Community acquired pressure injuries in a work-related spinal cord injury population: Problem characterization and assessment of a working solution.

Background: To characterize the problem of community-acquired pressure injuries (CAPIs) in a work-related spinal cord injury (SCI) population in Canada and assess the benefits of a person-centered solution. Characterization of the problem and a solution, albeit in an insured Worker's Compensation Board of British Columbia (WorkSafeBC) cohort, may inform the supply of solutions in the larger SCI population with disparate access to healthcare.

Methods: For this observational study, data on 244 WorkSafeBC clients, who received an intervention featuring pressure injury (PI) assessment between 2011 and 2015, were used to characterize the problem.

Burnout in the emergency department: Randomized controlled trial of an attention-based training program.

Background: Burnout (encompassing emotional exhaustion, depersonalization and personal accomplishment) in healthcare professionals is a major issue worldwide. Emergency medicine physicians are particularly affected, potentially impacting on quality of care and attrition from the specialty.

Objective: The aim of this study was to apply an attention-based training (ABT) program to reduce burnout among emergency multidisciplinary team (MDT) members from a large urban hospital.

Mantra meditation programme for emergency department staff: a qualitative study.

Objectives: Rates of burnout and stress in healthcare practitioners are steadily increasing. Emergency department (ED) staff are particularly susceptible to such poor outcomes. Mantra meditation (MM) may contribute to increased well-being.

Significant gynecological bleeding in women with low von Willebrand factor levels.

Gynecological bleeding is frequently reported in women with von Willebrand disease (VWD). Low von Willebrand factor (VWF) may be associated with significant bleeding phenotype despite only mild plasma VWF reductions. The contribution of gynecological bleeding to this phenotype has yet to be described.

Relating Bryophyte Assemblages to a Remotely Sensed Depth-to-Water Index in Boreal Forests.

Given the habitat moisture (air humidity or soil moisture) preferences of many forest bryophytes, we explored whether the depth-to-water (DTW) index, derived from remotely sensed Light Detection and Ranging (LiDAR) data, was related to fine-scale patterns of spatial variation in bryophyte abundance, diversity, and composition. The goal was to assess the utility of the topographic DTW index as a tool to decipher trends in bryophyte assemblages along a site wetness gradient in the boreal mixedwood forest. Discrete Airborne Laser Scanning (ALS) data were acquired over the entire Ecosystem Management Emulating Natural Disturbance (EMEND) experimental site located in northwestern Alberta, Canada (56° 46' 13″ N, 118° 22' 28″ W), based on which we calculated a mathematical index of approximate depth to water at or below the soil surface at 1 m resolution using the Wet-Areas Mapping model.

Self-management interventions for skin care in people with a spinal cord injury: part 1-a systematic review of intervention content and effectiveness.

Study Design: Systematic review.

Objectives: To review the content and effectiveness of skin care self-management interventions for people with SCI.

Setting: International.

Advancing research and clinical care in the management of neuropathic pain after spinal cord injury: Key findings from a Canadian summit.

: Optimal management of neuropathic pain (NP) is essential to enhancing health-related quality of life for individuals living with spinal cord injury (SCI). A key strategic priority for the Ontario Neurotrauma Foundation (ONF) and Rick Hansen Institute (RHI) is optimizing NP management after SCI. : A National Canadian Summit, sponsored by ONF and RHI, was held to develop a strategic plan to improve NP management after SCI.

Quality of Life and Health Utility Scores Among Canadians Living With Traumatic Spinal Cord Injury - A National Cross-Sectional Study.

Study Design: National, multicenter, cross-sectional study.

Objective: The goal of this study was to provide overall quality of life (QOL) and health utility (HU) values for patients with traumatic spinal cord injury (SCI) stratified by injury level and neurological status.

Summary Of Background Data: Traumatic SCI is a leading cause of disability.

Novel insights into the clinical phenotype and pathophysiology underlying low VWF levels.

Critical clinical questions remain unanswered regarding diagnosis and management of patients with low von Willebrand factor (VWF) levels (30-50 IU/dL). To address these questions, the Low VWF Ireland Cohort (LoVIC) study investigated 126 patients registered with low VWF levels. Despite marginally reduced plasma VWF levels, International Society of Thrombosis and Haemostasis Bleeding Assessment Tool (ISTH BAT) confirmed significant bleeding phenotypes in the majority of LoVIC patients.

The Economic Burden of Urinary Tract Infection and Pressure Ulceration in Acute Traumatic Spinal Cord Injury Admissions: Evidence for Comparative Economics and Decision Analytics from a Matched Case-Control Study.

Secondary complications of spinal cord injury (SCI) are a burden to affected individuals and the rest of society. There is limited evidence of the economic burden or cost of complications in SCI populations in Canada, however, which is necessary for comparative economic analyses and decision analytic modeling of possible solutions to these common health problems. Comparative economic analyses can inform resource allocation decisions, but the outputs are only as good as the inputs.

Spinal Cord Injury Clinical Registries: Improving Care across the SCI Care Continuum by Identifying Knowledge Gaps.

Timely access and ongoing delivery of care and therapeutic interventions is needed to maximize recovery and function after traumatic spinal cord injury (tSCI). To ensure these decisions are evidence-based, access to consistent, reliable, and valid sources of clinical data is required. The Access to Care and Timing Model used data from the Rick Hansen SCI Registry (RHSCIR) to generate a simulation of healthcare delivery for persons after tSCI and to test scenarios aimed at improving outcomes and reducing the economic burden of SCI.

Self-management interventions to improve skin care for pressure ulcer prevention in people with spinal cord injuries: a systematic review protocol.

Background: Pressure ulcers are a serious, common, lifelong, and costly secondary complication of spinal cord injury (SCI). Community-dwelling people with a SCI can prevent them with appropriate skin care (i.e.

Out of Sight, out of Mind? An Audit Which Proposes a Follow-Up and Management Pathway for Inferior Vena Cava Filters.

Insertion of an IVC filter can be a safe and effective way to avoid PE in thrombosis patients who cannot be anticoagulated. If temporary filters are not promptly removed they can become difficult to remove, causing avoidable complications and often requiring lifelong warfarin. In this study, two sequential audits of retrieval of temporary IVC filters were conducted before and after the implementation of a coordinated management strategy for IVC filter follow-up.

The Economic Burden of Autonomic Dysreflexia during Hospitalization for Individuals with Spinal Cord Injury.

We sought to determine the economic burden of autonomic dysreflexia (AD) from the perspective of the Canadian healthcare system in a case series of individuals with spinal cord injury (SCI) presenting to emergency care. In doing so, we sought to illustrate the potential return on investments in the translation of evidence-informed practices and developments in the prevention, diagnosis, and management of AD. Activity-based costing methodology was employed to estimate the direct healthcare or hospitalization costs of AD following presentation to the emergency department.

School-based early childhood education and age-28 well-being: effects by timing, dosage, and subgroups.

Advances in understanding the effects of early education have benefited public policy and developmental science. Although preschool has demonstrated positive effects on life-course outcomes, limitations in knowledge on program scale, subgroup differences, and dosage levels have hindered understanding. We report the effects of the Child-Parent Center Education Program on indicators of well-being up to 25 years later for more than 1400 participants.

Age 26 cost-benefit analysis of the child-parent center early education program.

Using data collected up to age 26 in the Chicago Longitudinal Study, this cost-benefit analysis of the Child-Parent Centers (CPC) is the first for a sustained publicly funded early intervention. The program provides services for low-income families beginning at age 3 in 20 school sites. Kindergarten and school-age services are provided up to age 9 (third grade).

Predicting Adult Criminal Behavior from Juvenile Delinquency: Ex-Ante vs. Ex-Post Benefits of Early Intervention.

Recent analyses of the long-term societal benefits from early intervention (prenatal care, home visitation, and high quality preschool) for at-risk children commonly include significant savings to society in the form of reduced juvenile delinquency and adult criminal behavior. However, a nontrivial proportion of the reported benefits of several early intervention programs are based on forecasts of criminal behavior throughout adulthood conditional on intervention effects on delinquency in adolescence. Data from the Chicago Longitudinal Study (CLS), an investigation of the life course of 1,539 children from low-income families born in 1979-1980, are used to investigate the bias resulting from predicting the effect of early intervention on adult criminal behavior from the effect on delinquency in adolescence.

Protamine sulfate down-regulates thrombin generation by inhibiting factor V activation.

Protamine sulfate is a positively charged polypeptide widely used to reverse heparin-induced anticoagulation. Paradoxically, prospective randomized trials have shown that protamine administration for heparin neutralization is associated with increased bleeding, particularly after cardiothoracic surgery with cardiopulmonary bypass. The molecular mechanism(s) through which protamine mediates this anticoagulant effect has not been defined.

Fine needle aspiration findings in malignant ameloblastoma: a case report and differential diagnosis.

We present a case of malignant ameloblastoma presenting in the posterior mandible and cervical lymph nodes of an African American child. This case is somewhat unusual in that the patient was an adolescent and presented with metastatic disease. This partly clinical as well as cytologic diagnosis was facilitated by the presence of typical ameloblastoma cytology in multiple cervical lymph nodes adjacent to the histologically confirmed intraosseous ameloblastoma.

Platelet factor 4 impairs the anticoagulant activity of activated protein C.

Platelet factor 4 (PF4) is an abundant platelet alpha-granule chemokine released following platelet activation. PF4 interacts with thrombomodulin and the gamma-carboxyglutamic acid (Gla) domain of protein C, thereby enhancing activated protein C (APC) generation by the thrombin-thrombomodulin complex. However, the protein C Gla domain not only mediates protein C activation in vivo, but also plays a critical role in modulating the diverse functional properties of APC once generated.

Efficacy and safety of once daily low molecular weight heparin (tinzaparin sodium) in high risk pregnancy.

Low molecular weight heparin (LMWH) is widely regarded as the anticoagulant treatment of choice for the prevention and treatment of venous thromboembolism during pregnancy. However, previous studies have demonstrated that the pharmacokinetic profiles of LMWH vary significantly with increasing gestation. Consequently, it remains unclear whether LMWH regimens recommended for use in nonpregnant individuals can be safely extrapolated to pregnant women.

Dissociation of activated protein C functions by elimination of protein S cofactor enhancement.

Activated protein C (APC) plays a critical anticoagulant role in vivo by inactivating procoagulant factor Va and factor VIIIa and thus down-regulating thrombin generation. In addition, APC bound to the endothelial cell protein C receptor can initiate protease-activated receptor-1 (PAR-1)-mediated cytoprotective signaling. Protein S constitutes a critical cofactor for the anticoagulant function of APC but is not known to be involved in regulating APC-mediated protective PAR-1 signaling.

Concentration-dependent roles for heparin in modifying lipopolysaccharide-induced activation of mononuclear cells in whole blood.

In addition to their anticoagulant activity, unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) have important immunomodulatory properties. However, different studies have reported conflicting pro- and anti-inflammatory effects in association with heparin. Moreover, the molecular basis for these heparin effects on inflammation remains unclear.