Social Vulnerability in Patients with Multimorbidity: A Cross-Sectional Analysis.

Background: Social aspects play an important role in individual health and should be taken into consideration in the long-term care for people with multimorbidity.

Purposes: To describe social vulnerability, to examine its correlation with the number of chronic conditions, and to investigate which chronic conditions were significantly associated with the most socially vulnerable state in patients with multimorbidity.

Methods: Cross-sectional analysis from the baseline data of the Patient-Centred Innovations for Persons with Multimorbidity (PACEinMM) Study.

[Prohibition of tobacco sales to minors in France and Quebec. Comparison of legislative frameworks, their enforcement, and underage smoking].

Background: Prohibition of tobacco sales to minors is a provision of the World Health Organization Framework Convention on tobacco control. This measure is effective to reduce youth tobacco use, if the legislation adopted is properly implemented and enforced. Through the examples of France and Quebec, the objective of this study is to compare legislative frameworks prohibiting tobacco sales to minors, their enforcement, and possible impact on underage smoking.

Are Magnetic Resonance Imaging Technologies Crucial to Our Understanding of Spinal Conditions?

Persistent spinal (traumatic and nontraumatic) pain is common and contributes to high societal and personal costs globally. There is an acknowledged urgency for new and interdisciplinary approaches to the condition, and soft tissues, including skeletal muscles, the spinal cord, and the brain, are rightly receiving increased attention as important biological contributors. In reaction to the recent suspicion and questioned value of imaging-based findings, this paper serves to recognize the promise that the technological evolution of imaging techniques, and particularly magnetic resonance imaging, is allowing in characterizing previously less visible morphology.

Ultrasonography of multifidus muscle morphology and function in ice hockey players with and without low back pain.

Objectives: To examine the relationship between lumbar multifidus (LM) morphology, function, echo-intensity (EI) and body composition among a group of university level ice hockey players with and without low back pain (LBP).

Design: Cross-sectional study.

Setting: University Research Centre.

A roadmap for urban evolutionary ecology.

Urban ecosystems are rapidly expanding throughout the world, but how urban growth affects the evolutionary ecology of species living in urban areas remains largely unknown. Urban ecology has advanced our understanding of how the development of cities and towns change environmental conditions and alter ecological processes and patterns. However, despite decades of research in urban ecology, the extent to which urbanization influences evolutionary and eco-evolutionary change has received little attention.

Joint effects of group sex-ratio and Wolbachia infection on female reproductive success in the terrestrial isopod Armadillidium vulgare.

Background: In species that reproduce with sexual reproduction, males and females often have opposite strategies to maximize their own fitness. For instance, males are typically expected to maximize their number of mating events, whereas an excessive number of mating events can be costly for females. Although the risk of sexual harassment by males and resulting costs for females are expected to increase with the proportion of males, it remains unknown whether and how parasitic distorters of a host population's sex-ratio can shape this effect on the fitness of females.

GPs' management of polypharmacy and therapeutic dilemma in patients with multimorbidity: a cross-sectional survey of GPs in France.

Background: GPs are confronted with therapeutic dilemmas in treating patients with multimorbidity and/or polypharmacy when unfavourable medication risk-benefit ratios (RBRs) conflict with patients' demands.

Aim: To understand GPs' attitudes about prescribing and/or deprescribing medicines for patients with multimorbidity and/or polypharmacy, and factors associated with their decisions.

Design And Setting: Cross-sectional survey in 2016 among a national panel of 1266 randomly selected GPs in private practice in France.

Health Professional-Identified Barriers to Living Donor Kidney Transplantation: A Qualitative Study.

Background: Living donor kidney transplantation (LDKT) has several advantages over deceased donor kidney transplantation. Yet rates of living donation are declining in Canada and there exists significant interprovincial variability. Efforts to improve living donation tend to focus on the patient and barriers identified at their level, such as not knowing how to ask for a kidney or lack of education.

Engaging family partners in deceased organ donation research-a reflection on one team's experience.

Purpose: Clinical researchers are now encouraged to include patient partners in all research projects. Nevertheless, published accounts of patient engagement in complex research projects, such as those involving critically ill and dying patients, are lacking. Whether this absence is due to the relatively new emergence of patient engagement research methods or fundamental challenges regarding family engagement in challenging research contexts is unclear.

Web-Based Tailored Intervention to Support Optimal Medication Adherence Among Kidney Transplant Recipients: Pilot Parallel-Group Randomized Controlled Trial.

Background: Optimal immunosuppressive medication adherence is essential to graft survival. Transplant-TAVIE is a Web-based tailored intervention developed to promote this adherence.

Objective: The objective of our study was to evaluate the Transplant-TAVIE intervention's acceptability, feasibility, and preliminary efficacy.

Inland surface waters in protected areas globally: Current coverage and 30-year trends.

Inland waters are unique ecosystems offering services and habitat resources upon which many species depend. Despite the importance of, and threats to, inland water, global assessments of protected area (PA) coverage and trends have focused on land habitats or have assessed land and inland waters together. We here provide the first assessment of the level of protection of inland open surface waters and their trends (1984-2015) within PAs for all countries, using a globally consistent, high-resolution (30 m) and validated dataset on permanent and seasonal surface waters based on Landsat images.

Assessing quality indicators related to mental health emergency room utilization.

Background: This descriptive study compared 2014-15 to 2005-06 data on the quality of mental health services (MHS) in relation to emergency room (ER) use to assess the impact of the 2005 Quebec MH reform regarding access, continuity and appropriateness of care for patients with mental illnesses (PMI).

Methods: Data emanated from the Quebec Integrated Chronic Disease Surveillance System (Quebec/Canada). Participants (865,255 for 2014-15; 817,395 for 2005-06) were age 12 or over, with at least one MI, including substance use disorders (SUD), diagnosed during an ER visit, outpatient treatment or hospitalization.

Integration of chronic disease prevention and management services into primary care (PR1MaC): findings from an embedded qualitative study.

Background: The PR1MaC study was conducted to evaluate the integration of Chronic Disease Prevention and Management services into primary care practices and was reported effective. The aim of this study was to further explore the effects of the PR1MaC intervention on patients and their family.

Methods: We conducted a qualitative study embedded in a randomized controlled trial.

Predicting poorer health outcomes in older community-dwelling patients with multimorbidity: prospective cohort study assessing the accuracy of different multimorbidity definitions.

Purpose: Multimorbidity is commonly defined and measured using condition counts. The UK National Institute for Health Care Excellence Guidelines for Multimorbidity suggest that a medication-orientated approach could be used to identify those in need of a multimorbidity approach to management.

Objectives: To compare the accuracy of medication-based and diagnosis-based multimorbidity measures at higher cut-points to identify older community-dwelling patients who are at risk of poorer health outcomes.

How do familiarity and relatedness influence mate choice in Armadillidium vulgare?

Mate choice is an important process in sexual selection and usually prevents inbreeding depression in populations. In the terrestrial isopod Armadillidium vulgare, the close physical proximity between individuals may increase the risk of reproducing with siblings. Moreover, individuals of this species can be infected with the feminizing bacteria of Wolbachia, which influence male mate choice.

The "Patient-centered coordination by a care team" questionnaire achieves satisfactory validity and reliability.

Increasing prevalence of chronic conditions and multimorbidity challenges health care systems and calls for patient-centered coordination of care. Implementation and evaluation of health policies focusing on the development of patient-centered coordination of care needs valid instruments measuring this dimension of care. The aim of this validation study was to assess the psychometric properties of the French version of the 14-item Patient-Centered Coordination by a Care Team (PCCCT) questionnaire in a primary care setting.

"Still learning and evolving in our approaches": patient and stakeholder engagement among Canadian community-based primary health care researchers.

Plain English Summary: Increasingly, health researchers are conducting their research in partnership with non-researchers such as patients and caregivers, advocacy groups, clinicians, and policymakers. The idea behind this partnership is to make research more relevant and appropriate. However, so far there is not much evidence about how this partnership or engagement actually affects research.

The Dépistage Cognitif de Québec: A New Clinician's Tool for Early Recognition of Atypical Dementia.

Introduction: Early recognition of atypical dementia remains challenging partly because of lack of cognitive screening instruments precisely tailored for this purpose.

Methods: We assessed the validity and reliability of the Dépistage Cognitif de Québec (DCQ; www.dcqtest.

Putatively adaptive genetic variation in the giant California sea cucumber (Parastichopus californicus) as revealed by environmental association analysis of restriction-site associated DNA sequencing data.

Understanding the spatial scale of local adaptation and the factors associated with adaptive diversity are important objectives for ecology and evolutionary biology, and have significant implications for effective conservation and management of wild populations and natural resources. In this study, we used an environmental association analysis to identify important bioclimatic variables correlated with putatively adaptive genetic variation in a benthic marine invertebrate-the giant California sea cucumber (Parastichopus californicus)-spanning coastal British Columbia and southeastern Alaska. We used a redundancy analysis (RDA) with 3,699 single nucleotide polymorphisms (SNPs) obtained using RAD sequencing to detect candidate markers associated with 11 bioclimatic variables, including sea bottom and surface conditions, across two spatial scales (entire study area and within subregions).

Promoting cross-jurisdictional primary health care research: developing a set of common indicators across 12 community-based primary health care teams in Canada.

AimTo describe the process by which the 12 community-based primary health care (CBPHC) research teams worked together and fostered cross-jurisdictional collaboration, including collection of common indicators with the goal of using the same measures and data sources. BACKGROUND: A pan-Canadian mechanism for common measurement of the impact of primary care innovations across Canada is lacking. The Canadian Institutes for Health Research and its partners funded 12 teams to conduct research and collaborate on development of a set of commonly collected indicators.

Assessment of scalability of evidence-based innovations in community-based primary health care: a cross-sectional study.

Background: In 2013, the Canadian Institutes of Health Research funded 12 community-based primary health care research teams to develop evidence-based innovations. We aimed to explore the scalability of these innovations.

Methods: In this cross-sectional study, we invited the 12 teams to rate their evidence-based innovations for scalability.

[Emergency Department Use in Quebec for Patients with Mental Disorders, including Substance use Disorders].

Objectives This study investigated emergency department (ED) use, reasons for emergency visits, hospitalization rates, and duration of hospitalization in 2014-15 for a cohort of patients with mental disorders (MDs) including substance use disorders (SUDs), regarding sex, age and residential areas. Results were compared with data from patients without MDs for 2014-15, and with another cohort from 2000-01, which marked the beginning of primary care reform in Quebec and elsewhere, with the aim of measuring ED use over time. Methods Based on data from the Quebec Integrated Chronic Disease Surveillance System (QICDSS), participants included patients age 12 and over, diagnosed with at least one MD (or SUD) during an ED visit, hospitalization, or outpatient consultation in 2014-15 and 2000-01.

A reflective practice intervention to act on the moral distress of nurses providing end-of-life care on acute care units.

Background:: Nurses providing end-of-life care in acute care units often suffer from moral distress. Reflective practice (RP) may enable these nurses to realise desirable practice and then decrease their moral distress.

Aims:: This study aims to assess the feasibility, acceptability, and preliminary effects of an RP intervention on moral distress.