Utilization and Complications of Central Venous Access Devices in Oncology Patients.

Purpose: To describe how central venous access devices (CVADs) are utilized for ambulatory oncology patients and to evaluate the rate of complications.

Method: Single institution retrospective study of oncology patients with CVADs who received systemic treatment at the Walker Family Cancer Centre (WFCC) between 1 January and 31 December 2018.

Results: A total of 480 CVADS were placed in 305 patients, of which 408 (85%) were peripherally inserted central catheters (PICCs) and 72 (15%) were implanted vascular access devices (PORTs).

A Method for Confidence Intervals of High Quantiles.

The high quantile estimation of heavy tailed distributions has many important applications. There are theoretical difficulties in studying heavy tailed distributions since they often have infinite moments. There are also bias issues with the existing methods of confidence intervals (CIs) of high quantiles.

Adverse Outcomes after Advanced EVAR in Patients with Sarcopaenia.

Purpose: To determine whether low total psoas muscle area (tPMA), as a surrogate for sarcopaenia, is a predictor of adverse outcomes in patients undergoing advanced EVAR.

Materials And Methods: A retrospective review of medical records was performed for 257 patients who underwent advanced EVAR (fenestrated or branched technique) in a single tertiary centre from 1 January 2008 to 1 September 2019. The study cohort was divided into tertiles based on tPMA measurement performed independently by two observers from a peri-procedural CT scan at the level of mid-L3 vertebral body.

Linking the hemodynamic consequences of adverse childhood experiences to an altered HPA axis and acute stress response.

Adverse childhood experiences (ACEs), such as maltreatment and severe household dysfunction, represent a significant threat to public health as ACEs are associated with increased prevalence of several chronic diseases. Biological embedding, believed to be rooted in dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, is the prevailing theory by which chronic diseases become imprinted in individuals following childhood adversity. A shift towards HPA axis hypoactivity occurs in response to ACEs exposure and is proposed to contribute towards altered cortisol secretion, chronic low-grade inflammation, and dysregulated hemodynamic and autonomic function.

Moral Distress and Other Wellness Measures in Canadian Critical Care Physicians.

Understanding the magnitude of moral distress and its associations may point to solutions. To understand the magnitude of moral distress and other measures of wellness in Canadian critical care physicians, to determine any associations among these measures, and to identify potentially modifiable factors. This was an online survey of Canadian critical care physicians whose e-mail addresses were registered with either the Canadian Critical Care Society or the Canadian Critical Care Trials Group.

Transitions in Labour Force Participation over the Palliative Care Trajectory.

Background: Home-based palliative programs rely on family caregivers, who often miss time from employment. This article identified changes in caregivers' labour force participation over the palliative trajectory.

Methods: Family caregivers (n = 262) were interviewed biweekly to measure transitions across four employment categories.

Evaluation of the prevalence of Echinococcus multilocularis in dogs that visit off-leash dog parks in southern Ontario, Canada.

Prior to 2012, Echinococcus multilocularis was not known to occur in any host in Ontario, Canada. However, since that year, five cases of alveolar echinococcosis have been diagnosed in dogs that resided at the western end of Lake Ontario. In addition, E.

ADAPTED SERVQUAL: A Health Service Quality Scale Incorporating Indicators of Sanitation and Hygiene.

Background And Objectives: Many scales have been developed to measure health care quality over the years, but no scale available today incorporates all important indicators of sanitation and hygiene in health care. This study therefore assessed the psychometric properties of an adapted scale, hereby called ADAPTED SERVQUAL, in an attempt to provide a scale that includes relevant indicators of hospital hygiene and sanitation.

Methods: The setting of the study was low- and medium-capacity hospitals in the Greater Accra Region of Ghana.

The challenge of deciding between home-discharge versus hospitalization in COVID-19 patients: The role of initial imaging and clinicolaboratory data.

Background/objective: It is important to predict the COVID-19 patient's prognosis, particularly in countries with lack or deficiency of medical resource for patient's triage management. Currently, WHO guideline suggests using chest imaging in addition to clinicolaboratory evaluation to decide on triage between home-discharge versus hospitalization. We designed our study to validate this recommendation to guide clinicians.

Adverse Childhood Experiences (ACEs) Predict Increased Arterial Stiffness from Childhood to Early Adulthood: Pilot Analysis of the Niagara Longitudinal Heart Study.

An association among adults between adverse childhood experiences (ACEs) and arterial stiffness and between arterial stiffness and cardiovascular disease has been established. Recent cross-sectional evidence suggests that ACEs is linked to the development and progression of arterial stiffness, but it remains unclear when these changes begin to manifest. We examine the relationship between ACEs and changes in arterial stiffness from childhood into adulthood using population-based longitudinal data.

Testing of a (Spiritual) Self-Assessment Tool ((S)SAT) in a Community Hospital Setting.

The (Spiritual) Self-Assessment Tool Study was designed to test the novel engagement tool's effectiveness. Providing the (Spiritual) Self-Assessment Tool Study to newly admitted medical patients led to few instances where the tool was completed. Nevertheless, the (Spiritual) Self-Assessment Tool Study patient questionnaire generated significant secondary findings: a third of responding patients consider their hospital care incomplete without their care team having access to (Spiritual) Self-Assessment Tool data.

Psychological morbidity associated with prostate cancer: Rates and predictors of depression in the RADICAL PC study.

Introduction: Across all cancer sites and stages, prostate cancer has one of the greatest median five-year survival rates, highlighting the important focus on survivorship issues following diagnosis and treatment. In the current study, we sought to evaluate the prevalence and predictors of depression in a large, multicenter, contemporary, prospectively collected sample of men with prostate cancer.

Methods: Data from the current study were drawn from the baseline visit of men enrolled in the RADICAL PC study.

A Primary Care Provider's Guide to Pain After Spinal Cord Injury: Screening and Management.

Individuals with spinal cord injury (SCI) often experience chronic pain as a secondary complication. It can significantly impair mental health, sleep, mood, and overall quality of life. It is important for providers within a primary care setting to recognize the different types of pain such as nociceptive and neuropathic.

Validating the use of a stereoscopic robotized teleophthalmic drone slit lamp.

Objective: To validate the use of a mechanized remotely operated stereoscopic drone slit lamp (DSL) in assessing anterior segment pathology in ophthalmology patients compared with conventional slit lamp (CSL).

Methods: Patients were recruited from eye clinics at Hotel Dieu Hospital in Kingston, Ontario, Canada. Each patient was assessed by 2 examiners.

Hit the chronic… physical activity: are cannabis associated mental health changes in adolescents attenuated by remaining active?

Purpose: High-frequency cannabis use in adolescents has been associated with adult mental illness. In contrast, physical activity has been demonstrated to benefit mental health status. The purpose of this study was to examine whether, within a 1-year prospective study design, changes in cannabis use frequency are associated with changes in mental health, and whether meeting physical activity guidelines moderates these associations.

Converting to Connect: A Rapid RE-AIM Evaluation of the Digital Conversion of a Clerkship Curriculum in the Age of COVID-19.

Background: With the advent of the 2019 coronavirus pandemic, a decision was made to remove medical students from clinical rotations for their own safety. This forced students on a core emergency medicine (EM) rotation at McMaster University to immediately cease all in-person activities. An urgent need for a virtual curriculum emerged.

Impact of the COVID-19 pandemic on emergency CT head utilization in Ontario-an observational study of tertiary academic hospitals.

Purpose: To determine the impact of the Coronavirus disease-2019 (COVID-19) pandemic on the volume, indications, and results of CT heads performed in the emergency department (ED) at Canadian tertiary academic centers in Ontario.

Methods: A retrospective review of consecutive CT head examinations ordered through the ED during the early stages of the COVID-19 pandemic in Canada (March 12-April 8, 2020) was performed and compared with that during the pre-COVID-19 period (February 12-March 10, 2020). CT reports were reviewed for the exam indication and the presence of predefined acute findings.

Virtual care models for cancer survivorship.

Virtual care models for cancer survivorship are needed to support patients living with the chronic effects of cancer treatment, while increasing health system capacity. Characteristics that may be critical to their success have not been adequately studied. This scoping review summarizes previous efforts to virtualize survivorship care to inform future innovations in the field.

Evidence of continued exposure to legacy persistent organic pollutants in threatened migratory common terns nesting in the Great Lakes.

Persistent organic pollutants (POPs) accumulate in the food web of the Great Lakes ecosystem, causing concern that these chemicals play a role in the decline of avian species such as colonial-nesting waterbirds. In this study, samples from four life stages of the common tern (Sterna hirundo), a threatened species in New York State, were collected post-mortem in the Buffalo-Niagara region (United States). Brains (n = 26) and livers (n =27) were analyzed for polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), and the insecticide p,p'-dichlorodiphenyltrichloroethane (DDT) and its two metabolites p,p'-dichlorodiphenyldichloroethylene (DDE) and p,p'-dichlorodiphenyldichloroethane (DDD).

Depression in post-traumatic stress disorder.

Major depressive disorder (MDD) symptoms commonly occur after trauma-exposure, both alone and in combination with post-traumatic stress disorder (PTSD). This article reviews recent research on comorbidity between these disorders, including its implications for symptom severity and response to treatment. Despite considerable symptom overlap, the two disorders represent distinct constructs and depend, at least in part, on separate biological mechanisms.

An Integrated Study of Infection in Honduran Children: Human Seroepidemiology and Environmental Contamination in a Coastal Community.

(1) Background: Infections caused by and are considered zoonoses of global importance. Reports from North and South America indicate that human infections are widespread in both continents, but epidemiological information from Central America is still lacking. (2) Methodology: In the present cross-sectional multi-year study, we aimed to undertake the first seroepidemiological and environmental study on toxocariasis in Honduras.