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The association of outdoor temperature and self-reported Raynaud's phenomenon severity among people with systemic sclerosis: a Scleroderma Patient-centered Intervention Network Cohort study.

BACKGROUND: Raynaud's phenomenon is the earliest and most common systemic sclerosis manifestation. Episodes can be triggered by cold exposure and ambient temperature changes. Small studies have found that Raynaud's phenomenon outcomes were associated with season. We aimed to map the degree that differences in ambient temperature are associated with Raynaud's phenomenon outcomes across the temperature spectrum. METHODS: People with Raynaud's phenomenon secondary to systemic sclerosis in the Scleroderma Patient-centered Intervention Network Cohort completed past-week Raynaud's phenomenon severi

Changes in Health Care Costs, Survival, and Time Toxicity in the Era of Immunotherapy and Targeted Systemic Therapy for Melanoma.

IMPORTANCE: Melanoma treatment has evolved during the past decade with the adoption of adjuvant and palliative immunotherapy and targeted therapies, with an unclear impact on health care costs and outcomes in routine practice. OBJECTIVE: To examine changes in health care costs, overall survival (OS), and time toxicity associated with primary treatment of melanoma. DESIGN, SETTING, AND PARTICIPANTS: This cohort study assessed a longitudinal, propensity score (PS)-matched, retrospective cohort of residents of Ontario, Canada, aged 20 years or older with stages II to IV cutaneous melanoma ident

A Multidimensional Diagnostic Approach for Chronic Obstructive Pulmonary Disease.

IMPORTANCE: Individuals at risk for chronic obstructive pulmonary disease (COPD) but without spirometric airflow obstruction can have respiratory symptoms and structural lung disease on chest computed tomography. Current guidelines recommend COPD diagnostic schemas that do not incorporate imaging abnormalities. OBJECTIVE: To determine whether a multidimensional COPD diagnostic schema that includes respiratory symptoms and computed tomographic imaging abnormalities identifies additional individuals with disease. DESIGN, SETTING, AND PARTICIPANTS: This cohort study included 2 longitudinal coho

Association between premorbid neuropsychological conditions and pediatric mild traumatic brain injury/concussion recovery time and symptom severity: a systematic review.

OBJECTIVE: The objective of this review was to identify associations between premorbid neuropsychological conditions and pediatric mild traumatic brain injury/concussion recovery time and symptom severity. INTRODUCTION: There is a lack of evidence-based clinical guidelines for the care of children with a premorbid neuropsychological condition who have sustained a mild traumatic brain injury, also known as concussion. This necessitates inquiry for any associations that may exist, which may contribute to an enhanced understanding of injury recovery patterns. INCLUSION CRITERIA: Participants in

Blood phosphorylated tau 181 as a biomarker for Alzheimer's disease: a diagnostic performance and prediction modelling study using data from four prospective cohorts.

BACKGROUND: CSF and PET biomarkers of amyloid β and tau accurately detect Alzheimer's disease pathology, but the invasiveness, high cost, and poor availability of these detection methods restrict their widespread use as clinical diagnostic tools. CSF tau phosphorylated at threonine 181 (p-tau181) is a highly specific biomarker for Alzheimer's disease pathology. We aimed to assess whether blood p-tau181 could be used as a biomarker for Alzheimer's disease and for prediction of cognitive decline and hippocampal atrophy. METHODS: We developed and validated an ultrasensitive blood immunoassay for

Variations in practice and outcomes in the Canadian NICU network: 1996-1997.

BACKGROUND: Previous reports of variations in outcomes among neonatal intensive care units (NICUs) examined only specific subpopulations of interest (eg, very low birth weight [VLBW] infants <1500 g of birth weight [BW]). OBJECTIVES: We report on current practice and outcomes variations in a population-based national study of Canadian NICUs from January 8, 1996 to October 31, 1997. METHOD: Information on 20 488 admissions to 17 tertiary level NICUs across Canada was prospectively collected by trained abstractors using a standard manual of operations and definitions. Data were verified and an

The health of primary caregivers of children with cerebral palsy: how does it compare with that of other Canadian caregivers?

BACKGROUND: Caring for any child involves considerable resources, but the demands for these resources are often increased when caring for a child with a disability. These demands have implications for the psychologic and physical health of the caregiver (CG). Although a number of recent trends in health care stress the importance of studying and promoting the health of CGs of children with disabilities, the literature in this area exhibits 2 major weaknesses, ie, most studies draw conclusions from relatively small, potentially biased, clinic-based samples and the majority of work has focused o

Incidence and risk factors of C. trachomatis, N. gonorrhoeae and syphilis among a cohort of urban Canadian gay, bisexual and other men who have sex with men, 2017-2023: informing the potential impact of doxycycline prophylaxis.

OBJECTIVES: Doxycycline as post-exposure prophylaxis (doxy-PEP) has emerged as an efficacious strategy to reduce Chlamydia trachomatis (C. trachomatis), Neisseria gonorrhoeae (N. gonorrhoeae) and syphilis (sexually transmitted infections (STIs)) among gay, bisexual and other men who have sex with men (GBM). There is a need to identify prescribing criteria that maximise the number of STIs averted while minimising excessive use. DESIGN: In this prospective longitudinal cohort study with repeated measures and biobehavioural data collection, participants completed a questionnaire and tested for S

Genome-wide association study meta-analysis identifies three novel loci for circulating anti-Müllerian hormone levels in women.

STUDY QUESTION: Can additional genetic variants for circulating anti-Müllerian hormone (AMH) levels be identified through a genome-wide association study (GWAS) meta-analysis including a large sample of premenopausal women? SUMMARY ANSWER: We identified four loci associated with AMH levels at P < 5 × 10-8: the previously reported MCM8 locus and three novel signals in or near AMH, TEX41 and CDCA7. WHAT IS KNOWN ALREADY: AMH is expressed by antral stage ovarian follicles in women, and variation in age-specific circulating AMH levels has been associated with disease outcomes. However, the physi

Evaluation of the feasibility, diagnostic yield, and clinical utility of rapid genome sequencing in infantile epilepsy (Gene-STEPS): an international, multicentre, pilot cohort study.

BACKGROUND: Most neonatal and infantile-onset epilepsies have presumed genetic aetiologies, and early genetic diagnoses have the potential to inform clinical management and improve outcomes. We therefore aimed to determine the feasibility, diagnostic yield, and clinical utility of rapid genome sequencing in this population. METHODS: We conducted an international, multicentre, cohort study (Gene-STEPS), which is a pilot study of the International Precision Child Health Partnership (IPCHiP). IPCHiP is a consortium of four paediatric centres with tertiary-level subspecialty services in Australia

Association of outcomes in acute flaccid myelitis with identification of enterovirus at presentation: a Canadian, nationwide, longitudinal study.

BACKGROUND: Acute flaccid myelitis (AFM) is characterised by rapid onset of limb weakness with spinal cord grey-matter abnormalities on MRI scan. We aimed to assess whether detection of enterovirus in respiratory or other specimens can help predict prognosis in children with AFM. METHODS: In this nationwide, longitudinal study, we evaluated the significance of detection of enterovirus in any sample in predicting outcomes in a cohort of Canadian children younger than 18 years presenting with AFM to tertiary paediatric hospitals in Canada in 2014 and 2018. All patients fulfilled the 2015 US Cen

Obesity is associated with alterations in antral follicle dynamics in eumenorrheic women.

STUDY QUESTION: Are ovarian antral follicle dynamics altered in women with obesity and regular ovulatory cycles? SUMMARY ANSWER: Eumenorrheic women with obesity display evidence of suppressed antral follicle dynamics as judged by fewer recruitment events, selectable follicles, and anovulatory dominant follicles, as well as lower anti-Müllerian hormone (AMH) concentrations and an increased prevalence of luteal phase defects. WHAT IS KNOWN ALREADY: Ovarian antral follicle development is a dynamic process involving distinct follicular and endocrine events that are critical for the occurrence of

CHC for pelvic pain in women with endometriosis: ineffectiveness or discontinuation due to side-effects.

STUDY QUESTION: What are the use patterns and factors associated with combined hormonal contraception (CHC) ineffectiveness or discontinuation due to side-effects in patients with endometriosis and pelvic pain? SUMMARY ANSWER: Worse chronic pelvic pain (CPP) severity and pelvic floor myalgia were associated with continuous CHC ineffectiveness, while poorer quality-of-life was associated with continuous CHC discontinuation due to side-effects. WHAT IS KNOWN ALREADY: CHC is a first line of therapy for endometriosis-associated pelvic pain in women. However, some patients state that CHC is ineff

Proceedings of the Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2018

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An Enhanced Approach for Economic Evaluation of Long-Term Benefits of School-Based Health Promotion Programs.

Chronic diseases constitute a tremendous public health burden globally. Poor nutrition, inactive lifestyles, and obesity are established independent risk factors for chronic diseases. Public health decision-makers are in desperate need of effective and cost-effective programs that prevent chronic diseases. To date, most economic evaluations consider the effect of these programs on body weight, without considering their effects on other risk factors (nutrition and physical activity). We propose an economic evaluation approach that considers program effects on multiple risk factors rather than o

The Economic Burden of Cancer in Canada from a Societal Perspective.

Cancer patients and their families experience considerable financial hardship; however, the current published literature on the economic burden of cancer at the population level has typically focused on the costs from the health system's perspective. This study aims to estimate the economic burden of cancer in Canada from a societal perspective. The analysis was conducted using the OncoSim-All Cancers model, a Canadian cancer microsimulation model. OncoSim simulates cancer incidence and deaths using incidence and mortality data from the Canadian Cancer Registry and demography projections from

Abstract Proceedings of the 38th Annual Canadian Association of Psychosocial Oncology (CAPO) Conference, June 2023.

On behalf of the Canadian Association of Psychosocial Oncology, we are pleased to present the Abstracts from the 2023 Annual Conference, titled "Co-designing Psychosocial Oncology: Optimizing Outcomes for All". The conference was held in Montreal from 20 June 2023 to 22 June 2023. This conference brought together key stakeholders including multidisciplinary professionals from nursing, psychology, psychiatry, social work, spiritual care, nutrition, medicine, rehabilitation medicine, occupational health and radiation therapy for both adult and pediatric populations. Participants included clinici

Medical Assistance in Dying in Oncology Patients: A Canadian Academic Hospital's Experience.

BackgroundMedical assistance in dying (MAID) was legislatively enacted in Canada in June 2016. Most studies of patients who received MAID grouped patients with cancer and non-cancer diagnoses. Our goal was to analyze the characteristics of oncology patients who received MAID in a Canadian tertiary care hospital.MethodsWe conducted a retrospective review of all patients with cancer who received MAID between June 2016 and July 2020 at London Health Sciences Centre (LHSC). We describe patients' demographics, oncologic characteristics, symptoms, treatments, and palliative care involvement.ResultsN

Характеристика разнообразия многочисленных склерозных популяций в Канаде: обзор аналитического исследования.

СПРАВОЧНАЯ ИНФОРМАЦИЯ: Цель этого аналитического обзора заключалась в выявлении существующей информации и пробелов в знаниях, касающихся характеристик разнообразия групп населения склероза (МС) в Канаде. МЕТОДЫ: Мы искали MedLINE, EMBASE, Cumsted Index in Medsing and Alimate Health Lification (CINAHL), SCOPUS and ProQuest's глобальный набор данных и диссертаций с 2010 года по 12 января 2024 года. Источниками данных являются тематические доклады/серии, когортные исследования, исследования по контролю за конкретными случаями, аналитические перекрестные исследования, случайные клинические испытан

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… The remaining studies used a mixture of re-analysis of study-specific datasets, medical records review and the Canadian Longitudinal Study on Aging platform. 33 Primary data collection studies ( n  = 102, including the one that also used secondary data) most often relied on MS Clinics for recruitment …

The Survivor Unmet Needs Survey (SUNS) for haematological cancer survivors: a cross-sectional study assessing the relevance and psychometric properties.

BackgroundRelevant and psychometrically sound needs assessment tools are necessary for accurate assessment of haematological cancer survivors unmet needs. No previous study has developed nor psychometrically evaluated a comprehensive needs assessment tool for use with population-based samples of haematological cancer survivors. This study aimed to assess the validity and reliability of the Survivor Unmet Needs Survey (SUNS) with haematological cancer survivors.MethodsThe relevance, content and face validity of the SUNS to haematological cancer survivors was assessed using qualitative interview