Factors associated with early deterioration after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis.

Background And Purpose: Spontaneous intracerebral hemorrhage (ICH) is a devastating form of stroke with a poor prognosis overall. We conducted a systematic review and meta-analysis to identify and describe factors associated with early neurologic deterioration (END) after ICH.

Methods: We sought to identify any factor which could be prognostic in the absence of an intervention.

Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Background: The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery.

Methods: We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013.

Opening Minds Stigma Scale for Health Care Providers (OMS-HC): examination of psychometric properties and responsiveness.

Background: Diminishing stigmatization for those with mental illnesses by health care providers (HCPs) is becoming a priority for programming and policy, as well as research. In order to be successful, we must accurately measure stigmatizing attitudes and behaviours among HCPs. The Opening Minds Stigma Scale for Health Care Providers (OMS-HC) was developed to measure stigma in HCP populations.

Depression as a predictor of occupational transition in a multiple sclerosis cohort.

In MS, transitions between working and not-working status may occur in association with depression. This can complicate patients' ability to promptly obtain disability support due to an expectation that their functioning will improve after the depression resolves, a viewpoint that sees depression assuming a role as a causal determinant of disability. In this study, prospective data were used to model the relationship between depressive symptoms and the transition out of employment.

Exercise as an add-on strategy for the treatment of major depressive disorder: a systematic review.

Antidepressants are currently the treatment of choice for major depressive disorder (MDD). Nevertheless, a high percentage of patients do not respond to a first-line antidepressant drug, and combination treatments and augmentation strategies increase the risk of side effects. Moreover, a significant proportion of patients are treatment-resistant.

Point prevalence and correlates of depression in a national community sample with multiple sclerosis.

Objective: The prevalence of depression in multiple sclerosis (MS) is known to be elevated, but nearly all available studies have estimated period prevalence. The objective of this study was to estimate the point prevalence of depression in a representative community sample using the Patient Health Questionnaire, Brief (PHQ-9).

Methods: The data source for this study was the Survey of Living with Neurological Conditions in Canada, which was derived from a representative sample of household residents.

Patient satisfaction with care in epilepsy: how much do we know?

Objective: Satisfaction with epilepsy care (SEC) encompasses care delivery, expectations, attitudes, and disease course. Through a systematic review of the evidence, we explore how and where the SEC of patients is being measured, the level of SEC overall and in specific domains, and its relationship to clinical and demographic variables.

Methods: We searched Medline, PsycINFO, CINAHL, Cochrane Register of Controlled Trials, and EMBASE using medical subject headings and keywords related to satisfaction with care and epilepsy in adults and children, in all languages.

Retrospective and prospectively assessed childhood adversity in association with major depression, alcohol consumption and painful conditions.

Background: Considerable evidence now links childhood adversity to a variety of adult health problems. Unfortunately, almost all of these studies have relied upon retrospective assessment of childhood events, creating a vulnerability to bias. In this study, we sought to examine three associations using data sources that allowed for both prospective and retrospective assessment of childhood events.

An overview of the statistical methods reported by studies using the Canadian community health survey.

Background: The Canadian Community Health Survey (CCHS) is a cross-sectional survey that has collected information on health determinants, health status and the utilization of the health system in Canada since 2001. Several hundred articles have been written utilizing the CCHS dataset. Previous analyses of statistical methods utilized in the literature have focused on a particular journal or set of journals to understand the statistical literacy required for understanding the published research.

Prevalence of neurological conditions across the continuum of care based on interRAI assessments.

Background: Although multiple studies have estimated the prevalence of neurological conditions in the general Canadian population, limited research exists regarding the proportion affected with these conditions in non-acute health care settings in Canada. Data from standardized clinical assessments based on the interRAI suite of instruments were used to estimate the prevalence of eight neurological conditions across the continuum of care including Alzheimer's disease, Parkinson's disease, epilepsy, traumatic brain injury, multiple sclerosis, cerebral palsy, Huntington's disease, and amyotrophic lateral sclerosis.

Methods: Cohorts of individuals receiving care in nursing homes (N=103,820), home care (N=91,021), complex continuing care (N=10,581), and psychiatric hospitals (N=23,119) in Canada were drawn based on their most recent interRAI assessment within each sector for a six-month period in 2010.

A prediction algorithm for first onset of major depression in the general population: development and validation.

Objective: Prediction algorithms are useful for making clinical decisions and for population health planning. However, such prediction algorithms for first onset of major depression do not exist. The objective of this study was to develop and validate a prediction algorithm for first onset of major depression in the general population.

Evidence-based guideline: assessment and management of psychiatric disorders in individuals with MS: report of the Guideline Development Subcommittee of the American Academy of Neurology.

Objective: To make evidence-based recommendations for screening, diagnosing, and treating psychiatric disorders in individuals with multiple sclerosis (MS).

Methods: We reviewed the literature (1950 to August 2011) and evaluated the available evidence.

Results And Recommendations: Clinicians may consider using the Center for Neurologic Study Emotional Lability Scale to screen for pseudobulbar affect (Level C).

The reliability and sensitivity of the National Institutes of Health Stroke Scale for spontaneous intracerebral hemorrhage in an uncontrolled setting.

Background And Purpose: The National Institutes of Health Stroke Scale (NIHSS) is commonly used to measure neurologic function and guide treatment after spontaneous intracerebral hemorrhage (ICH) in routine stroke clinics. We evaluated its reliability and sensitivity to detect change with consecutive and unique rater combinations in a real-world setting.

Methods: Conservative measures of interrater reliability (unweighted Kappa (κ), Intraclass Correlation Coefficient (ICC1,1) and sensitivity to detect change (Minimal Detectable Difference (MDD)) were estimated.

The role of systematic reviews and meta-analyses of incidence and prevalence studies in neuroepidemiology.

Background: Systematic reviews and meta-analyses on the incidence and prevalence of neurological conditions are important methods of quantifying the burden and risk of disease.

Methods: The rigorous methodology required in order to minimize publication bias, account for study heterogeneity, and variation in study quality are described. When appropriate, a meta-analysis is a powerful statistical tool that can help synthesize a vast literature quantitatively, taking into account study heterogeneity.

Mental health practice and attitudes of family physicians can be changed!

Objectives: An adult mental health module was developed in British Columbia to increase the use of evidence-based screening and cognitive behavioral self-management tools as well as medications that fit within busy family physician time constraints and payment systems. Aims were to enhance family physician skills, comfort, and confidence in diagnosing and treating mental health patients using the lens of depression; to improve patient experience and partnership; to increase use of action or care plans; and to increase mental health literacy and comfort of medical office assistants.

Methods: The British Columbia Practice Support Program delivered the module using the Plan-Do-Study-Act cycle for learning improvement.

Diagnostic data for neurological conditions in interRAI assessments in home care, nursing home and mental health care settings: a validity study.

Background: The interRAI suite of assessment instruments can provide valuable information to support person-specific care planning across the continuum of care. Comprehensive clinical information is collected with these instruments, including disease diagnoses. In Canada, interRAI data holdings represent some of the largest repositories of clinical information in the country for persons with neurological conditions.

Receiving workplace mental health accommodations and the outcome of mental disorders in employees with a depressive and/or anxiety disorder.

Objectives: To investigate the association between receiving workplace accommodations and the 1-year risk of mood/anxiety disorders.

Methods: A general population sample of employees in Alberta, Canada, with a prior or current mental disorder (N = 715) was observed for 1 year. Mental disorders were determined on the basis of the Diagnostic and Statistical Manual, 4th revision, criteria.

Glycan structure determinants for cation-independent mannose 6-phosphate receptor binding and cellular uptake of a recombinant protein.

The cation-independent mannose 6-phosphate receptor (CI-MPR) plays a critical role in intracellular transport of lysosomal enzymes as well as the uptake of recombinant proteins. To define the minimal glycan structure determinants necessary for receptor binding and cellular uptake, we synthesized a series of glycans containing mono-, di-, tri-, tetra-, and hexamannoses terminated with either one or two phosphates for conjugating to a model protein, recombinant human acid α-glucosidase. A high affinity interaction with the CI-MPR can be achieved for the enzyme conjugated to a dimannose glycan with a single phosphate.

Reducing the stigma of mental illness in undergraduate medical education: a randomized controlled trial.

Background: The stigma of mental illness among medical students is a prevalent concern that has far reaching negative consequences. Attempts to combat this stigma through educational initiatives have had mixed results. This study examined the impact of a one-time contact-based educational intervention on the stigma of mental illness among medical students and compared this with a multimodal undergraduate psychiatry course at the University of Calgary, Canada that integrates contact-based educational strategies.

Cost of spontaneous intracerebral hemorrhage in Canada during 1 decade.

Background And Purpose: Spontaneous intracerebral hemorrhage (ICH) is widely considered to be the most devastating form of stroke in North America. Currently there is no clear understanding of the cost of treatment in Canada and thus no way of understanding how to manage ICH spending in this country.

Methods: We used a cohort study design to report and to examine the cost of ICH hospital care in a Canadian health center during 1 decade.

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Background/objective: Antipsychotic use in children is increasing. The purpose of the present article is to provide guidance to clinicians on the clinical management of extrapyramidal side effects of second-generation antipsychotics.

Methods: Published literature, key informant interviews, and discussions with panel members and stakeholder partners were used to identify key clinical areas of guidance and preferences on format for the present recommendations.

Prevalence and incidence of ischemic heart disease in multiple sclerosis: A population-based validation study.

Background: Studies suggest an altered risk of ischemic heart disease (IHD) in multiple sclerosis (MS), but data are limited. We aimed to validate and apply administrative case definitions to estimate the incidence and prevalence of IHD in MS.

Methods: Using administrative data we identified persons with incident MS (MSPOP) and a matched general population (GPOP) cohort.