Examining Access to Primary Care for People With Opioid Use Disorder in Ontario, Canada: A Randomized Clinical Trial.

Importance: People with opioid use disorder are less likely than others to have a primary care physician.

Objective: To determine if family physicians are less likely to accept people with opioid use disorder as new patients than people with diabetes.

Design, Setting, And Participants: This randomized clinical trial used an audit design to survey new patient intake at randomly selected family physicians in Ontario, Canada.

Towards a Postgraduate Oncology Training Model for Family Medicine: Mixed Methods Evaluation of a Breast Oncology Rotation.

Background: Family physicians have low knowledge and preparedness to manage patients with cancer. A breast oncology clinical rotation was developed for family medicine residents to address this gap in medical education.

Objectives And Methods: A breast oncology rotation for family residents was evaluated using a pre-post knowledge questionnaire and semi-structured interviews comparing rotation (RRs) versus non-rotation (NRRs) residents.

Socioeconomic and immigration status and COVID-19 testing in Toronto, Ontario: retrospective cross-sectional study.

Background: Preliminary evidence suggests that individuals living in lower income neighbourhoods are at higher risk of COVID-19 infection. The relationship between sociodemographic characteristics and COVID-19 risk warrants further study.

Methods: We explored the association between COVID-19 test positivity and patients' socio-demographic variables, using neighborhood sociodemographic data collected retrospectively from two COVID-19 Assessment Centres in Toronto, ON.

Clinician acceptability of self-collected human papillomavirus swabs as a primary cervical cancer screening method.

Objective: To determine knowledge and acceptability of and opinions about human papillomavirus (HPV) self-screening as an alternative to Papanicolaou testing among Canadian primary care providers (PCPs: family physicians and nurse practitioners) and obstetrician-gynecologists (OB-GYNs).

Design: Descriptive, cross-sectional, anonymous, online pilot survey.

Setting: Two academic teaching hospitals in downtown Toronto, Ont.

Association between new-onset anosmia and positive SARS-CoV-2 tests among people accessing outpatient testing in Toronto, Ontario: a retrospective cross-sectional study.

Background: Reports have suggested that anosmia is strongly associated with SARS-CoV-2 infection, but patients were often asked about this symptom after their diagnosis. This study assessed associations between prospectively reported anosmia and other symptoms related to SARS-CoV-2 infection, and SARS-CoV-2 positivity in community testing centres in Toronto, Ontario.

Methods: We conducted a retrospective cross-sectional study in which data were collected from 2 COVID-19 assessment centres affiliated with 2 hospitals in Toronto, Ontario, from Apr.

Clinical learnings from a virtual primary care program monitoring mild to moderate COVID-19 patients at home.

Background: Virtual consults have replaced in-person visits for many home-isolated patients with COVID-19 disease.

Objectives: To describe the natural history, clinical management and outcomes of community-dwelling patients with COVID-19, who received support from a family medicine-led, virtual CovidCare@Home program in Toronto, Ontario, Canada.

Methods: Observational, descriptive study conducted by retrospective chart review of 98 patients enrolled during the first 5 weeks of program implementation (8 April-11 May 2020); 73 patients with laboratory-confirmed COVID-19, with symptom onset ≤ 14 days before initial consult were included for analysis.

Clinical Decision Support Systems for Opioid Prescribing for Chronic Non-Cancer Pain in Primary Care: A Scoping Review.

Background And Objectives: Clinical decision support systems (CDSSs) may help clinicians prescribe opioids for chronic noncancer pain (CNCP) more appropriately. This scoping review determined the extent and range of the current evidence on CDSSs for opioid prescribing for CNCP in primary care, and whether investigators followed best evidence and current guidance in designing, implementing and evaluating these complex interventions.

Methods: We searched 9 electronic databases and other data sources for studies from January 1, 2008 to October 11, 2019.

Breastfeeding During Family Medicine Residency.

Background And Objectives: Canadian residents' breastfeeding experiences have only been reported in studies that broadly explored pregnancy and parenthood. We sought to fully explore Canadian family medicine resident mothers' breastfeeding experiences, and identify strategies to support workplace breastfeeding for future trainees.

Methods: Using an online survey, University of Toronto family medicine residents who gave birth from 2010 through 2016 were queried about their exclusive and overall breastfeeding duration, barriers, and facilitators to workplace breastfeeding, and strategies to improve the breastfeeding experience for future resident mothers.

Outcomes During Early Implementation of Mifepristone-Buccal Misoprostol Abortions up to 63 Days of Gestation in a Canadian Clinical Setting.

Objective: In January 2017, mifepristone became available in Canada. The goal of this study was to determine the effectiveness and safety of mifepristone-misoprostol abortion during its early implementation in a Canadian setting.

Methods: This retrospective chart review included the first 477 patients who had a mifepristone-misoprostol abortion from March 13 to October 31, 2017, in an urban sexual health clinic.

Beyond Plan B: A Qualitative Study of Canadian Pharmacists' Emergency Contraception Counselling Practices.

Objective: Pharmacists are often the front-line health care providers for women seeking emergency contraception (EC). This study explored Ontario pharmacists' EC counselling practices and their perceived barriers to recommending the most effective EC method, the copper IUD (Cu-IUD).

Methods: This qualitative study used one-on-one, semistructured interviews with 20 pharmacists working in pharmacies located within a 1-km radius of a large sexual health clinic that offered postcoital IUDs in downtown Toronto.

Physician and Patient Barriers to Breast Cancer Preventive Therapy.

The uptake of selective estrogen receptor modulators (SERMs) and aromatase inhibitors (AIs) for the primary prevention of breast cancer is low, despite their proven efficacy in several randomized clinical trials. This review summarizes the latest data on physicians' and women's barriers to breast cancer preventive therapy. Physicians' challenges include: identifying suitable candidates for preventive therapy, inadequate training and confidence in risk assessment and counselling, insufficient knowledge of risk-reducing medications, and lack of time.

Role expectations in dementia care among family physicians and specialists.

Background: The assessment and ongoing management of dementia falls largely on family physicians. This pilot study explored perceived roles and attitudes towards the provision of dementia care from the perspectives of family physicians and specialists.

Methods: Semi-structured, one-to-one interviews were conducted with six family physicians and six specialists (three geriatric psychiatrists, two geriatricians, and one neurologist) from University of Toronto-affiliated hospitals.

Pathways to dementia diagnosis among South Asian Canadians.

Urban centers are increasingly ethnically diverse. However, some visible minorities are less likely than their majority counterparts to seek and receive services and treatment for dementia. This study explored experiences of South Asian Canadians, Canada's largest visible minority group, prior to dementia diagnosis.

Laying the foundation: teaching policy and advocacy to medical trainees.

Background: A novel and comprehensive two-year health policy curriculum was developed and implemented for family medicine residents at two University of Toronto-affiliated teaching sites.

Aim: To evaluate the impact of the curriculum on residents' knowledge of health policy issues, and its usefulness to their learning.

Method: The evaluation included a pre-post delivery assessment of residents' content-based knowledge of issues in the Canadian healthcare system.

Physicians' attitudes and behaviour toward screening mammography in women 40 to 49 years of age.

Objective: To determine family physicians' attitudes and behaviour toward screening mammography, breast self-examination, and breast awareness in women aged 40 to 49 at average risk of breast cancer.

Design: Cross-sectional survey.

Setting: Women's College Hospital and Sunnybrook Health Sciences Centre, both in Toronto, Ont.

Preparing for an influenza pandemic: model of an immunization clinic in an urban family practice.

Problem Addressed: The surge in patient demand for the H1N1 influenza vaccine during the 2009 pandemic.

Objective Of The Program: To facilitate timely delivery of the 2009 H1N1 influenza vaccine to a family practice population while preserving regular clinic function and to create a model of effective vaccination delivery for future outbreaks.

Program Description: An academic family practice in Toronto, Ont, adopted a process-improvement approach and implemented 3 Saturday stand-alone H1N1 vaccination clinics to accommodate increased demand for the vaccine.

A comparison of hospital and nonhospital colonoscopy: wait times, fees and guideline adherence to follow-up interval.

Background: Although colonoscopy is increasingly performed in nonhospital facilities, studies to date examining differences between colonoscopy services in hospital and nonhospital settings have been limited, in large part, to administrative databases.

Objectives: To describe the experiences of patients receiving colonoscopy in hospital and nonhospital settings, and to compare these settings with respect to wait times and recommended follow-up interval to the next colonoscopy.

Methods: A postal survey of 2000 patients, 50 to 70 years of age, from an urban academic family practice was conducted.

Pathways to diagnosis: exploring the experiences of problem recognition and obtaining a dementia diagnosis among Anglo-Canadians.

Increasing evidence suggests that early diagnosis and management of dementia-related symptoms may improve the quality of life for patients and their families. However, individuals may wait from 1-3 years from the onset of symptoms before receiving a diagnosis. The objective of this qualitative study was to explore the perceptions and experiences of problem recognition, and the process of obtaining a diagnosis among individuals with early-stage dementia and their primary carers.

Intestinal transit of fat depends on accelerating effect of cholecystokinin and slowing effect of an opioid pathway.

Fat has been described to both accelerate and slow intestinal transit. We hypothesized that the fat-induced jejunal brake depends on the combined accelerating effect of CCK and the slowing effect of an opioid pathway. Using a multifistulated model, intestinal transit was measured in four dogs, while 60 mM oleate was delivered into the proximal gut with either 0 or 6 mg naloxone, and 0.