Myocardial Protection in Mitral Valve Surgery: Comparison Between Minimally Invasive Approach and Standard Sternotomy.

Objective: To compare antegrade and retrograde cardioplegia administration in minimally invasive mitral valve surgery (MIMS) and open mitral valve surgery (OMS) for myocardial protection.

Design: Retrospective study.

Setting: Tertiary care university hospital.

L'évaluation d'impact sur la santé en Montérégie : un processus appuyé sur le courtage de connaissances.

Le présent article fait état du modèle de soutien à la prise de décision appliqué à l'évaluation d'impact sur la santé (EIS) en Montérégie, au Canada. Pour répondre à la volonté de soutenir l'élaboration de politiques et projets municipaux favorables à la santé et fondés sur les données probantes, la Direction de santé publique a mis en œuvre une démarche d'EIS dont les fondements pratiques s'inspirent des expériences internationales en matière d'EIS et dont les assises théoriques reposent sur le partage et le courtage de connaissances. L'expérience montérégienne démontre que la stratégie de courtage de connaissances appliquées à l'EIS encourage un partage respectueux des responsabilités et rôles de chacune des parties prenantes et favorise l'utilisation des connaissances de santé publique dans la prise de décision municipale.

Transesophageal echocardiographic imaging of multiple complications following mitral valve replacement.

Unlabelled: We present a case of mitral valve (MV) replacement that resulted in multiple complications, as diagnosed by transesophageal echocardiography (TEE), including left ventricular outflow tract obstruction, aortic dissection and left ventricular rupture. We also describe that identification of bleeding originating from the posterior aspect of the heart by the surgical team should trigger a complete TEE evaluation for adequate diagnosis. An 84-year-old woman underwent a MV replacement.

Innovative approaches in the perioperative care of the cardiac surgical patient in the operating room and intensive care unit.

Perioperative care for cardiac surgery is undergoing rapid evolution. Many of the changes involve the application of novel technologies to tackle common challenges in optimizing perioperative management. Herein, we illustrate recent advances in perioperative management by focusing on a number of novel components that we judge to be particularly important.

[Validity 'and Utilities' clinic of a grid observation (PACSLAC-F) to evaluate the pain in seniors with dementia's living in the Long-Term Care ].

This study presents the validation of the French Canadian version (PACLSAC-F) of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC). Unlike the published validation of the English version of the PACSLAC, which was validated retrospectively, the French version was validated prospectively. The PACSLAC-F was completed by nurses working in long-term care facilities after observing 86 seniors, with severe cognitive impairment, in calm, painful or distressing but non-painful situations.

[The professional life and the health of nurses since the transformation of the Québec health system.].

Over the last years, the Quebec health system has gone through a period of transformation aimed at cost reduction and better efficiency. The present study describes the effects of the transformation on the professional life and on the health of nurses in the Quebec City urban area. Despite a cross-sectional study not allowing links from cause to effect and despite the fact that the study only includes nurses who were still employed by institutions, the research shows an increase of the prevalence of a higher level of psychological distress in nurses since the beginning of the transformation.

[Assess the impact of the health education program prescription drugs: yes...no...maybe].

Objective: Assess the impact of the health education program Les médicaments: Oui ...

Myelin staining of deep white matter in the dorsolateral prefrontal cortex in schizophrenia, bipolar disorder, and unipolar major depression.

Neuroimaging and postmortem studies suggest the involvement of white matter disease in schizophrenia, bipolar disorder, and unipolar major depression. To date there is no published, collective study of myelin staining in these three psychiatric disorders. Deep white matter lesions, potentially affecting corticolimbic circuits, have been particularly implicated in late life depression and poor outcome bipolar disorder.

Engaging health care workers in improving their work environment.

Aim: This study describes the perceptions of health care workers who were involved in a participatory approach for the reorganization of care and work, aimed at creating an optimum work environment.

Background: Quebec's health network has undertaken large-scale organizational changes to ensure the quality of health care and services for the population.

Method: This participatory research was carried out by means of interviews.

Reorganizing care and work: process and productivity gains.

A Montreal-area hospital implemented organizational changes to improve the psychosocial environment for patients and health care workers and enhance organizational efficiency. This article describes a participatory approach to improving the organization of care and work, an approach focused on productivity gains in an organization. Productivity gains were analyzed in 13 units of the Department of Nursing, which had introduced a series of organizational changes.

Validation of the critical-care pain observation tool in adult patients.

Background: Little research has been conducted to validate pain assessment tools in critical care, especially for patients who cannot communicate verbally.

Objective: To validate the Critical-Care Pain Observation Tool.

Methods: A total of 105 cardiac surgery patients in the intensive care unit, recruited in a cardiology health center in Quebec, Canada, participated in the study.

Patterns in information strategies used by older men to understand and deal with prostate cancer: an application of the modélisation qualitative research design.

Background: The increasing need of older individuals to safely self-manage their chronic illnesses requires that they clearly understand health-related information. Thus, this study examined health literacy as lived by men with prostate cancer (PC), rather than as assessed by professionals.

Objectives: This study aimed to describe, analyse, and understand informational strategies of men with PC.

Towards an integrated approach for the management of ageing nurses.

Aim: The objective of this study is to provide an overview of the ageing of the nursing workforce and to explore retention strategies centred on the entire professional life and on all age groups.

Background: The presence of an increasing proportion of ageing workers presents a major challenge to the nursing profession. Evaluation Presentation of theories about the development of a healthy workplace leads to the identification of a framework on which managers can base their management decisions.

New approaches of organizing care and work: giving way to participation, mobilization, and innovation.

Quebec's health network has undertaken large-scale organizational changes to ensure the continuity, accessibility, and quality of health care and services for the population. This article describes the optimal approach for making changes to the organization of care and work for patients, health care workers, and organizations. This participative action research was carried out by means of interviews and document analysis.

[Pain indicators in critical care].

In this descriptive/qualitative study, focus groups and individual interviews were completed with 48 critical care nurses and 12 critical care physicians. Results showed that many indicators are used by those clinicians for pain assessment in intubated patients, whatever their level of consciousness. Nurses and physicians mentioned giving weight to the patient's self-assessmen tof pain even when intubated, communication then being by means of signs.

Improving the psychosocial work environment.

Aim: This paper reports a pilot project to evaluate the effectiveness of a participatory organizational intervention to improve the psychosocial work environment in one long-term care unit.

Background: Since the early 1990s, health care institutions in Quebec have been constantly changing in order to improve the efficiency of the health care system. These changes have affected the work environment and have contributed to higher rates of burnout and absenteeism among nurses and other health care workers.

Pain assessment and management in critically ill intubated patients: a retrospective study.

Background: Little research has been done on pain assessment in critical care, especially in patients who cannot communicate verbally.

Objectives: To describe (1) pain indicators used by nurses and physicians for pain assessment, (2) pain management (pharmacological and nonpharmacological interventions) undertaken by nurses to relieve pain, and (3) pain indicators used for pain reassessment by nurses to verify the effectiveness of pain management in patients who are intubated.

Methods: Medical files from 2 specialized healthcare centers in Quebec City, Quebec, were reviewed.

[Adoption and maintenance of health behavior: the challenge of treatment compliance].

The aim of this article is to give an overview of the different concepts related to the phenomenon of regularity so as to better outline it in the context of a medical treatment. The attitudes, the beliefs, the perception of the personal control as well as the motivation are presented as the different factors influencing the adoption and upholding of a health behaviour. The recent conception of the learning process and the active role given to the learner have led to the recognition of the fact that, in order to have an effective learning process, the learner must become involved in the self management and self control of his own learning process.

[Models of health behavior].

One of the challenges for health professionals is to understand how individuals adopt and maintain healthy behaviours that lead to a better quality of life. This review of health behaviour models will help nurses determine appropriate interventions, and enhance programs that promote health and prevent sickness in individuals or groups of individuals. In order to establish priorities and to prevent omitting important points in planning such health programs, many theoretical and conceptual models have attempted to explain health behaviours as well as the indicators of compliance.

How to facilitate the orientation of new nurses into the workplace.

The orientation of new nursing graduates into the workplace is an impressive challenge. A research study was performed to identify the key elements of a program that would address the various issues regarding this orientation. A team of researchers from Laval University and the Centre Hospitalier Universitaire de Quebec (CHUQ) used a descriptive and participative research method and identified five key elements that must be considered in order for this orientation to succeed.

[Future shock of the new graduates].

How do new nursing graduates take their place in a changing workforce with continuing changes to health care delivery and budgetary cuts in health care institutions? To understand the importance of successfully adjusting to new employment and the rate at which new graduates leave the profession, it is necessary to understand what goes on during their first months on the job. This qualitative research project was conducted over an 18-month period and focused on the initial work adjustment period. It involved 31 nursing graduates working in five different hospitals in Quebec's Estrie Region.

[The exercise of partnership: an exploratory analysis throughout the development of a crisis intervention service in the Haut-Richelieu territory].

This article analyzes the concept, the implementation process and the objective of a crisis intervention center in the Haut-Richelieu area. It examines the driving and resisting forces to the practice of partnership as established by the Quebec government in its official policy for mental health. The authors describe the practice of partnership during the different phases of the project's implementation by showing the impact of this approach on the risks involved or on the potential for misdirection.