Individuals with a fragility fracture and a prescription for bone active medication have a positive perception of the medication but do not associate it with fracture risk reduction.

Unlabelled: Most participants reported a positive perception of bone active medication despite sustaining a fracture while taking the medication, reporting medication side effects, or having a healthcare provider stop the prescription. Participants did not appear to connect the medication to fracture risk, suggesting this connection should be emphasized by healthcare providers.

Objective: Our purpose was to examine perceptions about bone active medication from individuals with a fragility fracture and a prescription for bone active medication.

A lifetime economic model of mortality and secondary care use for patients discharged from hospital following acute stroke.

Background: The long-term health-economic consequences of acute stroke are typically extrapolated from short-term outcomes observed in different studies, using models based on assumptions about longer-term morbidity and mortality. Inconsistency in these assumptions and the methods of extrapolation can create difficulties when comparing estimates of lifetime cost-effectiveness of stroke care interventions.

Aims: To develop a long-term model consisting of a set of equations to estimate the lifetime effects of stroke care interventions to promote consistency in extrapolation of short-term outcomes.

Educational booklet reinforces knowledge of osteoporosis and influences intentions to improve bone health in previously diagnosed and treated patients.

Unlabelled: We examined individuals' experiences using an educational booklet developed by the Ontario Osteoporosis Strategy. The booklet appeared to motivate individuals to make changes to their existing management of their bone health and served as a reference tool reaffirming current practices and beliefs for others.

Introduction: The purpose of this study was to examine individuals' experiences of the educational booklet and explore the influence of the booklet on individuals' beliefs and actions regarding their bone health.

Is a 'healthy diet' and a 'calcium-rich diet' the same thing? Qualitative study examining perceptions of a calcium-rich diet in individuals who have received bone health education.

Background: In the present study, we aimed to (i) examine perceptions of achieving calcium and vitamin D recommended dietary allowance (RDA) and (ii) determine how participants talked about food in relation to RDA recommendations.

Methods: Participants aged ≥50 years who were prescribed osteoporosis medication and received two modes of bone health education were eligible. Relying on a qualitative description design, we interviewed participants 1 month after they had attended an education session and received a self-management booklet.

Effectiveness of 24-h mobile reporting tool during a malaria outbreak in Mpumalanga Province, South Africa.

Background: As surveillance is a key strategy for malaria elimination in South Africa, ensuring strong surveillance systems is a National Department of Health priority. Historically, real time tracking of case trends and reporting within 24 h-a requirement in South Africa's National surveillance guidelines-has not been possible. To enhance surveillance and response efficiency, a mobile surveillance tool, MalariaConnect, was developed using Unstructured Supplementary Service Data (USSD) technology.

Outcome of Acetaminophen-Induced Acute Liver Failure Managed Without Intracranial Pressure Monitoring or Transplantation.

Acetaminophen-induced acute liver failure (ALF) may require emergency liver transplantation (LT) in the presence of specific criteria, and its management may also include intracranial pressure (ICP) monitoring in selected patients at high risk of cerebral edema. We aimed to test the hypothesis that management of such patients without ICP monitoring or LT would yield outcomes similar to those reported with conventional management. We interrogated a database of all patients treated in an intensive care unit for acetaminophen-induced ALF between November 2010 and October 2016 and obtained relevant information from electronic medical records.

Quantitative analysis of antibiotic usage in British sheep flocks.

The aim of this study was to examine the variation in antibiotic usage between 207 commercial sheep flocks using their veterinary practice prescribing records. Mean and median prescribed mass per population corrected unit (mg/PCU) was 11.38 and 5.

Morphology and the gradient of a symmetric potential predict gait transitions of dogs.

Gaits and gait transitions play a central role in the movement of animals. Symmetry is thought to govern the structure of the nervous system, and constrain the limb motions of quadrupeds. We quantify the symmetry of dog gaits with respect to combinations of bilateral, fore-aft, and spatio-temporal symmetry groups.

MASSIVE TRANSFUSION PROTOCOL: STANDARDIZING CARE TO IMPROVE PATIENT OUTCOMES.

Providing rapid response is a primary goal when caring for surgical patients with injuries involving massive blood loss. Massive transfusion protocols have been developed in some tertiary care health care facilities to ensure a rapid and efficient response in the provision of care to patients with a massive and uncontrolled hemorrhage. The purpose of this article is to discuss a massive transfusion protocol and to describe the process used to implement a massive transfusion protocol at Winnipeg's Health Sciences Centre (the site) as well as to describe its impact in the operating room department.

Intraoperative MRI: the challenges of providing a safe environment for patients and personnel.

Real-time intraoperative magnetic resonance imaging (iMRI) provides a tremendous benefit to patients undergoing brain tumour surgery. This paper will discuss the Winnipeg Health Sciences Centre's experience implementing a new iMRI program in a new neurosurgery operating room suite. It will review MRI technology and discuss related safety considerations for patients and personnel.

Evacuating an OR is a complex process: who does what?

It became necessary, following the relocation of the entire Winnipeg Health Sciences Centre Adult OR department in 2007 and in consideration of fire code regulations, to re-evaluate and modify the existing evacuation plan and to simulate, and test, these modifications in the new environment. Planning a fire evacuation simulation for a large tertiary OR is a very complex process and involves a great deal of planning and attention to detail. It requires a multidisciplinary approach as it involves many departments.

Is stainless steel really "stainless"?

Initial purchase and replacement costs for surgical instrumentation are significant components in today's operating room budgets. OR staff and medical device reprocessing personnel work together as a team to ensure effective management of this valuable commodity. The purpose of this article is to discuss the composition of stainless steel surgical instruments, to identify processes to minimize damage to instruments caused by staining, corrosion, and pitting, and to utilize that information to describe effective measures to manage instrumentation in both the OR and reprocessing areas.

Code blue: what to do?

Cardiac arrest may occur intraoperatively at any time. The purpose of this article is to help the reader recognize and assist in the management of an intraoperative cardiac arrest. Patients who are at risk for cardiac arrest in the OR are identified and different types of pulseless arrythmias are identified.

iSoBAR--a concept and handover checklist: the National Clinical Handover Initiative.

Effective communication at clinical handover is important for improving patient safety and reducing adverse outcomes. In consultation with doctors, nurses and allied health staff in the Western Australian Country Health Service, we developed a clinical handover checklist, adapted from an existing tool for standardising communication. The acronym "iSoBAR" (identify-situation-observations-background-agreed plan-read back) summarises the components of the checklist.

Food groups and risk of forearm fractures in postmenopausal women in Chengdu, China.

Background: Forearm fractures are a major cause of disability in postmenopausal women. However, no prior report on the relationship of dietary patterns and forearm fracture in mainland China is available and the results from Western studies may not be applicable to the Chinese population.

Objective: To determine whether food groups are associated with the risk of forearm fracture among postmenopausal women in China.

Oh, by the way, the patient is pregnant!

Approximately one to three per cent of pregnant women undergo surgery that is unrelated to their pregnancy. In Canada this represents about 5,000 patients each year that present unique challenges to the perioperative nurse and the entire surgical team. Approximately five to ten per cent of these patients are involved in trauma, which causes 46.

Performance appraisals in the OR: everyone's business.

Performance appraisals affect everyone. Perioperative nurses often participate in staff orientations and act as preceptors for other learners. Nurses also participate in their own performance appraisal process.

Diet, activity, and other lifestyle risk factors for forearm fracture in postmenopausal women in China: a case-control study.

Objective: Forearm fractures are a major cause of disability in postmenopausal women, but the risk factors have not been previously studied in China and the results from Western studies may not be applicable to the Chinese population. The aim of this study was to determine whether calcium intake, activity level, lifestyle, and other factors are associated with risk of forearm fracture among Chinese postmenopausal women.

Design: In this case-control study, the authors used a structured questionnaire to assess potential risk factors in 209 postmenopausal women 50 to 70 years old with new forearm fractures identified in eight hospitals in Chengdu and in age and location of residence-matched control subjects randomly selected from the community.

Henrik Kacser--a neglected author?

All sciences progress by elaborating new concepts and by finding new relationships between the parts of a system of interacting components. Henrik Kacser, with a background in Biophysics and Genetics, was well placed to develop a new and comprehensive analysis of the control of metabolic fluxes and metabolite concentrations; and to demonstrate that changes in the concentration of normal metabolites were as important in Genetics as changes in the composition of metabolites in bringing about a change in trait.

Don't tip the scales! Care for patients involved in a police investigation.

Occasionally perioperative nurses are involved in the complex role of caring for medical-legal evidence while also advocating for the patient's right for privacy. Appropriate management of evidence may be the deciding factor in the outcome of a criminal investigation. Understanding the importance of evidence is the first step in learning how to prevent its unintentional destruction during the surgical procedure.

Phosphorus release in aerobic sludge digestion.

The objectives of this study are to examine the phosphorus release in aerobic sludge digestion and to better understand its governing mechanisms. In this study, phosphorus release was examined using the secondary sludge from both conventional and biological nutrient removal processes. The experiments were carried out at room temperature (22 +/- 2 degrees C), with or without automatic control of pH (4.

Surgical counts can be risky business!

The surgical count plays a vital role in enabling perioperative nurses to provide a safe environment to surgical patients. Counting errors are preventable. Although national standards of care provide excellent guidelines for developing effective count protocols, counting procedures are often modified according to individual health care policy.

A rational treatment of Mendelian genetics.

Background: The key to a rational treatment of elementary Mendelian genetics, specifically to an understanding of the origin of dominant and recessive traits, lies in the facts that: (1) alleles of genes encode polypeptides; (2) most polypeptides are catalysts, i.e. enzymes or translocators; (3) the molecular components of all traits in all cells are the products of systems of enzymes, i.

We still fail to account for Mendel's observations.

Background: The present article corrects common textbook accounts of Mendel's experiments by re-establishing what he wrote and how he accounted for his observations. It notes the long-established tests for the validity of any explanations that purport to explain observations obtained by experiment. Application of these tests to Mendel's paper shows that the arguments he used to explain his observations were internally consistent but were, on one crucial issue, implausible.