Implementation processes and capacity-building needs in Ontario maternal-newborn care hospital settings: a cross-sectional survey.

Background: Maternal-newborn care does not always align with the best available evidence. Applying implementation science to change initiatives can help move evidence-informed practices into clinical settings. However, it remains unknown to what extent current implementation practices in maternal-newborn care align with recommendations from implementation science, and how confident nurses, other health professionals, and leaders are completing steps in the implementation process.

An Integrated Rapid Response Model for Pediatric Patients Requiring In-Patient Medical Stabilization: Lessons Learned to Enable Regional Capacity Building.

There was an unprecedented surge in admissions for medical stabilization of pediatric patients with eating disorders during the COVID-19 pandemic in Ontario. Eleven hospitals established an integrated rapid response model to ensure timely in-patient access for these patients. This population was cared for in re-allocated community hospital beds as a result of engaging hospital leadership, strengthening partnerships, consulting experts, leveraging existing resources and developing regional bed access strategies.

Looking at Diabetes Through Different Lenses: Focus Groups Conducted With Somali Canadian Families and Their Health-care Providers.

Objectives: In Toronto, many families with Somali backgrounds have children living with type 1 diabetes (T1D). At our clinic, children with African and Caribbean backgrounds have higher glycated hemoglobin than children from European backgrounds. In this study, we explored the experiences and perspectives of Somali Canadian families with children living with T1D, as well as health-care professionals (HCPs) who care for them, to better understand how T1D impacts these families.

Planning and implementing practice changes in Ontario maternal-newborn hospital units: a secondary qualitative analysis.

Background: Moving evidence into practice is complex, and pregnant and birthing people and their infants do not always receive care that aligns with the best available evidence. Implementation science can inform how to effectively move evidence into practice. While there are a growing number of examples of implementation science being studied in maternal-newborn care settings, it remains unknown how real-world teams of healthcare providers and leaders approach the overall implementation process when making practice changes.

Magnesium and Fracture Risk in the General Population and Patients Receiving Dialysis: A Narrative Review.

Purpose Of Review: Magnesium is an essential mineral for bone metabolism, but little is known about how magnesium intake alters fracture risk. We conducted a narrative review to better understand how magnesium intake, through supplementation, diet, or altering the concentration of dialysate magnesium, affects mineral bone disease and the risk of fracture in individuals across the spectrum of kidney disease.

Sources Of Information: Peer-reviewed clinical trials and observational studies.

Identifying the research, advocacy, policy and implementation needs for the prevention and management of respiratory syncytial virus lower respiratory tract infection in low- and middle-income countries.

Introduction: The high burden of respiratory syncytial virus (RSV) infection in young children disproportionately occurs in low- and middle-income countries (LMICs). The PROUD (Preventing RespiratOry syncytial virUs in unDerdeveloped countries) Taskforce of 24 RSV worldwide experts assessed key needs for RSV prevention in LMICs, including vaccine and newer preventive measures.

Methods: A global, survey-based study was undertaken in 2021.

Monoclonal antibody treatment of COVID-19 in a pregnant woman with common variable immunodeficiency.

Background: Since the first reported case of COVID-19, infections due to the virus have ranged from mild to severe. Patients with inborn errors of immunity are thought to be at increased risk for infections such as COVID-19 due to the nature of their disease and being immunocompromised. Similarly, pregnant women by nature of physiological changes in immunity are susceptible to infections and consequently are felt to be at greater risk of contracting COVID-19 with potential grave consequences for not only the mother but also the fetus.

Assessment of Canadian perinatal mental health services from the provider perspective: Where can we improve?

Purpose: Perinatal mental health disorders are common, and rates have increased during the COVID-19 pandemic. It is unclear where providers may improve perinatal mental health care, particularly in countries lacking national guidelines, such as Canada.

Methods: A cross-sectional survey of perinatal health providers was conducted to describe the landscape of perinatal mental health knowledge, screening, and treatment practices across Canada.

Hydration and meal habits of physicians and medical learners: a literature review.

Purpose: Nutrition and hydration are important components of physician and medical learner well-being; meal-skipping and insufficient hydration are known to negatively impact cognition. Existing data on these phenomena are sparse and rarely considered together; furthermore, there is a lack of literature on interventions to address these problems. We therefore aimed to characterize existing literature on this topic.

Effect of COVID-19 on computed tomography usage and critical test results in the emergency department: an observational study.

Background: The effect of the coronavirus disease 2019 (COVID-19) pandemic on new or unexpected radiologic findings in the emergency department (ED) is unclear. The aim of this study was to determine the effect of the COVID-19 pandemic on the number of computed tomography (CT) critical test results in the ED.

Methods: We performed a retrospective observational study of ED CT usage at 4 Ontario hospitals (1 urban academic, 1 northern academic, 1 urban community and 1 rural community) over 1 month during the COVID-19 pandemic (April 2020) and over the same month 1 year earlier (April 2019; before the pandemic).

Major Outcomes With Personalized Dialysate TEMPerature (MyTEMP): Rationale and Design of a Pragmatic, Registry-Based, Cluster Randomized Controlled Trial.

Background: Small randomized trials demonstrated that a lower compared with higher dialysate temperature reduced the average drop in intradialytic blood pressure. Some observational studies demonstrated that a lower compared with higher dialysate temperature was associated with a lower risk of all-cause mortality and cardiovascular mortality. There is now the need for a large randomized trial that compares the effect of a low vs high dialysate temperature on major cardiovascular outcomes.

Moving in for Renovations: An Innovative Solution for Replacing End-of-Life Capital Equipment. The Michael Garron Hospital-Sunnybrook Collaborative Catheterization Laboratory Project.

Replacement of an end-of-life cardiac catheterization laboratory ("cath lab") can pose a significant challenge to a hospital, particularly in single-cath-lab institutions. The disruption in patient care requires innovative approaches to minimize the inconvenience and ensure ongoing quality of care. We describe a unique approach whereby Michael Garron Hospital (MGH) "leased" a cath lab within Sunnybrook Health Sciences Centre for a 12-week period during a cath lab replacement project at MGH.

Cultivating Innovative Pragmatic Cluster-Randomized Registry Trials Embedded in Hemodialysis Care: Workshop Proceedings From 2018.

Hemodialysis is a life-sustaining treatment for persons with kidney failure. However, those on hemodialysis still face a poor quality of life and a short life expectancy. High-quality research evidence from large randomized controlled trials is needed to identify interventions that improve the experiences, outcomes, and health care of persons receiving hemodialysis.

Improvement in sleep quality after total shoulder arthroplasty.

: Poor sleep quality due to nocturnal pain is increasingly reported as a major symptom in advanced glenohumeral arthritis. The current study aimed to evaluate preoperative and postoperative sleep quality, shoulder pain, and function in patients who underwent total shoulder arthroplasty (TSA). Preoperative factors contributing to delayed improvements in sleep quality were examined.

Microbial Degradation of Cellulosic Material and Gas Generation: Implications for the Management of Low- and Intermediate-Level Radioactive Waste.

Deep geologic repositories (DGR) in Canada are designed to contain and isolate low- and intermediate-level radioactive waste. Microbial degradation of the waste potentially produces methane, carbon dioxide and hydrogen gas. The generation of these gases increase rock cavity pressure and limit water ingress which delays the mobility of water soluble radionuclides.

Dizziness in a community hospital: central neurological causes, clinical predictors, and diagnostic yield and cost of neuroimaging studies.

: Neuroimaging is contributing to the rising costs of dizziness evaluation. This study examined the rate of central neurological causes of dizziness, relevant clinical predictors, and the costs and diagnostic yields of neuroimaging in dizziness assessment. : We retrospectively reviewed the records of 521 adult patients who visited the hospital during a 12-month period with dizziness as the chief complaint.

Low intensity pulsed ultrasound for bone healing: systematic review of randomized controlled trials.

 To determine the efficacy of low intensity pulsed ultrasound (LIPUS) for healing of fracture or osteotomy. Systematic review and meta-analysis. Medline, Embase, CINAHL, Cochrane Central Register of Controlled Trials, and trial registries up to November 2016.