Effects of opioid use in pregnancy on pediatric development and behaviour in children older than age 2: Systematic review.

Objective: To summarize information on the effects of opioid use in pregnancy on subsequent pediatric development and behaviour.

Data Sources: Searches were performed in EMBASE, MEDLINE, and PsycINFO for peer-reviewed, English articles, including a manual search of their references, that were published between January 1, 2000, and May 1, 2018.

Study Selection: Of the 543 articles reviewed, 19 relevant articles that focused on developmental effects of opioid exposure in utero were identified.

Prevalence of chronic kidney disease and cardiovascular comorbidities in adults in First Nations communities in northwest Ontario: a retrospective observational study.

Background: The prevalence of adult chronic kidney disease and cardiovascular comorbidities in Canadian Indigenous communities is largely unknown. We conducted a study to document the prevalence of chronic kidney disease and concurrent diabetes mellitus, hypertension and dyslipidemia in a First Nations population in northwest Ontario.

Methods: In this observational study, we used retrospective data collected from regional electronic medical records of 16 170 adults (age ≥ 18 yr) from 26 First Nations communities in northwest Ontario from May 2014 to May 2017.

Characterizing high-frequency emergency department users in a rural northwestern Ontario hospital: a 5-year analysis of volume, frequency and acuity of visits.

Introduction: High-frequency emergency department users contribute substantially to urban emergency department workloads. The scope of this issue in rural emergency care provision is largely unknown.

Methods: We retrospectively analyzed emergency department visits at the Sioux Lookout Meno Ya Win Health Centre and associated primary care data from 2010 to 2014 for high-frequency (≥ 6 annual visits) and non-high-frequency(< 6 annual visits) emergency department users.

Maternal opioid use disorder and neonatal abstinence syndrome in northwest Ontario: a 7-year retrospective analysis.

Introduction: Opioid use in pregnancy is increasing globally. In northwest Ontario, rates of neonatal abstinence syndrome (NAS) are alarmingly high. We sought to document the increasing rates of opioid exposure during pregnancy and associated cases of NAS over a 7-year period in northwest Ontario.

Nonpharmacological management of neonatal abstinence syndrome: a review of the literature.

Background: Infants with neonatal abstinence syndrome (NAS) experience withdrawal that occurs as a result of termination of placental opioid supply following delivery. Common symptoms include restlessness, tremors, agitation and gastrointestinal disturbances. Severe NAS is often treated using opioids and/or sedatives.

Epidemiology of invasive pneumococcal and Haemophilus influenzae diseases in Northwestern Ontario, Canada, 2010-2015.

Introduction: North American indigenous populations experience a high burden of invasive bacterial infections. Because Streptococcus pneumoniae and Haemophilus influenzae have multiple antigenic variants, the existing vaccines cannot prevent all cases. This study addresses the current epidemiology of invasive H.

Defining "high-frequency" emergency department use: Does one size fit all for urban and rural areas?

Objective: To suggest a functional definition for identification of "high-frequency" emergency department (ED) users in rural areas.

Design: Retrospective analysis of secondary data.

Setting: Sioux Lookout Meno Ya Win Health Centre in northwestern Ontario.

Maternal-Fetal Monitoring of Opioid-Exposed Pregnancies: Analysis of a Pilot Community-Based Protocol and Review of the Literature.

Objectives: To describe/analyse a novel, community-based prenatal monitoring protocol for opioid-exposed pregnancies developed by our centre in 2014 to optimize prenatal care for this population. A literature review of published monitoring protocols for this population is also presented.

Methods: Retrospective comparison of pre-protocol (n = 215) and post-protocol (n = 251) cohorts.

Prescription opioid prescribing, use/misuse, harms and treatment among Aboriginal people in Canada: a narrative review of available data and indicators.

Introduction: Prescription opioid (PO) misuse and related harms are high in Canada, and a major public health challenge. In Canada, 1.4 million individuals (4.

A 5 year retrospective study of emergency department use in Northwest Ontario: a measure of mental health and addictions needs.

Objective: The main objective of this study was to understand the five-year trend in total emergency department (ED) visits, frequency of use, and diagnoses and disposition of patients. Since the region has experienced a profound increase in opioid use disorder since 2009, we were particularly interested in changes in the volume of mental health and addiction (MHA) ED presentations.

Methods: Retrospective aggregate data analysis of ED visits to the Sioux Lookout Meno Ya Win Health Centre 2010-2014.

Observational study of the safety of buprenorphine+naloxone in pregnancy in a rural and remote population.

Objectives: To describe the effect of in utero exposure to the buprenorphine+naloxone combination product in a rural and remote population.

Setting: A district hospital that services rural and remote, fly-in communities in Northwestern Ontario, Canada.

Participants: A retrospective cohort study was conducted of 855 mother infant dyads between 1 July 2013 and 30 June 2015.

Interlaminar epidural steroid injections for low back pain in rural Ontario.

Introduction: We sought to document the efficacy of interlaminar epidural steroid injections (ESIs) for the relief of low back pain in a rural population.

Methods: We conducted a prospective observational cohort study with brief follow-up telephone interviews at 1, 3 and 6 months after interlaminar ESI.

Results: A total of 47 ESIs were administered to the 24 participants.

Length of Stay and Achievement of Functional Milestones in a Rural First Nations Population in Northwestern Ontario during Acute-Care Admission after Total Hip Replacement: A Retrospective Chart Review.

Purpose: To understand the postoperative acute-care physiotherapy course for First Nations people returning after total hip replacement (THR) to remote communities with limited rehabilitation services and to evaluate length of stay and attainment of functional milestones after THR to determine to what extent an urban-based clinical pathway is transferrable to and effective for First Nations patients in a rural setting.

Methods: Data were collected retrospectively by reviewing charts of patients who underwent THR in the Northwest Ontario catchment area from 2007 through 2012.

Results: For the 36 patient charts reviewed, median length of stay (LOS) at the Sioux Lookout Meno Ya Win Health Centre (SLMHC) was 7.

Clostridium difficile infection in rural Ontario: a retrospective multisite population-based study.

Introduction: We conducted a retrospective, population-based study to assess the prevalence of Clostridium difficile infections and the associated risk factors among inpatients and outpatients in our region.

Methods: We used laboratory data over a 2-year period to identify inpatient and outpatient cases of C. difficile infection.

Evaluation of an inpatient medical withdrawal program in rural Ontario: a 1-year prospective study.

Introduction: We present a 1-year program evaluation of the Medical Withdrawal Support Service (MWSS) provided at the Sioux Lookout Meno Ya Win Health Centre. The centre's service area includes 4 rural municipalities and 28 First Nations communities. The program involves inpatient detoxification for opioid dependence with the use of buprenorphine-naloxone.

Vancomycin use in a rural hospital: a 3-year retrospective study.

Introduction: Urban centres often perform audits of vancomycin use as they face outbreaks of resistant organisms. We undertook this study to understand the indications and duration of intravenous vancomycin in a rural setting.

Methods: We conducted a retrospective chart audit for all patients who received intravenous vancomycin over a 3-year period at a rural hospital in northwestern Ontario.

Incidence of narcotic abuse during pregnancy in northwestern Ontario: three-year prospective cohort study.

Objective: To document the incidence and outcomes of narcotic use during pregnancy in northwestern Ontario.

Design: Three-year prospective cohort study.

Setting: Sioux Lookout and surrounding communities in northwestern Ontario.