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.

Surgical treatment choices for breast cancer in Newfoundland and Labrador: a retrospective cohort study.

Background: Mastectomy is often chosen by women for treatment of breast cancer, even when breast-conserving surgery (BCS) is an option. Newfoundland and Labrador has a high mastectomy rate. We documented the number of breast cancers over a given period in the province and their related surgical treatments, and explored the impact of several variables on surgical choice.

Breast cancer surgical treatment choices in Newfoundland and Labrador, Canada: Patient and surgeon perspectives.

Background: Breast cancer remains the second-leading cause of cancer death among Canadian women. Treatment for breast cancer often includes surgery. Many women have a choice between mastectomy (MT; removal of the entire breast) or breast conserving surgery (BCS; removal of the tumour and some noncancerous breast tissue) followed by radiation.

An investigation of cancer rates in the Argentia region, Newfoundland and Labrador: an ecological study.

Background: The Argentia region of Newfoundland and Labrador, Canada, was home to a US naval base during a 40-year period between the 1940s and the 1990s. Activities on the base resulted in contamination of the soil and groundwater in the region with chemicals such as heavy metals and dioxins, and residents have expressed concern about higher rates of cancer in their community. This study investigated the rate of cancer diagnosis that is disproportionately high in the Argentia region.

A randomized controlled trial of the effect of an intensive 1-year care management program on measures of health status in independent, community-living old elderly: the Eldercare project.

Background: Primary care practitioners are familiar with the frail elderly and commonly have to deal with their multi-morbidity and their functional decline, both physically and mentally. However, there are well elderly with high quality of life and very few co-morbidities who seldom seek medical care.

Objective: To determine if a nurse-based program of home-delivered care, linked directly with the primary care practitioner or primary care team, would improve quality of life, symptoms, satisfaction with care and utilization of community and medical services, in independent community living old elderly.

The healthy aged: Descriptive analysis by sex of cognitively functioning elderly patients 80 years and older living independently in the community.

Objective: To describe a population of cognitively functioning seniors aged 80 years and older who are livingin dependently in the community.

Design: Descriptive cross-sectional study based on the enrolment cohort of a randomized controlled trial.

Setting: St John's, Nfld.

Use of natural health products in children: survey of parents in waiting rooms.

Objective: To determine how common it is for parents to give natural health products (NHPs) to their children, which NHPs are being used, why they are being used, and parents' assessments of the benefits and side effects of NHPs.

Design: Survey.

Setting: Newfoundland and Labrador.

Use of natural health products in children: experiences and attitudes of family physicians in Newfoundland and Labrador.

Objective: To determine the experiences of family physicians in Newfoundland and Labrador with parents' use of natural health products (NHPs) for their children and to assess physicians' attitudes toward use of NHPs in children.

Design: A survey using the Dillman approach.

Setting: Newfoundland and Labrador.

Use of bisphosphonates in metastatic breast cancer: single institution review at the Dr. H. Bliss Murphy Cancer Centre.

Purpose: Bone metastases occur in 65-75% of patients with metastatic breast cancer. These patients are at risk of developing skeletal-related events (SREs). SREs are defined as any pathological fracture, spinal cord compression, hypercalcemia, and surgery or radiation required for treatment of bone metastases.

Evaluation of Hemo Techt NS-Plus system for use in a province-wide colorectal cancer screening program.

Objectives: The NS-Plus automated analyzer and fecal immunochemical testing (FIT) testing system (Alfresa Pharma) was evaluated for use in Newfoundland and Labrador's provincial colorectal cancer (CRC) screening program.

Design And Methods: Various method performance characteristics were evaluated including the sample stability. The sensitivity for detecting neoplastic lesions was evaluated in 249 patients scheduled for colonoscopy.

Expecting a good quality of life in health: assessing people with diverse diseases and conditions using the WHOQOL-BREF.

Background And Objectives: Fulfilling patient expectations is central to defining a good quality of life (QoL) in health. The WHOQOL-BREF was developed using novel, person-centred methods and is a generic patient-reported outcomes measure (PROM). However, without robust psychometric performance, PROMs cannot be relied upon to assess individuals.

Attainment of Canadian Diabetes Association recommended targets in patients with type 2 diabetes: a study of primary care practices in St John's, Nfld.

Objective: To examine the degree to which targets for diabetes (blood pressure [BP], glycated hemoglobin [HbA1c], and low-density lipoprotein cholesterol [LDL-C]) are achieved in family practices and how these results compare with family physicians' perceptions of how well targets are being achieved.

Design: Chart audit and physician survey.

Setting: Newfoundland and Labrador.

Issues in conducting cross-cultural research: implementation of an agreed international protocol [corrected] designed by the WHOQOL Group for the conduct of focus groups eliciting the quality of life of older adults.

Multi-centre and cross-cultural research require the use of common protocols if the results are to be either pooled or compared. All too often adherence to protocols is not discussed in reports and where it is reported poor adherence is frequently noted. This paper discusses the use of international guidelines developed by WHOQOL Field Centres to conduct and report focus groups aimed at eliciting key concepts of quality of life among older adults.