Effectiveness of adjunctive, personalised psychosocial intervention for non-response to opioid agonist treatment: Study protocol for a pragmatic randomised controlled trial.

Introduction: Opioid use disorder (OUD) is a debilitating and relapsing psychiatric disorder; opioid agonist therapy (OAT) is the front-line, evidence-supported treatment. A substantial number of patients relapse or continue to use heroin or other illicit drugs during OAT. There is considerable heterogeneity in the OAT-resistant sub-population, with many behavioural moderators of treatment response.

Canadian Triage and Acuity Scale: testing the mental health categories.

Purpose: The study tested the inter-rater reliability and accuracy of triage nurses' assignment of urgency ratings for mental health patient scenarios based on the 2008 Canadian Triage and Acuity Scale (CTAS) guidelines, using a standardized triage tool. The influence of triage experience, educational preparation, and comfort level with mental health presentations on the accuracy of urgency ratings was also explored.

Methods: Study participants assigned urgency ratings to 20 mental health patient scenarios in randomized order using the CTAS.

Reducing uncertainty in triaging mental health presentations: examining triage decision-making.

Little is known about how emergency department (ED) nurses make decisions and even less is known about triage nurses' decision-making. There is compelling motivation to better understand the processes by which triage nurses make decisions, particularly with complex patient populations such as those with frequently emotive mental health and illness issues. While accuracy and reliability of triage decisions generally have been improved through the introduction of standardised triage scales and instruments, other factors such as lack of knowledge or confidence related to mental health issues, past experiences that may elicit transference and countertransference, judgments about individuals based on their behavioural presentations may impact on decisions made at triage.

Cholesterol screening in an at-risk pediatric population.

Elevation of low-density lipoprotein (LDL) cholesterol is a recognized risk factor for premature atherosclerosis and such elevations have their antecedents in the pediatric population. This study evaluated the frequency of elevated LDL cholesterol in children and adolescents (8-18 years) in whom one parent had a history of premature ischemic heart disease (<55 years). Patients had a fasting lipid profile performed and results were classified as normal, borderline/high, or high in accordance with the American Academy of Pediatrics (AAP) guidelines.

Education to improve the triage of mental health patients in general hospital emergency departments.

General hospital emergency departments (EDs) are obvious places for individuals in distress or in a mental health crisis to seek assistance. However, triage nurses admit to a lack of expertise and confidence in psychiatric assessment which can result in less accurate assessments than for medical or trauma presentations. The objectives of a collaborative project between an Adult Mental Health Program and an Adult Emergency Program in a Canadian regional health authority were to: provide education and training to triage nurses regarding mental health and illness; monitor the transit of mental health patients through the ED; monitor wait times; and determine the adequacy of the Canadian Triage Acuity and Assessment Scale in the triage of psychiatric presentations.