Identifying atypical femoral fractures--a retrospective review.

Subtrochanteric atypical femoral fractures (AFFs) have been reported in patients on osteoporosis therapy (bisphosphonates and denosumab). In 2010, and again in 2013, the ASBMR AFF Task Force developed strict diagnostic criteria for AFFs. This is the first study using these criteria to define the prevalence of AFFs in Canada.

Temporal changes in the causal foundations of palliative care symptoms.

Purpose: We use longitudinal data to test and extend a structural equation model documenting changes in the causal connections among symptoms experienced in the final weeks of life. Our central thesis is that the relief of suffering and the promotion of quality end of life care require tailoring interventions to reflect the shifting causal foundations of symptoms.

Methods: Symptom information on pain, anxiety, nausea, shortness of breath, drowsiness, loss of appetite, tiredness, depression, and well-being was extracted from a palliative care database.

Comparison of treatment received versus long-standing guidelines for stage III colon and stage II/III rectal cancer patients diagnosed in Alberta, Saskatchewan, and Manitoba in 2004.

Purpose: Guideline-recommended treatment for stage II/III colorectal cancer includes postsurgical chemotherapy and/or radiation as standard of care. This study measures adherence to guidelines across 3 Canadian provinces and evaluates the relationship of patient characteristics with receiving standard care.

Patients And Methods: All surgically treated patients diagnosed in 2004 with stage III colon or stage II/III rectal cancer and residing in Alberta, Saskatchewan, or Manitoba were identified from provincial cancer registries.

Under-reporting of compensable mesothelioma in Alberta.

Background: When combined with a history of occupational asbestos exposure, mesothelioma is often presumed work-related. In Canada, workers diagnosed with mesothelioma caused by occupational asbestos exposure are often eligible for compensation under provincial workers' compensation boards. Although occupational asbestos exposure causes the majority of mesothelioma, Canadian research suggests less than half of workers actually apply for compensation.

A general method for identifying excess revisit rates: the case of hypertension.

Objective: To provide a description and application of a novel methodology for comparing actual to expected visit rates at the physician level (controlling for patient characteristics) that could be employed in healthcare monitoring and management.

Data Sources/study Setting: Two fiscal years (1997/1998 and 1998/1999) of health utilization data extracted from linked administrative data sets on a population-based cohort of 13,688 patients (aged 25+ with hypertension) involving 157 physicians.

Study Design: We re-analyzed data from a previously published retrospective cohort study to develop and apply a new methodology for identifying higher or lower than expected physician visit rates for hypertension.

The changing causal foundations of cancer-related symptom clustering during the final month of palliative care: a longitudinal study.

Background: Symptoms tend to occur in what have been called symptom clusters. Early symptom cluster research was imprecise regarding the causal foundations of the coordinations between specific symptoms, and was silent on whether the relationships between symptoms remained stable over time. This study develops a causal model of the relationships between symptoms in cancer palliative care patients as they approach death, and investigates the changing associations among the symptoms and between those symptoms and well-being.

Possible links between behavioral and physiological indices of tiredness, fatigue, and exhaustion in advanced cancer.

Goals: In this theoretical paper, we present the Edmonton Fatigue Framework (EFF), a new framework for the study of tiredness, fatigue, and exhaustion in advanced cancer.

Materials And Methods: The Fatigue Adaptation Model (FAM), the starting point for the EFF, was drawn from a literature review pertaining to fatigue in depression, chronic fatigue syndrome, cancer, shift workers, and athletes published in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), PubMed, PsychINFO, SPORTdiscus, and CancerLit between 1995 and 2004, and from seven qualitative studies conducted by our group. The EFF, an elaboration of the FAM, was constructed after an expansion of our literature review to 2006 and team discussion.

Do evidence-based treatments provide incremental benefits to patients with congestive heart failure already receiving angiotensin-converting enzyme inhibitors? A secondary analysis of one-year outcomes from the Assessment of Treatment with Lisinopril and Survival (ATLAS) study.

Background: In patients with congestive heart failure (CHF), use of submaximal doses of angiotensin-converting enzyme (ACE) inhibitors (ie, low-dose ACE inhibitors) represents usual care in routine clinical practice, whereas high-dose ACE inhibitors, beta-blockers, and digoxin have each been shown to improve outcomes.

Objective: We examined whether treatment with high dose-ACE inhibitors, beta-blockers, and digoxin would each provide incremental benefits over that achieved with usual care and whether concurrent use of high-dose ACE inhibitors, beta-blockers, and digoxin would provide maximal benefits.

Methods: We conducted a secondary analysis of a randomized, controlled, active-comparator trial.

Effect of home care service levels on health outcomes in hip fracture patients in Alberta.

As the population ages, and there is more pressure on acute and long-term care services, governments will continue to search for ways to save healthcare dollars. Home care has been touted as an alternative to long-term care; however, not enough is known about quality of care and patient outcomes.

Mortality and morbidity associated with osteoporosis drug treatment following hip fracture.

This study examined post-fracture osteoporosis drug treatment in hip fracture patients and the association of treatment with mortality and morbidity. Pre- and post-fracture demographic/health information was collected on a cohort of hip fracture patients aged 65+ years. Post-fracture administrative data on prescription drug use and health care utilization was linked to the cohort data.

Variations in treatment of femoral neck fractures in Alberta.

Objectives: To examine, in the province of Alberta, temporal trends, regional variations in treatment options and in-hospital death rates after a femoral neck fracture.

Design: A retrospective cohort study.

Patients: Six years' data were abstracted from the Alberta Morbidity File, the Alberta Health Stakeholder File and the Alberta Health Care Claims File.

Continuity of care and health decline associated with a hip fracture.

Objectives: Identify determinants of health decline associated with hip fracture with the goal of designing interventions.

Method: Prefracture and postfracture information was obtained from participants aged 65-plus years fracturing a hip between July 1996 and August 1997. Health utilization data were linked to the cohort data and to an age-gender matched cohort of nonfracture seniors.