Barriers and enablers to opioid deprescription: A qualitative study.

Background: Canada has the fourth highest per capita rate of opioid prescriptions in the world, contributing to the country's opioid crisis. Due to both their pain-relieving and euphoric properties, opioids can be highly addictive, leading to potential overdose and death. Deprescription is an endorsed and organized method of discontinuing a drug but very little is known about the barriers that Canadian physicians face when attempting to deprescribe opioids, particularly those who practice in rural areas (which have some of the highest rates of opioid users).

"Anybody who can clarify or humanize the experience would be such a help": An interpretive description of perceptions of genomic health and nursing care in individuals with cancer predisposition syndromes.

Purpose: There is increased use of genomic testing in oncology care. Yet, individuals with hereditary cancer predisposition syndromes (CPS) experience challenges when navigating the lifelong CPS healthcare considerations. The purpose of this study is to describe the healthcare experiences of individuals living with CPS and their perceptions of genomic-informed nursing care.

Whose Responsibility Is It? Implementing Patient-Prioritized Healthcare System Change in Oncology.

This brief commentary describes the reflections on a fundamental question by the Public Interest Group on Cancer Research, a successful academic-community partnership focused on cancer research, education, public engagement, and advocacy in Canada's Eastern province of Newfoundland and Labrador. Our Group has achieved some success in a short time with very limited funding. It has successfully created public spaces for conversations about cancer care and priorities for research and regularly advocated for health service change prioritized by input from patients and family members.

"Should I Let Them Know I Have This?": Multifaceted Genetic Discrimination and Limited Awareness of Legal Protections among Individuals with Hereditary Cancer Syndromes.

Introduction: Hereditary cancer syndromes (HCS), such as hereditary breast and ovarian cancer syndrome (HBOC) and Lynch syndrome (LS), represent approximately 10% of all cancers. Along with medical burdens associated with the genetic risk of developing cancer, many individuals face stigma and discrimination. Genetic discrimination refers to negative treatment, unfair profiling, or harm based on genetic characteristics, manifesting as "felt" stigma (ostracization without discriminatory acts) or "enacted" stigma (experiencing discriminatory acts).

A qualitative study of the barriers and facilitators impacting the implementation of a quality improvement program for emergency departments: SurgeCon.

Background: The implementation of intervention programs in Emergency Departments (EDs) is often fraught with complications due to the inherent complexity of the environment. Hence, the exploration and identification of barriers and facilitators prior to an implementation is imperative to formulate context-specific strategies to ensure the tenability of the intervention.

Objectives: In assessing the context of four EDs prior to the implementation of SurgeCon, a quality improvement program for ED efficiency and patient satisfaction, this study identifies and explores the barriers and facilitators to successful implementation from the perspective of the healthcare providers, patients, researchers, and decision-makers involved in the implementation.

Exploring family communication preferences in hereditary breast and ovarian cancer and Lynch syndrome: a national Canadian survey.

Background: Individuals affected with cancer predisposition (CPS) syndromes such as BRCA1, BRCA2 or Lynch syndrome (LS) are at an elevated risk of multiple cancers. Identifying high-risk individuals is important if they are to access risk-reducing strategies. Interventions such as risk-reducing salpingo-oophorectomy in carriers of BRCA pathogenic or likely pathogenic (P/LP) variants or regular colonoscopy for carriers of LS P/LP variants are highly effective and reduce mortality.

Correction: Patient education materials for non-specific low back pain and sciatica: A systematic review and meta-analysis.

[This corrects the article DOI: 10.1371/journal.pone.

Public attitudes towards genomic data sharing: results from a provincial online survey in Canada.

Background: While genomic data sharing can facilitate important health research and discovery benefits, these must be balanced against potential privacy risks and harms to individuals. Understanding public attitudes and perspectives on data sharing is important given these potential risks and to inform genomic research and policy that aligns with public preferences and needs.

Methods: A cross sectional online survey measured attitudes towards genomic data sharing among members of the general public in an Eastern Canadian province.

"I think there has to be a mutual respect for there to be value": Evaluating patient engagement in a national clinical trial on de-implementation of low value care.

Background: The evaluation of patient engagement in research is understudied and under-reported, making it difficult to know what engagement strategies work best and when. We provide the results of an evaluation of patient engagement in a large Canadian research program focused on the de-implementation of low-value care. We aimed to evaluate the experience and impact of patient engagement in the study.

A qualitative study exploring perceived barriers and enablers to fidelity of training and delivery for an intervention to reduce non-indicated imaging for low back pain.

Background: Non-specific low back pain (LBP) commonly presents to primary care, where inappropriate use of imaging remains common despite guideline recommendations against its routine use. Little is known about strategies to enhance intervention fidelity (i.e.

The Effects of Cancer Beliefs and Sociodemographic Factors on Colorectal Cancer Screening Behaviours in Newfoundland and Labrador.

Objectives: This study investigated the beliefs about cancer treatment, outcomes, and screening among adults aged 50−74 in Newfoundland and Labrador and whether these beliefs or sociodemographic factors were associated with differences in colorectal cancer (CRC) screening behaviours. Methods: This analysis uses data collected from an online survey of adults on cancer awareness and prevention in NL. Chi-square tests were used to assess differences in distributions of beliefs based on CRC screening behaviour.

The Use of Patient Engagement to Gather Perceptions on the Cost of Infant Feeding.

Purpose: Patient-oriented research (POR) and patient engagement (PE) has highlighted the value of incorporating patients' ideas and priorities in health research. Using the guiding principles of POR and PE, the current study conducted PE sessions to gain insight on the perceptions of mothers regarding the costs of infant feeding.

Methods: Four patient engagement sessions were held with mothers residing in Newfoundland and Labrador between November 2019 and January 2020.

Physician-reported barriers to using evidence-based antibiotic prescription guidelines in primary care: protocol for a systematic review and synthesis of qualitative studies using the Theoretical Domains Framework.

Introduction: Overprescription of antibiotics poses a significant threat to healthcare globally as it contributes to the issue of antibiotic resistance. While antibiotics should be predominately prescribed for bacterial infections, they are often inappropriately given for uncomplicated upper respiratory tract infections (URTIs) and related conditions, such as the common cold. This study will involve a qualitative systematic review of physician-reported barriers to using evidence-based antibiotic prescription guidelines in primary care settings and synthesise the findings using a theoretical basis.

Patient education materials for non-specific low back pain and sciatica: A systematic review and meta-analysis.

Introduction: Guidelines recommend patient education materials (PEMs) for low back pain (LBP), but no systematic review has assessed PEMs on their own. We investigated the effectiveness of PEMs on process, clinical, and health system outcomes for LBP and sciatica.

Methods: Systematic searches were performed in MEDLINE, EMBASE, CINAHL, PsycINFO, SPORTDiscus, trial registries and grey literature through OpenGrey.

Public Interest Group on Cancer Research: a successful patient-researcher partnership in Newfoundland and Labrador.

Background: Partnering with patients and family members affected by cancer is essential for meaningful research, public engagement and outreach, and advocacy activities.

Objective: Our objective was to create a public interest group through an academic-community partnership focused on cancer research and public engagement.

Methods: A purposeful recruitment process was implemented to ensure a diverse and inclusive group.

Patient-centered care in the emergency department: a systematic review and meta-ethnographic synthesis.

Background: Patient-centered care (PCC) is an emerging priority in many healthcare settings but lacks clarity in the emergency department (ED). It is of interest to know what PCC practices are most important to patients to better their experience. The objective of this study was to conduct a mixed-methods systematic review of PCC in the ED.

A Quality Improvement Emergency Department Surge Management Platform (SurgeCon): Protocol for a Stepped Wedge Cluster Randomized Trial.

Background: Despite many efforts, long wait times and overcrowding in emergency departments (EDs) have remained a significant health service issue in Canada. For several years, Canada has had one of the longest wait times among the Organisation for Economic Co-operation and Development countries. From a patient's perspective, this challenge has been described as "patients wait in pain or discomfort for hours before being seen at EDs.

Implementation of an ED surge management platform: a study protocol.

Background: Emergency departments (EDs) around the world are struggling with long wait times and overcrowding. To address these issues, a quality improvement program called SurgeCon was created to improve ED efficiency and patient satisfaction. This paper presents a framework for managing and evaluating the implementation of an ED surge management platform.

Public interest in unexpected genomic findings: a survey study identifying aspects of sequencing attitudes that influence preferences.

We describe public preferences for unexpected genomic findings and explore predictors of preferences using an online survey in an Eastern Canadian province. Items measuring attitudes toward features of unexpected findings and genomic sequencing concerns were entered in logistic regression models predicting interest in unexpected findings. Very high levels of interest were observed in unexpected findings for treatable disorders and carrier results, with lesser interest in unexpected findings for non-treatable disorders and unclassified variants.

Operationalizing a patient engagement plan for health research: Sharing a codesigned planning template from a national clinical trial.

Introduction: Engaging with patients about their lived experience of health and illness and their experience within the healthcare system can help inform the provision of care, health policies and health research. In the context of health research, however, operationalizing the levels of patient engagement is not straightforward. We suggest that a key challenge to the routine inclusion of patients as partners in health research is a lack of tangible guidance regarding how this can be accomplished.

Psychological Distress and Quality of Life in Participants Undergoing Genetic Testing for Arrhythmogenic Right Ventricular Cardiomyopathy Caused by TMEM43 p.S358L: Is It Time to Offer Population-Based Genetic Screening?

Purpose: We have identified 27 families in Newfoundland and Labrador (NL) with the founder variant TMEM43 p.S358L responsible for 1 form of arrhythmogenic right ventricular cardiomyopathy. Current screening guidelines rely solely on cascade genetic screening, which may result in unrecognized, high-risk carriers who would benefit from preemptive implantable cardioverter-defibrillator therapy.