Saskatchewan Health

About: Saskatchewan Health is a government organization based out in Regina, Saskatchewan, Canada. It is known for research contribution in the topics: Population & Health care. The organization has 442 authors who have published 489 publications receiving 7728 citations.

Association of Concussion With the Risk of Suicide: A Systematic Review and Meta-analysis.

Abstract: Importance Concussion is the most common form of traumatic brain injury (TBI). While most patients fully recover within 1 week of injury, a subset of patients might be at a higher risk of suicide. Objective To assess the risk of suicide after concussion. Data Sources We performed a systematic search of Medline (PubMed), Embase, PsycINFO, and Published International Literature on Traumatic Stress (PILOTS) from 1963 to May 1, 2017. We also searched Google Scholar and conference proceedings and contacted experts in the field to seek additional studies. Study Selection Studies that quantified the risk of suicide, suicide attempt, or suicidal ideation after a concussion and/or mild TBI were included. Studies that included children and adults, including military and nonmilitary personnel, were included. Two authors independently reviewed all titles and abstracts to determine study eligibility. Data Extraction and Synthesis Study characteristics were extracted independently by 2 trained investigators. Study quality was assessed using the Newcastle-Ottawa Scale. Study data were pooled using random-effects meta-analysis. Main Outcomes and Measures The primary exposure was concussion and/or mild TBI, and the primary outcome was suicide. Secondary outcomes were suicide attempt and suicidal ideation. Results Data were extracted from 10 cohort studies (n = 713 706 individuals diagnosed and 6 236 010 individuals not diagnosed with concussion and/or mild TBI), 5 cross-sectional studies (n = 4420 individuals diagnosed and 11 275 individuals not diagnosed with concussion and/or mild TBI), and 2 case-control studies (n = 446 individuals diagnosed and 8267 individuals not diagnosed with concussion and/or mild TBI). Experiencing concussion and/or mild TBI was associated with a 2-fold higher risk of suicide (relative risk, 2.03 [95% CI, 1.47-2.80]; I 2 = 96%; P Conclusions and Relevance Experiencing concussion and/or mild TBI was associated with a higher risk of suicide. Future studies are needed to identify and develop strategies to decrease this risk.

Reduction of Healthcare Resource Utilisation and Costs Following the Use of Risperidone for Patients with Schizophrenia Previously Treated with Standard Antipsychotic Therapy

Abstract: The objective of this study was to assess the change in healthcare resource utilisation and costs related to the initiation of risperidone therapy in patients with chronic schizophrenia. The study design used a retrospective cohort and linked data from 5 databases (patient, prescription drug, hospital, physician and mental health services) within the province of Saskatchewan. Study participants included all those patients who were registered in the Saskatchewan Health Linkable Data Files and received at least 1 prescription for risperidone between 1 July 1993 and 31 December 1993. In order to receive risperidone in Saskatchewan, patients needed to have failed or become intolerant to previous antipsychotic therapy. Utilisation information from the databases was collected for equivalent periods, in this case an average of 10 months, before and after initiation of risperidone. Results were as follows: hospital admissions decreased by 60.3%, length of hospital stay decreased by 58.2%, and physician visits decreased by 22.3%, after initiation of risperidone. There was also a slight reduction in visits to mental health services. The cost of antipsychotic medication increased during risperidone treatment; however, when all costs were added up, there was an estimated annual cost saving of $Can7925/patient/year after initiation of risperidone. Such results need to be interpreted in the light of possible mitigating effects operative in longitudinal studies of schizophrenia.

“Extrauterine growth restriction” and “postnatal growth failure” are misnomers for preterm infants

Abstract: Preterm infants are increasingly diagnosed as having "extrauterine growth restriction" (EUGR) or "postnatal growth failure" (PGF). Usually EUGR/PGF is diagnosed when weight is <10th percentile at either discharge or 36-40 weeks postmenstrual age. The reasons why the phrases EUGR/PGF are unhelpful include, they: (i) are not predictive of adverse outcome; (ii) are based only on weight without any consideration of head or length growth, proportionality, body composition, or genetic potential; (iii) ignore normal postnatal weight loss; (iv) are usually assessed prior to growth slowing of the reference fetus, around 36-40 weeks, and (v) are usually based on an arbitrary statistical growth percentile cut-off. Focus on EUGR/PGF prevalence may benefit with better attention to nutrition but may also harm with nutrition delivery above infants' actual needs. In this paper, we highlight challenges associated with such arbitrary cut-offs and opportunities for further refinement of understanding growth and nutritional needs of preterm neonates.