Background: In response to the escalating global prevalence of substance use and the specific challenges faced in Northern Ontario, Canada, an Addiction Medicine Unit (AMU) was established at Health Sciences North (HSN) in Sudbury. This protocol outlines the approach for a comprehensive evaluation of the AMU, with the aim of assessing its impact on patient outcomes, healthcare utilization, and staff perspectives.
Methods: We conducted a parallel mixed-method study that encompassed the analysis of single-center-level administrative health data and primary data collection, including a longitudinal observational study (target n = 1,200), pre- and post-admission quantitative interviews (target n = 100), and qualitative interviews (target n = 25 patients and n = 15 staff). We implemented a participatory approach to this evaluation, collaborating with individuals who possess lived or living expertise in drug use, frontline staff, and decision-makers across the hospital. Data analysis methods encompass a range of statistical techniques, including logistic regression models, Cox proportional hazards models, Kaplan-Meier curves, Generalized Estimating Equations (GEE), and thematic qualitative analysis, ensuring a robust evaluation of patient outcomes and healthcare utilization.
Discussion: This protocol serves as the foundation for a comprehensive assessment designed to provide insights into the AMU's effectiveness in addressing substance use-related challenges, reducing healthcare disparities, and improving patient outcomes. All study procedures have been meticulously designed to align with the ethical principles outlined in the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans. The findings will be disseminated progressively through committees and working groups established for this research, and subsequently published in peer-reviewed journals. Anticipated outcomes include informing evidence-based healthcare decision-making and driving improvements in addiction treatment practices within healthcare settings.
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http://dx.doi.org/10.1186/s12913-023-10313-0 | DOI Listing |
J Clin Exp Hepatol
December 2024
Max Centre for Liver and Biliary Sciences, Max Super Specialty Hospital, Saket, New Delhi 110017, India.
Background: Locoregional therapy (LRT) in patients with hepatocellular carcinoma (HCC) before liver transplantation (LT) has a role in improving the tumor biology and post-LT survival outcome apart from downstaging and bridging. We retrospectively analyzed our database of adult living donor liver transplants (LDLT) for HCC, to compare the survival outcomes in Group-1 (upfront-LT, HCC within Milan/UCSF/AFP<1000 ng/ml) and Group-2 (LT post-LRT, HCC beyond UCSF/irrespective of tumor burden with AFP>1000 ng/ml). We also explored the risk factors for recurrence on follow-up.
View Article and Find Full Text PDFComput Struct Biotechnol J
November 2024
Intellicode Cooperation, Republic of Korea.
Conventional personal health record (PHR) management systems are centralized, making them vulnerable to privacy breaches and single points of failure. Despite progress in standardizing healthcare data with the FHIR format, hospitals often lack efficient platforms for transferring PHRs, leading to redundant tests and delayed treatments. To address these challenges, we propose a decentralized PHR management system leveraging Personal Data Stores (PDS) and Decentralized Identifiers (DIDs) in line with the Web 3.
View Article and Find Full Text PDFLancet Reg Health West Pac
January 2025
Department of Medicine, National University of Singapore, Yong Loo Lin School of Medicine, Singapore, Singapore.
Background: Little is known about the practices and resources employed by general practitioners (GPs) in Singapore to manage late-life depression. As the country is stepping up its efforts to promote collaborative care across community mental health and geriatric care, understanding GPs' current practices when managing late-life depression appears timely.
Methods: This qualitative descriptive study explored the perspectives on late-life depression of 28 private GPs practicing in Singapore through online semi-structured group and individual interviews.
Lancet Reg Health West Pac
January 2025
Division of Nephrology, National Clinical Research Centre for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Background: Early diagnosis of chronic kidney disease (CKD) is crucial for timely intervention to delay disease progression and improve patient outcomes. However, data for clinical characteristics of Chinese patients with undiagnosed, early-stage CKD are lacking.
Methods: REVEAL-CKD is a multinational, observational study using real-world data in selected countries to describe factors associated with undiagnosed stage 3 CKD, time to diagnosis, and CKD management post diagnosis.
J Surg Case Rep
January 2025
Department of Otolaryngology-Head and Neck Surgery, King Fahd Specialist Hospital, Dammam 32253, Saudi Arabia.
Isolated maxillary fungal pathologies involve a variety of clinical entities. These include invasive and non-invasive variants, where each has a unique pathogenesis, clinical manifestation, and approach for management. The aim of this case series is to investigate the several ways that fungal infections of the maxillary sinus might present, with the approach to diagnose and manage these conditions.
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