Sunnybrook Health Sciences Centre

About: Sunnybrook Health Sciences Centre is a healthcare organization based out in Toronto, Ontario, Canada. It is known for research contribution in the topics: Population & Breast cancer. The organization has 7689 authors who have published 15236 publications receiving 523019 citations. The organization is also known as: Sunnybrook.

Major depressive episodes and work stress: results from a national population survey.

Abstract: Objectives. We determined the proportion of workers meeting criteria for major depressive episodes in the past year and examined the association between psychosocial work-stress variables and these episodes.Methods. Data were derived from the Canadian Community Health Survey 1.2, a population-based survey of 24324 employed, community-dwelling individuals conducted in 2002. We assessed depressive episodes using the Composite International Diagnostic Interview.Results. Of the original sample, 4.6% (weighted n=745948) met criteria for major depressive episodes. High job strain was significantly associated with depression among men (odds ratio [OR]=2.38; 95% confidence interval [CI]=1.29, 4.37), and lack of social support at work was significantly associated with depression in both genders (men, OR=2.70; 95% CI=1.55, 4.71; women, OR=2.37; 95% CI=1.71, 3.29). Women with low levels of decision authority were more likely to have depression (OR=1.59; 95% CI=1.06, 2.39) than were women with high levels of authorit...

Intensive Hemodialysis Associates with Improved Pregnancy Outcomes: A Canadian and United States Cohort Comparison

Abstract: Pregnancy is rare in women with ESRD and when it occurs, it is often accompanied by significant maternal and fetal morbidity and even mortality. Preliminary data from the Toronto Nocturnal Hemodialysis Program suggested that increased clearance of uremic toxins by intensified hemodialysis improves pregnancy outcomes, but small numbers and the absence of a comparator group limited widespread applicability of these findings. We compared pregnancy outcomes from 22 pregnancies in the Toronto Pregnancy and Kidney Disease Clinic and Registry (2000–2013) with outcomes from 70 pregnancies in the American Registry for Pregnancy in Dialysis Patients (1990–2011). The primary outcome was the live birth rateandsecondaryoutcomesincludedgestationalageandbirthweight.ThelivebirthrateintheCanadian cohort (86.4%) was significantly higher than the rate in the American cohort (61.4%; P=0.03). Among patients with established ESRD, the median duration of pregnancy in the more intensively dialyzed Toronto cohort was 36 weeks (interquartile range, 32–37) compared with 27 weeks (interquartile range, 21–35) in the American cohort (P=0.002). Furthermore, a dose response between dialysis intensity and pregnancy outcomes emerged, with live birth rates of 48% in women dialyzed #20 hours per week and 85%inwomendialyzed.36hoursperweek(P=0.02),withalongergestationalageandgreaterinfantbirth weight for women dialyzed more intensively. Pregnancy complications were few and manageable. We conclude that pregnancy may be safe and feasible in women with ESRD receiving intensive hemodialysis.

Measuring patient satisfaction with anesthesia care: a review of current methodology.

Abstract: I n clinical settings such as anesthesia, using patient satisfaction as an indicator to monitor the quality of clinical care has potential merit. For patients, satisfaction represents, at least in theory, an evaluation of the healthcare experience based on their own values, perceptions, and interactions with the healthcare environment. For healthcare providers, patient satisfaction can be used to assess the actual impact of healthcare processes on the patients themselves. Patients’ ratings of their satisfaction can reflect many facets of care not easily examined in any other manner: compassionate bedside skills, efficient attendance to needs, participation in decision-making, and adequate communication and information (1). An ideal measure of patient satisfaction could therefore provide unique feedback on the quality of practice for medical specialties such as anesthesia. A renewed focus has been sought for patient satisfaction as a clinical end point and a quality indicator of anesthesia care. Previous studies have demonstrated the limitations of using adverse anesthetic events to monitor anesthesia care (2). Major outcomes (death and complications such as myocardial infarction, cardiac arrest, and severe brain injury) are too rare to allow useful comparisons among institutions. Assessing minor outcomes (such as pain and nausea) pose significant methodological problems of uncertain case mix, inconsistent reporting compliance, imprecise definitions, and underand overreporting. Orkin et al. (3) emphasized the still unproven relationships between most intermediate events (for example, transient intraand postoperative hypoxemia) and clinically significant adverse events (death, myocardial infarction, etc.), as well as the difficulties in establishing those relationships. They also suggested that, in light of the