Intimate partner violence (IPV) is a common concern among military Veterans that negatively impacts health. The United States' Veterans Health Administration (VHA) has launched a national IPV Assistance Program (IPVAP) to provide comprehensive services to Veterans, their families and caregivers, and VHA employees who use or experience IPV. Grounded in a holistic, Veteran-centered psychosocial rehabilitation framework that guides all facets of the program, the IPVAP initiated the pilot implementation of a novel intervention called Recovering from IPV through Strengths and Empowerment (RISE).
View Article and Find Full Text PDFBackground: Intimate partner violence (IPV) is a significant public health problem that is commonly experienced by women and associated with psychosocial health issues. Recovering from IPV through Strengths and Empowerment (RISE) is a brief, clinician-administered, variable-length (1-6 sessions), modular, individualized psychosocial counseling intervention developed for women experiencing IPV. We present qualitative feedback and quantitative helpfulness ratings from women patients of the Veterans Health Administration who completed a randomized clinical trial (RCT) comparing RISE to a clinician-administered advocacy-based Enhanced Care as Usual (ECAU; a single structured session consisting of psychoeducation, safety-planning, resources, and referrals).
View Article and Find Full Text PDFBackground: Following hip fracture surgery, patients from residential care are frequently excluded from inpatient rehabilitation. We aimed to assess the impact of place of residence and other factors such as frailty on rehabilitation outcomes after hip fracture surgery.
Methods: Retrospective cohort study.
Improving quality of care and patient outcomes is a professional duty of all health care workers. Quality improvement is a part of health policy, an accreditation requirement of residency programs, and a recognized sub-specialty in academic medicine. Given the increasing need for ophthalmological services with our aging population, it is critical for ophthalmologists and their staff to develop the necessary skills in quality improvement to ensure access to care that is safe, patient-centered, effective, efficient, equitable, and timely.
View Article and Find Full Text PDFPurpose: To evaluate long-term (4.5 to 6 y) changes in the position of Ahmed glaucoma valve (AGV) tubes.
Materials And Methods: Adult patients aged 18 years and above, 1 to 2 months post-AGV implantation were enrolled.
Purpose: To compare the intraoperative complication rates in cataract surgery performed by resident trainees and staff ophthalmologists.
Setting: Kensington Eye Institute, University of Toronto, Toronto, Canada.
Design: Prospective case series.
Objective: To analyze the outcomes of photorefractive keratectomy (PRK) on residual myopia and hyperopia post-laser in situ keratomileusis (LASIK) and to compare these results with PRK on eyes without previous laser refractive surgery.
Design: Retrospective comparative cohort study.
Participants: Patients undergoing PRK between 2006 and 2010 were reviewed.
Purpose: The purpose of this study was to determine the risk of a steroid pressure response from inhaled corticosteroids.
Patients And Methods: This randomized, double-masked, placebo-controlled trial included 22 adults with well-controlled open-angle glaucoma or ocular hypertension. Consenting participants were randomized to a 6-week course of twice-daily fluticasone propionate 250-μg metered-dose inhaler or saline placebo metered-dose inhaler.
Kienböck's disease is idiopathic osteonecrosis of the lunate, leading to its fracture and collapse. This study compares internal and external bone micro-architecture of normal and fractured lunates (Kienböck's), by using high-resolution three-dimensional (3D) micro-computed tomography (micro-CT) on the whole bone of the two lunate types, and histology. Fractured Kienböck-diseased lunates were obtained from patients undergoing proximal-row-carpectomy, while normal cadaveric lunates served as controls.
View Article and Find Full Text PDFPurpose: To report the outcome and the reversibility of refractive outcomes after intrastromal corneal ring segment (ICRS) explantation in patients with keratoconus treated with ICRS implantation and same-day collagen crosslinking (CXL).
Methods: This is a retrospective review of ICRS explantation in 3 eyes of 3 patients with keratoconus that had undergone femtosecond laser-enabled placement of paired ICRS (Intacs) with same-day CXL by a single surgeon between 2008 and 2011. The main outcome measures included baseline/preexplantation/postexplantation visual acuity, refractive error, keratometry, and higher order aberrations.
Purpose: To evaluate the efficacy of single or paired intrastromal corneal ring segments (ICRS) combined with ultraviolet-A and riboflavin collagen crosslinking (CXL) in patients with keratoconus.
Setting: Cornea Unit, Toronto Western Hospital, Toronto, Ontario, Canada.
Design: Retrospective comparative case series.
Purpose: To evaluate the efficacy of phototherapeutic keratectomy (PTK) combined with implantation of a single inferior intrastromal corneal ring segment (ICRS) and riboflavin with ultraviolet-A collagen crosslinking (CXL) performed sequentially on the same day in the management of keratoconus.
Setting: Cornea Unit, Toronto Western Hospital, Toronto, Ontario, Canada.
Design: Case series.
Purpose: Glaucoma drainage devices (GDD) are used in the surgical management of medically refractory glaucoma. One late serious complication is erosion and exposure of the tube, clip, or plate. In this study, we evaluated the effectiveness of oral buccal mucous membrane allografts with corneal lamellar grafts for the repair of GDD erosions.
View Article and Find Full Text PDFA case is presented of a life-threatening septicaemia and associated peripheral necrosing microembolic phenomenon, resulting from a dog lick to an insignificant burn wound. The isolated bacterium was Capnocytophaga canimorsus, a slow-growing Gram-negative bacillus commonly found in dog saliva. Any clinician seeing patients with a history of dog bite/saliva contact and progressive illness should consider this bacterium as a possible offender and take special care to elicit an accurate history, specifically including questions regarding animal contact.
View Article and Find Full Text PDFObjective: To compare microwave endometrial ablation (MEA) with a levonorgestrel-releasing intrauterine device (Mirena) in the management of heavy menstrual bleeding.
Design: A retrospective cohort study
Sample: Thirty-nine women were treated with MEA and 23 women with Mirena, in the South East Regional Health Service of South Australia during 1998 to 2001; the mean duration of follow-up was 14.6 months.