Publications by authors named "R W Shulman"
Background & Aims: Mood disorders and disorders of gut-brain interaction (DGBI) are highly prevalent, commonly comorbid, and lack fully effective therapies. Although selective serotonin reuptake inhibitors (SSRIs) are first-line pharmacological treatments for these disorders, they may impart adverse effects, including anxiety, anhedonia, dysmotility, and, in children exposed in utero, an increased risk of cognitive, mood, and gastrointestinal disorders. SSRIs act systemically to block the serotonin reuptake transporter and enhance serotonergic signaling in the brain, intestinal epithelium, and enteric neurons.
View Article and Find Full Text PDFIntroduction: Accurate report of stool form is essential to diagnosis and assessment of treatment response. The modified Bristol Stool Form Scale for Children (mBSFS-C) classifies stool form into 5 types and is reliable and valid. However, a direct comparison of provider's and children's ratings using the mBSFS-C vs the traditional BSFS that uses 7 stool form types has not been done.
View Article and Find Full Text PDFArticle Synopsis
- Type 1 diabetes (T1D) requires continuous blood glucose monitoring and insulin management, making self-management a critical part of everyday life for patients.
- The study involved six focus groups with 24 adult participants in Ontario to gather insights on important outcome measures for developing a virtual self-management education and support trial.
- Key findings revealed six themes related to T1D management, including adapting to needs, personalized health indicators, technology use, trust in healthcare providers, benefits of peer support, and thoughts on virtual care during and after COVID-19.
There is a growing interest in the application of stereotactic body radiotherapy (SBRT) for the treatment of oligometastatic cancers. This increasing appeal of SBRT has highlighted the need for more sophisticated radiotherapy techniques that allow high doses of radiation to be delivered to multiple sites while limiting the exposure of neighboring healthy tissue. A major obstacle to achieving this aim has been the occurrence of interfraction target variability: the tendency of both the tumor and the surrounding tissue to undergo day-to-day non-synchronous shifts in position.
View Article and Find Full Text PDFAim: To test whether an audit and feedback-based intervention improved HbA1c 12 months after transfer to type 1 diabetes adult care.
Methods: Multi-centre, quasi-experimental pre-post study of an AF-based intervention targeting paediatric diabetes teams, which encouraged the implementation of an evidence-informed structured transition process at five paediatric diabetes centres in Ontario, Canada. Participants entered the study at their final paediatric visit.