, Dickson A, Fowler SA. OUP accepted manuscript. J Can Assoc Gastroenterol 2022; 6:55-63. [PMID: 37025513 PMCID: PMC10071297 DOI: 10.1093/jcag/gwac015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Rural dwellers with inflammatory bowel disease (IBD) face barriers to accessing specialized health services. We aimed to contrast health care utilization between rural and urban residents diagnosed with IBD in Saskatchewan, Canada. Methods We completed a population-based retrospective study from 1998/1999 to 2017/2018 using administrative health databases. A validated algorithm was used to identify incident IBD cases aged 18+. Rural/urban residence was assigned at IBD diagnosis. Outpatient (gastroenterology visits, lower endoscopies, and IBD medications claims) and inpatient (IBD-specific and IBD-related hospitalizations, and surgeries for IBD) outcomes were measured after IBD diagnosis. Cox proportional hazard, negative binomial, and logistic models were used to evaluate associations adjusting by sex, age, neighbourhood income quintile, and disease type. Hazard ratios (HR), incidence rate ratios (IRR), odds ratios (OR), and 95% confidence intervals (95% CI) were reported. Results From 5,173 incident IBD cases, 1,544 (29.8%) were living in rural Saskatchewan at IBD diagnosis. Compared to urban dwellers, rural residents had fewer gastroenterology visits (HR = 0.82, 95% CI: 0.77-0.88), were less likely to have a gastroenterologist as primary IBD care provider (OR = 0.60, 95% CI: 0.51-0.70), and had lower endoscopies rates (IRR = 0.92, 95% CI: 0.87-0.98) and more 5-aminosalicylic acid claims (HR = 1.10, 95% CI: 1.02-1.18). Rural residents had a higher risk and rates of IBD-specific (HR = 1.23, 95% CI: 1.13-1.34; IRR = 1.22, 95% CI: 1.09-1.37) and IBD-related (HR = 1.20, 95% CI: 1.11-1.31; IRR = 1.23, 95% CI: 1.10-1.37) hospitalizations than their urban counterparts. Conclusion We identified rural-urban disparities in IBD health care utilization that reflect rural-urban inequities in the access to IBD care. These inequities require attention to promote health care innovation and equitable management of patients with IBD living in rural areas.
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Affiliation(s)
- Juan Nicolás Peña-Sánchez
- Correspondence: Juan Nicolás Peña-Sánchez, MD, MPH, PhD, Room 3232—E-Wing Health Sciences, 104 Clinic Place, Saskatoon, SK S7N5E5, Canada, e-mail:
| | - Jessica Amankwah Osei
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Canada
| | | | - Xinya Lu
- Health Quality Council, Saskatchewan, Canada
| | | | | | | | | | | | | | - Sharyle A Fowler
- Department of Medicine, College of Medicine, University Saskatchewan, Canada
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Abdelrasoul A, Westphalen H, Saadati S, Shoker A. Hemodialysis biocompatibility mathematical models to predict the inflammatory biomarkers released in dialysis patients based on hemodialysis membrane characteristics and clinical practices. Sci Rep 2021; 11:23080. [PMID: 34845257 PMCID: PMC8630185 DOI: 10.1038/s41598-021-01660-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 10/20/2021] [Indexed: 02/07/2023] Open
Abstract
Chronic kidney disease affects millions of people around the globe and many patients rely on hemodialysis (HD) to survive. HD is associated with undesired life-threatening side effects that are linked to membrane biocompatibility and clinical operating conditions. The present study develops a mathematical model to predict the inflammatory biomarkers released in HD patients based on membrane morphology, chemistry, and interaction affinity. Based on the morphological characteristics of two clinical-grade HD membrane modules (CTA and PAES-PVP) commonly used in Canadian hospitals, a molecular docking study, and the release of inflammatory cytokines during HD and in vitro incubation experiments, we develop five sets of equations that describe the concentration of eight biomarkers (serpin/antithrombin-III, properdin, C5a, 1L-1α, 1L-1β, C5b-9, IL6, vWF). The equations developed are functions of membrane properties (pore size, roughness, chemical composition, affinity to fibrinogen, and surface charge) and HD operating conditions (blood flow rate, Qb, and treatment time, t). We expand our model based on available clinical data and increase its range of applicability in terms of flow rate and treatment time. We also modify the original equations to expand their range of applicability in terms of membrane materials, allowing the prediction and validation of the inflammatory response of several clinical and synthesized membrane materials. Our affinity-based model solely relies on theoretical values of molecular docking, which can significantly reduce the experimental load related to the development of more biocompatible materials. Our model predictions agree with experimental clinical data and can guide the development of novel materials and support evidence-based membrane synthesis of HD membranes, reducing the need for trial-and-error approaches.
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Affiliation(s)
- Amira Abdelrasoul
- Department of Chemical and Biological Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada.
- Division of Biomedical Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada.
| | - Heloisa Westphalen
- Department of Chemical and Biological Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada
| | - Shaghayegh Saadati
- Department of Chemical and Biological Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada
- Division of Biomedical Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada
| | - Ahmed Shoker
- Nephrology Division, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK, S7N 5E5, Canada
- Saskatchewan Transplant Program, St. Paul's Hospital, 1702 20th Street West, Saskatoon, SK, S7M 0Z9, Canada
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Abstract
OBJECTIVES An estimated 30%-40% of women attending infertility tertiary care facilities experience clinically significant depression and anxiety. However, current psychological interventions for infertility are only modestly effective in this population. In this study, we aimed to identify the specific psychological components of infertility-related distress to assist in the development of a more targeted and effective therapeutic intervention. To our knowledge, this study is the first of its kind to include the views and opinions of mental health professionals who specialise in the field of infertility and the first to explore therapies currently used by mental health professionals. DESIGN A qualitative approach using semistructured individual interviews and focus group interviews with women who have experience with infertility and also mental health professionals specialising in the field of infertility. Thematic analysis was used to identify patterns and themes emerging from the data. PARTICIPANTS Twenty-one women (aged 25-41 years) struggling to conceive for ≥12 months and 14 mental health professionals participated in semistructured interviews about the psychological challenges related to infertility. RESULTS Five themes, each divided into subthemes, emerged from the data and these were developed into a model of infertility-related distress. These five themes are: (1) anxiety, (2) mood disturbance, (3) threat to self-esteem, identity and purpose, (4) deterioration of the couple and (5) weakened support network. In addition, therapeutic techniques used by mental health professionals were identified. CONCLUSIONS The results of this study suggest specific clinical targets that future interventions treating infertility-related distress should address.
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Affiliation(s)
- Loveness Dube
- Department of Psychology, University of Regina Faculty of Arts, Regina, Saskatchewan, Canada
| | - Nokuthula Nkosi-Mafutha
- Department of Nursing Education, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa
| | - Ashley A Balsom
- Department of Psychology, University of Regina Faculty of Arts, Regina, Saskatchewan, Canada
| | - Jennifer L Gordon
- Department of Psychology, University of Regina Faculty of Arts, Regina, Saskatchewan, Canada
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Bregnard C, Rais O, Herrmann C, Kahl O, Brugger K, Voordouw MJ. Beech tree masting explains the inter-annual variation in the fall and spring peaks of Ixodes ricinus ticks with different time lags. Parasit Vectors 2021; 14:570. [PMID: 34749794 PMCID: PMC8577035 DOI: 10.1186/s13071-021-05076-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 10/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The tick Ixodes ricinus is an important vector of tick-borne diseases including Lyme borreliosis. In continental Europe, the nymphal stage of I. ricinus often has a bimodal phenology with a large spring peak and a smaller fall peak. There is consensus about the origin of the spring nymphal peak, but there are two alternative hypotheses for the fall nymphal peak. In the direct development hypothesis, larvae quest as nymphs in the fall of the same year that they obtained their larval blood meal. In the developmental diapause hypothesis, larvae overwinter in the engorged state and quest as nymphs one year after they obtained their larval blood meal. These two hypotheses make different predictions about the time lags that separate the larval blood meal and the density of questing nymphs (DON) in the spring and fall. METHODS Inter-annual variation in seed production (masting) by deciduous trees is a time-lagged index for the density of vertebrate hosts (e.g., rodents) which provide blood meals for larval ticks. We used a long-term data set on the masting of the European beech tree and a 15-year study on the DON at 4 different elevation sites in western Switzerland to differentiate between the two alternative hypotheses for the origin of the fall nymphal peak. RESULTS Questing I. ricinus nymphs had a bimodal phenology at the three lower elevation sites, but a unimodal phenology at the top elevation site. At the lower elevation sites, the DON in the fall was strongly correlated with the DON in the spring of the following year. The inter-annual variation in the densities of I. ricinus nymphs in the fall and spring was best explained by a 1-year versus a 2-year time lag with the beech tree masting index. Fall nymphs had higher fat content than spring nymphs indicating that they were younger. All these observations are consistent with the direct development hypothesis for the fall peak of I. ricinus nymphs at our study site. Our study provides new insight into the complex bimodal phenology of this important disease vector. CONCLUSIONS Public health officials in Europe should be aware that following a strong mast year, the DON will increase 1 year later in the fall and 2 years later in the spring. Studies of I. ricinus populations with a bimodal phenology should consider that the spring and fall peak in the same calendar year represent different generations of ticks.
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Affiliation(s)
- Cindy Bregnard
- Laboratory of Ecology and Evolution of Parasites, Institute of Biology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Olivier Rais
- Laboratory of Ecology and Epidemiology of Parasites, Institute of Biology, University of Neuchâtel, Neuchâtel, Switzerland
- Laboratory of Eco-Epidemiology of Parasites, Institute of Biology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Coralie Herrmann
- Laboratory of Eco-Epidemiology of Parasites, Institute of Biology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Olaf Kahl
- tick-radar GmbH, 10555 Berlin, Germany
| | - Katharina Brugger
- Unit for Veterinary Public Health and Epidemiology, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210 Vienna, Austria
| | - Maarten J. Voordouw
- Laboratory of Ecology and Evolution of Parasites, Institute of Biology, University of Neuchâtel, Neuchâtel, Switzerland
- Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada
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Kokokyi S, Klest B, Anstey H. A patient-oriented research approach to assessing patients' and primary care physicians' opinions on trauma-informed care. PLoS One 2021; 16:e0254266. [PMID: 34242358 PMCID: PMC8270182 DOI: 10.1371/journal.pone.0254266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 06/24/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To gather patients' and primary care physicians' (PCP) opinions on trauma-informed Care (TIC) and to investigate the acceptability of recommendations developed by patient, family, and physician advisors. DESIGN Cross-sectional research survey design and patient engagement. SETTING Canada, 2017 to 2019. PARTICIPANTS English-speaking adults and licensed PCPs residing in Canada. MAIN OUTCOME MEASURES Participants were given a series of questionnaires including a list of physician actions and a list of recommendations consistent with TIC. RESULTS Patients and PCPs viewed TIC as important. Both patients and PCPs rated the following recommendations as helpful and likely to positively impact patient care: physician training, online trauma resource centres, information pamphlets, the ability to extend appointment times, and clinical pathways for responding to trauma. PCPs' responses were significantly more positive than patients' responses. CONCLUSION TIC is important to patients and PCPs. Patients and PCPs believe changes to physician training, patient engagement, and systemic factors would be helpful and likely to positively impact patient care. Future research needs to be conducted to investigate whether these recommendations improve patient care.
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Affiliation(s)
- Seint Kokokyi
- Department of Clinical Health Psychology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Bridget Klest
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Hannah Anstey
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
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Abstract
BACKGROUND The incidence of Lyme borreliosis and other tick-borne diseases is increasing in Europe and North America. There is currently much interest in identifying the ecological factors that determine the density of infected ticks as this variable determines the risk of Lyme borreliosis to vertebrate hosts, including humans. Lyme borreliosis is caused by the bacterium Borrelia burgdorferi sensu lato (s.l.) and in western Europe, the hard tick Ixodes ricinus is the most important vector. METHODS Over a 15-year period (2004-2018), we monitored the monthly abundance of I. ricinus ticks (nymphs and adults) and their B. burgdorferi s.l. infection status at four different elevations on a mountain in western Switzerland. We collected climate variables in the field and from nearby weather stations. We obtained data on beech tree seed production (masting) from the literature, as the abundance of Ixodes nymphs can increase dramatically 2 years after a masting event. We used generalized linear mixed effects models and AIC-based model selection to identify the ecological factors that influence inter-annual variation in the nymphal infection prevalence (NIP) and the density of infected nymphs (DIN). RESULTS We found that the NIP decreased by 78% over the study period. Inter-annual variation in the NIP was explained by the mean precipitation in the present year, and the duration that the DNA extraction was stored in the freezer prior to pathogen detection. The DIN decreased over the study period at all four elevation sites, and the decrease was significant at the top elevation. Inter-annual variation in the DIN was best explained by elevation site, year, beech tree masting index 2 years prior and the mean relative humidity in the present year. This is the first study in Europe to demonstrate that seed production by deciduous trees influences the density of nymphs infected with B. burgdorferi s.l. and hence the risk of Lyme borreliosis. CONCLUSIONS Public health officials in Europe should be aware that masting by deciduous trees is an important predictor of the risk of Lyme borreliosis.
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Affiliation(s)
- Cindy Bregnard
- Laboratory of Ecology and Evolution of Parasites, Institute of Biology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Olivier Rais
- Laboratory of Ecology and Epidemiology of Parasites, Institute of Biology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Maarten Jeroen Voordouw
- Laboratory of Ecology and Evolution of Parasites, Institute of Biology, University of Neuchâtel, Neuchâtel, Switzerland
- Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada
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Granadillo Rodríguez M, Flath B, Chelico L. The interesting relationship between APOBEC3 deoxycytidine deaminases and cancer: a long road ahead. Open Biol 2020; 10:200188. [PMID: 33292100 PMCID: PMC7776566 DOI: 10.1098/rsob.200188] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/26/2020] [Indexed: 12/24/2022] Open
Abstract
Cancer is considered a group of diseases characterized by uncontrolled growth and spread of abnormal cells and is propelled by somatic mutations. Apolipoprotein B mRNA-editing enzyme catalytic polypeptide-like 3 (APOBEC3) family of enzymes are endogenous sources of somatic mutations found in multiple human cancers. While these enzymes normally act as an intrinsic immune defence against viruses, they can also catalyse 'off-target' cytidine deamination in genomic single-stranded DNA intermediates. The deamination of cytosine forms uracil, which is promutagenic in DNA. Key factors to trigger the APOBEC 'off-target' activity are overexpression in a non-normal cell type, nuclear localization and replication stress. The resulting uracil-induced mutations contribute to genomic variation, which may result in neutral, beneficial or harmful consequences for the cancer. This review summarizes the functional and biochemical basis of the APOBEC3 enzyme activity and highlights their relationship with the most well-studied cancers in this particular context such as breast, lung, bladder, and human papillomavirus-associated cancers. We focus on APOBEC3A, APOBEC3B and APOBEC3H haplotype I because they are the leading candidates as sources of somatic mutations in these and other cancers. Also, we discuss the prognostic value of the APOBEC3 expression in drug resistance and response to therapies.
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Affiliation(s)
| | | | - Linda Chelico
- Department of Microbiology and Immunology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Saadati S, Eduok U, Abdelrasoul A, Shoker A. A surface-enhanced Raman scattering-based approach for rapid and highly sensitive quantitative analysis of 3-carboxy-4-methyl-5-propyl-2-furanpropionate and indole-3-acetic acid in saline, human serum and uremic serum of patients with chronic kidney disease. RSC Adv 2020; 10:43489-43496. [PMID: 35519726 PMCID: PMC9058093 DOI: 10.1039/d0ra06123a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/08/2020] [Indexed: 12/12/2022] Open
Abstract
3-Carboxy-4-methyl-5-propyl-2-furanpropionate (CMPF) and indole-3-acetic acid (IAA) are critical protein-bound uremic toxins that occur during chronic kidney disease (CKD). This study offers the first reported instance of surface-enhanced Raman scattering (SERS) coupled with an Au nanoparticle substrate for the simple quantification of CMPF and IAA in human serum samples. The detection limits of the CMPF and IAA analysis were estimated to be 0.04 nM (S/N = 3) and 0.05 μM (S/N = 3), respectively. The results demonstrate that the SERS technique is fast-acting and highly sensitive when it comes to the simultaneous and individual quantitative detection of CMPF and IAA in biological samples. We believe that this analytical tool could serve as a very useful method for practical applications during the analysis of CMPF and IAA in the serum and urine of patients at all stages of CKD and of healthy volunteers as well as in various reservoirs.
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Affiliation(s)
- Shaghayegh Saadati
- Department of Chemical and Biological Engineering, University of Saskatchewan 57 Campus Drive Saskatoon Saskatchewan S7N 5A9 Canada +306 966 4777 +306 966 2946
- Division of Biomedical Engineering, University of Saskatchewan 57 Campus Drive Saskatoon Saskatchewan S7N 5A9 Canada
| | - Ubong Eduok
- Department of Chemical and Biological Engineering, University of Saskatchewan 57 Campus Drive Saskatoon Saskatchewan S7N 5A9 Canada +306 966 4777 +306 966 2946
| | - Amira Abdelrasoul
- Department of Chemical and Biological Engineering, University of Saskatchewan 57 Campus Drive Saskatoon Saskatchewan S7N 5A9 Canada +306 966 4777 +306 966 2946
- Division of Biomedical Engineering, University of Saskatchewan 57 Campus Drive Saskatoon Saskatchewan S7N 5A9 Canada
| | - Ahmed Shoker
- Nephrology Division, College of Medicine, University of Saskatchewan 107 Wiggins Rd Saskatoon SK S7N 5E5 Canada
- Saskatchewan Transplant Programn, St. Paul's Hospital 1702 20th Street West Saskatoon Saskatchewan S7M 0Z9 Canada
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Abstract
Purpose To examine the psychological impact of fertility treatment suspensions resulting from the COVID-19 pandemic and to clarify psychosocial predictors of better or worse mental health. Methods 92 women from Canada and the United States (ages 20–45 years) whose fertility treatments had been cancelled were recruited via social media. Participants completed a battery of questionnaires assessing depressive symptoms, perceived mental health impact, and change in quality of life related to treatment suspensions. Potential predictors of psychological outcomes were also examined, including several personality traits, aspects of social support, illness cognitions, and coping strategies. Results 52% of respondents endorsed clinical levels of depressive symptoms. On a 7-point scale, participants endorsed a significant decline in overall quality of life (M(SD) = -1.3(1.3), p < .0001) as well as a significant decline in mental health related to treatment suspensions on a scale from -5 to +5 (M(SD) = -2.1(2.1), p < .001). Several psychosocial variables were found to positively influence these outcomes: lower levels of defensive pessimism (r = -.25, p < .05), greater infertility acceptance (r = .51, p < .0001), better quality social support (r = .31, p < .01), more social support seeking (r = .35, p < .001) and less avoidance of infertility reminders (r = -.23, p = .029). Conclusion Fertility treatment suspensions have had a considerable negative impact on women’s mental health and quality of life. However, these findings point to several protective psychosocial factors that can be fostered in the future to help women cope.
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Affiliation(s)
- Jennifer L. Gordon
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
- * E-mail:
| | - Ashley A. Balsom
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
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Bright K, Dube L, Hayden KA, Gordon JL. Effectiveness of psychological interventions on mental health, quality of life and relationship satisfaction for individuals and/or couples undergoing fertility treatment: a systematic review and meta-analysis protocol. BMJ Open 2020; 10:e036030. [PMID: 32690514 PMCID: PMC7371139 DOI: 10.1136/bmjopen-2019-036030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/17/2020] [Accepted: 05/14/2020] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Infertility is a global public health problem affecting men, women and couples worldwide. The medical implications of infertility are often of primary focus in healthcare settings, but the experience of infertility also has a considerable social, emotional and psychological impact. Interventions aimed at alleviating psychological symptoms in individual and/or couples undergoing fertility treatment requires a systematic and comprehensive review of the literature to determine the efficacy of psychological interventions. The objective of this review is to evaluate the effectiveness, feasibility and acceptability of psychological interventions for individuals and/or couples seeking fertility to treat anxiety, depression, distress, quality of life and relationship satisfaction, as well as improve pregnancy rates. METHODS AND ANALYSIS The search strategy will involve 11 databases, including MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily (Ovid), EMBASE (Ovid), PsycINFO (Ovid), Cochrane Central Register of Controlled Trials (OVID), The Cumulative Index to Nursing and Allied Health Literature (CINAHL) with Full Text (EBSCO), Social Work Abstracts (EBSCO), SocINDEX with Full Text (EBSCO), Academic Search Complete (EBSCO), Family & Society Studies Worldwide (EBSCO), Family Studies Abstracts (EBSCO) and Scopus. These databases will be searched from their inception to September 2019. Independent reviewers will search peer-reviewed published studies through electronic databases and additional sources, will extract the data and assess the methodological quality. Random-effects meta-analysis will be carried out by calculating effect sizes as Cohen's d indices. Heterogeneity will be examined by the I2 and the Q statistics. ETHICS AND DISSEMINATION The current review does not require ethics approval. The results will be disseminated through publications in peer-reviewed journals. PROSPERO REGISTRATION NUMBER CRD42019133757.
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Affiliation(s)
- Katherine Bright
- Department of Nursing, University of Calgary, Calgary, Alberta, Canada
- Department of Outpatient Psychiatry, Alberta Health Services, Calgary, Alberta, Canada
| | - Loveness Dube
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - K Alix Hayden
- Department of Libraries and Cultural Resources, University of Calgary, Calgary, Alberta, Canada
| | - Jennifer L Gordon
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
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Abstract
OBJECTIVES The purpose of this study was to develop a replicable methodology of mobile ecological momentary assessments (EMAs) to capture prospective physical activity (PA) within free-living social and physical contexts by leveraging citizen-owned smartphones running on both Android and iOS systems. DESIGN Data were obtained from the cross-sectional pilots of the SMART Platform, a citizen science and mobile health initiative. SETTING The cities of Regina and Saskatoon, Canada. PARTICIPANTS 538 citizen scientists (≥18 years) provided PA data during eight consecutive days using a custom-built smartphone application, and after applying a rigid inclusion criteria, 89 were included in the final analysis. OUTCOME MEASURES EMAs enabled reporting of light, moderate, and vigorous PA, as well as physical and social contexts of PA. Retrospective PA was reported using International Physical Activity Questionnaire (IPAQ). For both measures, PA intensities were categorised into mean minutes of light and moderate-to-vigorous PA per day. Wilcoxon signed ranks tests and Spearman correlation procedures were conducted to compare PA intensities reported via EMAs and IPAQ. RESULTS Using EMAs, citizen scientists reported 140.91, 87.16 and 70.38 mean min/day of overall, light and moderate-to-vigorous PA, respectively, whereas using IPAQ they reported 194.39, 116.99 and 98.42 mean min/day of overall, light and moderate-to-vigorous PA, respectively. Overall (ρ=0.414, p<0.001), light (ρ=0.261, p=0.012) and moderate-to-vigorous PA (ρ=0.316, p=0.009) were fairly correlated between EMA and IPAQ. In comparison with EMAs, using IPAQ, citizen scientists reported significantly greater overall PA in active transportation (p=0.002) and recreation, sport and leisure-time domains (p=0.003). CONCLUSIONS This digital epidemiological and citizen science methodology adapted mobile EMAs to capture not only prospective PA, but also important physical and social contexts within which individuals accumulate PA. Ubiquitous tools can be leveraged via citizen science to capture accurate active living patterns of large populations in free-living conditions through innovative EMAs.
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Affiliation(s)
- Tarun Reddy Katapally
- Johnson Shoyama Graduate School of Public Policy, University of Regina, Regina, Saskatchewan, Canada
- Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Luan Manh Chu
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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