Protocol and Statistical Analysis Plan for a Comparative Interrupted Time Series Evaluation of the Impact of Deemed Consent for Organ Donation Legislative Reform in Nova Scotia, Canada.

The Canadian province of Nova Scotia recently became the first North American jurisdiction to implement deemed consent for deceased organ donation as part of a comprehensive legislative reform of their donation and transplantation system. This study will examine the performance metrics and effectiveness of this policy in comparison with other Canadian provinces via a natural experiment evaluation. We will use a cross-sectional controlled interrupted time series quasi-experimental design.

Family and emergency physicians' knowledge and attitudes toward organ donation and deemed consent: Human Organ and Tissue Donation Act in Nova Scotia.

Objective: To understand Nova Scotian family physicians' and emergency department (ED) physicians' knowledge of, attitudes about, and experience with organ donation and transplantation in the context of the Human Organ and Tissue Donation Act (HOTDA).

Design: An electronic, self-administered survey.

Setting: Nova Scotia.

Early experiences of deemed consent legislation for organ donation in Nova Scotia: a qualitative study.

Purpose: In 2021, Nova Scotia, Canada, became the first jurisdiction in North America to adopt a deemed consent organ donation system under its revised Human Organ and Tissue Donation Act. This study sought to understand the early experiences of program staff and clinicians involved in implementing this legislation.

Methods: We conducted semistructured interviews with members of the provincial organ donation program and intensive care unit and emergency department clinicians (n = 14).

Development of the Nova Scotia Potential Donor Audit (PDA) Tool and 2020 Historic Performance Database: Lessons Learned From the First 1000 Medical Record Reviews.

Background: Legislation and accountability frameworks are key components of high-performing deceased-donation systems. In 2021, Nova Scotia (NS), Canada, became the first jurisdiction in North America to enact deemed consent legislation and concurrently implemented mandatory referral legislation similar to that found in other Canadian provinces. Frontline financial resources were provided by the government to support the development of program infrastructure, including implementation of means to evaluate system performance.

Development of a consortium to examine organ donation legislative and system reforms: A report from the LEADDR consortium.

In April 2019, the province of Nova Scotia became the first jurisdiction in North America to pass legislation that incorporated deemed consent for deceased organ donation. The reform included many other important updates, including the hierarchy for consent, enabled donor and recipient contact, and mandatory referral of potential deceased donors. Additionally, system reforms were implemented to improve the deceased donation system in Nova Scotia.

Views of leaders in under-represented and equity-denied communities on organ and tissue donation in Nova Scotia, Canada, in light of the Human Organ and Tissue Donation Act: a qualitative descriptive study.

Objective: To explore the views of underserved and equity-denied communities in Nova Scotia, Canada, regarding organ and tissue donation and deemed consent legislation.

Design: A qualitative descriptive study was undertaken, employing both interviews and focus groups.

Setting: The province of Nova Scotia, Canada-the first jurisdiction in North America to implement deemed consent legislation for organ and tissue donation.

Nurse knowledge and attitudes towards organ donation and deemed consent: the Human Organ and Tissue Donation Act in Nova Scotia.

Purpose: In April 2019, the Human Organ and Tissue Donation Act (HOTDA) in Nova Scotia was modified to incorporate a deemed consent model. In this study, we sought to understand intensive care unit (ICU) and emergency department (ED) nurses' knowledge of and confidence around organ donation and transplantation, experiences with organ donors and recipients, attitudes toward organ donation and deemed consent, and perceived opportunities and barriers to a deemed consent approach in view of the legislative change.

Methods: We sent an electronic, self-administered survey to all ICU and ED nurses in Nova Scotia.

Estimated Impact of Deemed Consent Legislation for Organ Donation on Individuals With Kidney Failure: A Dynamic Decision Analytic Model.

Background: There is little data modeling the impact of deemed consent legislation (eligible individuals who do not register their decision to decline to be a donor are presumed to consent after death) on outcomes for individuals with kidney failure.

Objective: To estimate the change in life-years (LYs) and quality-adjusted life-years (QALYs) resulting from different changes in the rate of deceased donor kidney transplantation associated with deemed consent legislation and health system transformation.

Design: Dynamic Decision Analytic Model.

Incidence of cardiovascular disease and mortality in childhood solid organ transplant recipients: a population-based study.

Background: With improved survival among children after transplantation, our understanding of the risk for developing other comorbidities is improving, yet little is known about the long-term risk of cardiovascular events and mortality after solid organ transplantation.

Methods: In a cohort study using health administrative data, we compared cardiovascular events in children (n = 615) with liver, lung, kidney, small bowel, or multi-organ transplant at the Hospital for Sick Children, Toronto, Canada, with asthmatic children (n = 481,697) between 1996 and 2014. Outcomes included non-fatal cardiovascular events, cardiovascular death, all-cause mortality, and a composite of non-fatal and fatal cardiovascular events.

Day-to-day variation in students' academic success: The role of self-regulation, working memory, and achievement goals.

Self-regulation was found to be positively associated with school performance. Interrelations between self-regulation, working memory (WM), and achievement goals, in particular mastery goals, have been established, as well as associations with academic outcomes. It stands to reason that self-regulation, WM, achievement goals, and academic success are related on a daily level.

Reciprocal relations of subjective sleep quality and affective well-being in late childhood.

High sleep quality has been associated with beneficial outcomes across the life span. Intensive longitudinal studies suggest that these beneficial effects can also be observed on a day-to-day level. However, the dynamic interplay between subjective sleep quality and affective well-being in children's daily life has only rarely been investigated.

The association of intraosseous vascular access and survival among pediatric patients with out-of-hospital cardiac arrest.

Introduction: In pediatric out-of-hospital cardiac arrest (OHCA) the effect of intraosseous (IO) or intravenous (IV) access on outcomes is unclear.

Methods: We analyzed prospectively collected data of non-traumatic OHCA in the Resuscitation Outcomes Consortium registry from 2011 to 2015. We included EMS-treated patients ≤17 years of age, classified patients based on vascular access routes, and calculated success rates of IO and IV attempts.

Ambulatory assessment of rumination and worry: Capturing perseverative cognitions in children's daily life.

Rumination and worry are common forms of perseverative cognition in children. Research has started to target perseverative cognitions in the everyday life of children, however, valid measurement instruments reliably capturing rumination and worry in children's daily life are still missing. We conducted two ambulatory assessment studies validating short scales suitable for the measurement of rumination and worry in children's daily life.

A Program of Research to Evaluate the Impact of Deceased Organ Donation Legislative Reform in Nova Scotia: The LEADDR Program.

Background: This is the first time deemed consent, where the entire population of a jurisdiction is considered to have consented for donation unless they have registered otherwise, will be implemented in North America. While relatively common in other regions of the world-notably Western Europe-it is uncertain how this practice will influence deceased donation practices and attitudes in Canada.

Methods: We describe a Health Canada funded program of research that will evaluate the implementation process and full impact of the deceased organ donation legislation and the health system transformation in Nova Scotia that includes opt-out consent.

Interhospital Transfer and Outcomes in Patients with AKI: A Population-Based Cohort Study.

Background: Patients with AKI may require interhospital transfer to receive RRT. Interhospital transfer may lead to delays in therapy, resulting in poor patient outcomes. There is minimal data comparing outcomes among patients undergoing transfer for RRT versus those who receive RRT at the hospital to which they first present.

The bright and the dark side of peer relationships: Differential effects of relatedness satisfaction and frustration at school on affective well-being in children's daily lives.

Satisfaction and frustration of the basic psychological need for relatedness have been postulated to play a vital role for affective well-being. Yet, this prediction has not been thoroughly tested in schoolchildren's everyday lives. In this work, we examined the association between relatedness satisfaction and frustration at school on daily and average positive affect (PA) and negative affect (NA) using ambulatory assessment in three intensive longitudinal studies with children aged 9-12 (total = 317).

Cultivating Innovative Pragmatic Cluster-Randomized Registry Trials Embedded in Hemodialysis Care: Workshop Proceedings From 2018.

Hemodialysis is a life-sustaining treatment for persons with kidney failure. However, those on hemodialysis still face a poor quality of life and a short life expectancy. High-quality research evidence from large randomized controlled trials is needed to identify interventions that improve the experiences, outcomes, and health care of persons receiving hemodialysis.

Kidney disease and care among First Nations people with diabetes in Ontario: a population-based cohort study.

Background: End-stage kidney disease is a serious complication of diabetes. We describe the prevalence of chronic kidney disease, prevalence and incidence of end-stage kidney disease and quality of care of early-stage chronic kidney disease for First Nations people with diabetes compared to other Ontarians with diabetes.

Methods: We conducted a retrospective cohort study in Ontario using linked administrative data at ICES.

Incidence, Treatment, and Implications of Kidney Stones During Pregnancy: A Matched Population-Based Cohort Study.

To determine the incidence of kidney stones in pregnancy, the risk of adverse birth outcomes, and treatment trends. We performed a population-based matched cohort study using Ontario's health care databases. All pregnancies in Ontario from 2004 to 2014 were identified.

Serum Creatinine Levels Before, During, and After Pregnancy.

This study uses Canadian administrative health databases to estimate gestational age–specific serum creatinine levels before, during, and after pregnancy among women without antecedent kidney disease.

Momentary working memory performance is coupled with different dimensions of affect for different children: A mixture model analysis of ambulatory assessment data.

Elementary schoolchildren's working memory performance (WMP) fluctuates from moment to moment and day to day, yet the underlying mechanisms are not well understood. In the present study, affective states were investigated as predictors of these fluctuations. Interindividual differences in the intraindividual affect-WMP associations were expected, and their structure was explored.