Patient-reported Differences in Obstructive Sleep Apnea Care between Jurisdictions with and without Government Funding for Continuous Positive Airway Pressure.

Funding for obstructive sleep apnea (OSA) treatment may impact how patients access care, wait times, and costs of care. The aim of this study was to compare differences in diagnosis and treatment of OSA between Canadian jurisdictions with and without public funding for continuous positive airway pressure (CPAP). We administered an anonymous internet survey to Canadian adults reporting a physician diagnosis of OSA.

Preliminary testing of a patient decision aid for patients with relapsing-remitting multiple sclerosis.

Background: Multiple first-line disease modifying therapies (DMTs) are available for relapsing-remitting multiple sclerosis (RRMS), each with different characteristics. We developed an interactive patient decision aid (PtDA) to promote informed shared decision-making (SDM).

Objective: To test the preliminary effectiveness of the PtDA in participants with RRMS.

Directed forgetting in associative memory: Dissociating item and associative impairment.

We report three item-method directed forgetting (DF) studies to evaluate whether DF impairs primarily item memory, or whether it also impairs associative memory. The current studies used a modified associative recognition paradigm that allowed disentangling item impairment from associative impairment in DF. Participants studied scene-object pairings, followed by DF cues (item-method), and at test were presented with a previously studied scene along with three objects, one of which was studied with that scene (target), whereas the remaining two objects were studied with different scenes (lures).

Variation in the Management of Pain, Agitation, and Delirium in Intensive Care Units in British Columbia.

Background: Pain, agitation, and delirium are associated with negative outcomes in critically ill patients. Reducing variation in pain, agitation, and delirium management among institutions could improve care.

Objectives: To define opportunities to improve pain, agitation, and delirium management in intensive care units in British Columbia, Canada.

Development and usability testing of a patient decision aid for newly diagnosed relapsing multiple sclerosis patients.

Background: Multiple sclerosis (MS) patients often struggle with treatment decisions, in part due to the increasing number of approved disease modifying therapies, each with different characteristics, and also since physicians can struggle to identify which of these characteristics matter most to each individual patient. Decision uncertainty can contribute to late treatment initiation and treatment non-adherence-causes of 'undertreatment' in MS. An interactive online patient decision aid that informs patients of their options, considers their individual preferences and goals, and facilitates conversations with their physicians, could improve how patients with relapsing forms of MS make evidence-based treatment decisions.

An update on the measurement of productivity losses due to rheumatoid diseases.

Many health systems are interested in the impact of disease and interventions on non-health outcomes. Over the last 10 years, work productivity has become one of the most important topics. This study was conducted to review guidelines for economic evaluations worldwide to identify how views on the types of productivity costs to be included differ across jurisdictions and to review recent trials that have measured productivity losses to identify trends and compare consistency with guidelines from different jurisdictions.

Endocrine effects of oral dehydroepiandrosterone in men with HIV infection: a prospective, randomized, double-blind, placebo-controlled trial.

Dehydroepiandrosterone (DHEA) is commonly used by HIV-infected men, but its endocrine effects in this population are not well defined. We conducted an 8-week randomized, placebo-controlled trial to determine the effects of escalating doses (100-400 mg/d) of DHEA on the hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes, and on a number of metabolic parameters in 69 HIV-positive men (31 in DHEA-treated group, 38 in placebo group). High-dose (250 microg) corticotropin and luteinizing hormone-releasing hormone stimulation tests were carried out in all subjects.