Medical Specialties Commons^™

Heterogeneous Knowledge Of Childhood Seizures And Epilepsy Care In Canadian Healthcare Providers: Identifying The Gaps, Michelle Kregel, Sherry Coulson, Emily Guarasci, Andrea Andrade

Paediatrics Publications

Epilepsy is the most common chronic neurological condition in children. Many barriers exist in early recognition which cause delay in care and impact quality of life. Some of these children require advanced treatments which are underutilized due to lack of education, awareness and referrals. Overall, childhood epilepsy is underdiagnosed and poorly understood by non-expert providers. We investigated awareness and knowledge about epilepsy from primary care providers via the quality of their referrals. We prospectively collected and examined all epilepsy related referrals to the Paediatric Neurology Division at Children’s Hospital in London, Ontario, Canada during a six-month period. We developed a …

Chromium And Cobalt In Leather: A Danish Market Survey, Mikkel Bak Jensen, Farzad Seyed-Alinaghi, Ivan Chen, Jonas F. Hedberg, Yolanda S. Hedberg, Claus Zachariae, Jeanne Duus Johansen

Chemistry Publications

Introduction

Leather has been a significant source of chromium (Cr) allergy in Denmark since the 1990s. More recently, cobalt (Co) allergy has been identified in leather as a source of allergic contact dermatitis.

Objectives

To measure Cr and Co levels in Danish leather goods.

Methods

A total of 87 leather samples were collected, all tanned in Europe. Handheld X-ray fluorescence (XRF) device was used to screen for the presence of Cr and Co. The 20 leather samples with the highest concentrations of Co and Co were tested using International Organization for Standardization (ISO)-standards.

Results

XRF analysis showed Cr in 78/87 …

Cobourg's Covid-19 Vaccination Effort: A Model Of Community Engagement For Crisis Response, Sayra Cristancho, Emily Field, Crystal Gaudet

Surgery Publications

For many community members, emergency planning occurs in the background. Community members are not usually engaged in the planning activities. But people see the effects of planning when an emergency strikes. And when responses don’t appear to be happening or appear slow, empowered communities take charge. That’s what happened in Cobourg, Ontario between 2021 and 2022 when the community drove the implementation of the Covid-19 mass vaccination clinic at the Cobourg Community Centre, known as the CCC initiative. In this report, we synthesize the results of a qualitative assessment of the CCC clinic, including lessons and recommendations that other communities …

A Shared Decision-Making Process Utilizing A Decision Coach In Pediatric Epilepsy Surgery, Michelle Kregel, Natalie Evans, Bonnie Wooten, Craig Campbell, Sandrine De Ribaupierre, Andrea Andrade

Paediatrics Publications

BACKGROUND & RATIONALE: The process to evaluate candidacy for epilepsy surgery is lengthy and stressful for caregivers, therefore the decision can be challenging. There is not a lot of information in regard to how families of a child living with epilepsy navigate the stressful decision during surgical candidacy evaluation. With difficult decisions comes the possibility of increased decisional conflict in both the child and the family.

METHODS: A project designed to provide greater knowledge to the family was conducted utilizing the shared decision-making (SDM) process to assist families in the decision-making during surgical candidacy evaluation; this was done using a …

The Role Of Geography And Distance On Physician Follow-Up After A First Hospitalization With A Diagnosis Of A Schizophrenia Spectrum Disorder: A Retrospective Population-Based Cohort Study In Ontario, Canada, Kelly Anderson, Martin Rotenberg, Peter Gozdyra, Paul Kurdyak

Data and Test Instruments

No abstract provided.

The Impact Of Maternal Diabetes On Birth To Placental Weight Ratio And Umbilical Cord Oxygen Values With Implications For Fetal-Placental Development, Sheryl Choo, Barbra De Vrijer, Timothy R H Regnault, Hilary K Brown, Larry Stitt, Bryan S Richardson

Obstetrics & Gynaecology Publications

Introduction

We determined the impact of gestational diabetes (GDM) and pre-existing diabetes (DM) on birth/placental weight and cord oxygen values with implications for placental efficiency and fetal-placental growth and development.

Methods

A hospital database was used to obtain birth/placental weight, cord PO₂ and other information on patients delivering between Jan 1, 1990 and Jun 15, 2011 with GA >34 weeks (N = 69,854). Oxygen saturation was calculated from the cord PO₂ and pH data, while fetal O₂ extraction was calculated from the oxygen saturation data. The effect of diabetic status on birth/placental weight and cord oxygen values …

Families' Knowledge Change In Paediatric Drug Resistant Epilepsy: A Novel Clinic Model, Michelle Kregel, Sherry Coulson, Maryam N Nouri, Rochelle Sorzano, Andrea Andrade

Paediatrics Publications

BACKGROUND: Epilepsy is a chronic condition that affects approximately 95,000 Ontarians, of whom approximately 15,000 are children under the age of 18. Drug resistant epilepsy (DRE) will affect around 30% of these children who will require more advanced care due to their medical complexities. The purpose of this study is to determine if receiving care in a paediatric Comprehensive Epilepsy Clinic (CEC) is associated with positive outcomes for children living with DRE and their families by looking at three health outcomes: 1) families' knowledge of their child's diagnosis and treatment plan, 2) navigational access to both the hospital and community …

Differences In Clinical Presentation At First Hospitalization And The Impact On Involuntary Admissions Among First-Generation Migrant Groups With Non-Affective Psychotic Disorders, Kelly Anderson, Rebecca Rodrigues

Data and Test Instruments

No abstract provided.

Speech/Language Impairment Or Specific Learning Disability? Examining The Usage Of Educational Categories, Lisa Archibald, Wendy C. Georgan, Tiffany Hogan

Data and Test Instruments

No abstract provided.

Assessing The Impact Of Pregnancy And Birth Factors On The Maternal And Infant Microbiota, Kait F. Al, Laura Allen, Samantha Bedell, Jeremy P. Burton, Barbra De Vrijer

Obstetrics & Gynaecology Publications

Background: The microbiota acquired at birth is known to play an intimate role in later life health and disease and has been shown to be affected by the mode of birth. There has been recent interest in microbiota correction by maternal vaginal seeding in Cesarean section-born infants; however, the safety of this practice has been debated. The aim of this study was to assess how other factors, such as timing of sampling, maternal obesity, vaginal Group B Streptococcus colonization (GBS), and antibiotic exposure, affect the maternal and infant microbiota.

Methods: Maternal vaginal and saliva samples were collected at three time …

A Simple Perfused Cadaver Model For Damage Control Vascular Surgery Training, Shane A. Smith, Vivian C. Mcalister O.C.

Surgery Publications

No abstract provided.

An App-Based Ecological Momentary Assessment Of Undergraduate Mental Health During The Covid-19 Pandemic In Canada (Smart Healthy Campus Version 2.0): Longitudinal Study, Kelly Anderson, Chris Brogly, Daniel Lizotte, Marc Mitchell, Mark Speechley, Arlene Macdougall, Erin Huner, Michael Bauer

Data and Test Instruments

No abstract provided.

Comparing Youth With Vs Without Outpatient Mental Health Services On Subsequent Acute Mental Health Care Visits, Kelly Anderson, Jordan Edwards, Li Wang, Anne Fuller, Katholiki Georgiades

Data and Test Instruments

No abstract provided.

Neighbourhood-Level Social Capital, Marginalisation, And The Incidence Of Schizophrenia And Schizoaffective Disorder In Toronto, Canada: A Retrospective Population-Based Cohort Study, Kelly Anderson, Martin Rotenberg, Kwame Mckenzie, Andrew Tuck

Data and Test Instruments

No abstract provided.

Return On Investment From Service Transformation For Young People Experiencing Mental Health Problems: Approach To Economic Evaluations In Access Open Minds (Esprits Ouverts), A Multi-Site Pan-Canadian Youth Mental Health Project, Kelly Anderson

Data and Test Instruments

No abstract provided.

Assessing Cerebral Blood Flow, Oxygenation And Cytochrome C Oxidase Stability In Preterm Infants During The First 3 Days After Birth, Ajay Rajaram, Daniel Milej, Marianne Suwalski, Lilian Kebaya, Matthew Kewin, Lawrence Yip, Sandrine De Ribaupierre, Victor Han, Mamadou Diop, Soume Bhattacharya, Keith St. Lawrence

Paediatrics Publications

A major concern with preterm birth is the risk of neurodevelopmental disability. Poor cerebral circulation leading to periods of hypoxia is believed to play a significant role in the etiology of preterm brain injury, with the first three days of life considered the period when the brain is most vulnerable. This study focused on monitoring cerebral perfusion and metabolism during the first 72 h after birth in preterm infants weighing less than 1500 g. Brain monitoring was performed by combining hyperspectral near-infrared spectroscopy to assess oxygen saturation and the oxidation state of cytochrome c oxidase (oxCCO), with diffuse correlation spectroscopy …

Fetal Sex Impacts Birth To Placental Weight Ratio And Umbilical Cord Oxygen Values With Implications For Regulatory Mechanisms, Bryan S. Richardson, Akasham Rajagopaul, Barbra De Vrijer, Genevieve Eastabrook, Timothy R.H. Regnault

Obstetrics & Gynaecology Publications

Background: We determined the effect of fetal sex on birth/placental weight and umbilical vein and artery oxygen values with implications for placental efficiency and regulatory mechanisms underlying fetal–placental growth differences. Methods: A hospital database was used to obtain birth/placental weight, cord PO2 and other information on patients delivering between Jan 1, 1990 and Jun 15, 2011 with GA > 34 weeks (N = 69,836). Oxygen saturation was calculated from the cord PO2 and pH data, while fractional O2 extraction was calculated from the oxygen saturation data. The effect of fetal sex on birth/placental weight, cord PO2, O2 saturation, and fractional O2 …

Ecological Interchangeability: Supporting Team Adaptive Expertise In Moments Of Disruption, Sayra Cristancho, Emily Field, Lorelei Lingard, Taryn Taylor, Kathryn Hibbert, Graham Thompson, William Hibbert

Obstetrics & Gynaecology Publications

While undesirable, unexpected disruptions offer unique opportunities to enact adaptive expertise. For adaptive expertise to flourish, individuals and teams must embrace both efficiency and adaptation. While some industries do it readily, others continue to struggle with the tension between efficiency and adaptation, particularly when otherwise stable situations are unexpectedly disrupted. For instance, in healthcare settings, the efficiency mandate for strict compliance with scopes of practice can deter teams from using the adaptive strategy of making their members interchangeable. Yet, interchangeability has been hinted as a key capacity of today’ teams that are required to navigate fluid team structures. Because interchangeability …

Expression And Localization Of Nrf2/Keap1 Signalling Pathway Genes In Mouse Preimplantation Embryos Exposed To Free Fatty Acids., Grace Dionne, Michele D. Calder, Dean H Betts, Basim Abu Rafea, Andrew J Watson

Obstetrics & Gynaecology Publications

Obese women experience greater incidence of infertility, with reproductive tracts exposing preimplantation embryos to elevated free fatty acids (FFA) such as palmitic acid (PA) and oleic acid (OA). PA treatment impairs mouse preimplantation development in vitro, while OA co-treatment rescues blastocyst development of PA treated embryos. In the present study, we investigated the effects of PA and OA treatment on NRF2/Keap1 localization, and relative antioxidant enzyme (Glutathione peroxidase; Gpx1, Catalase; Cat, Superoxide dismutase; Sod1 and γ-Glutamylcysteine ligase catalytic unit; Gclc) mRNA levels, during in vitro mouse preimplantation embryo development. Female mice were superovulated, mated, and embryos cultured in the presence …

Principles Of Dormancy Evident In High-Grade Serous Ovarian Cancer, Trevor G. Shepherd, Frederick A. Dick

Paediatrics Publications

In cancer, dormancy refers to a clinical state in which microscopic residual disease becomes non-proliferative and is largely refractory to chemotherapy. Dormancy was first described in breast cancer where disease can remain undetected for decades, ultimately leading to relapse and clinical presentation of the original malignancy. A long latency period can be explained by withdrawal from cell proliferation (cellular dormancy), or a balance between proliferation and cell death that retains low levels of residual disease (tumor mass dormancy). Research into cellular dormancy has revealed features that define this state. They include arrest of cell proliferation, altered cellular metabolism, and unique …

Sleep Problems And Psychological Well-Being: Baseline Findings From The Canadian Longitudinal Study On Aging, Kelly Anderson, Rebecca Rodrigues, Kathryn Nicholson, Giuseppe Guaiana, Piotr Wilk, Saverio Stranges

Data and Test Instruments

No abstract provided.

Facing Hierarchy: A Qualitative Study Of Residents' Experiences In An Obstetrical Simulation Scenario, Adam B Garber, Glenn Posner, Taylor Roebotham, M Dylan Bould, Taryn Taylor

Obstetrics & Gynaecology Publications

BACKGROUND: Residents in surgical specialties face a steep hierarchy when managing medical crises. Hierarchy can negatively impact patient safety when team members are reluctant to speak up. Yet, simulation has scarcely been previously utilized to qualitatively explore the way residents in surgical specialities navigate this challenge. The study aimed to explore the experiences of residents in one surgical specialty, obstetrics and gynecology (Ob/Gyn), when challenging hierarchy, with the goal of informing future interventions to optimize resident learning and patient safety.

METHODS: Eight 3rd- and 4th-year Ob/Gyn residents participated in a simulation scenario in which their supervising physician made an erroneous …

Radiation Exposure Determination In A Secure, Cloud-Based Online Environment, Ben C. Shirley, Eliseos J. Mucaki, Peter Rogan

Biochemistry Publications

Rapid sample processing and interpretation of estimated exposures will be critical for triaging exposed individuals after a major radiation incident. The dicentric chromosome (DC) assay assesses absorbed radiation using metaphase cells from blood. The Automated Dicentric Chromosome Identifier and Dose Estimator System (ADCI) identifies DCs and determines radiation doses. This study aimed to broaden accessibility and speed of this system, while protecting data and software integrity. ADCI Online is a secure web-streaming platform accessible worldwide from local servers. Cloud-based systems containing data and software are separated until they are linked for radiation exposure estimation. Dose estimates are identical to ADCI …

Highlighting The Mechanistic Relationship Between Perinatal Depression And Preeclampsia: A Scoping Review, Mei Yuan, Samantha Bedell, Barbra De Vrijer, Genevieve Eastabrook, Jefferson C. Frisbee, Stephanie J. Frisbee

Obstetrics & Gynaecology Publications

Background: Although there is scientific literature supporting an association between depression and preeclampsia (PE), little is known about the underlying mechanistic pathways that may explain these observed associations. Thus, this study aimed to outline the relationship between depression and PE, and to highlight the underlying cardiovascular and metabolic risk factors that are common to both. Methods: A scoping review of the literature was conducted in Medline, Scopus, and Web of Science. Results: From 706 articles initially identified, 23 articles met the inclusion criteria and were included in this review. Although some studies reported a positive association between PE and postpartum …

Parental Perspectives On The Transfer Process For Critically Ill Children, Saoirse Cameron, Anna C. Gunz

Paediatrics Publications

Objective: To understand parental stressors and identify potential stress-mitigators during interfacility transfer of critically ill children. Methods: Descriptive qualitative multi-case study using semi-structured interviews. This study involved caregivers of patients admitted to the Paediatric Critical Care Unit at Children’s Hospital, London Health Sciences Centre transported from outlying hospitals. Study participants were recruited through purposeful sampling. Interviews were recorded, transcribed verbatim and manually de-identified. Coding was performed by two independent coders using a standard method of content analysis to identify common themes. Results: Themes were identified and reached saturation after twelve interviews were completed. Children were admitted primarily from Northwestern and …

Sex-Specific Alterations In Hepatic Cholesterol Metabolism In Low Birth Weight Adult Guinea Pigs., Ousseynou Sarr, Katherine E Mathers, Christina Vanderboor, Kristina Wiggers, Aditya Devgan, Daniel B Hardy, Lin Zhao, Timothy Regnault

Paediatrics Publications

BACKGROUND: Intrauterine growth restriction and low birth weight (LBW) have been widely reported as an independent risk factor for adult hypercholesterolaemia and increased hepatic cholesterol in a sex-specific manner. However, the specific impact of uteroplacental insufficiency (UPI), a leading cause of LBW in developed world, on hepatic cholesterol metabolism in later life, is ill defined and is clinically relevant in understanding later life liver metabolic health trajectories.

METHODS: Hepatic cholesterol, transcriptome, cholesterol homoeostasis regulatory proteins, and antioxidant markers were studied in UPI-induced LBW and normal birth weight (NBW) male and female guinea pigs at 150 days.

RESULTS: Hepatic free and …

The Origin And Contribution Of Cancer-Associated Fibroblasts In Colorectal Carcinogenesis, Hiroki Kobayashi, Krystyna A. Gieniec, Tamsin R.M. Lannagan, Tongtong Wang, Naoya Asai, Yasuyuki Mizutani, Tadashi Iida, Ryota Ando, Elaine M. Thomas, Akihiro Sakai, Nobumi Suzuki, Mari Ichinose, Josephine A. Wright, Laura Vrbanac, Jia Q. Ng, Jarrad Goyne, Georgette Radford, Matthew J. Lawrence, Tarik Sammour, Yoku Hayakawa, Sonja Klebe, Alice E. Shin, Samuel Asfaha, Mark L. Bettington, Florian Rieder, Nicholas Arpaia, Tal Danino, Lisa M. Butler, Alastair D. Burt

Paediatrics Publications

Background & Aims: Cancer-associated fibroblasts (CAFs) play an important role in colorectal cancer (CRC) progression and predict poor prognosis in CRC patients. However, the cellular origins of CAFs remain unknown, making it challenging to therapeutically target these cells. Here, we aimed to identify the origins and contribution of colorectal CAFs associated with poor prognosis. Methods: To elucidate CAF origins, we used a colitis-associated CRC mouse model in 5 different fate-mapping mouse lines with 5-bromodeoxyuridine dosing. RNA sequencing of fluorescence-activated cell sorting–purified CRC CAFs was performed to identify a potential therapeutic target in CAFs. To examine the prognostic significance of the …

Still Trouble With Serum Creatinine Measurements, Alexandra Kowalczyk, Maria Esther Diaz-Gonzalez De Ferris, Guido Filler

Paediatrics Publications

No abstract provided.

Cervicofacial Actinomycosis In The Pediatric Population: Presentation And Management, Karan Gandhi, Benjamin D. Van Der Woerd, M. Elise Graham, Michelle Barton, Julie E. Strychowsky

Paediatrics Publications

Background: Infection caused by Actinomyces species is a rare cause of head and neck infection in children. This chronic cervicofacial infection can present with localized swelling, abscess formation, sinus drainage and can be complicated by osteomyelitis. Methods: Presented are 2 pediatric cases of secondary actinomycosis in the context of congenital lesions: 1 patient with a previously excised preauricular sinus and another with a persistent sublingual mass. A comprehensive literature search was conducted for reported cases of pediatric actinomycosis in the cervicofacial region. Results: Both cases presented were successfully treated with a combination of complete surgical excision of the lesions and …

The Prevalence Of Physical Multimorbidity Among People With Non‐Affective Psychotic Disorders 10 Years After First Diagnosis: A Matched Retrospective Cohort Study, Kelly Anderson, Myanca Rodrigues, Saverio Stranges, Bridget Ryan

Data and Test Instruments

No abstract provided.