Showing papers by "Saskatchewan Health published in 2012"

Selective serotonin reuptake inhibitor (SSRI) antidepressants, prolactin and breast cancer

Abstract: Selective serotonin reuptake inhibitors (SSRIs) are a widely prescribed class of anti-depressants. Laboratory and epidemiologic evidence suggests that a prolactin-mediated mechanism secondary to increased serotonin levels at neuronal synapses could lead to a potentially carcinogenic effect of SSRIs. In this population-based case-control study, we evaluated the association between SSRI use and breast cancer risk as a function of their relative degree of inhibition of serotonin reuptake as a proxy for their impact on prolactin levels. Cases were 2,129 women with primary invasive breast cancer diagnosed from 2003-2007, and controls were 21,297 women randomly selected from the population registry. Detailed information for each SSRI prescription dispensed was compiled using the Saskatchewan prescription database. Logistic regression was used to evaluate the impact of use of high and lower inhibitors of serotonin reuptake and duration of use, as well as to assess the effect of individual high inhibitors on the risk of breast cancer. Exclusive users of high or lower inhibitors of serotonin reuptake were not at increased risk for breast cancer compared with nonusers of SSRIs (OR = 1.01, CI = 0.88-1.17 and OR = 0.91, CI = 0.67-1.25 respectively), regardless of their duration of use or menopausal status. While we cannot rule out the possibility of a clinically important risk increase (OR = 1.83, CI = 0.99-3.40) for long-term users of sertraline (≥24 prescriptions), given the small number of exposed cases (n=12), the borderline statistical significance and the wide confidence interval, these results need to be interpreted cautiously. In this large population-based case-control study, we found no conclusive evidence of breast cancer risk associated with the use of SSRIs even after assessing the degree of serotonin reuptake inhibition and duration of use. Our results do not support the serotonin-mediated pathway for the prolactin-breast cancer hypothesis.

Predicting weekly variation of Culex tarsalis (Diptera: Culicidae) West Nile virus infection in a newly endemic region, the Canadian prairies.

Abstract: West Nile virus (WNV) spread across most of North America within a short time period after its incursion into the Western Hemisphere. The Canadian prairies had the highest human incidence of WNV disease in Canada, particularly in 2007. Statistical modeling and geographic information systems can be used to develop a predictive model and facilitate the mobilization of targeted disease management strategies. Using data collected between 2005 and 2008, we constructed models integrating abiotic and biotic factors to predict the WNV infection rate in female Culex tarsalis Coquillett, the primary vector of WNV in the Canadian prairies. During the study period, the highest mean Cx. tarsalis infection rate was during week 34 (late August). The Cx. tarsalis infection rate increased with increasing Cx. tarsalis abundance and mean temperature lagged from 1 to 8 wk, but decreased with increasing mean precipitation lagged from 2 to 6 wk. Furthermore, precipitation was a ‘distorter variable’ that altered the association between Cx. tarsalis abundance and the WNV infection rate. Our model clarified how weather influenced the Cx. tarsalis infection rate in the Canadian prairies, a newly and highly WNV endemic region of North America. An understanding of the role of lagged weather variables was essential for providing sufficient lead time to predict WNV occurrence, and for implementing disease control and prevention strategies. Furthermore, it is a useful tool for assessing the potential effects of future climate change on WNV in areas near its northern distributional limit.

USRC: A New Strategy for Adding Digital Images to the Medical School Curriculum

Abstract: Many medical schools use learning management systems (LMSs) to give students access to online lecture notes, assignments, quizzes, and other learning resources. LMSs can also be used to provide access to digital radiology images, potentially improving preclinical teaching in anatomy, physiology, and pathology while also allowing students to develop interpretation skills that are important in clinical practice. However, it is unclear how radiology images can best be stored, imported, and displayed in an LMS. We developed University of Saskatchewan Radiology Courseware (USRC), a new web application that allows course designers to import images into pages linked to BlackBoard Learn, a popular LMS. Page content, including images, annotations, captions, and supporting text, are stored as teaching cases on a MIRC (Medical Imaging Resource Center) server. Course designers create cases in MIRC, and then create a corresponding page in BlackBoard by modifying an HTML template so that it holds the URL of a MIRC case. When a user visits the page in BlackBoard, the page requests content from the MIRC case, reformats the text for display in BlackBoard, and loads an image viewer plug-in that allows students to view and interact with the images stored in the case. The USRC technology can be used to reformat MIRC cases for presentation in any website or in any learning management system that supports custom pages written in HTML with embedded JavaScript.

Should we feed back research results in the midst of a study

Abstract: Background This report is an introduction to a series of three research papers that describe the evolution of the approaches taken by the Translating Research in Elder Care (TREC) research team during its first four years to feed back the research findings to study participants. TREC is an observational multi-method health services research project underway in 36 nursing homes in the prairie provinces of Canada. TREC has actively involved decision makers from the sector in all stages from initial planning, through data collection to dissemination activities. However, it was not planned as a fully integrated knowledge translation project. These three papers describe our progress towards fully integrated knowledge translation—with respect to timely and requested feedback processes. The first paper reports on the process and outcomes of creating and evaluating the feedback of research findings to healthcare aides (unregulated health professionals). These aides provide over 80% of the direct care in our sample and actively requested the feedback as a condition of their continued cooperation in the data acquisition process. The second paper describes feedback from nursing home administrators on preliminary research findings (a facility annual report) and evaluation of the reports’ utility. The third paper discusses an approach to providing a more in-depth form of feedback (expanded feedback report) at one of the TREC nursing homes.