Showing papers by "Saskatchewan Health published in 2015"

Multi-Province Listeriosis Outbreak Linked to Contaminated Deli Meat Consumed Primarily in Institutional Settings, Canada, 2008

Abstract: A multi-province outbreak of listeriosis occurred in Canada from June to November 2008. Fifty-seven persons were infected with 1 of 3 similar outbreak strains defined by pulsed-field gel electrophoresis, and 24 (42%) individuals died. Forty-one (72%) of 57 individuals were residents of long-term care facilities or hospital inpatients during their exposure period. Descriptive epidemiology, product traceback, and detection of the outbreak strains of Listeria monocytogenes in food samples and the plant environment confirmed delicatessen meat manufactured by one establishment and purchased primarily by institutions was the source of the outbreak. The food safety investigation identified a plant environment conducive to the introduction and proliferation of L. monocytogenes and persistently contaminated with Listeria spp. This outbreak demonstrated the need for improved listeriosis surveillance, strict control of L. monocytogenes in establishments producing ready-to-eat foods, and advice to vulnerable populations and institutions serving these populations regarding which high-risk foods to avoid.

Incidence and prevalence of dementia in linked administrative health data in Saskatchewan, Canada: a retrospective cohort study

Abstract: Determining the epidemiology of dementia among the population as a whole in specific jurisdictions – including the long-term care population–is essential to providing appropriate care. The objectives of this study were to use linked administrative databases in the province of Saskatchewan to determine the 12-month incidence and prevalence of dementia for the 2012/13 period (1) among individuals aged 45 and older in the province of Saskatchewan, (2) according to age group and sex, and (3) according to diagnosis code and other case definition criteria. We used a population-based retrospective cohort study design and extracted data from 10 provincial health databases linked by a unique health services number. The cohort included individuals 45 years and older at first identification of dementia between April 1, 2001 and March 31, 2013 based on case definitions met within any one of four administrative health databases (Hospital Discharge Abstracts, Physician Service Claims, Prescription Drug, and RAI-MDS, i.e., Long-term Care). A total of 3,270 incident cases of dementia (7.28 per 1,000 PAR) and 13,012 prevalent cases (28.16 per 1,000 PAR) were identified during 2012/13. This study found the incidence rate increased by 2.8 to 5.1 times and the prevalence rate increased by 2.6 to 4.6 times every 10 years after 45 years of age. Overall, the age-standardised incidence rate was significantly lower among females than males (7.04 vs. 7.65 per 1,000 PAR) and the age-standardised prevalence rate was significantly higher among females than males (28.92 vs. 26.53 per 1,000 PAR). Over one-quarter (28 %) of all incident cases were admitted to long-term care before a diagnosis was formally recorded in physician or hospital data, and nearly two-thirds of these cases were identified at admission with impairment at the moderate to very severe level or a disease category of Alzheimer’s disease/other dementia. Linking multiple sources of registry data contributes to our understanding of the epidemiology of dementia across multiple segments of the population, inclusive of individuals residing in long-term care. This information is foundational for public awareness and policy recommendations, health promotion and prevention strategies, appropriate health resource planning, and research priorities.

The effects of patient education programs on medication use among asthma and COPD patients: a propensity score matching with a difference-in-difference regression approach

Abstract: Adherence to medication is one of the critical determinants of successful management of chronic diseases including asthma and chronic obstructive pulmonary disease (COPD). Given that poor adherence with self-management medication is very common among asthma and COPD patients, interventions that improve the use of chronic disease management medications for this patient group have potential to generate positive health outcomes. In an effort to improve asthma and COPD care, the Lung Association of Saskatchewan has implemented an intervention by providing access to effective and high quality asthma and COPD education for both patients and health care professionals along with increasing access to spirometry. By evaluating the impacts of this intervention, our purpose in this paper is to examine the effectiveness of spirometry use, and asthma and COPD education in primary care setting on medication use among asthma and COPD patients. At the time of the intervention, the Lung Association of Saskatchewan has not assigned a control group. Therefore we used a propensity score matching to create a control group using administrative health databases spanning 6 years prior to the intervention. Using Saskatchewan administrative health databases, the impacts of the intervention on use of asthma and COPD medications were estimated for one to four years after the intervention using a difference in difference regression approach. The paper shows that overall medication use for the intervention group is higher than that of the control group. On average, intervention group uses more asthma and COPD drugs. Within the asthma and COPD drugs, this intervention creates a persistent effect over time in the form of higher utilization of chronic management drugs equivalent to $157 and $195 in a given year during four years after the intervention. The study suggests that effective patient education and increasing access to spirometry increases the utilization of chronic disease management drugs among asthma and COPD patients. This type of interventions with patient education focus has potential to save healthcare dollars by providing better disease management among this patient group.

Implementation of a patient decision aid for men with localized prostate cancer: evaluation of patient outcomes and practice variation

Abstract: Men with localized prostate cancer often have unrealistic expectations. Practitioners are poor judges of men’s preferences, contributing to preference misdiagnosis and unwarranted practice variation. Patient decision aids (PtDAs) can support men with decisions about localized prostate cancer. This is a comparative case study of two strategies for implementing PtDAs in clinical pathways for men with localized prostate cancer, evaluating (a) PtDA use; (b) impact on men, practitioners, and health system outcomes; and (c) factors influencing sustained use. Guided by the Knowledge to Action Framework, this comparative case study will be conducted using administrative data, interviews, and surveys. Cases will be bound by geographic location (one hospital in Ontario; province of Saskatchewan) and time. Eligible participants will be all men newly diagnosed with localized prostate cancer, with outcomes assessed using administrative data and interviews. Nurses, urologists, radiation oncologists, and managers will be surveyed and a smaller sample interviewed. Cases will be established for each setting with findings compared across cases. Changes in the proportions of men given the PtDA over 2 years will be determined from administrative data. Factors associated with receiving the PtDA will be explored using multivariable logistic regression analysis. To assess the impact of the PtDA, outcomes will be described using mean and standard deviation (men’s decisional conflict) and frequency and proportions (practitioners consulted, uptake of treatment). To estimate the effect of the PtDA on these outcomes, adjusted mean differences and odds ratios will be calculated using exploratory multivariable general linear regression and binary or multinomial logistic regression. Factors influencing sustained PtDA use will be assessed using descriptive analysis of survey findings and thematic analysis of interview transcripts. Determining how to embed PtDAs effectively within clinical pathways for men with localized prostate cancer is essential. PtDAs have the potential to strengthen men’s active role in making prostate cancer decisions, enhance uptake of shared decision-making by practitioners, and reduce practice variation. Our team of researchers and knowledge users will use findings to improve current PtDA use and consider scaling-up implementation.

Detection of Enterovirus D68 in Canadian Laboratories

Abstract: The recent emergence of a severe respiratory disease caused by enterovirus D68 prompted investigation into whether Canadian hospital and provincial laboratories can detect this virus using commercial and laboratory-developed assays. This study demonstrated analytical sensitivity differences between commercial and laboratory-developed assays for the detection of enterovirus D68.

University of Saskatchewan Radiology Courseware (USRC): An Assessment of Its Utility for Teaching Diagnostic Imaging in the Medical School Curriculum

Abstract: Problem: We have found it very challenging to integrate images from our radiology digital imaging repository into the curriculum of our local medical school. Thus, it has been difficult to convey important knowledge related to viewing and interpreting diagnostic radiology images. We sought to determine if we could create a solution for this problem and evaluate whether students exposed to this solution were able to learn imaging concepts pertinent to medical practice. Intervention: We developed University of Saskatchewan Radiology Courseware (USRC), a novel interactive web application that enables preclinical medical students to acquire image interpretation skills fundamental to clinical practice. This web application reformats content stored in Medical Imaging Resource Center teaching cases for BlackBoard Learn™, a popular learning management system. We have deployed this solution for 2 successive years in a 1st-year basic sciences medical school course at the College of Medicine, University of Saskatche...

Print vs. Digital Collections in Special Libraries

Abstract: The world of libraries and information centers has never been more complex. Information professionals are kept busy providing services to library users who increasingly expect instant access to information on multiple technology platforms and librarians continue to find ways to offer users these services, despite shrinking budgets and fewer employees. One of the biggest challenges faced by today’s libraries is the rapid pace of change taking place in collection management. As more and more information becomes available electronically, libraries are acquiring and maintaining either hybrid collections of print and electronic resources or are moving towards electronic-only collections. This transition began in the 1990’s with the movement to electronic journal (e-journal) content (Duranceau, 1999) and continues today as libraries move towards providing access to electronic books (e-books). In this article the authors examine literature related to the changes happening in special libraries with regards to maintaining hybrid or electronic-only collections. Because published research in this area largely focuses on academic and public libraries, the authors have used their own libraries; the Saskatchewan Health Information Resources Partnership (SHIRP), a completely electronic library and the Canadian Grain Commission Library (CGC), a hybrid library, as case studies in order to augment the existing published research with the perspective of special libraries. The objective of the article is to present a brief general history of collection development and management in research libraries focusing primarily on changes that have occurred in electronic publishing over the past twenty years and provide insight into how these changes affect small, specialized research libraries. BACKGROUND