Journal articles: 'Health status indicators – Ontario – Toronto'

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Mahendra, Ahalya, Jane Y. Polsky, Éric Robitaille, Marc Lefebvre, Tina McBrien, and Leia M. Minaker. "Status report - Geographic retail food environment measures for use in public health." Health Promotion and Chronic Disease Prevention in Canada 37, no. 10 (October 2017): 357–62. http://dx.doi.org/10.24095/hpcdp.37.10.06.

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The Association of Public Health Epidemiologists in Ontario (APHEO) Core Indicators Work Group standardizes definitions and calculation methods for over 120 public health indicators to enhance accurate and standardized community health status reporting across public health units in Ontario. The Built Environment Subgroup is a multi-disciplinary group made up of planners, researchers, policy analysts, registered dietitians, geographic information systems (GIS) analysts and epidemiologists. The Subgroup selected and operationalized a suite of objective, standardized indicators intended to help public health units and regional health authorities assess their community retail food environments. The Subgroup proposed three indicators that use readily available data sources and GIS tools to characterize geographic access to various types of retail food outlets within neighbourhoods in urban settings. This article provides a status report on the development of these food environment indicators.

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Kanoatova, Suman, Eric N. Liberda, and M. Anne Harris. "Population health indicators across Ontario’s Public Health Units: a cross-sectional analysis of the Canadian Community Health Survey." Environmental Health Review 64, no. 3 (November 2021): 68–78. http://dx.doi.org/10.5864/d2021-018.

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Background Currently, 34 public health units (PHUs) in Ontario deliver public health programs and services to reduce preventable diseases, promote and protect health of their communities, and reduce persistent health inequities. Changes to the structure of Ontario PHUs have been proposed. This analysis compares the current 34 Ontario PHUs based on key health indicators for the purpose of determining local health needs in delivering public health programs and as a baseline for measuring the effect of any future changes to PHU structure. Methods We used data from the 2015–2016 Canadian Community Health Survey (CCHS), a voluntary cross-sectional survey about health status of Canadians. Twenty-one health indicators measured by the CCHS and particularly relevant to PHU responsibilities were identified and compared across units. In this descriptive, cross-sectional analyses we used survey-weighted frequency calculations of the selected indicator variables by PHU and χ2 analyses to test differences in indicator distribution across PHU. Results All indicators except for sex were distributed unevenly by PHU. We particularly highlight differences across units in modifiable indicators and risk factors such as obesity, fruit and vegetable consumption, physical inactivity, smoking, and access to primary care physicians. Impact of the study While all PHUs strive towards the same mandated responsibilities, considerable variations in health indicators exist between health units. This underscores the necessity for PHUs to tailor programs and deliver services based on local needs. Future changes to PHU structure must be tested against baseline to determine if they ameliorate or exacerbate health inequities in Ontario.

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Hosang, Stephanie, Natasha Kithulegoda, and Noah Ivers. "Documentation of Behavioral Health Risk Factors in a Large Academic Primary Care Clinic." Journal of Primary Care & Community Health 13 (January 2022): 215013192210744. http://dx.doi.org/10.1177/21501319221074466.

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Objective: To determine the prevalence of alcohol, smoking, and physical activity status documentation at a family health team in Toronto, Ontario, and to explore the patient characteristics that predict documentation of these lifestyle risk factor statuses. Design: Manual retrospective review of electronic medical records (EMRs). Setting: Large, urban, academic family health team in Toronto, Ontario. Participants: Patients over the age of 18 that had attended a routine clinical appointment in March, 2018. Main Outcome Measures: Prevalence and content of risk factor status in electronic medical records for alcohol, smoking, and physical activity. Results: The prevalence of alcohol, smoking, and physical activity documentation was 86.4%, 90.4%, and 66.1%, respectively. These lifestyle risk factor statuses were most often documented in the “risk factors” section of the EMR (83.7% for alcohol, 88.1% for smoking, and 47.9% for physical activity). Completion of a periodic health review within 1 year was most strongly associated with documentation (alcohol odds ratio [OR] 9.79, 95% Confidence Interval [CI] 2.12, 45.15; smoking OR 1.77 95% CI 0.51, 6.20; physical activity OR 3.52 95% CI 1.67, 7.40). Conclusion: Documentation of lifestyle risk factor statuses is strongly associated with having a recent periodic health review. If “annual physicals” continue to decline, primary care providers should final additional opportunities to address these key determinants of health.

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Salehi, Leila, Aisha K. Lofters, Susan M. Hoffmann, Jane Y. Polsky, and Katherine D. Rouleau. "Health and growth status of immigrant and refugee children in Toronto, Ontario: A retrospective chart review." Paediatrics & Child Health 20, no. 8 (November 1, 2015): e38-e42. http://dx.doi.org/10.1093/pch/20.8.e38.

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Scheim, Ayden I., Ruby Sniderman, Ri Wang, Zachary Bouck, Elizabeth McLean, Kate Mason, Geoff Bardwell, et al. "The Ontario Integrated Supervised Injection Services Cohort Study of People Who Inject Drugs in Toronto, Canada (OiSIS-Toronto): Cohort Profile." Journal of Urban Health 98, no. 4 (June 28, 2021): 538–50. http://dx.doi.org/10.1007/s11524-021-00547-w.

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AbstractThe Ontario Integrated Supervised Injection Services cohort in Toronto, Canada (OiSIS-Toronto) is an open prospective cohort of people who inject drugs (PWID). OiSIS-Toronto was established to evaluate the impacts of supervised consumption services (SCS) integrated within three community health agencies on health status and service use. The cohort includes PWID who do and do not use SCS, recruited via self-referral, snowball sampling, and community/street outreach. From 5 November 2018 to 19 March 2020, we enrolled 701 eligible PWID aged 18+ who lived in Toronto. Participants complete interviewer-administered questionnaires at baseline and semi-annually thereafter and are asked to consent to linkages with provincial healthcare administrative databases (90.2% consented; of whom 82.4% were successfully linked) and SCS client databases. At baseline, 86.5% of participants (64.0% cisgender men, median ([IQR] age= 39 [33–49]) had used SCS in the previous 6 months, of whom most (69.7%) used SCS for <75% of their injections. A majority (56.8%) injected daily, and approximately half (48.0%) reported fentanyl as their most frequently injected drug. As of 23 April 2021, 291 (41.5%) participants had returned for follow-up. Administrative and self-report data are being used to (1) evaluate the impact of integrated SCS on healthcare use, uptake of community health agency services, and health outcomes; (2) identify barriers and facilitators to SCS use; and (3) identify potential enhancements to SCS delivery. Nested sub-studies include evaluation of “safer opioid supply” programs and impacts of COVID-19.

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Stratton, J., D. L. Mowat, R. Wilkins, and M. Tjepkema. "Income disparities in life expectancy in the City of Toronto and Region of Peel, Ontario." Chronic Diseases and Injuries in Canada 32, no. 4 (September 2012): 208–15. http://dx.doi.org/10.24095/hpcdp.32.4.05.

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Introduction To understand the lack of a gradient in mortality by neighbourhood income in a previous study, we used individual-level data from the 1991–2001 Canadian census mortality follow-up study to examine income-related disparities in life expectancy and probability of survival to age 75 years in the City of Toronto and Region of Peel. Methods We calculated period life tables for each sex and income adequacy quintile, overall and separately for immigrants and non-immigrants. Results For all cohort members of both sexes, including both immigrants and non-immigrants, there was a clear gradient across the income quintiles, with higher life expectancy in each successively richer quintile. However, the disparities by income were much greater when the analysis was restricted to non-immigrants. The lesser gradient for immigrants appeared to reflect the higher proportion of recent immigrants in the lower income quintiles. Conclusion These findings highlight the importance of using individual-level ascertainment of income whenever possible, and of including immigrant status and period of immigration in assessments of health outcomes, especially for areas with a high proportion of immigrants.

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Reid, Scott, and Anita LeBaron. "Autumn electrofishing reduces harm to Ontario (Canada) stream fishes collected during watershed health monitoring." Conservation Evidence Journal 18 (January 1, 2021): 31–36. http://dx.doi.org/10.52201/cej18hjvu9134.

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Electrofishing surveys provide important information on watershed health, and the status of imperiled and recreationally important stream fishes. Concerns about the harmful effects of electrofishing on the endangered redside dace Clinostomus elongatus have resulted in restrictions on its use in sampling activities in the province of Ontario, Canada. However, the effectiveness of these restrictions is unproven. We undertook a paired sampling gear study in 2018-2019 to test whether an alternate gear (seine nets) or a change in electrofishing timing (autumn rather than summer) reduced harm to stream fishes. The study took place in streams located in the Greater Toronto Area. We found large differences in the frequency and magnitude of sampling-related mortalities between sampling gear and seasons. During individual surveys, electrofishing mortality never exceeded 9% in the summer or 4% in the autumn, while seining-related mortality reached 60% at two stream sites. Overall, autumn electrofishing resulted in mortality rates that were 5.6 and 15 times lower than summer electrofishing and summer seining. These results indicate that survival of Ontario stream fishes can be improved by delaying electrofishing until early autumn.

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Rotenberg, Martin, Andrew Tuck, Kelly Anderson, and Kwame McKenzie. "S131. NEIGHBOURHOOD-LEVEL SOCIAL CAPITAL, MARGINALIZATION, AND THE INCIDENCE OF PSYCHOTIC DISORDERS IN TORONTO, CANADA: A RETROSPECTIVE POPULATION-BASED COHORT STUDY." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S85. http://dx.doi.org/10.1093/schbul/sbaa031.197.

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Abstract Background Previous studies have shown mixed results regarding the relationship between social capital and the risk of developing a psychotic disorder, and this has yet to be studied in North America. This study aims to examine the relationship between neighbourhood-level social capital, marginalization, and the incidence of psychotic disorders in Toronto, Canada. Methods A retrospective cohort of people aged 14 to 40 years residing in Toronto, Canada in 1999 (followed to 2008) was constructed from population-based health administrative data. Incident cases of schizophrenia spectrum psychotic disorders were identified using a validated algorithm. Voter participation rates in a municipal election were used as a proxy neighbourhood-level indicator of social capital. Exposure to neighbourhood-level marginalization was obtained from the Ontario Marginalization Index. Poisson regression models adjusting for age and sex were used to calculate incidence rate ratios (IRR) for each social capital quintiles and marginalization quintile. Results In the study cohort (n = 640,000) over the 10-year follow-up period, we identified 4,841 incident cases of schizophrenia spectrum psychotic disorders. We observed elevated rates of psychotic disorders in areas with the highest levels (IRR = 1.13, 95% CI 1.00–1.27) and moderate levels (IRR = 1.23, 95% CI 1.12–1.36) of social capital, when compared to areas with the lowest levels of social capital, after adjusting for neighbourhood-level indicators of marginalization. The risk associated with social capital was not present when analyzed in only the females in the cohort. All neighbourhood marginalization indicators, other than ethnic concentration, were significantly associated with risk. Discussion The risk of developing a psychotic disorder in Toronto, Canada is associated with socioenvironmental exposures. Social capital is associated with risk, however, the impact of social capital on risk differs by sex and social capital quintile. Across the entire cohort, exposure to all neighbourhood-level marginalization indicators, except ethnic concentration, impacts risk. Future research should examine how known individual-level risk factors, including immigration, ethnicity, and family history of a mental disorder may interact with these findings.

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Gorey, Kevin M., Isaac N. Luginaah, Emma Bartfay, Karen Y. Fung, Eric J. Holowaty, Frances C. Wright, Caroline Hamm, and Sindu M. Kanjeekal. "Effects of Socioeconomic Status on Colon Cancer Treatment Accessibility and Survival in Toronto, Ontario, and San Francisco, California, 1996–2006." American Journal of Public Health 101, no. 1 (January 2011): 112–19. http://dx.doi.org/10.2105/ajph.2009.173112.

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Offord, David R., Michael H. Boyle, Jan E. Fleming, Heather Munroe Blum, and Naomi I. Rae Grant. "Summary of Selected Results." Canadian Journal of Psychiatry 34, no. 6 (August 1989): 483–91. http://dx.doi.org/10.1177/070674378903400602.

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Selected results from the Ontario Child Health Study (OCHS), a cross-sectional community survey of Ontario children four to 16 years of age, are presented in the areas of prevalence, risk indicators and service utilization. The six month prevalence of one or more of four psychiatric disorders (conduct disorder, hyperactivity, emotional disorder, and somatization), in children four to 16 years of age, in Ontario was 18.1%. The highest rate was in 12 to 16 year old girls, and the lowest rate in four to 11 year old girls. Co-morbidity among these four disorders was high while the proportion of disorders identified by more than one respondent was low. Psychiatric disorders co-occurred significantly with other morbidities in children, including poor school performance, chronic health problems, substance use and suicidal behaviour. Chronic medical illness in the child as well as single parent status, living in a family on social assistance and residing in subsidized housing, were all strong indicators of increased rates of psychiatric disorders in children. Specialized mental health/social services, over a six month period, reached fewer than one of five children with psychiatric disorders, as measured in the study. In contrast, ambulatory medical care (primarily visits to family doctors and pediatricians) served almost 60% of Ontario children four to 16 years old, over the same six month period. The results are compared with those in the literature.

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Dubelt-Moroz, Alexandra, Marika Warner, Bryan Heal, Saman Khalesi, Jessica Wegener, Julia O. Totosy de Zepetnek, Jennifer J. Lee, et al. "Food Insecurity, Dietary Intakes, and Eating Behaviors in a Convenience Sample of Toronto Youth." Children 9, no. 8 (July 27, 2022): 1119. http://dx.doi.org/10.3390/children9081119.

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Background: Food insecurity has been shown to be associated with poor dietary quality and eating behaviors, which can have both short- and long-term adverse health outcomes in children. The objective was to investigate the food security status, dietary intakes, and eating behaviors in a convenience sample of youth participating in the Maple Leaf Sports Entertainment LaunchPad programming in downtown Toronto, Ontario. Methods: Youth aged 9–18 years were recruited to participate in the study. Food security status, dietary intakes, and eating behaviors were collected using parent- or self-reported questionnaires online. Results: Sixty-six youth (mean ± SD: 11.7 ± 1.9 years) participated in the study. The prevalence of household food insecurity was higher than the national average (27.7% vs. 16.2%). Dietary intake patterns were similar to the national trends with low intakes of fiber, inadequate intakes of calcium and vitamin D; and excess intakes of sodium, added sugar, and saturated fat. Despite a low prevalence of poor eating habits, distracted eating was the most frequently reported poor eating habit. Conclusions: Although youth were at high risk for experiencing household food insecurity, inadequate dietary intake patterns were similar to the national trends. Our findings can be used to develop future programming to facilitate healthy dietary behaviors appropriate for the target community.

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Hargreaves, Sarah K., Paul DeJong, Ken Laing, Tony McQuail, and Laura L. Van Eerd. "Management sensitivity, repeatability, and consistency of interpretation of soil health indicators on organic farms in southwestern Ontario." Canadian Journal of Soil Science 99, no. 4 (December 1, 2019): 508–19. http://dx.doi.org/10.1139/cjss-2019-0062.

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Assessment tools are needed to evaluate the effect of farming practices on soil health, as there is increasing interest from growers to improve the health of their soils. However, there is limited information on the efficacy of different soil health indicators on commercial farms and perhaps less so on organic farms. To assess efficacy, three organic growers in cooperation with the Ecological Farmers Association of Ontario’s Farmer-Led Research Program tested management sensitivity, measurement repeatability, and consistency of interpretation of different soil health indicators. On each farm, we compared permanganate-oxidizable carbon (active carbon), organic matter, wet aggregate stability, phospholipid fatty acid analysis, Haney soil health test, and Haney nutrient test on one field of grower-perceived high productivity, one field of grower-perceived low productivity, and one reference site (undisturbed, permanent cover). Our results were consistent with previous research that showed grower perception of productivity and soil health associated with management-sensitive soil health indicators. Of the indicators tested, active carbon was the only indicator that was sensitive, repeatable, and consistent across the three farms, and soil organic matter was highly repeatable and consistent to detect differences greater than 0.5% organic matter. This study highlights differences among soil health indicators on commercial farms, and it concludes that active carbon and organic matter were the most useful soil health indicators for these organic farms. Participating growers intend to use results to benchmark current soil status and to help guide land management decisions towards improved soil health.

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Jacobs, P., LG Shane, K. Fassbender, EL Wang, R. Moineddin, and EL Ford-Jones. "Economic Analysis of Rotavirus-Associated Diarrhea in the Metropolitan Toronto and Peel Regions of Ontario." Canadian Journal of Infectious Diseases 13, no. 3 (2002): 167–74. http://dx.doi.org/10.1155/2002/926349.

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OBJECTIVE: To measure the economic cost of rotavirus- associated diarrhea for a selected group of families, in a nonexperimental setting, and to estimate the factors that influence these costs.DESIGN: Use and other socioeconomic data from a family survey (the Pediatric Rotavirus Epidemiology Study for Immunization) of children who tested positive for rotavirus were collected for the metropolitan Toronto and Peel regions of Ontario during the rotavirus season of 1997-1998. Service costs were estimated from provider data. A statistical regression analysis was used to explain the variances of provincial health care costs, prescription drug costs and indirect (work-loss) costs.SETTING: Data were collected in hospitals, emergency rooms, paediatric practices, primary care clinics and licensed daycare centres. Hospital coverage was wide, but community coverage was not.PATIENTS AND OTHER PARTICIPANTS: Children with diarrhea were tested for rotavirus. Those who tested positive and whose parents consented for their children to participate were included in the study.INTERVENTIONS: NoneMAIN OUTCOME MEASURES: The main outcomes were provincial health care costs, drug costs, nonmedical costs and thenumber of days of work missed by parents per child, as well as factors that determine these costs.RESULTS: Children in the most severe category incurred costs of $2,663/person, and those in the least severe categories incurred costs of approximately $350/person. The most important determinant to explain provincial health care costs was the number of health problems that the child had before having rotavirus. Costs due to work loss of parents were considerable for children in all severity groups and were influenced by family working conditions.CONCLUSIONS: When considering the economic implications of rotavirus, prior health status should be considered and indirect costs should be recognized for their importance.

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Boucher, Beatrice A., Elizabeth Manafò, Meaghan R. Boddy, Lynn Roblin, and Rebecca Truscott. "The Ontario Food and Nutrition Strategy: identifying indicators of food access and food literacy for early monitoring of the food environment." Health Promotion and Chronic Disease Prevention in Canada 37, no. 9 (September 2017): 313–19. http://dx.doi.org/10.24095/hpcdp.37.9.06.

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Introduction To address challenges Canadians face within their food environments, a comprehensive, multistakeholder, intergovernmental approach to policy development is essential. Food environment indicators are needed to assess population status and change. The Ontario Food and Nutrition Strategy (OFNS) integrates the food, agriculture and nutrition sectors, and aims to improve the health of Ontarians through actions that promote healthy food systems and environments. This report describes the process of identifying indicators for 11 OFNS action areas in two strategic directions (SDs): Healthy Food Access, and Food Literacy and Skills. Methods The OFNS Indicators Advisory Group used a five-step process to select indicators: (1) potential indicators from national and provincial data sources were identified; (2) indicators were organized by SD, action area and data type; (3) selection criteria were identified, pilot tested and finalized; (4) final criteria were applied to refine the indicator list; and (5) indicators were prioritized after reapplication of selection criteria. Results Sixty-nine potential indicators were initially identified; however, many were individual-level rather than system-level measures. After final application of the selection criteria, one individual-level indicator and six system-level indicators were prioritized in five action areas; for six of the action areas, no indicators were available. Conclusion Data limitations suggest that available data may not measure important aspects of the food environment, highlighting the need for action and resources to improve system-level indicators and support monitoring of the food environment and health in Ontario and across Canada.

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Gray, Sarah. "Biological requirements or social expectations? Entanglements of sex and gender in nutrition policies in Ontario secondary schools." Health Education Journal 80, no. 7 (May 18, 2021): 773–84. http://dx.doi.org/10.1177/00178969211011208.

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Objectives: An increasing number of nutrition policies have been implemented in Ontario schools as part of a concerted effort to address students’ well-being. This article explores understandings of biological differences in nutrition requirements between young men and women and the extent to which these differences are (re)produced in social eating behaviours and food pedagogies. Setting: A suburban school (grades 9–12) located in the Greater Toronto-Hamilton Area in Ontario, Canada. Method: Critical policy analysis combined with 13 focus groups of students (13–18 years old) in one Ontario school. A biopedagogical lens was used to analyse how young people develop and deploy their own reasoning and question the messages they receive about expected behaviour. Results: Focus group discussions suggest that dominant discourses and constructions about sex/gender are reproduced within the school environment, which has implications for the effectiveness of nutrition policies in schools. Furthermore, differences between young men and women’s eating behaviours were found to be contradictory to biopedagogical instructions from educational institutions and governmental agencies. For some young people, the pedagogical messages received are limited in their effectiveness because young people have not been convinced that it is worth risking their social status or because their content is contrary to messages received from media or their peers. Conclusion: Incorporating student voice in the creation of educational policy will assist health educators and school officials to understand sex/gender influences on the behaviour of students in terms of financial considerations, peer influence and social image. Optimising student voice to understand how they themselves may contribute to the implementation of policies will in turn increase the policies’ effectiveness.

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Bekele, Tsegaye, Evan J. Collins, Robert G. Maunder, Sandra Gardner, Sergio Rueda, Jason Globerman, Thao Lan Le, et al. "Childhood Adversities and Physical and Mental Health Outcomes in Adults Living with HIV: Findings from the Ontario HIV Treatment Network Cohort Study." AIDS Research and Treatment 2018 (2018): 1–17. http://dx.doi.org/10.1155/2018/2187232.

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We sought to estimate the prevalence of childhood adversity and examine its relationship with health outcomes among people living with HIV. Study participants included 1409 adults living with HIV and receiving care in Toronto, Canada. Data on childhood adversity, health behaviors, HIV outcome measures, depression, and health-related quality of life (HRQOL) were collected through face-to-face interviews and medical records. Statistical analyses included multivariable linear and logistic regression modeling. The prevalence of any childhood adversity was 71% (individual types ranged from 11% to 44%) and higher prevalence was associated with younger age, Indigenous or African/Caribbean/Black ethnicity, lower socioeconomic status, and higher rates of cigarette smoking and nonmedicinal drug use. Greater number of childhood adversities was associated with greater odds of depression and decreasing mental HRQOL. HIV care providers need to screen for childhood adversities and address childhood trauma within the context of HIV care.

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McIntyre, Lynn, Valerie Tarasuk, and Tony Jinguang Li. "Improving the nutritional status of food-insecure women: first, let them eat what they like." Public Health Nutrition 10, no. 11 (November 2007): 1288–98. http://dx.doi.org/10.1017/s1368980007702902.

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AbstractObjectiveTo determine the extent to which identified nutrient inadequacies in the dietary intakes of a sample of food-insecure women could be ameliorated by increasing their access to the ‘healthy’ foods they typically eat.DesignMerged datasets of 226 food-insecure women who provided at least three 24-hour dietary intake recalls over the course of a month. Dietary modelling, with energy adjustment for severe food insecurity, explored the effect of adding a serving of the woman's own, and the group's typically chosen, nutrient-rich foods on the estimated prevalence of nutrient inadequacy.Setting and subjectsOne study included participants residing in 22 diverse community clusters from the Atlantic Provinces of Canada, and the second study included food bank attendees in Toronto, Ontario, Canada. Of the 226 participants, 78% lived alone with their children.ResultsWhile nutritional vulnerability remained after modelling, adding a single serving of either typically chosen ‘healthy’ foods from women's own diets or healthy food choices normative to the population reduced the prevalence of inadequacy by at least half for most nutrients. Correction for energy deficits resulting from severe food insecurity contributed a mean additional 20% improvement in nutrient intakes.ConclusionsFood-insecure women would sustain substantive nutritional gains if they had greater access to their personal healthy food preferences and if the dietary compromises associated with severe food insecurity were abated. Increased resources to access such choices should be a priority.

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Marshall, Emily Gard, Mylaine Breton, Michael Green, Lynn Edwards, Caitlyn Ayn, Mélanie Ann Smithman, Shannon Ryan Carson, et al. "CUP study: protocol for a comparative analysis of centralised waitlist effectiveness, policies and innovations for connecting unattached patients to primary care providers." BMJ Open 12, no. 3 (March 2022): e049686. http://dx.doi.org/10.1136/bmjopen-2021-049686.

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IntroductionAccess to a primary care provider is a key component of high-functioning healthcare systems. In Canada, 15% of patients do not have a regular primary care provider and are classified as ‘unattached’. In an effort to link unattached patients with a provider, seven Canadian provinces implemented centralised waitlists (CWLs). The effectiveness of CWLs in attaching patients to regular primary care providers is unknown. Factors influencing CWLs effectiveness, particularly across jurisdictional contexts, have yet to be confirmed.Methods and analysisA mixed methods case study will be conducted across three Canadian provinces: Ontario, Québec and Nova Scotia. Quantitatively, CWL data will be linked to administrative and provider billing data to assess the rates of patient attachment over time and delay of attachment, stratified by demographics and compared with select indicators of health service utilisation. Qualitative interviews will be conducted with policymakers, patients, and primary care providers to elicit narratives regarding the administration, use, and access of CWLs. An analysis of policy documents will be used to identify contextual factors affecting CWL effectiveness. Stakeholder dialogues will be facilitated to uncover causal pathways and identify strategies for improving patient attachment to primary care.Ethics and disseminationApproval to conduct this study has been granted in Ontario (Queens University Health Sciences and Affiliated Teaching Hospitals Research Ethics Board, file number 6028052; Western University Health Sciences Research Ethics Board, project 116591; University of Toronto Health Sciences Research Ethics Board, protocol number 40335), Québec (Centre intégré universitaire de santé et de services sociaux de l'Estrie, project number 2020–3446) and Nova Scotia (Nova Scotia Health Research Ethics Board, file number 1024979).

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Zamin, Monique T., Monique M. Pitre, and John M. Conly. "Development of an Intravenous-to-Oral Route Conversion Program for Antimicrobial Therapy at a Canadian Tertiary Care Health Facility." Annals of Pharmacotherapy 31, no. 5 (May 1997): 564–70. http://dx.doi.org/10.1177/106002809703100507.

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OBJECTIVE: To describe the effect of introducing a route conversion program on the prescribing of antimicrobials for the treatment of respiratory tract infections and skin/soft tissue infections in a sample population. DESIGN: Concurrent, pre- and postintervention study. SETTING: Four general internal medicine wards at The Toronto Hospital, a 1170-bed, tertiary care health center in Toronto, Ontario, Canada. PARTICIPANTS: Patients receiving antimicrobial therapy for respiratory tract infections and skin/soft tissue infections. INTERVENTION: Written guidelines and education sessions were presented to residents, interns, medical students, and pharmacists responsible for the care of patients admitted to four general internal medicine wards. MAIN OUTCOME MEASURES: Clinical and laboratory parameters related to the status of the infection were monitored prospectively and compared with the course of drug therapy, with consideration of the patient's ability to meet the criteria established in the guidelines. The number of days of intravenous therapy prescribed despite appropriateness of oral therapy was tallied. RESULTS: Twenty-seven patients (28 infections) were identified for inclusion in the 7-week preliminary audit, and 30 patients (32 infections) were included in the audit after the program, which continued for 5 weeks. Following implementation of the program, the number of days that intravenous therapy was continued despite the appropriateness of oral therapy was reduced from 41% to 26% of the total days of intravenous therapy prescribed. CONCLUSIONS: The program had a positive influence on antimicrobial prescribing behavior in the population studied. Strategies to ensure continued benefit from the program have been developed.

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Nam, Austin, David M. J. Naimark, Matthew B. Stanbrook, and Murray D. Krahn. "Using a Health Economic Framework to Prioritize Quality Indicators: An Example With Smoking Cessation in Chronic Obstructive Pulmonary Disease." MDM Policy & Practice 4, no. 1 (January 2019): 238146831985235. http://dx.doi.org/10.1177/2381468319852358.

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Background. Health care performance monitoring is a major focus of the modern quality movement, resulting in widespread development of quality indicators and making prioritizations an increasing focus. Currently, few prioritization methods of performance measurements give serious consideration to the association of performance with expected health benefits and costs. We demonstrate a proof-of-concept application of using a health economic framework to prioritize quality indicators by expected variations in population health and costs, using smoking cessation in chronic obstructive pulmonary disease (COPD) as an example. Methods. We developed a health state transition, microsimulation model to represent smoking cessation practices for adults with COPD from the health care payer perspective in Ontario, Canada. Variations in life years, quality-adjusted life years (QALYs), and lifetime costs were associated with changes in performance. Incremental net health benefit (INHB) was used to represent the joint variation in mortality, morbidity, and costs associated with the performance of each quality indicator. Results. Using a value threshold of $50,000/QALY, the indicators monitoring assessment of smoking status and smoking cessation interventions were associated with the largest INHBs. Combined performance variations among groups of indicators showed that 81% of the maximum potential INHB could be represented by three out of the six process indicators. Conclusions. A health economic framework can be used to bring dimensions of population health and costs into explicit consideration when prioritizing quality indicators. However, this should not preclude policymakers from considering other dimensions of quality that are not part of this framework.

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Meaney, Christopher, Rahim Moineddin, Sumeet Kalia, Babak Aliarzadeh, and Michelle Greiver. "Using Primary Care Clinical Text Data and Natural Language Processing to Identify Indicators of COVID-19 in Toronto, Canada." PLOS Digital Health 1, no. 12 (December 7, 2022): e0000150. http://dx.doi.org/10.1371/journal.pdig.0000150.

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The objective of this study was to investigate whether a rule-based natural language processing (NLP) system, applied to primary care clinical text data, could be used to monitor COVID-19 viral activity in Toronto, Canada. We employed a retrospective cohort design. We included primary care patients with a clinical encounter between January 1, 2020 and December 31, 2020 at one of 44 participating clinical sites. During the study timeframe, Toronto first experienced a COVID-19 outbreak between March-2020 and June-2020; followed by a second viral resurgence from October-2020 through December-2020. We used an expert derived dictionary, pattern matching tools and contextual analyzer to classify primary care documents as 1) COVID-19 positive, 2) COVID-19 negative, or 3) unknown COVID-19 status. We applied the COVID-19 biosurveillance system across three primary care electronic medical record text streams: 1) lab text, 2) health condition diagnosis text and 3) clinical notes. We enumerated COVID-19 entities in the clinical text and estimated the proportion of patients with a positive COVID-19 record. We constructed a primary care COVID-19 NLP-derived time series and investigated its correlation with independent/external public health series: 1) lab confirmed COVID-19 cases, 2) COVID-19 hospitalizations, 3) COVID-19 ICU admissions, and 4) COVID-19 intubations. A total of 196,440 unique patients were observed over the study timeframe, of which 4,580 (2.3%) had at least one positive COVID-19 document in their primary care electronic medical record. Our NLP-derived COVID-19 time series describing the temporal dynamics of COVID-19 positivity status over the study timeframe demonstrated a pattern/trend which strongly mirrored that of other external public health series under investigation. We conclude that primary care text data passively collected from electronic medical record systems represent a high quality, low-cost source of information for monitoring/surveilling COVID-19 impacts on community health.

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Brundage, Michael Donald, Patti Groome, Timothy Hanna, Christopher M. Booth, Weidong Kong, Tina Dyer, Brenda Carter, and William J. Mackillop. "Cancer survival outcomes in Ontario, Canada: Significant unexplained variation." Journal of Clinical Oncology 36, no. 30_suppl (October 20, 2018): 36. http://dx.doi.org/10.1200/jco.2018.36.30_suppl.36.

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36 Background: Cancer-specific outcomes are critical for assessing quality of care, and are key quality indicators for cancer control programs. Previous analyses of Ontario (Canada) data show that regional survival differences at the Local Health Integrated Network (LHIN) level exist for relative survival, overall survival, cancer-specific survival (CSS), and mortality rates.We sought to describe: 5-year cancer-specific survival (5Y-CSS) rates among Ontario LHINs; the impact of adjusting for known patient factors; and 5Y-CSS rates among patients diagnosed at Ontario's 50 largest cancer diagnosing hospitals. Methods: Newly diagnosed cases (colorectal, lung, breast, or prostate cancer) were identified in the Ontario Cancer Registry. Records were linked to data from CIHI and Statistics Canada, to identify date of diagnosis, cause-specific vital status, diagnosing hospital, and other reported variables. Cox regression models were used, and all models were adjusted for age and sex. Results: N = 498,382 incident cases (2007-2013) were included. 5Y-CSS varied across LHINs for all patients combined (range 62%-72%; p < 0.0001). Considering colorectal cancer cases as illustrative (N = 57,927), 5Y-CSS varied among LHINs from 58.4%-66.4% (p < 0.0001). Further adjusting for socioeconomic and urban-rural status minimally reduced that variation. Limiting the analysis cohort to patients diagnosed in one of Ontario's 50 largest hospitals (N = 43,245), 5Y-CSS ranged from 52% to 72% (p < 0.0001) among hospitals, and from 55% to 63% (p < 0.0001) among the hospitals affiliated with regional cancer centres. Comparable findings were seen for patients diagnosed with lung, breast, or prostate cancer. Collaborative staging data were available for a subset of patients; 5Y-CSS within all stage III patients (N = 5,360) ranged from 72% to 87%. Conclusions: Important, highly significant differences in cancer survival outcomes exist across Ontario. These are of great interest to patients, health-care providers, system administrators, and policy makers, and are not explained by adjusting for the variables included in these analyses.

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ALZAHRANI, KHALID, RAJIV GANDHI, JUSTIN deBEER, DANIELLE PETRUCCELLI, and NIZAR MAHOMED. "Prevalence of Clinically Significant Improvement Following Total Knee Replacement." Journal of Rheumatology 38, no. 4 (January 15, 2011): 753–59. http://dx.doi.org/10.3899/jrheum.100233.

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Objective.Although total knee replacement (TKR) has a high reported success rate, the pain relief and functional improvement after surgery vary. The purpose of our retrospective cohort study was to determine the prevalence of patients showing no clinically important improvement 1 year after TKR, and patient factors that may predict this outcome.Methods.We reviewed primary TKR registry data that were collected from 2 academic hospitals: the Toronto Western Hospital and the Hamilton Health Sciences Henderson Hospital in Ontario, Canada. Relevant covariates including demographic data, body mass index, and comorbidity were recorded. Knee joint pain and functional status were assessed at baseline and at 1-year followup with the Western Ontario McMaster University Osteoarthritis Index (WOMAC) and Oxford Knee Score (OKS) to measure the change using the minimal clinically important difference (MCID). Logistic regression modeling was used to identify the predictors of interest.Results.Overall, 11.7% (373/3177) of patients reported no clinically important improvement 1 year after surgery. Logistic regression modeling showed that a greater patient age independently predicted no clinically important improvement on the WOMAC scale 1 year after surgery (p = 0.0003), while being male independently predicted no clinically important improvement on the OKS 1 year after surgery (p = 0.008).Conclusion.Awareness of the prevalence of patients who may show no clinically important improvement and factors that predict this outcome will help patients and surgeons set realistic expectations of surgery.

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Zoratti, Michael J., Kathryn Fisher, Dawn Guthrie, and Lauren E. Griffith. "A Profile of Older Adults With a History of Stroke Receiving Home Care in Ontario, Canada." Home Health Care Management & Practice 31, no. 3 (February 6, 2019): 162–71. http://dx.doi.org/10.1177/1084822318823731.

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The demand for home care services is increasing, yet the literature describing the clinical characteristics of community-dwelling individuals with a history of stroke who receive home care is limited. In this retrospective, cross-sectional, population-level study, data were sourced from home care recipients aged 65+ who had a routine assessment using the Resident Assessment Instrument for Home Care (RAI-HC) in Ontario between January 2007 and December 2011. The RAI-HC contains several health status indicators and validated health index scales. The association of a history of stroke on health status was assessed through a series of logistic regression models, adjusted for age, sex, and number of comorbidities. Sex differences were also explored. A change in odds of ≥25% was considered to indicate a clinically important finding. From the home care data ( N = 319,694), 56,909 individuals had a stroke diagnosis, with approximately 86% diagnosed with ≥3 chronic conditions. A stroke diagnosis was associated with a higher risk of limitations or impairments with communication, locomotion, continence, activities of daily living, and cognitive performance. A clinically meaningful difference was not observed for symptoms of depression. Few sex differences were observed. In an effort to support the development of effective home and community-based care programs, research is needed to understand differences in community-dwelling versus institutional populations. Community-dwelling individuals with a history of stroke show higher levels of impairment and limitations compared with those without, suggesting areas where home care resources could be improved to help manage the chronic effects of stroke.

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Chu, Anna, Lisa Barbera, Rinku Sutradhar, Urun Erbas Oz, Erin O'Leary, and Hsien Seow. "Association between end-of-life cancer care and immigrant status: a retrospective cohort study in Ontario, Canada." BMJ Open 11, no. 6 (May 2021): e042978. http://dx.doi.org/10.1136/bmjopen-2020-042978.

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ObjectiveTo compare recent immigrants and long-term residents in Ontario, Canada, on established health service quality indicators of end-of-life cancer care.DesignRetrospective, population-based cohort study of cancer decedents between 2004 and 2015.SettingOntario, Canada.ParticipantsWe grouped 13 085 immigrants who arrived in Ontario in 1985 or later into eight major ethnic groups based on birth country, mother tongue and surname, and compared them to 229 471 long-term residents who were ≥18 years at the time of death.Primary and secondary outcome measuresAggressive care, defined as a composite of ≥2 emergency department visits, ≥2 new hospitalisations or an intensive care unit admission within 30 days of death; and supportive care, defined as a physician house call within 2 weeks, or palliative nursing or personal support worker home visit within 6 months of death. Multivariable logistic regression was used to examine the association between immigration status and the odds of each main outcome.ResultsCompared with long-term residents, immigrants overall and by ethnic group had higher rates of aggressive care (13.7% vs 17.5%, respectively; p<0.001). Among immigrants, Southeast Asians had the highest use while White-Eastern and Western Europeans had the lowest. Supportive care use was similar between long-term residents and immigrants (50.0% vs 50.5%, respectively; p=0.36), though lower among Southeast Asians (46.6%) and higher among White-Western Europeans (55.6%). After adjusting for sociodemographic characteristics and comorbidities, immigrants remained more likely than long-term residents to receive aggressive care (OR: 1.15, 95% CI 1.09 to 1.21), yet were less likely to receive supportive care (OR: 0.95, 95% CI 0.91 to 0.98).ConclusionsAmong cancer decedents in Ontario, immigrants are more likely to use aggressive healthcare services at the end of life than long-term residents, while supportive care varies by ethnicity. Contributors to variation in end-of-life care require further study.

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Mucaki, Eliseos J., Ben C. Shirley, and Peter K. Rogan. "Likely community transmission of COVID-19 infections between neighboring, persistent hotspots in Ontario, Canada." F1000Research 10 (July 21, 2022): 1312. http://dx.doi.org/10.12688/f1000research.75891.2.

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Introduction: This study aimed to produce community-level geo-spatial mapping of confirmed COVID-19 cases in Ontario Canada in near real-time to support decision-making. This was accomplished by area-to-area geostatistical analysis, space-time integration, and spatial interpolation of COVID-19 positive individuals. Methods: COVID-19 cases and locations were curated for geostatistical analyses from March 2020 through June 2021, corresponding to the first, second, and third waves of infections. Daily cases were aggregated according to designated forward sortation area (FSA), and postal codes (PC) in municipal regions Hamilton, Kitchener/Waterloo, London, Ottawa, Toronto, and Windsor/Essex county. Hotspots were identified with area-to-area tests including Getis-Ord Gi*, Global Moran’s I spatial autocorrelation, and Local Moran’s I asymmetric clustering and outlier analyses. Case counts were also interpolated across geographic regions by Empirical Bayesian Kriging, which localizes high concentrations of COVID-19 positive tests, independent of FSA or PC boundaries. The Geostatistical Disease Epidemiology Toolbox, which is freely-available software, automates the identification of these regions and produces digital maps for public health professionals to assist in pandemic management of contact tracing and distribution of other resources. Results: This study provided indicators in real-time of likely, community-level disease transmission through innovative geospatial analyses of COVID-19 incidence data. Municipal and provincial results were validated by comparisons with known outbreaks at long-term care and other high density residences and on farms. PC-level analyses revealed hotspots at higher geospatial resolution than public reports of FSAs, and often sooner. Results of different tests and kriging were compared to determine consistency among hotspot assignments. Concurrent or consecutive hotspots in close proximity suggested potential community transmission of COVID-19 from cluster and outlier analysis of neighboring PCs and by kriging. Results were also stratified by population based-categories (sex, age, and presence/absence of comorbidities). Conclusions: Earlier recognition of hotspots could reduce public health burdens of COVID-19 and expedite contact tracing.

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Mucaki, Eliseos J., Ben C. Shirley, and Peter K. Rogan. "Likely community transmission of COVID-19 infections between neighboring, persistent hotspots in Ontario, Canada." F1000Research 10 (December 23, 2021): 1312. http://dx.doi.org/10.12688/f1000research.75891.1.

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Introduction: This study aimed to produce community-level geo-spatial mapping of confirmed COVID-19 cases in Ontario Canada in near real-time to support decision-making. This was accomplished by area-to-area geostatistical analysis, space-time integration, and spatial interpolation of COVID-19 positive individuals. Methods: COVID-19 cases and locations were curated for geostatistical analyses from March 2020 through June 2021, corresponding to the first, second, and third waves of infections. Daily cases were aggregated according to designated forward sortation area (FSA), and postal codes (PC) in municipal regions Hamilton, Kitchener/Waterloo, London, Ottawa, Toronto, and Windsor/Essex county. Hotspots were identified with area-to-area tests including Getis-Ord Gi*, Global Moran’s I spatial autocorrelation, and Local Moran’s I asymmetric clustering and outlier analyses. Case counts were also interpolated across geographic regions by Empirical Bayesian Kriging, which localizes high concentrations of COVID-19 positive tests, independent of FSA or PC boundaries. The Geostatistical Disease Epidemiology Toolbox, which is freely-available software, automates the identification of these regions and produces digital maps for public health professionals to assist in pandemic management of contact tracing and distribution of other resources. Results: This study provided indicators in real-time of likely, community-level disease transmission through innovative geospatial analyses of COVID-19 incidence data. Municipal and provincial results were validated by comparisons with known outbreaks at long-term care and other high density residences and on farms. PC-level analyses revealed hotspots at higher geospatial resolution than public reports of FSAs, and often sooner. Results of different tests and kriging were compared to determine consistency among hotspot assignments. Concurrent or consecutive hotspots in close proximity suggested potential community transmission of COVID-19 from cluster and outlier analysis of neighboring PCs and by kriging. Results were also stratified by population based-categories (sex, age, and presence/absence of comorbidities). Conclusions: Earlier recognition of hotspots could reduce public health burdens of COVID-19 and expedite contact tracing.

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Baia Medeiros, Deyvison T., Shoshana Hahn-Goldberg, Dionne M. Aleman, and Erin O’Connor. "Planning Capacity for Mental Health and Addiction Services in the Emergency Department: A Discrete-Event Simulation Approach." Journal of Healthcare Engineering 2019 (June 2, 2019): 1–11. http://dx.doi.org/10.1155/2019/8973515.

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Ontario has shown an increasing number of emergency department (ED) visits, particularly for mental health and addiction (MHA) complaints. Given the current opioid crises Canada is facing and the legalization of recreational cannabis in October 2018, the number of MHA visits to the ED is expected to grow even further. In face of these events, we examine capacity planning alternatives for the ED of an academic hospital in Toronto. We first quantify the volume of ED visits the hospital has received in recent years (from 2012 to 2016) and use forecasting techniques to predict future ED demand for the hospital. We then employ a discrete-event simulation model to analyze the impacts of the following scenarios: (a) increasing overall demand to the ED, (b) increasing or decreasing number of ED visits due to substance abuse, and (c) adjusting resource capacity to address the forecasted demand. Key performance indicators used in this analysis are the overall ED length of stay (LOS) and the total number of patients treated in the Psychiatric Emergency Services Unit (PESU) as a percentage of the total number of MHA visits. Our results showed that if resource capacity is not adjusted, ED LOS will deteriorate considerably given the expected growth in demand; programs that aim to reduce the number of alcohol and/or opioid visits can greatly aid in reducing ED wait times; the legalization of recreational use of cannabis will have minimal impact, and increasing the number of PESU beds can provide great aid in reducing ED pressure.

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BARTEN, DI-JANNE J. A., MARTIJN F. PISTERS, TIM TAKKEN, and CINDY VEENHOF. "Validity and Responsiveness of the Dutch McMaster Toronto Arthritis Patient Preference Questionnaire (MACTAR) in Patients with Osteoarthritis of the Hip or Knee." Journal of Rheumatology 39, no. 5 (April 1, 2012): 1064–73. http://dx.doi.org/10.3899/jrheum.110876.

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Objective.To determine the content validity, the construct validity, and the responsiveness of the Dutch McMaster Toronto Arthritis Patient Preference Questionnaire (MACTAR) in patients with osteoarthritis (OA) of the hip or knee.Methods.The MACTAR comprises 2 parts: a transitional part and a status part. Content validity was investigated by comparing patient-elicited activities to items on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Medical Outcomes Study Short-Form 36 (SF-36). Construct validity was determined by correlating MACTAR outcomes with WOMAC/SF-36 outcomes. Responsiveness was investigated by correlating MACTAR, WOMAC, and SF-36 change scores with patient global assessment (PGA) scores and plotting a receiver-operating characteristics (ROC) curve.Results.Eleven percent of the 894 impaired activities, identified by 192 patients, were not represented in either the WOMAC or the SF-36. The correlations (rs) investigated for the MACTAR transitional part varied between 0.27 and −0.40; the status part correlated moderately with the general health scale of the SF-36 (rs = 0.44). MACTAR change scores correlated better with PGA than with WOMAC/SF-36 change scores. The area under the ROC curve amounted to 0.90.Conclusion.Our results suggest that the MACTAR exhibits moderate construct validity and good responsiveness in a population of patients with OA of the hip or knee. The MACTAR is potentially better able to detect changes over time in activities that are important to individual patients compared to other tools measuring physical function (WOMAC, SF-36). Clinicians could use the MACTAR to evaluate clinically relevant changes over time in patient-specific physical functioning.

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Schiemann, Donald A. "Experiences With Bacteriological Monitoring of Pool Water." Infection Control 6, no. 10 (October 1985): 413–17. http://dx.doi.org/10.1017/s0195941700063505.

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AbstractA bacteriological study was completed on pools and whirlpools operated by hotels and private health clubs in the metropolitan area of Toronto, Ontario, Canada. Coliform bacteria, fecal coliform bacteria, and fecal streptococci were found only when other indices showed a drastic deterioration in water quality. Aerobic plate counts were higher, and staphylococci and Pseudomonas aeruginosa occurred more often in whirlpools than in swimming pools. There was a correlation between aerobic plate counts and the presence of staphylococci and P. aeruginosa. P. aeruginosa was rare in swimming pools in the absence of staphylococci; however, in whirlpools the organism was often found in the absence of staphylococci, and when aerobic plate counts were low. P. aeruginosa and plate counts in excess of 3,000 per ml occurred more frequently in whirlpools when the free chlorine residual was less than one part per million. The surface film showed concentrations of staphylococci far greater than the pool water. Whirlpools appear to present a different ecosystem that favors the establishment of P. aeruginosa. Staphylococci, but not Staphylococcus aureus, are useful in indicators of pool water quality but better laboratory methodology is required. Additional attention should be directed to the bacteriology of the water surface film, which presents a more direct hazard to bathers.

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Anderson, Kelly, and Jordan Edwards. "T123. RISK FACTORS FOR PSYCHOTIC DISORDERS WITHIN MIGRANT GROUPS IN CANADA." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S277. http://dx.doi.org/10.1093/schbul/sbaa029.683.

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Abstract Background Although there is a large evidence base suggesting elevated rates of psychotic disorder for some migrant groups, relative to the non-migrant host population, less is known about factors that modify the risk of psychosis within migrant groups. Our objective was to assess whether pre-migration, migration-related, and post-migration factors were associated with an elevated risk of psychotic disorder among first-generation migrants in Ontario, Canada. Methods Using linked population-based health administrative data, we constructed a retrospective cohort of first-generation migrants to Ontario over a 20-year period between 1992 and 2012. We identified first onset non-affective psychotic disorders using a validated algorithm. Pre-migration factors included sex, country of origin, education, occupation, marital status, and language. Migration-related factors included age at migration, year of migration, duration of residence, and migrant class. Post-migration factors included rural place of residence and neighbourhood-level indicators of marginalization. We used Poisson regression models to compute incidence rate ratios for each pre-migration, migration-related, and post-migration factor to assess its magnitude of effect on the risk of developing psychosis, relative to migrants who did not develop psychotic disorder. Results Our cohort included over two million first-generation migrants over the 20-year period. Preliminary findings suggest that males, refugees, and people who set up residence in urban centres have higher rates of psychotic disorder, and people who are older at the time of migration and those who set up residence in high-income areas have lower rates of psychotic disorder. Full results for pre-migration, migration-related, and post-migration risk factors will be presented. Discussion Migrant status is one of few well-established risk factors for psychotic disorder, yet we have limited understanding of the underlying etiology. The findings from this study help to identify high-risk groups to target for intervention. Improving our understanding of key risk factors for psychotic disorders within migrant groups is crucial for informing prevention and early intervention efforts.

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Liboro, Renato M. "Catholic Family Ties: Sustaining and Supporting HIV-Positive Canadian Gay Men’s Faith, Mental Health, and Wellbeing." Religions 11, no. 8 (July 30, 2020): 391. http://dx.doi.org/10.3390/rel11080391.

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Research has documented that sexual minorities and people living with HIV/AIDS have successfully used religious coping to help them overcome life challenges related to their sexual orientation and HIV status, including religious struggles surrounding their faith brought about by stigma and discrimination that have historically been promoted by organized religion. Research has also documented how sexual minorities and people living with HIV/AIDS have utilized family support as a vital resource for effectively coping with life challenges associated with homophobia, heterosexism, and HIV stigma, which have historically been perpetuated in certain family and faith dynamics. The aim of the community-engaged, qualitative study described in this article was to examine the synergistic effects of religious coping and family support, particularly in the context of Catholic family ties, as a unified mechanism for supporting HIV-positive gay men in the face of religious struggles and other life challenges. Confidential, semi-structured interviews were conducted with nine HIV-positive, gay men from the Greater Toronto Area of Ontario, Canada, to obtain their perspectives on how and why their Catholic family ties have helped support them through their religious struggles and other life challenges. Utilizing a modified Grounded Theory approach, interview data were collected and analyzed until data saturation was achieved. The findings and lessons learned from the study’s analysis are discussed in this article, which elaborates on the unique synergy of religious coping and family support as interconnected mechanisms that could be of significant value for supporting HIV-positive gay men experiencing religious struggles and other life challenges.

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Staley, Zachery R., Josey Grabuski, Ed Sverko, and Thomas A. Edge. "Comparison of Microbial and Chemical Source Tracking Markers To Identify Fecal Contamination Sources in the Humber River (Toronto, Ontario, Canada) and Associated Storm Water Outfalls." Applied and Environmental Microbiology 82, no. 21 (August 19, 2016): 6357–66. http://dx.doi.org/10.1128/aem.01675-16.

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ABSTRACTStorm water runoff is a major source of pollution, and understanding the components of storm water discharge is essential to remediation efforts and proper assessment of risks to human and ecosystem health. In this study, culturableEscherichia coliand ampicillin-resistantE. colilevels were quantified and microbial source tracking (MST) markers (including markers for generalBacteroidalesspp., human, ruminant/cow, gull, and dog) were detected in storm water outfalls and sites along the Humber River in Toronto, Ontario, Canada, and enumerated via endpoint PCR and quantitative PCR (qPCR). Additionally, chemical source tracking (CST) markers specific for human wastewater (caffeine, carbamazepine, codeine, cotinine, acetaminophen, and acesulfame) were quantified. Human and gull fecal sources were detected at all sites, although concentrations of the human fecal marker were higher, particularly in outfalls (mean outfall concentrations of 4.22 log10copies, expressed as copy numbers [CN]/100 milliliters for human and 0.46 log10CN/100 milliliters for gull). Higher concentrations of caffeine, acetaminophen, acesulfame,E. coli, and the human fecal marker were indicative of greater raw sewage contamination at several sites (maximum concentrations of 34,800 ng/liter, 5,120 ng/liter, 9,720 ng/liter, 5.26 log10CFU/100 ml, and 7.65 log10CN/100 ml, respectively). These results indicate pervasive sewage contamination at storm water outfalls and throughout the Humber River, with multiple lines of evidence identifying Black Creek and two storm water outfalls with prominent sewage cross-connection problems requiring remediation. Limited data are available on specific sources of pollution in storm water, though our results indicate the value of using both MST and CST methodologies to more reliably assess sewage contamination in impacted watersheds.IMPORTANCEStorm water runoff is one of the most prominent non-point sources of biological and chemical contaminants which can potentially degrade water quality and pose risks to human and ecosystem health. Therefore, identifying fecal contamination in storm water runoff and outfalls is essential for remediation efforts to reduce risks to public health. This study employed multiple methods of identifying levels and sources of fecal contamination in both river and storm water outfall sites, evaluating the efficacy of using culture-based enumeration ofE. coli, molecular methods of determining the source(s) of contamination, and CST markers as indicators of fecal contamination. The results identified pervasive human sewage contamination in storm water outfalls and throughout an urban watershed and highlight the utility of using both MST and CST to identify raw sewage contamination.

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Rooks, Ronica. "Gentrification and Chronic Conditions in Older Adults: Service Providers’ Perspectives." Innovation in Aging 4, Supplement_1 (December 1, 2020): 341. http://dx.doi.org/10.1093/geroni/igaa057.1095.

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Abstract Where we live impacts our health, but this is more apt for older adults (aged 55+) aging-in-place in their neighborhoods. Gentrification, i.e. the transformation of neighborhoods from low to high value, can put community-dwelling older adults at risk for residential displacement with limited retirement incomes and financial stressors like increased housing costs and property taxes, residential turnover and changing access to resources. As a place-based stressor, gentrification may exacerbate social vulnerabilities (e.g., lower socioeconomic status and racial/ethnic minority status) related to chronic condition (CC) disparities. But, little gentrification research focuses on these issues. This research examines associations between gentrification and older adults’ CC management related to broader social determinants in Hamilton, Ontario, Canada from health and social service providers’ perspectives. Hamilton, a recovering steel industry city with in-migration from Toronto, is experiencing higher costs of living, income inequality and tension with recent gentrifiers. I conducted key informant interviews with service providers in city government and community-based organizations using thematic analysis. Across providers, food insecurity, social isolation and displacement were the biggest issues associated with gentrification and CC, particularly for older adults with lower incomes and government disability support. Results thus far reveal Hamilton has numerous older adult-focused providers, but older adults often have difficulties accessing services due to a lack of knowledge, not always asking or realizing when they need help and coordinated referral difficulties across providers. To address these challenges, providers consider environmental scans, mapping resources and advertisement in an online community information database from the city’s public library.

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Ku, Jennifer, Murray Krahn, John Trachtenberg, Michael Nesbitt, Robin Kalnin, Gina Lockwood, and Shabbir M. H. Alibhai. "Changes in health utilities and health-related quality of life over 12 months following radical prostatectomy." Canadian Urological Association Journal 3, no. 6 (May 1, 2013): 445. http://dx.doi.org/10.5489/cuaj.1171.

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Introduction: Although radical prostatectomy (RP) is an effectivetreatment for prostate cancer, it has potentially deleterious effectson health-related quality of life (HRQoL). Utility is an importantglobal measure of HRQoL. This utility is also used in decisionmakingmodels and economic evaluations. There are no publishedprospective data characterizing men’s utilities for healthoutcomes post-RP.Methods: From July 2003 to June 2006, patients undergoing RP atthe University Health Network in Toronto, Ontario, Canada, completedthe Patient-Oriented Prostate Utility Scale (PORPUS), adisease-specific HRQoL and utility instrument. Men were includedif they had clinically localized prostate cancer and had completedHRQoL measures prior to surgery and at least once within9 to 18 months after the RP. Health-related quality of life wasmeasured prior to surgery and at 4 stages after surgery: 0 to 3months, 3 to 9 months, 9 to 18 months, and 18 to 30 months.Statistical analyses included pairwise t-tests and multivariable linearregression comparing changes in scores between baseline andthe 9- to 18-month range.Results: Two hundred and thirteen men (mean age 60.9, medianGleason score 7) met the inclusion criteria. At baseline, HRQoLwas high (mean PORPUS-P [psychometric] = 83.8). Scores declinedsharply by 3 months (65.5, p < 0.001) and improved but did notreach baseline by 9-18 months (75.1, p < 0.001). Utility scores(PORPUS-U[utility]) showed the same pattern: 0.94 at baseline;0.81 at 3 months (p < 0.001); and 0.88 at 9 to 18 months (p <0.001). Predictors of HRQoL, including baseline PORPUS score,nerve-sparing surgery and smoking status, decline after RP.Conclusion: Symptom scores are known to be affected up to12 months after RP. Our study demonstrates that global healthstatus also declines and remains affected 1 year after surgery.Introduction : La prostatectomie radicale est un traitement efficacecontre le cancer de la prostate, mais elle présente des effets indési -rables potentiels ayant un impact sur la qualité de vie liée à lasanté (QdVS), dont l’état de santé est une importante mesure glo -bale. Cette mesure est aussi utilisée dans les modèles décisionnelset les évaluations économiques. Aucune donnée prospective n’aété publiée concernant l’état de santé des patients après une PR.Méthodologie : Entre juillet 2003 et juin 2006, des patients ayantsubi une PR au sein du University Health Network à Toronto (Ontario)au Canada ont rempli le questionnaire PORPUS d’auto-évaluation,un instrument de mesure de la qualité de vie reliée à la santé et del’état de santé. Étaient inclus les hommes atteints d’un cancer de laprostate cliniquement localisé et ayant été évalués à l’aide d’ins -truments de mesure de la QdVS avant l’intervention chirurgicale etau moins une fois dans les 9 à 18 mois suivant la PR. La qualité devie reliée à la santé a été mesurée avant la chirurgie et à 4 reprisespar la suite : après 0 à 3 mois, 3 à 9 mois, 9 à 18 mois et 18 à 30mois. Les analyses statistiques incluaient des tests t par paires etune analyse de régression linéaire multivariée afin de comparer leschangements dans les scores entre les valeurs de départ et les valeursobtenues 9 à 18 mois après l’intervention.Résultats : Deux cent treize hommes (âge moyen, 60,9 ans, scorede Gleason médian, 7) répondaient aux critères d’inclusion. Audépart, les scores de QdVS étaient élevés (score PORPUS-P [psychométrique]moyen = 83,8). Les scores avaient chuté dramatiquementaprès 3 mois (65,5, p < 0,001); ils ont ensuite remonté,mais n’avaient pas atteint le niveau de départ après 9 à18 mois (75,1, p < 0,001). Les scores d’état de santé (PORPUS-U)ont suivi la même tendance : 0,94 au départ; 0,81 après3 mois (p < 0,001), et 0,88 après 9 à 18 mois (p < 0.001). Lesfacteurs de prédiction du score de QdVS qui diminuent sont lescore PORPUS au départ, le recours à une technique chirurgicalepréservant les filets nerveux et le tabagisme.Conclusion : Il est reconnu que les scores des symptômes sont affectésjusqu’à 12 mois après la PR. Notre étude montre que l’état desanté global diminue également et demeure affecté un an aprèsl’intervention chirurgicale.

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Goni, Vijay G., Mukesh Mishra, Sailee Kadam, and Sharat S. Gandhi. "Effect of Nucart VG (Boswellia serrata in combination with veg glucosamine sulphate) in comparison with glucosamine sulphate to improve quality of life of knee osteoarthritis patients: a randomized controlled trial." International Journal of Research in Orthopaedics 7, no. 5 (August 25, 2021): 976. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20213378.

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Background: Boswellia serrata has been proved to be an effective and safe herb for the treatment of osteoarthritis (OA). This study aims at assessing the synergistic effect of this herb with vegetarian glucosamine sulphate, a nutritional supplement, on knee osteoarthritis using quality of life indicators.Methods: This was an open label, parallel group randomized trial of 12-week duration. Sixty-six subjects were equally randomized to two treatment arms: Boswellia serrata extract (600 mg) and glucosamine (750 mg) [Nucart VG]; and glucosamine sulphate (market comparator) 750 mg. Patients were administered 1 tablet twice-a-day post-meal for three months. Efficacy of treatment was measured on primary end-points like EuroQol-5D (EQ-5D) (health status indicator), visual analogue scale (VAS) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scale (pain indicators), while safety was measured in terms of vital parameters. Both intention-to-treat (ITT) and per-protocol (PP) analyses were performed for comparing scores between the two groups.Results: The baseline characteristics of patients between two groups were insignificantly different (p>0.05). In ITT analysis, the health status (EQ-5D score) of patients in Nucart VG group improved significantly than the comparator group at follow up 2 (p=0.037) and showed further improvement at follow up 3 (p=0.012). The pain indicators i.e. VAS and WOMAC scores were significantly lower in Nucart VG group right from follow up 1 till follow up 3 (p<0.05). Similar were the observations during PP analysis.Conclusions: Nucart VG is beneficial for the treatment of mild to moderate knee OA, as inferred from the functional and health status assessment.

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Simons, Elinor, Sharon D. Dell, Rahim Moineddin, and Teresa To. "Neighborhood Material Deprivation Is Associated with Childhood Asthma Development: Analysis of Prospective Administrative Data." Canadian Respiratory Journal 2019 (May 19, 2019): 1–7. http://dx.doi.org/10.1155/2019/6808206.

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Rationale. Material deprivation has been proposed as a more comprehensive measure of socioeconomic status than parental income. Stronger associations between childhood emergency department visits for asthma and air pollution have been demonstrated among children living in neighborhoods with high levels of deprivation, but the associations with asthma development and ongoing asthma are not known. Objectives. We determined the associations between neighborhood material deprivation and the development of new and ongoing childhood asthma. Methods. Prospectively collected administrative data housed at the Institute for Clinical Evaluative Sciences were examined for Toronto children born from 1997 to 2003. Neighborhood material deprivation, comprising no high school graduation, lone parent families, government transfers, unemployment, low income, and homes needing major repairs, was reported in the Ontario Marginalization Index. Incident asthma was defined by the time of entry into the Ontario Asthma Surveillance Information System (OASIS) database. We measured the risk of incident asthma using Cox proportional hazards models and the associations between ongoing asthma visits and deprivation by year of life with generalized linear mixed models. Results. OASIS asthma criteria were met for 21% of the 326,383 children. After adjustment for characteristics strongly associated with asthma, including male sex, prematurity, obesity, and atopic conditions other than asthma, children with high birth neighborhood deprivation were at increased risk of incident asthma (HR 1.11; 95% CI, 1.09–1.13). High deprivation in a given year of life was associated with increased odds of ongoing asthma during that year of life (OR 1.03; 95% CI, 1.02–1.05). Conclusions. Children living in high-deprivation neighborhoods are at increased risk of incident and ongoing asthma. This study suggests that neighborhood material deprivation may represent a helpful tool for evaluating the effects of disparities in health and social advantages on the likelihood of developing and continuing to need healthcare visits for ongoing childhood asthma.

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Ezeife, Doreen Anuli, Joshua Morganstein, Sally C. Lau, Lisa Le, David Cella, Penelope Ann Bradbury, Geoffrey Liu, Adrian G. Sacher, Frances A. Shepherd, and Natasha B. Leighl. "Financial toxicity among patients with lung cancer in a publicly funded health care system." Journal of Clinical Oncology 36, no. 30_suppl (October 20, 2018): 192. http://dx.doi.org/10.1200/jco.2018.36.30_suppl.192.

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192 Background: Financial distress has been established as a clinically relevant patient-reported outcome (PRO) associated with worse mortality and quality of life, but remains under-recognized by health care providers. Our goal was to define factors associated with financial toxicity (FT) in a public healthcare system. Methods: Patients with advanced lung cancer were recruited from outpatient clinics at the Princess Margaret Cancer Centre (Toronto, Canada). FT was measured with the validated Comprehensive Score for Financial Toxicity (COST) instrument, a 12-item survey scored from 0-44 with lower scores reflecting worse financial well-being. Data on patient and treatment characteristics, total out-of-pocket costs (OOP) and extended insurance coverage (EIC) were collected. Multivariable logistic regression models were fit for COST score and each variable, to determine factors associated with greater FT (COST < 21). Results: Of 251 patients approached, 200 (80%) participated. Median age of the cohort was 65 years; 56% were female, 64% immigrants and 77% employed or on pension. Median total OOP while on treatment ranged between $1000-5000 CAD. Median COST score was 21 (range 0-44). FT was associated with age, with patients < 65 years reporting greater FT than older patients (COST 18.0 vs. 24.0, p < 0.0001). In multivariable logistic regression analysis, younger age was associated with greater FT, when adjusting for income, employment status, OOP and EIC (OR 3.6, [95% CI, 1.5-9.1]; p < 0.0001). Total OOP > $1000 and EIC also were associated with greater FT (adjusted OR 5.0 [95% CI, 2.0-12.1] and 3.7 [95% CI, 1.5-9.1], respectively). Conclusions: Age is significantly associated with FT in the Canadian (Ontario) public healthcare system, with younger lung cancer patients reporting greater financial distress. This study highlights priority patient populations where FT should be routinely assessed and appropriate resources for support offered.

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Naik, H., X. Qiu, M. C. Brown, L. Eng, D. Pringle, M. Mahler, H. Hon, et al. "Socioeconomic status and lifestyle behaviours in cancer survivors: smoking and physical activity." Current Oncology 23, no. 6 (December 22, 2016): 546. http://dx.doi.org/10.3747/co.23.3166.

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Purpose Smoking cessation and increased physical activity (pa) have been linked to better outcomes in cancer survivors. We assessed whether socioeconomic factors influence changes in those behaviours after a cancer diagnosis.Methods As part of a cross-sectional study, a diverse group of cancer survivors at the Princess Margaret Cancer Centre (Toronto, ON), completed a questionnaire about past and current lifestyle behaviours and perceptions about the importance of those behaviours with respect to their health. The influence of socioeconomic indicators on smoking status and physical inactivity at 1 year before and after diagnosis were assessed using multivariable logistic regression with adjustment for clinico-demographic factors.Results Of 1222 participants, 1192 completed the smoking component. Of those respondents, 15% smoked before diagnosis, and 43% of those smokers continued to smoke after. The proportion of survivors who continued to smoke increased with lower education level (p = 0.03). Of the 1106 participants answering pa questions, 39% reported being physically inactive before diagnosis, of whom 82% remained inactive afterward. Survivors with a lower education level were most likely to remain inactive after diagnosis (p = 0.003). Lower education level, household income, and occupation were associated with the perception that pa had no effect or could worsen fatigue and quality of life (p ≤ 0.0001).Conclusions In cancer survivors, education level was a major modifier of smoking and pa behaviours. Lower socioeconomic status was associated with incorrect perceptions about pa. Targeting at-risk survivors by education level should be evaluated as a strategy in cancer survivorship programs.

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Al Thaher, Yazan, Othman A. Alfuqaha, and Ahmed Dweidari. "Health-Related Quality of Life and Outcome after Total Knee Replacement: Results from a Cross-Sectional Survey in Jordan." Advances in Orthopedics 2021 (December 10, 2021): 1–8. http://dx.doi.org/10.1155/2021/5506809.

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Total knee replacement (TKR) is a common procedure that is considered cost-effective with excellent long-term survivorship. This cross-sectional study, which includes 118 selected patients in Jordan from January 2020 to January 2021, aims to assess health-related quality of life (HQOL), functional status, and associated factors before and after 3 to 12 months of TKR. Furthermore, several demographical factors were included in this study to evaluate the potential association with the procedure’s outcome. Western Ontario and McMaster Universities Osteoarthritis Index scale (WOMAC) and Short Form-36 (SF-36) scale were used in this study. It was found that the main change occurred 6–12 months after the procedure. Gender and age were found to be the primary predictor of quality of life among TKR patients. Patients before the TKR procedure experienced severe pain, joint stiffness, physical impairment, and psychological demand issues. After the TKR procedure, all symptoms were improved significantly. The TKR procedure can improve the quality of life for patients, which can be detected for several months after the procedure. Function and pain are the most critical indicators of improvement in quality of life. Assessing the quality of life is a key indicator for identifying patients without improvement, as well as improving the health care process and comparing other alternative interventions.

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Enzenauer, Robert W., Alex V. Levin, James E. Elder, J. Donald Morin, and Stan Calderwood. "Screening for Fungal Endophthalmitis in Children at Risk." Pediatrics 90, no. 3 (September 1, 1992): 451–57. http://dx.doi.org/10.1542/peds.90.3.451.

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To evaluate the efficacy of screening ophthalmologic examinations in high-risk children, we reviewed the medical records for all patients hospitalized from 1985 through 1989 at The Hospital for Sick Children, Toronto, Ontario, who underwent ophthalmological consultation to rule out endogenous fungal endophthalmitis (n = 176). The patients were divided into groups: Group 1 (n = 47), those with deep-tissue fungal infection, and Group 2 (n = 129), those at risk for invasive fungal disease. Group 2 was subdivided further into two subgroups: Group 2a (n = 48), those with evidence of superficial fungal colonization (positive fungal culture) but no deep-tissue involvement, and Group 2b (n = 81), those with no evidence of fungal colonization (negative fungal culture). Of these 176 patients, 7 were diagnosed with endogenous fungal endophthalmitis: 6 from Group 1, 1 from Group 2a, and 0 from Group 2b. We found a significant association between the development of endogenous fungal endophthalmitis and the status of the fungal culture result (P < .005). The odds ratio indicated the risk of endogenous fungal endophthalmitis in Group 1 patients with deep-tissue infection was at least 19 times that of Group 2 at-risk patients. The risk of endogenous fungal endophthalmitis in Group 1 patients was at least 7 times that of Group 2a colonized patients and 12 times that of Group 2b patients with no positive fungal culture. Our study confirms the necessity of careful dilated ophthalmoscopic examination in patients with invasive fungal disease and suggests screening for those at-risk patients with superficial fungal colonization. Our results, however, do not document the value of routine ophthalmoscopic consultation in at-risk children without evidence of any fungal colonization.

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Smith, Robert W., Kerry Kuluski, Andrew P. Costa, Samir K. Sinha, Richard H. Glazier, Alan Forster, and Lianne Jeffs. "Investigating the effect of sociodemographic factors on 30-day hospital readmission among medical patients in Toronto, Canada: a prospective cohort study." BMJ Open 7, no. 12 (December 2017): e017956. http://dx.doi.org/10.1136/bmjopen-2017-017956.

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ObjectiveTo examine the influence of patient-level sociodemographic factors on the incidence of hospital readmission within 30 days among medical patients in a large Canadian metropolitan city.DesignProspective cohort study.Setting and participantsPatients admitted to the General Internal Medicine service of an urban teaching hospital in Toronto, Canada participated in a survey of sociodemographic information. Patients were not surveyed if deemed medically unstable, receiving care in medical/surgical step-down beds or were isolated for infection control. Included in the final analysis was a diverse cohort of 1427 adult, non-palliative, patients who were discharged home.MeasuresThirteen patient-level sociodemographic variables were examined in relation to time to unplanned all-cause readmission within 30 days. Illness level was accounted for by the following covariates: self-perceived health status, previous hospital utilisation, primary diagnosis case mix group, Charlson Comorbidity Index score and inpatient length of stay.ResultsApproximately, 14.4% (n=205) of patients experienced readmission within 30 days. Sociodemographic factors were not significantly associated with time to readmission in unadjusted and adjusted analyses. Indicators of illness level, namely, previous hospitalisations, were the strongest risk factors for readmission within this cohort. One previous admission (adjusted HR 1.78; 95% CI 1.22 to 2.59, P<0.01) and at least four previous emergency department visits (adjusted HR 2.33; 95% CI 1.46 to 4.43, P<0.01) were associated with increased hazard of readmission within 30 days.ConclusionsPatient-level sociodemographic factors did not influence the incidence of unplanned all-cause readmission within 30 days. Further research is needed to understand the generalisability of our findings and investigate whether contextual factors, such as access to universal health insurance coverage, attenuate the effects of sociodemographic factors.

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Ware, Patrick, Amika Shah, Heather Joan Ross, Alexander Gordon Logan, Phillip Segal, Joseph Antony Cafazzo, Katarzyna Szacun-Shimizu, Myles Resnick, Tessy Vattaparambil, and Emily Seto. "Challenges of Telemonitoring Programs for Complex Chronic Conditions: Randomized Controlled Trial With an Embedded Qualitative Study." Journal of Medical Internet Research 24, no. 1 (January 26, 2022): e31754. http://dx.doi.org/10.2196/31754.

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Background Despite the growing prevalence of people with complex conditions and evidence of the positive impact of telemonitoring for single conditions, little research exists on telemonitoring for this population. Objective This randomized controlled trial and embedded qualitative study aims to evaluate the impact on and experiences of patients and health care providers (HCPs) using a telemonitoring system with decision support to manage patients with complex conditions, including those with multiple chronic conditions, compared with the standard of care. Methods A pragmatic, unblinded, 6-month randomized controlled trial sought to recruit 146 patients with ≥1 diagnosis of heart failure (HF), uncontrolled hypertension (HT), and insulin-requiring diabetes mellitus (DM) from outpatient specialty settings in Toronto, Ontario, Canada. Participants were randomized into the control and telemonitoring groups, with the latter being instructed to take readings relevant to their conditions. The telemonitoring system contained an algorithm that generated decision support in the form of actionable self-care directives to patients and alerts to HCPs. The primary outcome was health status (36-Item Short Form Health Survey questionnaire). Secondary outcomes included anxiety and depression, self-efficacy in chronic disease management, and self-reported health service use. HF-related quality of life and self-care measures were also collected from patients followed for HF. Within- and between-group change scores were analyzed for statistical significance (P<.05). A convenience sample of HCPs and patients in the intervention group was interviewed about their experiences. Results A total of 96 patients were recruited and randomized. Recruitment was terminated early because of implementation challenges and the onset of the COVID-19 pandemic. No significant within- and between-group differences were found for the main primary and secondary outcomes. However, a within-group analysis of patients with HF found improvements in self-care maintenance (P=.04) and physical quality of life (P=.046). Opinions expressed by the 5 HCPs and 13 patients who were interviewed differed based on the monitored conditions. Although patients with HF reported benefitting from actionable self-care guidance and meaningful interactions with their HCPs, patient and HCP users of the DM and HT modules did not think telemonitoring improved the clinical management of those conditions to the same degree. These differing experiences were largely attributed to the siloed nature of specialty care and the design of the decision support, whereby fluctuations in the status of HT and DM typically required less urgent interventions compared with patients with HF. Conclusions We recommend that future research conceive telemonitoring as a program and that self-management and clinical decision support are necessary but not sufficient components of such programs for patients with complex conditions and lower acuity. We conclude that telemonitoring for patients with complex conditions or within multidisciplinary care settings may be best operationalized through nurse-led models of care. Trial Registration ClinicalTrials.gov NCT03127852; https://clinicaltrials.gov/ct2/show/NCT03127852 International Registered Report Identifier (IRRID) RR2-10.2196/resprot.8367

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McCormack, Gavin R., Jason Cabaj, Heather Orpana, Ryan Lukic, Anita Blackstaffe, Suzanne Goopy, Brent Hagel, et al. "A scoping review on the relations between urban form and health: a focus on Canadian quantitative evidence." Health Promotion and Chronic Disease Prevention in Canada 39, no. 5 (May 2019): 187–200. http://dx.doi.org/10.24095/hpcdp.39.5.03.

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Introduction Despite the accumulating Canadian evidence regarding the relations between urban form and health behaviours, less is known about the associations between urban form and health conditions. Our study aim was to undertake a scoping review to synthesize evidence from quantitative studies that have investigated the relationship between built environment and chronic health conditions, self-reported health and qual¬ity of life, and injuries in the Canadian adult population. Methods From January to March 2017, we searched 13 databases to identify peer-reviewed quantitative studies from all years that estimated associations between the objectively-measured built environment and health conditions in Canadian adults. Studies under¬taken within urban settings only were included. Relevant studies were catalogued and synthesized in relation to their reported study and sample design, and health outcome and built environment features. Results Fifty-five articles met the inclusion criteria, 52 of which were published after 2008. Most single province studies were undertaken in Ontario (n = 22), Quebec (n = 12), and Alberta (n = 7). Associations between the built environment features and 11 broad health outcomes emerged from the review, including injury (n = 19), weight status (n = 19), cardiovascular disease (n = 5), depression/anxiety (n = 5), diabetes (n = 5), mortality (n = 4), self-rated health (n = 2), chronic conditions (n = 2), metabolic condi¬tions (n = 2), quality of life (n = 1), and cancer (n = 1). Consistent evidence for asso¬ciations between aggregate built environment indicators (e.g., walkability) and diabetes and weight and between connectivity and route features (e.g., transportation route, trails, pathways, sidewalks, street pattern, intersections, route characteristics) and injury were found. Evidence for greenspace, parks and recreation features impacting multiple health outcomes was also found. Conclusion Within the Canadian context, the built environment is associated with a range of chronic health conditions and injury in adults, but the evidence to date has limi¬tations. More research on the built environment and health incorporating rigorous study designs are needed to provide stronger causal evidence to inform policy and practice.

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Lim, David W., Helene Retrouvey, Isabel Kerrebijn, Benita Hosseini, Anne C. O'Neill, Tulin D. Cil, Toni Zhong, Stefan O. P. Hofer, David R. McCready, and Kelly A. Metcalfe. "Abstract B020: Does surgical procedure influence psychosocial outcomes after treatment in women with ductal carcinoma in situ?" Cancer Prevention Research 15, no. 12_Supplement_1 (December 1, 2022): B020. http://dx.doi.org/10.1158/1940-6215.dcis22-b020.

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Abstract Objective: Rates of bilateral mastectomy are increasing in women with ductal carcinoma in situ (DCIS). We aim to characterize the trajectory of psychosocial outcomes after surgery in women with DCIS. Methods: We have been prospectively collecting psychosocial data on women receiving surgery for stage 0-III breast cancer at University Health Network in Toronto, Ontario, Canada since 2009. We queried our prospective database to identify all women receiving surgery for DCIS between May 2009 and January 2020. Women completed validated psychosocial questionnaires (e.g. BREAST-Q, Impact of Event Scale, Hospital Anxiety & Depression Scale) pre-operatively, and at 6 and 12 months following surgery. We analyzed the change in psychosocial scores between three surgical procedures (breast-conserving therapy, unilateral mastectomy and bilateral mastectomy) using linear mixed models, controlling for age and sociodemographic factors (e.g. ethnicity, education level, income and marital status). P values < .05 were significant. Results: 89 women with DCIS were identified, with a mean age of 52.4 ± 10.3 years. By surgical procedure, 7 women underwent breast-conserving therapy (8%), 46 underwent unilateral mastectomy (52%) and 36 underwent bilateral mastectomy (40%). Breast satisfaction (-8, P = .03) and sexual well-being (-10, P = .02) scores decreased over time but was not influenced by surgical procedure. Younger women had worse psychosocial well-being scores (-0.5/year, P = .02), with no impact of surgical procedure. There was a significant interaction between surgical procedure and time for chest physical well-being scores (P = .04); women having breast-conserving therapy had better chest physical well-being scores compared with both unilateral and bilateral mastectomy (with no difference between mastectomy groups). Unemployed women had worse chest physical well-being scores (-9, P = .04). There was a significant interaction between procedure and time for distress scores (P = .02); women having unilateral or bilateral mastectomy had higher distress scores before surgery but at 12 months, there was no difference between surgical procedures. Women with a higher annual income (≥80,000$) had higher breast satisfaction (+10, P = .03), psychosocial well-being (+14, P = .004), and sexual well-being (+12, P = .02), and lower distress (-12, P = .004 ) scores than women earning less than 80,000$ per year. There was a significant interaction (P = .01) between procedure and time for anxiety scores; while all surgical groups had mild anxiety scores at baseline, the anxiety scores for both unilateral and bilateral mastectomy groups improved to normal range over time while scores for women having breast-conserving therapy remained mild. Conclusions: Surgical procedure influences chest physical well-being, distress and anxiety scores in women with DCIS. Our data may help inform surgical decision-making for women with DCIS, and highlight a need for identifying women with high distress at diagnosis who may benefit from targeted psychosocial support. Citation Format: David W. Lim, Helene Retrouvey, Isabel Kerrebijn, Benita Hosseini, Anne C. O'Neill, Tulin D. Cil, Toni Zhong, Stefan O.P. Hofer, David R. McCready, Kelly A. Metcalfe. Does surgical procedure influence psychosocial outcomes after treatment in women with ductal carcinoma in situ? [abstract]. In: Proceedings of the AACR Special Conference on Rethinking DCIS: An Opportunity for Prevention?; 2022 Sep 8-11; Philadelphia, PA. Philadelphia (PA): AACR; Can Prev Res 2022;15(12 Suppl_1): Abstract nr B020.

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Hapidin, Winda Gunarti, Yuli Pujianti, and Erie Siti Syarah. "STEAM to R-SLAMET Modification: An Integrative Thematic Play Based Learning with R-SLAMETS Content in Early Child-hood Education." JPUD - Jurnal Pendidikan Usia Dini 14, no. 2 (November 30, 2020): 262–74. http://dx.doi.org/10.21009/jpud.142.05.

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STEAM-based learning is a global issue in early-childhood education practice. STEAM content becomes an integrative thematic approach as the main pillar of learning in kindergarten. This study aims to develop a conceptual and practical approach in the implementation of children's education by applying a modification from STEAM Learning to R-SLAMET. The research used a qualitative case study method with data collection through focus group discussions (FGD), involving early-childhood educator's research participants (n = 35), interviews, observation, document analysis such as videos, photos and portfolios. The study found several ideal categories through the use of narrative data analysis techniques. The findings show that educators gain an understanding of the change in learning orientation from competency indicators to play-based learning. Developing thematic play activities into continuum playing scenarios. STEAM learning content modification (Science, Technology, Engineering, Art and Math) to R-SLAMETS content (Religion, Science, Literacy, Art, Math, Engineering, Technology and Social study) in daily class activity. Children activities with R-SLAMETS content can be developed based on an integrative learning flow that empowers loose part media with local materials learning resources. Keyword: STEAM to R-SLAMETS, Early Childhood Education, Integrative Thematic Learning References Ali, E., Kaitlyn M, C., Hussain, A., & Akhtar, Z. (2018). the Effects of Play-Based Learning on Early Childhood Education and Development. Journal of Evolution of Medical and Dental Sciences, 7(43), 4682–4685. https://doi.org/10.14260/jemds/2018/1044 Ata Aktürk, A., & Demircan, O. (2017). A Review of Studies on STEM and STEAM Education in Early Childhood. Journal of Kırşehir Education Faculty, 18(2), 757–776. Azizah, W. A., Sarwi, S., & Ellianawati, E. (2020). Implementation of Project -Based Learning Model (PjBL) Using STREAM-Based Approach in Elementary Schools. Journal of Primary Education, 9(3), 238–247. https://doi.org/10.15294/jpe.v9i3.39950 Badmus, O. (2018). Evolution of STEM, STEAM and STREAM Education in Africa: The Implication of the Knowledge Gap. In Contemporary Issues in Science, Technology, Engineering, Arts and Mathematics Teacher Education in Nigeria. Björklund, C., & Ahlskog-Björkman, E. (2017). Approaches to teaching in thematic work: early childhood teachers’ integration of mathematics and art. International Journal of Early Years Education, 25(2), 98–111. https://doi.org/10.1080/09669760.2017.1287061 Broadhead, P. (2003). Early Years Play and Learning. In Early Years Play and Learning. https://doi.org/10.4324/9780203465257 Canning, N. (2010). The influence of the outdoor environment: Den-making in three different contexts. European Early Childhood Education Research Journal, 18(4), 555–566. https://doi.org/10.1080/1350293X.2010.525961 Clapp, E. P., Solis, S. L., Ho, C. K. N., & Sachdeva, A. R. (2019). Complicating STEAM: A Critical Look at the Arts in the STEAM Agenda. Encyclopedia of Educational Innovation, 1–4. https://doi.org/10.1007/978-981-13-2262-4_54-1 Colucci, L., Burnard, P., Cooke, C., Davies, R., Gray, D., & Trowsdale, J. (2017). Reviewing the potential and challenges of developing STEAM education through creative pedagogies for 21st learning: how can school curricula be broadened towards a more responsive, dynamic, and inclusive form of education? BERA Research Commission, August, 1–105. https://doi.org/10.13140/RG.2.2.22452.76161 Conradty, C., & Bogner, F. X. (2018). From STEM to STEAM: How to Monitor Creativity. Creativity Research Journal, 30(3), 233–240. https://doi.org/10.1080/10400419.2018.1488195 Conradty, C., & Bogner, F. X. (2019). From STEM to STEAM: Cracking the Code? How Creativity & Motivation Interacts with Inquiry-based Learning. Creativity Research Journal, 31(3), 284–295. https://doi.org/10.1080/10400419.2019.1641678 Cook, K. L., & Bush, S. B. (2018). Design thinking in integrated STEAM learning: Surveying the landscape and exploring exemplars in elementary grades. School Science and Mathematics, 118(3–4), 93–103. https://doi.org/10.1111/ssm.12268 Costantino, T. (2018). STEAM by another name: Transdisciplinary practice in art and design education. Arts Education Policy Review, 119(2), 100–106. https://doi.org/10.1080/10632913.2017.1292973 Danniels, E., & Pyle, A. (2018). Defining Play-based Learning. In Encyclopedia on Early Childhood Development (Play-Based, Issue February, pp. 1–5). OISE University of Toronto. DeJarnette, N. K. (2018). Implementing STEAM in the Early Childhood Classroom. European Journal of STEM Education, 3(3), 1–9. https://doi.org/10.20897/ejsteme/3878 Dell’Erba, M. (2019). Policy Considerations for STEAM Education. Policy Brief, 1–10. Doyle, K. (2019). The languages and literacies of the STEAM content areas. Literacy Learning: The Middle Years, 27(1), 38–50. http://proxy.libraries.smu.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=eue&AN=133954204&site=ehost-live&scope=site Edwards, S. (2017). Play-based learning and intentional teaching: Forever different? Australasian Journal of Early Childhood, 42(2), 4–11. https://doi.org/10.23965/ajec.42.2.01 Faas, S., Wu, S.-C., & Geiger, S. (2017). The Importance of Play in Early Childhood Education: A Critical Perspective on Current Policies and Practices in Germany and Hong Kong. Global Education Review, 4(2), 75–91. Fesseha, E., & Pyle, A. (2016). Conceptualising play-based learning from kindergarten teachers’ perspectives. International Journal of Early Years Education, 24(3), 361–377. https://doi.org/10.1080/09669760.2016.1174105 Finch, C. R., Frantz, N. R., Mooney, M., & Aneke, N. O. (1997). Designing the Thematic Curriculum: An All Aspects Approach MDS-956. 97. Gess, A. H. (2019). STEAM Education. STEAM Education, November, 2011–2014. https://doi.org/10.1007/978-3-030-04003-1 Gronlund, G. (n.d.). “ Addressing Standards through Play-Based Learning in Preschool and Kindergarten .” Gronlund, G. (2015). Planning for Play-Based Curriculum Based on Individualized Goals to Help Each Child Thrive in Preschool and Kindergarten Gaye Gronlund. Gull, C., Bogunovich, J., Goldstein, S. L., & Rosengarten, T. (2019). Definitions of Loose Parts in Early Childhood Outdoor Classrooms: A Scoping Review. The International Journal of Early Childhood Education, 6(3), 37–52. Hapidin, Pujianti, Y., Hartati, S., Nurani, Y., & Dhieni, N. (2020). The continuous professional development for early childhood teachers through lesson study in implementing play based curriculum (case study in Jakarta, Indonesia). International Journal of Innovation, Creativity and Change, 12(10), 17–25. Hennessey, P. (2016). Full – Day Kindergarten Play-Based Learning : Promoting a Common Understanding. Education and Early Childhood Development, April, 1–76. gov.nl.ca/edu Henriksen, D. (2017). Creating STEAM with Design Thinking: Beyond STEM and Arts Integration. Steam, 3(1), 1–11. https://doi.org/10.5642/steam.20170301.11 Inglese, P., Barbera, G., La Mantia, T., On, P., Presentation, T., Reid, R., Vasa, S. F., Maag, J. W., Wright, G., Irsyadi, F. Y. Al, Nugroho, Y. S., Cutter-Mackenzie, A., Edwards, S., Moore, D., Boyd, W., Miller, E., Almon, J., Cramer, S. C., Wilkes-Gillan, S., … Halperin, J. M. (2014). Young Children’s Play and Environmental Education in Early Childhood Education. PLoS ONE, 2(3), 9–25. https://doi.org/10.1586/ern.12.106 Jacman, H. (2012). Early Education Curriculum. Pedagogical Development Unit, FEBRUARY 2011, 163. https://www.eursc.eu/Syllabuses/2011-01-D-15-en-4.pdf Jay, J. A., & Knaus, M. (2018). Embedding play-based learning into junior primary (Year 1 and 2) Curriculum in WA. Australian Journal of Teacher Education, 43(1), 112–126. https://doi.org/10.14221/ajte.2018v43n1.7 Kennedy, A., & Barblett, L. (2010). Supporting the Early Years Learning Framework. Research in Practise Series, 17(3), 1–12. Keung, C. P. C., & Cheung, A. C. K. (2019). Towards Holistic Supporting of Play-Based Learning Implementation in Kindergartens: A Mixed Method Study. Early Childhood Education Journal, 47(5), 627–640. https://doi.org/10.1007/s10643-019-00956-2 Keung, C. P. C., & Fung, C. K. H. (2020). Exploring kindergarten teachers’ pedagogical content knowledge in the development of play-based learning. Journal of Education for Teaching, 46(2), 244–247. https://doi.org/10.1080/02607476.2020.1724656 Krogh, S., & Morehouse, P. (2014). The Early Childhood Curriculum : Inquiry Learning Through Integration. Liao, C. (2016). From Interdisciplinary to Transdisciplinary: An Arts-Integrated Approach to STEAM Education. Art Education, 69(6), 44–49. https://doi.org/10.1080/00043125.2016.1224873 Lillard, A. S., Lerner, M. D., Hopkins, E. J., Dore, R. A., Smith, E. D., & Palmquist, C. M. (2013). The impact of pretend play on children’s development: A review of the evidence. Psychological Bulletin, 139(1), 1–34. https://doi.org/10.1037/a0029321 Maxwell, L. E., Mitchell, M. R., & Evans, G. W. (2008). Effects of Play Equipment and Loose Parts on Preschool Children’s Outdoor Play Behavior: An Observational Study and Design Intervention. Children, Youth and Environments, 18(2), 37–63. McLaughlin, T., & Cherrington, S. (2018). Creating a rich curriculum through intentional teaching. Early Childhood Folio, 22(1), 33. https://doi.org/10.18296/ecf.0050 Mengmeng, Z., Xiantong, Y., & Xinghua, W. (2019). Construction of STEAM Curriculum Model and Case Design in Kindergarten. American Journal of Educational Research, 7(7), 485–490. https://doi.org/10.12691/education-7-7-8 Milara, I. S., Pitkänen, K., Laru, J., Iwata, M., Orduña, M. C., & Riekki, J. (2020). STEAM in Oulu: Scaffolding the development of a Community of Practice for local educators around STEAM and digital fabrication. International Journal of Child-Computer Interaction, 26, 100197. https://doi.org/10.1016/j.ijcci.2020.100197 Moomaw, S. (2012). STEM Begins in the Early Years. School Science and Mathematics, 112(2), 57–58. https://doi.org/10.1111/j.1949-8594.2011.00119.x Peng, Q. (2017). Study on Three Positions Framing Kindergarten Play-Based Curriculum in China: Through Analyses of the Attitudes of Teachers to Early Linguistic Education. Studies in English Language Teaching, 5(3), 543. https://doi.org/10.22158/selt.v5n3p543 Pyle, A., & Bigelow, A. (2015). Play in Kindergarten: An Interview and Observational Study in Three Canadian Classrooms. Early Childhood Education Journal, 43(5), 385–393. https://doi.org/10.1007/s10643-014-0666-1 Pyle, A., & Danniels, E. (2017). A Continuum of Play-Based Learning: The Role of the Teacher in Play-Based Pedagogy and the Fear of Hijacking Play. Early Education and Development, 28(3), 274–289. https://doi.org/10.1080/10409289.2016.1220771 Quigley, C. F., Herro, D., & Jamil, F. M. (2017). Developing a Conceptual Model of STEAM Teaching Practices. School Science and Mathematics, 117(1–2), 1–12. https://doi.org/10.1111/ssm.12201 Ridgers, N. D., Knowles, Z. R., & Sayers, J. (2012). Encouraging play in the natural environment: A child-focused case study of Forest School. Children’s Geographies, 10(1), 49–65. https://doi.org/10.1080/14733285.2011.638176 Ridwan, A., Rahmawati, Y., & Hadinugrahaningsih, T. (2017). Steam Integration in Chemistry Learning for Developing 21st Century Skills. MIER Journail of Educational Studies, Trends & Practices, 7(2), 184–194. Rolling, J. H. (2016). Reinventing the STEAM Engine for Art + Design Education. Art Education, 69(4), 4–7. https://doi.org/10.1080/00043125.2016.1176848 Sancar-Tokmak, H. (2015). The effect of curriculum-generated play instruction on the mathematics teaching efficacies of early childhood education pre-service teachers. European Early Childhood Education Research Journal, 23(1), 5–20. https://doi.org/10.1080/1350293X.2013.788315 Sawangmek, S. (2019). Trends and Issues on STEM and STEAM Education in Early Childhood. Képzés És Gyakorlat, 17(2019/3-4), 97–106. https://doi.org/10.17165/tp.2019.3-4.8 Science, A. I. (n.d.). STEM Project-Based Learning. Spencer, R., Joshi, N., Branje, K., Lee McIsaac, J., Cawley, J., Rehman, L., FL Kirk, S., & Stone, M. (2019). Educator perceptions on the benefits and challenges of loose parts play in the outdoor environments of childcare centres. AIMS Public Health, 6(4), 461–476. https://doi.org/10.3934/publichealth.2019.4.461 Taylor, J., Bond, E., & Woods, M. (2018). A Multidisciplinary and Holistic Introduction. Varun A. (2014). Thematic Approach for Effective Communication in Early Childhood Education Thematic Approach for effective communication in ECCE. International Journal of Education and Psychological Research (IJEPR), 3(3), 49–51. https://www.researchgate.net/publication/289868193 Wang, X., Xu, W., & Guo, L. (2018). The status quo and ways of STEAM education promoting China’s future social sustainable development. Sustainability (Switzerland), 10(12). https://doi.org/10.3390/su10124417 Whitebread, D. D. (2012). The Importance of Play. Toy Industries of Europe, April, 1–55. https://doi.org/10.5455/msm.2015.27.438-441 Wong, S. M., Wang, Z., & Cheng, D. (2011). A play-based curriculum: Hong Kong children’s perception of play and non-play. International Journal of Learning, 17(10), 165–180. https://doi.org/10.18848/1447-9494/cgp/v17i10/47298 Zosh, J. M., Hopkins, E. J., Jensen, H., Liu, C., Neale, D., Hirsh-Pasek, K., Whitebread, Solis, S. L., & David. (2017). Learning through play : a review of the evidence (Issue November). The LEGO Foundation.

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Aleem, Ilyas, Yan Xu, Y. Raja Rampersaud, Markian Pahuta, Godefroy Hardy St-Pierre, Eric Crawford, Mohammad Zarrabian, et al. "Canadian Spine Society1.01: Do lumbar decompression and fusion patients recall their preoperative status? Recall bias in patient-reported outcomes1.02: Trends and costs of lumbar fusion and disc replacement surgeries in Ontario: a population-based study1.03: Ontario’s Inter-professional Spine Assessment and Education Clinics (ISAEC): patient, provider and system impact of an integrated model of care for the management of LBP1.04: Validation of the self-administered online assessment of preferences (SOAP) utility elicitation tool1.05: Performance indicators in spine surgery: a systematic review1.06: Inter-professional Spine Assessment and Education Clinics (ISAEC): a networked model of care with changes to referral population profile and reduced surgical wait-times1.07: Improving spine surgical access, appropriateness and efficiency in metropolitan, urban and rural settings1.08: Reliability of the spine CPR score among emergency physicians1.09: Deriving a clinical prediction model for degenerative spine disorders1.10: Development of validated computer-based preoperative predictive model for reaching ODI MCID with 86% accuracy based on 198 ASD patients with 2-year follow-up1.11: Validation of the spine CPR score1.12: Can ultrasound detect curve progression of scoliosis without ionizing radiation?1.13: Relationship between age and nonoperative utilization in elective cervical spine surgery1.14: Larger global sagittal correction associated with increased PJK and major complications, but lead to better correction and HRQoL scores1.15: Comprehensive analysis of SRS appearance domain score drivers and comparative relationship to satisfaction in adults2.16: Incremental cost to Canada’s health care system of acute complications following spinal cord injury2.17: The prevalence and natural history of problematic spasticity following traumatic spinal cord injury2.18: Exploring the possibility of using artificial neural networks to predict mortality after spinal cord injury2.19: Developing a new index to predict mortality after spinal cord injury using machine learning techniques2.20: The impact of complications and opportunities to improve function, health and quality of life: our best approach to “cure” SCI today2.21: Delays in time from injury to specialized SCI centres increase in-hospital mortality in acute SCI2.22: The modified extremity motor (MEM) classification: A neurological classification of traumatic central cord syndrome (TCCS)2.23: The stable spine central cord syndrome (SCCS): a prospective surgical cohort2.24: Changes following acute traumatic spinal cord injury: a prospective pilot study on serial MRIs2.25: Next-generation MRI identifies tract-specific injury and predicts focal neurological deficits in degenerative cervical myelopathy: development and characterization of accurate imaging biomarkers for spinal cord pathologies2.26: Translating state-of-the-art spinal cord MRI techniques to clinical use: a systematic review of clinical studies using DTI, MT, MWF, MRS and fMRI2.27: Motor cortex electrical stimulation to promote spinal cord injury recovery in an animal model2.28: Role of muscle damage on loading at the level adjacent to a lumbar spine fusion: a biomechanical analysis2.29: Classifying injury severity and predicting neurologic outcome after acute human spinal cord injury with cerebrospinal fluid biomarkers2.30: Spine surgery a mari usque ad mare3.31: Prognostic factors for survival in a surgical series of symptomatic metastatic epidural spinal cord compression: a prospective North American multi-centre study in 142 patients3.32: Surgical management of spinal osteoblastomas3.33: General population utilities for metastatic epidural spinal cord compression health states3.34: Instrumentation following decompression for spinal metastases — Is there a need for fusion in addition to internal fixation?3.35: Do racial differences affect surgical outcomes in patients with degenerative cervical myelopathy? Results from the prospective, multicentre AOSpine International study on 479 patients3.36: Is preoperative duration of symptoms a significant predictor of functional status and quality of life outcomes in patients undergoing surgery for the treatment of degenerative cervical myelopathy?3.37: Surgery for degenerative cervical myelopathy from an economic and outcome perspective: a cost–utility analysis of the combined data from the AOSpine North America and International studies3.38: Laminoplasty versus laminectomy and fusion to treat cervical spondylotic myelopathy: outcomes of the prospective multicentre AOSpine North America and International CSM studies3.39: The impact of spinal manipulation on lower extremity motor control in lumbar spinal stenosis patients: a single-blind randomized clinical trial3.40: Predictors of improved pain, function and quality of life following elective lumbar spine fusion surgery3.41: Objective measurement of free-living physical activity (performance) in lumbar spinal stenosis: Are physical activity guidelines being met?3.42: Two-year follow-up in spine clinical research: An adequate benchmark?3.43: The impact of presurgical self-reported exercise patterns on postsurgical outcomes3.44: Baseline and postoperative outcomes in patients undergoing surgery for degenerative lumbar spondylo-listhesis: a comparison study between single-payer and multitier health care systems3.45: An exploration of the inter-relationships between low back pain, obesity, inflammation and diabetic statusP01: Methylprednisolone for the treatment of patients with acute spinal cord injuries: a systematic review and meta-analysisP02: The relationship between preoperative clinical presentation and quantitative MRI features in patients with degenerative cervical myelopathyP03: Change in function, pain and quality of life following structured nonoperative treatment in patients with degenerative cervical myelopathy: a systematic reviewP04: Tobacco smoking and outcomes following surgical decompression in patients with symptomatic degenerative cervical myelopathyP05: Predicting the minimum clinically important difference in patients undergoing surgery for the treatment of degenerative cervical myelopathyP06: Timing of decompression in patients with acute spinal cord injury: a systematic reviewP07: Defining the pathway to definitive care and surgical decompression after traumatic spinal cord injury: results of a Canadian population-based cohort studyP08: Assessment of surgical treatment strategies for moderate to severe cervical spinal deformity reveals marked variation in approaches, osteotomies and fusion levelsP09: Frailty and postoperative outcomes in patients undergoing surgery for degenerative spine diseaseP10: Does sarcopenia as assessed by the normalized total psoas area predict early outcomes in elderly patients undergoing elective surgery for degenerative spine disease?P11: The relationship between pre-existing comorbidities and postinjury adverse events in traumatic spinal cord injury: a prospective Canadian cohort study focusing on potentially modifiable conditionsP12: The incidence, severity and impact of adverse events in adult spinal deformity patients: an ambispective cohort analysisP13: Factors affecting length of stay following 3-column spinal osteotomies in paediatric patientsP14: The rate and risk of curve progression following skeletal maturity — Does the story end with curve magnitude?P15: Integration of a spine assessment clinic prior to surgical consult — a program descriptionP16: Improved data capture and quality following implementation of standard operating procedures for a single site in the Canadian Spine Outcomes and Research Network databaseP17: Survival and clinical outcomes in patients with meta-static epidural spinal cord compression: results from the AOSpine Prospective Multicentre Study of 142 patientsP18: The clinical utility of the spinal instability neoplastic score (SINS) and its role in surgical management of patients with spinal metastatic diseaseP19: Patterns of spinal metastatic disease and mechanical instability: a retrospective correlation with tumour histologyP20: A retrospective analysis of the clinical utility of the Tokuhashi scale, and its impact in surgical management of spinal metastatic diseaseP21: Length of hospital stay following elective lumbar spine fusion surgeryP22: Interspinous process device versus decompression and fusion: further investigation with 2 year follow-up in a degenerative lumbar spondylolisthesis patient populationP23: The outcomes following decompression and fusion are compromised when it is preceded by a discectomy or decompressionP24: Predictors of response following nonsurgical treatment of low back pain." Canadian Journal of Surgery 59, no. 3 Suppl 2 (June 2016): S39—S63. http://dx.doi.org/10.1503/cjs.006916.

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Fayez, R., A. AlMuntashery, G. Bodie, A. Almamar, R. S. Gill, I. Raîche, C. L. Mueller, et al. "Canadian Surgery Forum1 Is laparoscopic sleeve gastrectomy a reasonable stand-alone procedure for super morbidly obese patients?2 Postoperative monitoring requirements of patients with obstructive sleep apnea undergoing bariatric surgery3 Role of relaparoscopy in the diagnosis and treatment of bariatric complications in the early postoperative period4 Changes of active and total ghrelin, GLP-1 and PYY following restrictive bariatric surgery and their impact on satiety: comparison of sleeve gastrectomy and adjustable gastric banding5 Prioritization and willingness to pay for bariatric surgery: the patient perspective6 Ventral hernia at the time of laparoscopic gastric bypass surgery: Should it be repaired?7 Linear stapled gastrojejunostomy with transverse handsewn enterotomy closure significantly reduces strictures for laparoscopic Roux-en-Y bypass8 Laparoscopic biliopancreatic diversion with duodenal switch as second stage for super super morbidly obese patients. Do all patients benefit?9 Sleeve gastrectomy in the super super morbidly obese (BMI > 60 kg/m²): a Canadian experience10 Laparoscopic gastric bypass for the treatment of refractory idiopathic gastroparesis: a report of 2 cases11 Duodeno-ileal switch as a primary bariatric and metabolic surgical option for the severely obese patient with comorbidities: review of a single-institution case series of duodeno-ileal intestinal bypass12 Management of large paraesophageal hernias in morbidly obese patients with laparoscopic sleeve gastrectomy: a case series13 Early results of the Ontario bariatric surgical program: using the bariatric registry14 Improving access to bariatric surgical care: Is universal health care the answer?15 Early and liberal postoperative exploration can reduce morbidity and mortality in patients undergoing bariatric surgery16 Withdrawn17 Identification and assessment of technical errors in laparoscopic Roux-en-Y gastric bypass18 A valid and reliable tool for assessment of surgical skill in laparoscopic Roux-en-Y gastric bypass19 Psychiatric predictors of presurgery drop-out following suitability assessment for bariatric surgery20 Predictors of outcomes following Roux-en-Y gastric bypass surgery at The Ottawa Hospital21 Prophylactic management of cholelithiasis in bariatric patients: Is routine cholecystectomy warranted?22 Early outcomes of Roux-en-Y gastric bypass in a publicly funded obesity program23 Similar incidence of gastrojejunal anastomotic stricture formation with hand-sewn and 21 mm circular stapler techniques during Roux-en-Y gastric bypass24 (CAGS Basic Science Award) Exogenous glucagon-like peptide-1 improves clinical, morphological and histological outcomes of intestinal adaptation in a distal-intestinal resection piglet model of short bowel syndrome25 (CAGS Clinical Research Award) Development and validation of a comprehensive curriculum to teach an advanced minimally invasive procedure: a randomized controlled trial26 Negative-pressure wound therapy (iVAC) on closed, high-risk incisions following abdominal wall reconstruction27 The impact of seed granting on research in the University of British Columbia Department of Surgery28 Quality of surgical care is inadequate for elderly patients29 Recurrence of inguinal hernia in general and hernia specialty hospitals in Ontario, Canada30 Oncostatin M receptor deficiency results in increased mortality in an intestinal ischemia reperfusion model in mice31 Laparoscopic repair of large paraesophageal hernias with anterior gastropexy: a multicentre trial32 Response to preoperative medical therapy predicts success of laparoscopic splenectomy for immune thrombocytopenic purpura33 Perioperative sepsis, but not hemorrhagic shock, promotes the development of cancer metastases in a murine model34 Measuring the impact of implementing an acute care surgery service on the management of acute biliary disease35 Patient flow and efficiency in an acute care surgery service36 The relationship between treatment factors and postoperative complications after radical surgery for rectal cancer37 Risk of ventral hernia after laparoscopic colon surgery38 Urinary metabolomics as a tool for early detection of Barrett’s and esophageal cancer39 Construct validity of individual and summary performance metrics associated with a computer-based laparo-scopic simulator40 Impact of a city-wide health system reorganization on emergency department visits in hospitals in surrounding communities41 Transcatheter aortic valve implantation for the nonoperative management of aortic stenosis: a cost-effectiveness analysis42 Breast cancer: racial differences in age of onset. A potential confounder in Canadian screening recommendations43 Risk taking in surgery: in and out of the comfort zone44 A tumour board in the office: Track those cancer patients!45 Increased patient BMI is not associated with advanced colon cancer stage or grade on presentation: a retrospective chart review46 Consensus statements regarding the multidisciplinary care of limb amputation patients in disasters or humanitarian emergencies. Report of the 2011 Humanitarian Action Summit Surgical Working Group on amputations following disasters or conflict47 Learning the CanMEDS role of professional: a pilot project of supervised discussion groups addressing the hidden curriculum48 Assessing the changing scope of training in Canadian general surgery programs: expected versus actual experience49 Predicting need for surgical management for massive gastrointestinal hemorrhage50 International health care experience: using CanMEDS to evaluate learning outcomes following a surgical mission in Mampong, Ghana51 The open abdomen: risk factors for mortality and rates of closure52 How surgeons think: an exploration of mental practice in surgical preparation53 The surgery wiki: a novel method for delivery of under-graduate surgical education54 Understanding surgical residents’ postoperative practices before implementing an enhanced recovery after surgery (ERAS) guideline at the University of Toronto55 From laparoscopic transabdominal to posterior retroperitoneal adrenalectomy: a paradigm shift in operative approach56 A retrospective audit of outcomes in patients over the age of 80 undergoing acute care abdominal surgery57 Canadian general surgery residents’ perspectives on work-hour regulations58 Timing of surgical intervention and its outcomes in acute appendicitis59 Preparing surgical trainees to deal with adverse events. An outline of learning issues60 Acute care surgical service: surgeon agreement at the time of handover61 Predicting discharge of elderly patients to prehospitalization residence following emergency general surgery62 Morbidity and mortality after emergency abdominal surgery in octo- and nonagenarians63 The impact of acute abdominal illness and urgent admission to hospital on the living situation of elderly patients64 A comparison of laparoscopic versus open subtotal gastrectomy for antral gastric adenocarcinoma: a North American perspective65 Minimally invasive excision of ectopic mediastinal parathyroid adenomas66 Perioperative outcomes of laparoscopic hernia repair in a tertiary care centre: a single institution’s experience67 Evaluation of a student-run, practical and didactic curriculum for preclerkship medical students68 Joseph Lister: Father of Modern Surgery69 Comparisons of melanoma sentinel lymph node biopsy prediction nomograms in a cohort of Canadian patients70 Local experience with myocutaneous flaps after extensive pelvic surgery71 The treatment of noncirrhotic splanchnic vein thrombosis: Is anticoagulation enough?72 Implementation of an acute care surgery service does not affect wait-times for elective cancer surgeries: an institutional experience73 Use of human collagen mesh for closure of a large abdominal wall defect, after colon cancer surgery, a case report74 The role of miR-200b in pulmonary hypoplasia associated with congenital diaphragmatic hernia75 Systematic review and meta-analysis of electrocautery versus scalpel for incising epidermis and dermis76 Accuracy of sentinel lymph node biopsy for early breast cancer in the community setting in St. John’s, New-foundland: results of a retrospective review77 Acute surgical outcomes in the 80 plus population78 The liberal use of platelets transfusions in the acute phase of trauma resuscitation: a systematic review79 Implementation of an acute care surgical on call program in a Canadian community hospital80 Short-term outcomes following paraesophageal hernia repair in the elderly patient81 First experience with single incision surgery: feasibility in the pediatric population and cost evaluation82 The impact of the establishment of an acute care surgery unit on the outcomes of appendectomies and cholecystectomies83 Description and preliminary evaluation of a low-cost simulator for training and evaluation of flexible endoscopic skills84 Tumour lysis syndrome in metastatic colon cancer: a case report85 Acute care surgery service model implementation study at a single institution86 Colonic disasters approached by emergent subtotal and total colectomy: lessons learned from 120 consecutive cases87 Acellular collagen matrix stent to protect bowel anastomoses88 Lessons we learned from preoperative MRI-guided wire localization of breast lesions: the University Health Network (UHN) experience89 Interim cost comparison for the use of platinum micro-coils in the operative localization of small peripheral lung nodules90 Routine barium esophagram has minimal impact on the postoperative management of patients undergoing esophagectomy for esophageal cancer91 Iron deficiency anemia is a common presenting issue with giant paraesophageal hernia and resolves following repair92 A randomized comparison of different ventilation strategies during thoracotomy and lung resection93 The Canadian Lung Volume Reduction Surgery study: an 8-year follow-up94 A comparison of minimally invasive versus open Ivor-Lewis esophagectomy95 A new paradigm in the follow-up after curative resection for lung cancer: minimal-dose CT scan allows for early detection of asymptomatic cancer activity96 Predictors of lymph node metastasis in early esophageal adenocarcinoma: Is endoscopic resection worth the risk?97 How well can thoracic surgery residents operate? Comparing resident and program director opinions98 The impact of extremes of age on short- and long-term outcomes following surgical resection of esophageal malignancy99 Epidermal growth factor receptor targeted gold nanoparticles for the enhanced radiation treatment of non–small cell lung cancer100 Laparoscopic Heller myotomy results in excellent outcomes in all subtypes of achalasia as defined by the Chicago classification101 Neoadjuvant chemoradiation versus surgery in managing esophageal cancer102 Quality of life postesophagectomy for cancer!103 The implementation, evolution and translocation of standardized clinical pathways can improve perioperative outcomes following surgical treatment of esophageal cancer104 A tissue-mimicking phantom for applications in thoracic surgical simulation105 Sublobar resection compared with lobectomy for early stage non–small cell lung cancer: a single institution study106 Not all reviews are equal: the quality of systematic reviews and meta-analyses in thoracic surgery107 Do postoperative complications affect health-related quality of life after video-assisted thoracoscopic lobectomy for patients with lung cancer? A cohort study108 Thoracoscopic plication for palliation of dyspnea secondary to unilateral diaphragmatic paralysis: A worthwhile venture?109 Thoracic surgery experience in Canadian general surgery residency programs110 Perioperative morbidity and pathologic response rates following neoadjuvant chemotherapy and chemoradiation for locally advanced esophageal carcinoma111 An enhanced recovery pathway reduces length of stay after esophagectomy112 Predictors of dysplastic and neoplastic progression of Barrett’s esophagus113 Recurrent esophageal cancer complicated by tracheoesophageal fistula: management by means of palliative airway stenting114 Pancreaticopleural fistula-induced empyema thoracis: principles and results of surgical management115 Prognostic factors of early postoperative mortality following right extended hepatectomy116 Optimizing steatotic livers for transplantation using a cell-penetrating peptide CPP-fused heme oxygenase117 Video outlining the technical steps for a robot-assisted laparoscopic pancreaticoduodenectomy118 Establishment of a collaborative group to conduct innovative clinical trials in Canada119 Hepatic resection for metastatic malignant melanoma: a systematic review and meta-analysis120 Acellular normothermic ex vivo liver perfusion for donor liver preservation121 Pancreatic cancer and predictors of survival: comparing the CA 19–9/bilirubin ratio with the McGill Brisbane Scoring System122 Staged liver resections for bilobar hepatic colorectal metastases: a single centre experience123 Economic model of observation versus immediate resection of hepatic adenomas124 Resection of colorectal liver metastasis in the elderly125 Acceptable long-term survival in patients undergoing liver resection for metastases from noncolorectal, non-neuroendocrine, nonsarcoma malignancies126 Patient and clinicopathological features and prognosis of CK19+ hepatocellular carcinomas: a case–control study127 The management of blunt hepatic trauma in the age of angioembolization: a single centre experience128 Liver resections for noncolorectal and non-neuroendocrine metastases: an evaluation of oncologic outcomes129 Developing an evidence-based clinical pathway for patients undergoing pancreaticoduodenectomy130 Hepatitis C infection and hepatocellular carcinoma in liver transplant: a 20 year experience131 The effect of medication on the risk of post-ERCP pancreatitis132 Temporal trends in the use of diagnostic imaging for patients with hepato-pancreato-biliary (HPB) conditions: How much ionizing radiation are we really using?196 A phase II study of aggressive metastasectomy for intra-and extrahepatic metastases from colorectal cancer133 Why do women choose mastectomy for breast cancer treatment? A conceptual framework for understanding surgical decision-making in early-stage breast cancer134 Synoptic operative reporting: documentation of quality of care data for rectal cancer surgery135 Learning curve analysis for cytoreductive surgery: a useful application of the cumulative sum (CUSUM) method136 Pancreatic cancer is strongly associated with a unique urinary metabolomic signature137 Concurrent neoadjuvant chemo/radiation in locally advanced breast cancer138 Impact of positron emission tomography on clinical staging of newly diagnosed rectal cancer: a specialized single centre retrospective study139 An evaluation of intraoperative Faxitron microradiography versus conventional specimen radiography for the excision of nonpalpable breast lesions140 Comparison of breast cancer treatment wait-times in the Southern Interior of British Columbia in 2006 and 2010141 Factors affecting lymph nodes harvest in colorectal carcinoma142 Laparoscopic adrenalectomy for metastases143 You have a message! Social networking as a motivator for fundamentals of laparoscopic surgery (FLS) training144 The evaluation and validation of a rapid diagnostic and support clinic for women assessment for breast cancer145 Oncoplastic breast surgery: oncologic benefits and limitations146 A qualitative study on rectal cancer patients’ preferences for location of surgical care147 The effect of surgery on local recurrence in young women with breast cancer148 Elevated IL-6 and IL-8 levels in tumour microenvironment is not associated with increased serum levels in humans with Pseudomyxoma peritonei and peritoneal mesothelioma149 Conversion from laparoscopic to open approach during gastrectomy: a population-based analysis150 A scoping review of surgical process improvement tools (SPITs) in cancer surgery151 Splenectomy during gastric cancer surgery: a population-based study152 Defining the polo-like kinase 4 (Plk4) interactome in cancer cell protrusions153 Neoadjuvant imatinib mesylate for locally advanced gastrointestinal stromal tumours154 Implementing results from ACOSOG Z0011: Practice-changing or practice-affirming?155 Should lymph node retrieval be a surgical quality indicator in colon cancer?156 Long-term outcomes following resection of retroperitoneal recurrence of colorectal cancer157 Clinical research in surgical oncology: an analysis of clinicaltrials.gov158 Radiation therapy after breast conserving surgery: When are we missing the mark?159 The accuracy of endorectal ultrasound in staging rectal lesions in patients undergoing transanal endoscopic microsurgery160 Quality improvement in gastrointestinal cancer surgery: expert panel recommendations for priority research areas161 Factors influencing the quality of local management of ductal carcinoma in situ: a cohort study162 Papillary thyroid microcarcinoma: Does size matter?163 Hyperthermic isolated limb perfusion for extremity soft tissue sarcomas: systematic review of clinical efficacy and quality assessment of reported trials164 Adherence to antiestrogen therapy in seniors with breast cancer: How well are we doing?165 Parathyroid carcinoma: Challenging the surgical dogma?166 A qualitative assessment of the journey to delayed breast reconstruction195 The role of yoga therapy in breast cancer patients167 Outcomes reported in comparative studies of surgical interventions168 Enhanced recovery pathways decrease length of stay following colorectal surgery, but how quickly do patients actually recover?169 The impact of complications on bed utilization after elective colorectal resection170 Impact of trimodal prehabilitation program on functional recovery after colorectal cancer surgery: a pilot study171 Complex fistula-in-ano: Should the plug be abandoned in favour of the LIFT or BioLIFT?172 Prognostic utility of cyclooxygenase-2 expression by colon and rectal cancer173 Laparoscopic right hemicolectomy with complete mesocolic excision provides acceptable perioperative outcomes but is complex and time-consuming: analysis of learning curves for a novice minimally invasive surgeon174 Intraoperative quality assessment following double stapled circular colorectal anastomosis175 Improving patient outcomes through quality assessment of rectal cancer care176 Are physicians willing to accept a decrease in treatment effectiveness for improved functional outcomes for low rectal cancer?177 Turnbull-Cutait delayed coloanal anastomosis for the treatment of distal rectal cancer: a prospective cohort study178 Preoperative high-dose rate brachytherapy in preparation for sphincter preservation surgery for patients with advanced cancer of the lower rectum179 Impact of an enhanced recovery program on short-term outcomes after scheduled laparoscopic colon resection180 The clinical results of the Turnbull-Cutait delayed coloanal anastomosis: a systematic review181 Is a vertical rectus abdominus flap (VRAM) necessary? An analysis of perineal wound complications182 Fistula plug versus endorectal anal advancement flap for the treatment of high transsphincteric cryptoglandular anal fistulas: a systematic review and meta-analysis183 Maternal and neonatal outcomes following colorectal cancer surgery184 Transanal drainage to treat anastomotic leaks after low anterior resection for rectal cancer: a valuable option185 Trends in colon cancer in Ontario: 2002–2009186 Validation of electronically derived short-term outcomes in colorectal surgery187 A population-based assessment of transanal and endoscopic resection for adenocarcinoma of the rectum188 Laparoscopic colorectal surgery in the emergency setting: trends in the province of Ontario from 2002 to 2009189 Prevention of perineal hernia after laparoscopic and robotic abdominoperineal resection: review with case series of internal hernia through pelvic mesh which was placed in attempt to prevent perineal hernia190 Effect of rectal cancer treatments on quality of life191 The use of antibacterial sutures as an adjunctive preventative strategy for surgical site infection in Canada: an economic analysis192 Impact of socioeconomic status on colorectal cancer screening and stage at presentation: preliminary results of a population-based study from an urban Canadian centre193 Initial perioperative results of the first transanal endoscopic microsurgery (TEM) program in the province of Quebec194 Use of negative pressure wound therapy decreases perineal wound infections following abdominal perineal resection." Canadian Journal of Surgery 55, no. 4 Suppl 1 (August 2012): S63—S135. http://dx.doi.org/10.1503/cjs.016712.

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Bailey, Chris, Alexandra Stratton, Neil Manson, Elliot Layne, Melissa McKeon, Simon Harris, Greg McIntosh, et al. "Canadian Spine Society01.1.1: Surgery versus standardized nonoperative care for the treatment of lumbar disc herniations: a Canadian trial02.1.1: Wait times for elective spine surgery across Canada: data from the Canadian Spine Outcomes and Research Network03.1.1: Presurgical physician utilization in elective thoracolumbar spine surgery candidates: a nationwide analysis from the CSORN database04.1.2: Activities performed and treatments conducted prior to consultation with a spine surgeon: Are patients and clinicians following evidence-based clinical practice guidelines?05.1.2: Patient-reported disability versus objective physical performance measures in assessing patient recovery06.1.2: Risk factors for work status in low back pain patients: a cross-sectional analysis of patients presenting to the Ontario Inter-professional Spine Assessment and Education Clinics07.1.3: Comparison of symptomatic, functional and demographic characteristics of postsurgical versus nonoperative LBP patients08.1.3: Are primary care patients with different patterns of low back pain epidemiologically distinct?09.1.3: Lack of prognostic model validation in low back pain prediction studies10.1.4: Larger scoliosis curve magnitude is associated with increased surgical and perioperative complications: a multi-centre analysis of 1173 adolescent idiopathic scoliosis curves11.1.4: Superior extension of upper instrumented level in distraction-based surgery: a surrogate for clinically significant PJK12.1.4: The optimal surgical approach for Lenke 5 curves: Is the anterior approach ready for a comeback?13.1.5: Improving quality and safety in pediatric spine surgery: the team approach14.1.5: Posterior vertebral column resection in pediatric deformity: the advantages of staging15.1.5: Minimally invasive surgery in adolescent idiopathic scoliosis: lessons learned at mean 2-year follow-up16.2.1: Development of a Canadian competency-based spine surgery fellowship education curriculum17.2.1: Computer-assisted surgery is an effective educational tool for the training of orthopedic surgery residents in pedicle screw placement18.2.1: Validation of the Calgary Spine Severity Score19.2.2: Can triaging referrals with a simple 3-item pain questionnaire reduce wait times for consultations for patients who would benefit from lumbar spinal surgery?20.2.2: Strategies to improve the credibility of meta-analyses in spine surgery: a systematic survey21.2.2: The societal cost of waiting to see a spine surgeon for lower back symptoms in Canada22.2.3: The cost of an adverse event depends on its definition and method of capture23.2.3: Economic evaluation of intraoperative cone beam CT-based navigation for the placement of spinal pedicle screws: a patient-level cost-effectiveness analysis24.2.3: Predictors of inappropriate emergency department utilization following elective thoracolumbar spine surgery25.2.4: Incidence, impact and risk factors of adverse events in thoracic and lumbar spine fractures. An ambispective cohort analysis of 390 patients26.2.4: Factors associated with adverse events in major elective spine, knee, and hip in-patient orthopedic surgery27.2.4: Prognostic factors for survival in surgical series of symptomatic metastatic epidural spinal cord compression: a prospective North American multicentre study in 142 patients28.2.5: A comparison of 2 prospective adverse event recording tools with institutional ICD-10 coding for detecting perioperative adverse events in patients undergoing spinal surgery29.2.5: Assessment of impact of long-cassette standing radiographs on surgical planning for lumbar pathology: an international survey of spine surgeons30.2.5: Long-term patient-reported outcome and surgical survivorship of MIS fusion for low-grade spondylolisthesis31.3.1: The effect of prolonged postoperative antibiotic administration on the rate of infection in patients undergoing posterior spine surgery requiring a Hemovac drain32.3.1: Preliminary results of a Phase 1 trial on the use of photodynamic therapy in vertebral metastases33.3.1: The minimal clinically important difference of the modified Japanese Orthopaedic Association score in patients with degenerative cervical myelopathy undergoing surgical intervention34.3.1: Patient and surgeon radiation exposure during spinal instrumentation using intraoperative CT-based navigation35.3.2: Are postoperative pelvic parameters and sagittal balance predictive of further lumbar surgery in patients with spinal stenosis?36.3.2: Postoperative ambulation in patients undergoing total hip arthroplasty, total knee arthroplasty and elective lumbar spine surgery to treat arthritic pathologies37.3.2 Pain on the brain: Is the SF-36 mental component summary enough?38.3.2: Accurate and safe cervical osteotomy for kyphotic deformity in ankylosing spondylitis39.3.3: Adjacent segment pathology in the lumbar spine: progressive disease or a consequence of iatrogenic fusion?40.3.3: The association of cervical spine alignment with neurological recovery in a prospective cohort of surgical myelopathy patients: analysis of a series of 124 cases41.3.3: Use of neuropathic pain questionnaires in predicting the development of failed back surgery syndrome following lumbar discectomy for radiculopathy42.3.3: Quality of life and neurological outcomes after surgical decompression in patients with cervical ossification of the posterior longitudinal ligament: prospective, multicentre AOSpine International study of 479 patients43.3.4: Minimally invasive decompression in focal lumbar spinal stenosis with or without stable spondylolisthesis — comparative outcomes and reoperation rates at a minimum of 2 years44.3.4: Impact of nonoperative care utilization on postthoracolumbar spine surgery outcomes: a national perspective using the CSORN registry45.3.4: Presurgical imaging, testing and injection utilization in elective thoracolumbar spine surgery candidates: a nationwide analysis from the CSORN database46.3.5: A clinical prediction rule for clinical outcomes in patients undergoing surgery for degenerative cervical myelopathy: analysis of an international AOSpine prospective multi-centre dataset of 743 patients47.3.5: A comparison of health-related quality of life outcomes in spinal cord injury patients residing in rural and urban areas48.3.5: Minimally invasive versus open discectomy: a systematic review and meta-analysis49.1.1: Validity of transcranial motor evoked potentials as early indicators of neural compromise in rat model of spinal cord compression50.1.2: Validation of true spine length radiographic measurements51.1.3: Closure of the intervertebral disc annulus fibrosus using a novel suture application device — in vivo porcine and ex vivo biomechanical evaluation52.1.4: Vertebroplasty versus kyphoplasty in osteoporotic vertebral compression fracture model: What is safer?53.1.5: Brain-derived neurotrophic factor promotes intraneural macrophage migration and allodynia in experimental disc-herniation neuropathy54.1.6: Development and evaluation of an open-source 3D virtual simulator with integrated motion-tracking as a teaching tool for pedicle screw insertion55.2.7: Preoperative “amber flag” psychological measure scores and patient expectations: a nationwide analysis from the CSORN database56.2.8: Assessment of frailty in elderly spinal surgery patients57.2.9: Predicting adverse events and their impact on hospital length of stay in a prospective Spine AdVerse Events Severity (SAVES) database58.2.10: Clinical and surgical predictors of perioperative complications in patients with degenerative cervical myelopathy: results from the multicentre, prospective AOSpine International study on 479 patients59.2.11: Longitudinal analysis of the incidence of adverse events in tertiary spine referral centres: a national perspective from the Canadian Spine Outcomes and Research Network (CSORN) registry60.2.12: The use of validated clinical outcome measures in spinal surgery: an analysis of recent annual meeting abstracts61.1.13: The efficacy and accuracy of cone beam CT (O-Arm) navigation (StealthStation) on screw position in primary cases of adult major deformity surgery62.1.14: Does early surgical decompression improve neurological recovery of complete spinal cord injury? A prospective cohort study63.1.15: The role of MRI in predicting surgical outcome in patients with degenerative cervical myelopathy64.1.16: Postsurgical patients can have similar functional improvements and return to work rates following rehabilitation as those treated nonsurgically65.1.17: Intraoperative cone beam CT (O-Arm) and stereotactic navigation (StealthStation) system in complex adult spine surgery — early experience and learning curve66.1.18: A pilot randomized controlled trial of iodine-impregnated plastic adhesive drape usage in spine surgery and the effect on wound bacterial load67.2.19: Dynesys long-term outcome study68.2.20: Maverick total disc replacement in a real-world patient population: a prospective, multicentre observational study69.2.21: Pedicle screw malposition in revision spinal surgery: efficacy of intraoperative CT-based navigation70.2.22: Intraoperative skull-femoral traction in posterior spinal arthrodesis for adolescent idiopathic scoliosis: the impact on perioperative outcomes and health resource utilization71.2.23: The effect of growth-friendly surgery on coronal and sagittal plane spine growth in idiopathic scoliosis72.2.24: A qualitative web-based expert opinion analysis on the adoption of intraoperative CT and navigation systems in spine surgery." Canadian Journal of Surgery 58, no. 3 Suppl 1 (June 2015): S43—S70. http://dx.doi.org/10.1503/cjs.005515.

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Johnson, G., K. Hickey, A. Azin, K. Guidolin, K. Guidolin, F. Shariff, J. Gentles, et al. "2021 Canadian Surgery Forum01. Design and validation of a unique endoscopy simulator using a commercial video game03. Is ethnicity an appropriate measure of health care marginalization?: A systematic review and meta-analysis of the outcomes of diabetic foot ulceration in the Aboriginal population04. Racial disparities in surgery — a cross-specialty matched comparison between black and white patients05. Starting late does not increase the risk of postoperative complications in patients undergoing common general surgical procedures06. Ethical decision-making during a health care crisis: a resource allocation framework and tool07. Ensuring stability in surgical training program leadership: a survey of program directors08. Introducing oncoplastic breast surgery in a community hospital09. Leadership development programs for surgical residents: a review of the literature10. Superiority of non-opioid postoperative pain management after thyroid and parathyroid operations: a systematic review and meta-analysis11. Timing of ERCP relative to cholecystectomy in patients with ductal gallstone disease12. A systematic review and meta-analysis of randomized controlled trials comparing intraoperative red blood cell transfusion strategies13. Postoperative outcomes after frail elderly preoperative assessment clinic: a single-institution Canadian perspective14. Selective opioid antagonists following bowel resection for prevention of postoperative ileus: a systematic review and meta-analysis15. Peer-to-peer coaching after bile duct injury16. Laparoscopic median arcuate ligament release: a video abstract17. Retroperitoneoscopic approach to adrenalectomy19. Endoscopic Zenker diverticulotomy: a video abstract20. Variability in surgeons’ perioperative management of pheochromocytomas in Canada21. The contribution of surgeon and hospital variation in transfusion practice to outcomes for patients undergoing elective gastrointestinal cancer surgery: a population-based analysis22. Perioperative transfusions for gastroesophageal cancers: risk factors and short- and long-term outcomes23. The association between frailty and time alive and at home after cancer surgery among older adults: a population-based analysis24. Psychological and workplace-related effects of providing surgical care during the COVID-19 pandemic in British Columbia, Canada25. Safety of venous thromboembolism prophylaxis in endoscopic retrograde cholangiopancreatography: a systematic review26. Complications and reintervention following laparoscopic subtotal cholecystectomy: a systematic review and meta-analysis27. Synchronization of pupil dilations correlates with team performance in a simulated laparoscopic team coordination task28. Receptivity to and desired design features of a surgical peer coaching program: an international survey9. Impact of the COVID-19 pandemic on rates of emergency department utilization due to general surgery conditions30. The impact of the current COVID-19 pandemic on the exposure of general surgery trainees to operative procedures31. Association between academic degrees and research productivity: an assessment of academic general surgeons in Canada32. Laparoscopic endoscopic cooperative surgery (LECS) for subepithelial gastric lesion: a video presentation33. Effect of the COVID-19 pandemic on acute care general surgery at an academic Canadian centre34. Opioid-free analgesia after outpatient general surgery: a pilot randomized controlled trial35. Impact of neoadjuvant immunotherapy or targeted therapies on surgical resection in patients with solid tumours: a systematic review and meta-analysis37. Surgical data recording in the operating room: a systematic review of modalities and metrics38. Association between nonaccidental trauma and neighbourhood socioeconomic status during the COVID-19 pandemic: a retrospective analysis39. Laparoscopic repair of a transdiaphragmatic gastropleural fistula40. Video-based interviewing in medicine: a scoping review41. Indocyanine green fluorescence angiography for prevention of anastomotic leakage in colorectal surgery: a cost analysis from the hospital payer’s perspective43. Perception or reality: surgical resident and faculty assessments of resident workload compared with objective data45. When illness and loss hit close to home: Do health care providers learn how to cope?46. Remote video-based suturing education with smartphones (REVISE): a randomized controlled trial47. The evolving use of robotic surgery: a population-based analysis48. Prophylactic retromuscular mesh placement for parastomal hernia prevention: a retrospective cohort study of permanent colostomies and ileostomies49. Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy: a retrospective cohort study on anastomotic complications50. A lay of the land — a description of Canadian academic acute care surgery models51. Emergency general surgery in Ontario: interhospital variability in structures, processes and models of care52. Trauma 101: a virtual case-based trauma conference as an adjunct to medical education53. Assessment of the National Surgical Quality Improvement Program Surgical Risk Calculator for predicting patient-centred outcomes of emergency general surgery patients in a Canadian health care system54. Sustainability of a narcotic reduction initiative: 1 year following the Standardization of Outpatient Procedure (STOP) Narcotics Study55. Barriers to transanal endoscopic microsurgery referral56. Geospatial analysis of severely injured rural patients in a geographically complex landscape57. Implementation of an incentive spirometry protocol in a trauma ward: a single-centre pilot study58. Impostor phenomenon is a significant risk factor for burnout and anxiety in Canadian resident physicians: a cross-sectional survey59. Understanding the influence of perioperative education on performance among surgical trainees: a single-centre experience60. The effect of COVID-19 pandemic on current and future endoscopic personal protective equipment practices: a national survey of 77 endoscopists61. Case report: delayed presentation of perforated sigmoid diverticulitis as necrotizing infection of the lower limb62. Investigating disparities in surgical outcomes in Canadian Indigenous populations63. Fundoplication is superior to medical therapy for Barrett esophagus disease regression and progression: a systematic review and meta-analysis64. Development of a novel online general surgery learning platform and a qualitative preimplementation analysis65. Hagfish slime exudate as a potential novel hemostatic agent: developing a standardized assessment protocol66. The effect of the first wave of the COVID-19 pandemic on surgical oncology case volumes and wait times67. Safety of same-day discharge in high-risk patients undergoing ambulatory general surgery68. External validation of the Codman score in colorectal surgery: a pragmatic tool to drive quality improvement69. Improved morbidity and gastrointestinal restoration rates without compromising survival rates for diverting loop ileostomy with colonic lavage versus total abdominal colectomy for fulminant Clostridioides difficile colitis: a multicentre retrospective cohort study70. Potential access to emergency general surgical care in Ontario71. Immersive virtual reality (iVR) improves procedural duration, task completion and accuracy in surgical trainees: a systematic review01. Clinical validation of the Canada Lymph Node Score for endobronchial ultrasound02. Venous thromboembolism in surgically treated esophageal cancer patients: a provincial population-based study03. Venous thromboembolism in surgically treated lung cancer patients: a population-based study04. Is frailty associated with failure to rescue after esophagectomy? A multi-institutional comparative analysis of outcomes05. Routine systematic sampling versus targeted sampling of lymph nodes during endobronchial ultrasound: a feasibility randomized controlled trial06. Gastric ischemic conditioning reduces anastomotic complications in patients undergoing esophagectomy: a systematic review and meta-analysis07. Move For Surgery, a novel preconditioning program to optimize health before thoracic surgery: a randomized controlled trial08. In case of emergency, go to your nearest emergency department — Or maybe not?09. Does preoperative SABR increase the risk of complications from lung cancer resection? A secondary analysis of the MISSILE trial10. Segmental resection for lung cancer: the added value of near-infrared fluorescence mapping diminishes with surgeon experience11. Toward competency-based continuing professional development for practising surgeons12. Stereotactic body radiotherapy versus surgery in older adults with NSCLC — a population-based, matched analysis of long-term dependency outcomes13. Role of adjuvant therapy in esophageal cancer patients after neoadjuvant therapy and curative esophagectomy: a systematic review and meta-analysis14. Evaluation of population characteristics on the incidence of thoracic empyema: an ecological study15. Determining the optimal stiffness colour threshold and stiffness area ratio cut-off for mediastinal lymph node staging using EBUS elastography and AI: a pilot study16. Quality assurance on the use of sequential compression stockings in thoracic surgery (QUESTs)17. The relationship between fissureless technique and prolonged air leak for patients undergoing video-assisted thoracoscopic lobectomy18. CXCR2 inhibition as a candidate for immunomodulation in the treatment of K-RAS-driven lung adenocarcinoma19. Assessment tools for evaluating competency in video-assisted thoracoscopic lobectomy: a systematic review20. Understanding the current practice on chest tube management following lung resection among thoracic surgeons across Canada21. Effect of routine jejunostomy tube insertion in esophagectomy: a systematic review and meta-analysis22. Recurrence of primary spontaneous pneumothorax following bullectomy with pleurodesis or pleurectomy: a retrospective analysis23. Surgical outcomes following chest wall resection and reconstruction24. Outcomes following surgical management of primary mediastinal nonseminomatous germ cell tumours25. Does robotic approach offer better nodal staging than thoracoscopic approach in anatomical resection for non–small cell lung cancer? A single-centre propensity matching analysis26. Competency assessment for mediastinal mass resection and thymectomy: design and Delphi process27. The contemporary significance of venous thromboembolism (deep venous thrombosis [DVT] and pulmonary embolus [PE]) in patients undergoing esophagectomy: a prospective, multicentre cohort study to evaluate the incidence and clinical outcomes of VTE after major esophageal resections28. Esophageal cancer: symptom severity at the end of life29. The impact of pulmonary artery reconstruction on postoperative and oncologic outcomes: a systematic review30. Association with surgical technique and recurrence after laparoscopic repair of paraesophageal hernia: a single-centre experience31. Enhanced recovery after surgery (ERAS) in esophagectomy32. Surgical treatment of esophageal cancer: trends in surgical approach and early mortality at a single institution over the past 18 years34. Adverse events and length of stay following minimally invasive surgery in paraesophageal hernia repair35. Long-term symptom control comparison of Dor and Nissen fundoplication following laparoscopic para-esophageal hernia repair: a retrospective analysis36. Willingness to pay: a survey of Canadian patients’ willingness to contribute to the cost of robotic thoracic surgery37. Radiomics in early-stage lung adenocarcinoma: a prediction tool for tumour immune microenvironments38. Effectiveness of intraoperative pyloric botox injection during esophagectomy: how often is endoscopic intervention required?39. An artificial intelligence algorithm for predicting lymph node malignancy during endobronchial ultrasound40. The effect of major and minor complications after lung surgery on length of stay and readmission41. Measuring cost of adverse events following thoracic surgery: a scoping review42. Laparoscopic paraesophageal hernia repair: characterization by hospital and surgeon volume and impact on outcomes43. NSQIP 5-Factor Modified Frailty Index predicts morbidity but not mortality after esophagectomy44. Trajectory of perioperative HRQOL and association with postoperative complications in thoracic surgery patients45. Variation in treatment patterns and outcomes for resected esophageal cancer at designated thoracic surgery centres46. Patient-reported pretreatment health-related quality of life (HRQOL) predicts short-term survival in esophageal cancer patients47. Analgesic efficacy of surgeon-placed paravertebral catheters compared with thoracic epidural analgesia after Ivor Lewis esophagectomy: a retrospective noninferiority study48. Rapid return to normal oxygenation after lung surgery49. Examination of local and systemic inflammatory changes during lung surgery01. Implications of near-infrared imaging and indocyanine green on anastomotic leaks following colorectal surgery: a systematic review and meta-analysis02. Repeat preoperative endoscopy after regional implementation of electronic synoptic endoscopy reporting: a retrospective comparative study03. Consensus-derived quality indicators for operative reporting in transanal endoscopic surgery (TES)04. Colorectal lesion localization practices at endoscopy to facilitate surgical and endoscopic planning: recommendations from a national consensus Delphi process05. Black race is associated with increased mortality in colon cancer — a population-based and propensity-score matched analysis06. Improved survival in a cohort of patients 75 years and over with FIT-detected colorectal neoplasms07. Laparoscopic versus open loop ileostomy reversal: a systematic review and meta-analysis08. Posterior mesorectal thickness as a predictor of increased operative time in rectal cancer surgery: a retrospective cohort study09. Improvement of colonic anastomotic healing in mice with oral supplementation of oligosaccharides10. How can we better identify patients with rectal bleeding who are at high risk of colorectal cancer?11. Assessment of long-term bowel dysfunction in rectal cancer survivors: a population-based cohort study12. Observational versus antibiotic therapy for acute uncomplicated diverticulitis: a noninferiority meta-analysis based on a Delphi consensus13. Radiotherapy alone versus chemoradiotherapy for stage I anal squamous cell carcinoma: a systematic review and meta-analysis14. Is the Hartmann procedure for diverticulitis obsolete? National trends in colectomy for diverticulitis in the emergency setting from 1993 to 201515. Sugammadex in colorectal surgery: a systematic review and meta-analysis16. Sexuality and rectal cancer treatment: a qualitative study exploring patients’ information needs and expectations on sexual dysfunction after rectal cancer treatment17. Video-based interviews in selection process18. Impact of delaying colonoscopies during the COVID-19 pandemic on colorectal cancer detection and prevention19. Opioid use disorder associated with increased anastomotic leak and major complications after colorectal surgery20. Effectiveness of a rectal cancer education video on patient expectations21. Robotic-assisted rectosigmoid and rectal cancer resection: implementation and early experience at a Canadian tertiary centre22. An online educational app for rectal cancer survivors with low anterior resection syndrome: a pilot study23. The effects of surgeon specialization on the outcome of emergency colorectal surgery24. Outcomes after colorectal cancer resections in octogenarians and older in a regional New Zealand setting — What are the predictors of mortality?25. Long-term outcomes after seton placement for perianal fistulae with and without Crohn disease26. A survey of patient and surgeon preference for early ileostomy closure following restorative proctectomy for rectal cancer — Why aren’t we doing it?27. Crohn disease independently associated with longer hospital admission after surgery28. Short-stay (≤ 1 d) diverting loop ileostomy closure can be selectively implemented without an increase in readmission and complication rates: an ACS-NSQIP analysis29. A comparison of perineal stapled rectal prolapse resection and the Altemeier procedure at 2 Canadian academic hospitals30. Mental health and substance use disorders predict 90-day readmission and postoperative complications following rectal cancer surgery31. Early discharge after colorectal cancer resection: trends and impact on patient outcomes32. Oral antibiotics without mechanical bowel preparation prior to emergency colectomy reduces the risk of organ space surgical site infections: a NSQIP propensity score matched study33. The impact of robotic surgery on a tertiary care colorectal surgery program, an assessment of costs and short-term outcomes — a Canadian perspective34. Should we scope beyond the age limit of guidelines? Adenoma detection rates and outcomes of screening and surveillance colonoscopies in patients aged 75–79 years35. Emergency department admissions for uncomplicated diverticulitis: a nationwide study36. Obesity is associated with a complicated episode of acute diverticulitis: a nationwide study37. Green indocyanine angiography for low anterior resection in patients with rectal cancer: a prospective before-and-after study38. The impact of age on surgical recurrence of fibrostenotic ileocolic Crohn disease39. A qualitative study to explore the optimal timing and approach for the LARS discussion01. Racial, ethnic and socioeconomic disparities in diagnosis, treatment and survival of patients with breast cancer: a SEER-based population analysis02. First-line palliative chemotherapy for esophageal and gastric cancer: practice patterns and outcomes in the general population03. Frailty as a predictor for postoperative outcomes following pancreaticoduodenectomy04. Synoptic electronic operative reports identify practice variation in cancer surgery allowing for directed interventions to decrease variation05. The role of Hedgehog signalling in basal-like breast cancer07. Clinical and patient-reported outcomes in oncoplastic breast conservation surgery from a single surgeon’s practice in a busy community hospital in Canada08. Upgrade rate of atypical ductal hyperplasia: 10 years of experience and predictive factors09. Time to first adjuvant treatment after oncoplastic breast reduction10. Preparing to survive: improving outcomes for young women with breast cancer11. Opioid prescription and consumption in patients undergoing outpatient breast surgery — baseline data for a quality improvement initiative12. Rectal anastomosis and hyperthermic intraperitoneal chemotherapy: Should we avoid diverting loop ileostomy?13. Delays in operative management of early-stage, estrogen-receptor positive breast cancer during the COVID-19 pandemic — a multi-institutional matched historical cohort study14. Opioid prescribing practices in breast oncologic surgery15. Oncoplastic breast reduction (OBR) complications and patient-reported outcomes16. De-escalating breast cancer surgery: Should we apply quality indicators from other jurisdictions in Canada?17. The breast cancer patient experience of telemedicine during COVID-1918. A novel ex vivo human peritoneal model to investigate mechanisms of peritoneal metastasis in gastric adenocarcinoma (GCa)19. Preliminary uptake and outcomes utilizing the BREAST-Q patient-reported outcomes questionnaire in patients following breast cancer surgery20. Routine elastin staining improves detection of venous invasion and enhances prognostication in resected colorectal cancer21. Analysis of exhaled volatile organic compounds: a new frontier in colon cancer screening and surveillance22. A clinical pathway for radical cystectomy leads to a shorter hospital stay and decreases 30-day postoperative complications: a NSQIP analysis23. Fertility preservation in young breast cancer patients: a population-based study24. Investigating factors associated with postmastectomy unplanned emergency department visits: a population-based analysis25. Impact of patient, tumour and treatment factors on psychosocial outcomes after treatment in women with invasive breast cancer26. The relationship between breast and axillary pathologic complete response in women receiving neoadjuvant chemotherapy for breast cancer01. The association between bacterobilia and the risk of postoperative complications following pancreaticoduodenectomy02. Surgical outcome and quality of life following exercise-based prehabilitation for hepatobiliary surgery: a systematic review and meta-analysis03. Does intraoperative frozen section and revision of margins lead to improved survival in patients undergoing resection of perihilar cholangiocarcinoma? A systematic review and meta-analysis04. Prolonged kidney procurement time is associated with worse graft survival after transplantation05. Venous thromboembolism following hepatectomy for colorectal metastases: a population-based retrospective cohort study06. Association between resection approach and transfusion exposure in liver resection for gastrointestinal cancer07. The association between surgeon volume and use of laparoscopic liver resection for gastrointestinal cancer08. Immune suppression through TIGIT in colorectal cancer liver metastases09. “The whole is greater than the sum of its parts” — a combined strategy to reduce postoperative pancreatic fistula after pancreaticoduodenectomy10. Laparoscopic versus open synchronous colorectal and hepatic resection for metastatic colorectal cancer11. Identifying prognostic factors for overall survival in patients with recurrent disease following liver resection for colorectal cancer metastasis12. Modified Blumgart pancreatojejunostomy with external stenting in laparoscopic Whipple reconstruction13. Laparoscopic versus open pancreaticoduodenectomy: a single centre’s initial experience with introduction of a novel surgical approach14. Neoadjuvant chemotherapy versus upfront surgery for borderline resectable pancreatic cancer: a single-centre cohort analysis15. Thermal ablation and telemedicine to reduce resource utilization during the COVID-19 pandemic16. Cost-utility analysis of normothermic machine perfusion compared with static cold storage in liver transplantation in the Canadian setting17. Impact of adjuvant therapy on overall survival in early-stage ampullary cancers: a single-centre retrospective review18. Presence of biliary anaerobes enhances response to neoadjuvant chemotherapy in pancreatic ductal adenocarcinoma19. How does tumour viability influence the predictive capability of the Metroticket model? Comparing predicted-to-observed 5-year survival after liver transplant for hepatocellular carcinoma20. Does caudate resection improve outcomes in patients undergoing curative resection for perihilar cholangiocarcinoma? A systematic review and meta-analysis21. Appraisal of multivariable prognostic models for postoperative liver decompensation following partial hepatectomy: a systematic review22. Predictors of postoperative liver decompensation events following resection in patients with cirrhosis and hepatocellular carcinoma: a population-based study23. Characteristics of bacteriobilia and impact on outcomes after Whipple procedure01. Inverting the y-axis: the future of MIS abdominal wall reconstruction is upside down02. Progressive preoperative pneumoperitoneum: a single-centre retrospective study03. The role of radiologic classification of parastomal hernia as a predictor of the need for surgical hernia repair: a retrospective cohort study04. Comparison of 2 fascial defect closure methods for laparoscopic incisional hernia repair01. Hypoalbuminemia predicts serious complications following elective bariatric surgery02. Laparoscopic adjustable gastric band migration inducing jejunal obstruction associated with acute pancreatitis: aurgical approach of band removal03. Can visceral adipose tissue gene expression determine metabolic outcomes after bariatric surgery?04. Improvement of kidney function in patients with chronic kidney disease and severe obesity after bariatric surgery: a systematic review and meta-analysis05. A prediction model for delayed discharge following gastric bypass surgery06. Experiences and outcomes of Indigenous patients undergoing bariatric surgery: a mixed-methods scoping review07. What is the optimal common channel length in revisional bariatric surgery?08. Laparoscopic management of internal hernia in a 34-week pregnant woman09. Characterizing timing of postoperative complications following elective Roux-en-Y gastric bypass and sleeve gastrectomy10. Canadian trends in bariatric surgery11. Common surgical stapler problems and how to correct them12. Management of choledocholithiasis following Roux-en-Y gastric bypass: a systematic review and meta-analysis." Canadian Journal of Surgery 64, no. 6 Suppl 2 (December 14, 2021): S80—S159. http://dx.doi.org/10.1503/cjs.021321.

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Journal articles on the topic 'Health status indicators – Ontario – Toronto'

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