Health Care Utilization After a Visit to a Within-Group Family Physician vs a Walk-In Clinic Physician.

Purpose: Primary care access is a key health system metric, but little research has compared models to provide primary care access when one's regular physician is not available. We compared health system use after a visit with a patient's own family physician group (ie, within-group physician who was not the patient's primary physician) vs a visit with a walk-in clinic physician who was not part of the patient's family physician group.

Methods: We conducted a population-based, retrospective cohort study using administrative data from Ontario, Canada, including all individuals formally enrolled with a family physician, from April 1, 2019 to March 31, 2020.

Compact low-repetition-rate femtosecond optical parametric oscillators enabled by Herriott cells.

We report the design and characterization of a femtosecond optical parametric oscillator containing an intracavity Herriott cell. Pumped by a 49.16-MHz Yb:fiber laser, the signal wavelength could be tuned over 1440-1530 nm, with the Herriott cell containing 81% of the free-space cavity length required for synchronous operation.

Cross-dispersion spectrograph calibration using only a laser frequency comb.

High-resolution cross-dispersion spectrographs are widely used in spectroscopy, but the two-dimensional format of the spectrum requires sophisticated calibration, conventionally performed by illuminating the instrument with a broadband hollow-cathode lamp and cross-referencing the result to an emission-line atlas. Here, we introduce a new technique to completely calibrate a high-resolution echelle spectrograph using only a laser frequency comb. Selected individual comb lines are removed from a broadband 20 GHz laser frequency comb-revealing their exact location in the spectrograph echellogram-and wavelength-tagged with sub-fm accuracy.

Chronic pain management in primary care: Using population-based data to examine family physician practice patterns.

Objective: To examine trends in chronic pain (CP) practice patterns among community-based family physicians (FPs).

Design: Population-based descriptive study using health administrative data.

Setting: British Columbia from fiscal years 2008-2009 to 2017-2018.

"Family doctors are also people": a qualitative analysis of how family physicians managed competing personal and professional responsibilities during the COVID-19 pandemic.

Background: Family physicians (FPs) fill an essential role in public health emergencies yet have frequently been neglected in pandemic response plans. This exclusion harms FPs in their clinical roles and has unintended consequences in the management of concurrent personal responsibilities, many of which were amplified by the pandemic. The objective of our study was to explore the experiences of FPs during the first year of the COVID-19 pandemic to better understand how they managed their competing professional and personal priorities.

"Technology has allowed us to do a lot more but it's not necessarily the panacea for everybody": Family physician perspectives on virtual care during the COVID-19 pandemic and beyond.

Introduction: Early in the COVID-19 pandemic, Canadian primary care practices rapidly adapted to provide care virtually. Most family physicians lacked prior training or expertise with virtual care. In the absence of formal guidance, they made individual decisions about in-person versus remote care based on clinical judgement, their longitudinal relationships with patients, and personal risk assessments.

Continuous ultraviolet to blue-green astrocomb.

Cosmological and exoplanetary science using transformative telescopes like the ELT will demand precise calibration of astrophysical spectrographs in the blue-green, where stellar absorption lines are most abundant. Astrocombs-lasers providing a broadband sequence of regularly-spaced optical frequencies on a multi-GHz grid-promise an atomically-traceable calibration scale, but their realization in the blue-green is challenging for current infrared-laser-based technology. Here, we introduce a concept achieving a broad, continuous spectrum by combining second-harmonic generation and sum-frequency-mixing in an MgO:PPLN waveguide to generate 390-520 nm light from a 1 GHz Ti:sapphire frequency comb.

Evaluating the cost of NP-led vs. GP-led primary care in British Columbia.

In 2020, British Columbia (BC) opened four pilot Nurse Practitioner Primary Care Clinics (NP-PCCs) to improve primary care access. The aim of this economic evaluation is to compare the average cost of care provided by Nurse Practitioners (NPs) working in BC's NP-PCCs to what it would have cost the government to have physicians provide equivalent care. Comparisons were made to both the Fee-For-Service (FFS) model and BC's new Longitudinal Family Physician (LFP) model.

GPU-accelerated full-field modelling of highly dispersive ultrafast optical parametric oscillators.

We demonstrate GPU-accelerated modelling of ultrafast optical parametric oscillators (OPOs) via the χ nonlinear envelope equation with 1265× improvement in execution time compared with a CPU-based approach. Incorporating an adaptive step-size algorithm and absorbing boundary conditions, our model is capable of simulating OPOs containing long (>10 mm) nonlinear crystals or significant intracavity dispersion with outputs generated in less than 1 minute, allowing the investigation of systems that were previously computationally prohibitive to explore. We implement real-world parameters such as optical coatings, material absorption, and non-ideal poling domains within quasi-phase matched nonlinear crystals, producing excellent agreement with the spectral tuning behaviour and average power from a previously reported prism-based OPO.

Brewster mirror ultrafast optical parametric oscillator with high precision wavelength tuning.

We demonstrate a synchronously-pumped optical parametric oscillator (OPO) with a cavity formed from high refractive index inverted prisms, also known as Brewster mirrors. Exploiting a single total internal reflection, this is the simplest device capable of deviating a laser beam by 180. The OPO produced a chirped signal output tunable from 1060 - 1570 nm with a maximum power of 114 mW.

Access to episodic primary care: a cross-sectional comparison of walk-in clinics and urgent primary care centers in British Columbia.

Aim: This study aimed to identify publicly reported access characteristics for episodic primary care in BC and provided a clinic-level comparison between walk-in clinics and UPCCs.

Background: Walk-in clinics are non-hospital-based primary care facilities that are designed to operate without appointments and provide increased healthcare access with extended hours. Urgent and Primary Care Centres (UPCCs) were introduced to British Columbia (BC) in 2018 as an additional primary care resource that provided urgent, but not emergent care during extended hours.

Evaluation of audit and feedback to family physicians on prescribing of opioid analgesics to opioid-naïve patients: A pragmatic randomized delay trial.

Background: Exposure to opioid analgesics have historically raised concern for a risk of developing opioid use disorder. Prescriber audit-and-feedback interventions may reduce opioid prescribing, but some studies have shown detrimental effects for current users. We examined the effectiveness of an audit and feedback intervention, named Portrait, to reduce initiation of opioid analgesics among opioid-naïve patients experiencing pain.

Productivity Decline or Administrative Avalanche? Examining Factors That Shape Changing Workloads in Primary Care.

Background: In Canada, family physicians (FPs) per capita have increased but so have access challenges. We explored changes in population characteristics, service delivery and FP practice that may help understand these trends.

Methods: We used linked administrative data in British Columbia to describe changes in patient ages and comorbidities, hospitalizations and receipt of services that may require FP coordination, review and/or follow-up: prescriptions dispensed, laboratory tests, diagnostic imaging (radiology and ultrasound), specialist visits and emergency department visits.

For health or for profit? Understanding how private financing and for-profit delivery operate within Canadian healthcare (4H|4P): protocol for a multimethod knowledge mobilisation research project.

Introduction: Privatisation through the expansion of private payment and investor-owned corporate healthcare delivery in Canada raises potential conflicts with equity principles on which Medicare (Canadian public health insurance) is founded. Some cases of privatisation are widely recognised, while others are evolving and more hidden, and their extent differs across provinces and territories likely due in part to variability in policies governing private payment (out-of-pocket payments and private insurance) and delivery.

Methods And Analysis: This pan-Canadian knowledge mobilisation project will collect, classify, analyse and interpret data about investor-owned privatisation of healthcare financing and delivery systems in Canada.

What can publicly funded schools teach us about how to fix the family doctor shortage?

Recent estimates suggest that up to 22% of Canadians over 18 do not have regular access to a family doctor or nurse practitioner. This lack of access is often characterized as a "family doctor shortage" and has been making headlines for decades. However, we have more family doctors than ever before, and in fact, the lack of primary care access is less about a shortage of physicians and more a need to develop a modern infrastructure and new way of funding and organizing care.

Walk-in clinic patient characteristics and utilization patterns in Ontario, Canada: a cross-sectional study.

Background: Walk-in clinics are common in North America and are designed to provide acute episodic care without an appointment. We sought to describe a sample of walk-in clinic patients in Ontario, Canada, which is a setting with high levels of primary care attachment.

Methods: We performed a cross-sectional study using health administrative data from 2019.

"I'm almost opioid-a-phobic": family medicine residents' perceptions of enhancing opioid analgesic and agonist treatment training in a Canadian setting.

Purpose: As deaths from the illicit drug poisoning crisis continue to rise in Canada, increasing the number of healthcare professionals qualified to effectively prescribe opioids could be beneficial. The willingness of family medicine residents to undertake structured training in prescribing opioids for Opioid Agonist Treatment (OAT) and pain management have not been well described.

Materials And Methods: Family medicine residents ( = 20) in British Columbia, Canada, were asked about their experience with and willingness to enrol in OAT training.

Up-to-date on cancer screening among Ontario patients seen by walk-in clinic physicians: A retrospective cohort study.

Walk-in clinics are typically viewed as high-volume locations for managing acute issues but also may serve as a location for primary care, including cancer screening, for patients without a family physician. In this population-based cohort study, we compared breast, cervical and colorectal cancer screening up-to-date status for people living in the Canadian province of Ontario who were formally enrolled to a family physician versus those not enrolled but who had at least one encounter with a walk-in clinic physician in the previous year. Using provincial administrative databases, we created two mutually exclusive groups: i) those who were formally enrolled to a family physician, ii) those who were not enrolled but had at least one visit with a walk-in clinic physician from April 1, 2019 to March 31, 2020.