Implementing and Sustaining Early Cancer Diagnosis Initiatives in Canada: An Exploratory Qualitative Study.

Background: The interval between suspected cancer and diagnosis for symptomatic patients is often fragmented, leading to diagnosis delays and increased patient stress. We conducted an exploratory qualitative study to explore barriers and facilitators to implementing and sustaining current initiatives across Canada that optimize early cancer diagnosis, with particular relevance for symptomatic patients.

Methods: The national study included a document review and key informant interviews with purposefully recruited participants.

Interventions to improve early cancer diagnosis of symptomatic individuals: a scoping review.

Objectives: To summarise the current evidence regarding interventions for accurate and timely cancer diagnosis among symptomatic individuals.

Design: A scoping review following the Joanna Briggs Institute's methodological framework for the conduct of scoping reviews and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist.

Data Sources: MEDLINE (Ovid), CINAHL (EBSCOhost) and PsycINFO (Ovid) bibliographic databases, and websites of relevant organisations.

How equitable is access to treatment for lung cancer patients? A population-based review of treatment practices in Ontario.

Aim: Guideline concordance is one of the metrics used by the Cancer Quality Council of Ontario and Cancer Care Ontario to assess the quality of cancer care and to drive quality improvement.

Materials & Methods: The rates for lung cancer surgical resection and concordance with the Cancer Care Ontario postoperative adjuvant chemotherapy (AC) guideline were assessed by health region during two time periods (2010-2011 and 2012-2013) according to five equity measures (age, sex, neighborhood income, location of residence and size of immigrant population).

Results: Of the patients with stage I/II NSCLC, 52.

Raising the bar: using program evaluation for quality improvement.

The Cancer Quality Council of Ontario has undertaken 3 programmatic reviews, in partnership with Cancer Care Ontario, to evaluate an emerging or existing program and to provide future directions. The reviews are a quality improvement tool consisting of an assessment of the program's current state, a critical appraisal, and an environmental scan in advance of an event where attendees hear best practices from jurisdictions and participate in a discussion leading to a set of recommendations for the program.

Prediction of incomplete screening mammograms based on age and race.

Objective: This study examined the age-associated rate of incomplete mammograms requiring additional testing based on Breast Imaging-Reporting and Data System (BIRADS) score.

Methods: A retrospective, observational study design from a tertiary medical center was used to evaluate which explanatory variables significantly predicted whether a woman had an incomplete mammogram. An incomplete mammogram was defined as a BIRADS score of 0 (requiring further imaging), whereas a benign process was defined as a BIRADS score of 1 or 2.

The visual analog scale in the immediate postoperative period: intrasubject variability and correlation with a numeric scale.

Unlabelled: The visual analog scale (VAS) has been used to assess the efficacy of pain management regimens in patients with acute postoperative pain, but its usefulness has not been confirmed in postoperative pain studies. We studied 60 subjects in the immediate postoperative period. The specific data collected were: VAS scores versus an 11-point numeric pain scale; repeatability in VAS scores over a short time interval; and change in VAS scores from one assessment period to the next versus a verbal report of change in pain.

Problems of inner city general practice in north-east London.

This paper looks at differences in primary health care between the inner city and suburban areas of the North-East London Faculty of the Royal College of General Practitioners. Most of the differences observed were in the expected direction. However, the inner city area did not appear worse off in terms of the proportion of doctors specifically trained for general practice, the availability of doctors outside normal surgery hours, the links between general practitioners and hospitals and the attitudes of doctors to change.

Hemodynamic responses in brain dead organ donor patients.

Because we have noticed dramatic hemodynamic responses in brain dead patients undergoing surgery for organ donation, we analyzed the anesthetic records of cadaver organ donors. Ten records contain complete data for heart rate, blood pressure, central venous pressure, and time of incision. Systolic pressure increased by a mean of 31 torr (P less than 0.

Systemic carnitine deficiency--a treatable inherited lipid-storage disease presenting as Reye's syndrome.

A 3 1/2-year-old boy presented at three months of age with an acute episode of lethargy, somnolence, hypoglycemia, hepatomegaly, and cardiomegaly, which responded poorly to restoration of the blood sugar level to normal. The absence of ketonuria during subsequent episodes of severe hypoglycemia prompted a search for a defect in fatty acid oxidation. Plasma carnitine (2.

Hypotension and respiratory distress caused by rapid infusion of mannitol or hypertonic saline.

Following a case of mannitol-induced respiratory and circulatory collapse, the effects of hyperosmolar injections on pulmonary arterial pressure, systemic blood pressure, and cardiac output were studied in dogs. The injection of 20 ml of 10% NaCl into the pulmonary artery increased pulmonary arterial pressure and decreased systemic blood pressure by approximately 50% of control values. Injections of solutions of equal hyperosmolar strength, 50 ml of 25% mannitol or 50 ml of 4% NaCl into the pulmonary artery produced no significant elevation of pulmonary arterial pressure, but were associated with comparable decreases in systemic blood pressure.