Pub Date : 2020-07-19DOI: 10.15273/dmj.vol46no2.10145
C. Long, Faisal S. Jarrar
.
．
{"title":"Using Person-Centred Technology to Survey Older Adults at Northwood","authors":"C. Long, Faisal S. Jarrar","doi":"10.15273/dmj.vol46no2.10145","DOIUrl":"https://doi.org/10.15273/dmj.vol46no2.10145","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":293977,"journal":{"name":"Dalhousie Medical Journal","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129574715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-19DOI: 10.15273/dmj.vol46no2.10144
A. Verge, K. Mukhida
Pain questionnaires often serve as an assessment tool for initial consultations in chronic pain clinics. The Pain Management Unit (PMU) is a tertiary care centre in Halifax, Nova Scotia. A number of clinicians in the PMU have noted that some patients express that questionnaires are time consuming to complete and believe they are not used in a manner that is helpful to their health care. The effectiveness of questionnaire-based pain evaluation is an area of active research. Text-heavy questionnaires have been criticized for their reliance on literacy and for the format’s inability to facilitate patient self-expression. Other methods of assessing pain have been suggested, including those that use pictograms, photographs and technology. This study was designed to gauge patients’ opinions on the current pain assessment method used in the PMU. In addition, it aimed to evaluate if incorporating art and technology appealed to current patients. The ultimate goal of this study was to evaluate if improvements could be made to patients’ pain assessment experience. Thirty patients were interviewed following their initial consultation appointments at the PMU. Interviews were transcribed verbatim and analyzed using NVivo Software to look for themes expressed by research participants. The study yielded a total of 20 different themes, such as repetition within the questionnaires, and the patient’s desire to incorporate different technologies such as an iPad or computer. Recommendations are proposed based on these themes to help guide the creation or modification of pain assessment tools.
{"title":"Patients' perspectives on methods of assessing pain","authors":"A. Verge, K. Mukhida","doi":"10.15273/dmj.vol46no2.10144","DOIUrl":"https://doi.org/10.15273/dmj.vol46no2.10144","url":null,"abstract":"Pain questionnaires often serve as an assessment tool for initial consultations in chronic pain clinics. The Pain Management Unit (PMU) is a tertiary care centre in Halifax, Nova Scotia. A number of clinicians in the PMU have noted that some patients express that questionnaires are time consuming to complete and believe they are not used in a manner that is helpful to their health care. The effectiveness of questionnaire-based pain evaluation is an area of active research. Text-heavy questionnaires have been criticized for their reliance on literacy and for the format’s inability to facilitate patient self-expression. Other methods of assessing pain have been suggested, including those that use pictograms, photographs and technology. This study was designed to gauge patients’ opinions on the current pain assessment method used in the PMU. In addition, it aimed to evaluate if incorporating art and technology appealed to current patients. The ultimate goal of this study was to evaluate if improvements could be made to patients’ pain assessment experience. Thirty patients were interviewed following their initial consultation appointments at the PMU. Interviews were transcribed verbatim and analyzed using NVivo Software to look for themes expressed by research participants. The study yielded a total of 20 different themes, such as repetition within the questionnaires, and the patient’s desire to incorporate different technologies such as an iPad or computer. Recommendations are proposed based on these themes to help guide the creation or modification of pain assessment tools.","PeriodicalId":293977,"journal":{"name":"Dalhousie Medical Journal","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121262268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-19DOI: 10.15273/dmj.vol46no2.10143
Oliver Poole, André Bernard, B. Kent, P. Brousseau
Rationale: Lower extremity joint arthroplasty can lead to significant blood loss, and the need for blood transfusion. The use of blood products is associated with a variety of adverse outcomes including infection, circulatory overload, and transfusion reaction. Objectives: The objective of this quality improvement study is to identify the prevalence of preoperative anemia at our institution, and elucidate its impact on perioperative transfusion in elective patients undergoing primary or revision hip arthroplasty. Methods: Data for this study was collected from four databases at our institution. Elective patients undergoing primary or revision hip arthroplasty were selected. Transfusion was defined as the receipt of a red blood cell transfusion on the surgical day through to postoperative day five. The primary outcome was the effect of preoperative anemia on transfusion rates. Results: The overall transfusion rate was 7.6%. Transfusion rates for primary and revision arthroplasty were 5.8% and 18.7% respectively. Patients with a preoperative hemoglobin between 100 and 120 g/L were 4.5 times more likely to be transfused than those with a hemoglobin between 121 and 140 g/L, and 15.4 times more likely than those greater than 140 g/L. Preoperative anemia was common, with 11.5% of all patients having a preoperative hemoglobin of 120 g/L or less. Conclusion: Preoperative anemia was common and was significantly associated with higher transfusion rates. These findings reinforce the need to optimize hip arthroplasty patients prior to surgery, where possible. As a quality control study, these findings may help direct policy regarding the deferral of elective hip arthroplasty patients who are anemic preoperatively.
{"title":"The impact of preoperative anemia on red blood cell transfusion in primary and revision hip arthroplasty: A retrospective analysis","authors":"Oliver Poole, André Bernard, B. Kent, P. Brousseau","doi":"10.15273/dmj.vol46no2.10143","DOIUrl":"https://doi.org/10.15273/dmj.vol46no2.10143","url":null,"abstract":"Rationale: Lower extremity joint arthroplasty can lead to significant blood loss, and the need for blood transfusion. The use of blood products is associated with a variety of adverse outcomes including infection, circulatory overload, and transfusion reaction. Objectives: The objective of this quality improvement study is to identify the prevalence of preoperative anemia at our institution, and elucidate its impact on perioperative transfusion in elective patients undergoing primary or revision hip arthroplasty. Methods: Data for this study was collected from four databases at our institution. Elective patients undergoing primary or revision hip arthroplasty were selected. Transfusion was defined as the receipt of a red blood cell transfusion on the surgical day through to postoperative day five. The primary outcome was the effect of preoperative anemia on transfusion rates. Results: The overall transfusion rate was 7.6%. Transfusion rates for primary and revision arthroplasty were 5.8% and 18.7% respectively. Patients with a preoperative hemoglobin between 100 and 120 g/L were 4.5 times more likely to be transfused than those with a hemoglobin between 121 and 140 g/L, and 15.4 times more likely than those greater than 140 g/L. Preoperative anemia was common, with 11.5% of all patients having a preoperative hemoglobin of 120 g/L or less. Conclusion: Preoperative anemia was common and was significantly associated with higher transfusion rates. These findings reinforce the need to optimize hip arthroplasty patients prior to surgery, where possible. As a quality control study, these findings may help direct policy regarding the deferral of elective hip arthroplasty patients who are anemic preoperatively.","PeriodicalId":293977,"journal":{"name":"Dalhousie Medical Journal","volume":"10 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116781199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-19DOI: 10.15273/dmj.vol46no2.10147
Ashley Whelan, A. Hussain
.
．
{"title":"Dr. Charles Miller Fisher: Important contributions to ophthalmology","authors":"Ashley Whelan, A. Hussain","doi":"10.15273/dmj.vol46no2.10147","DOIUrl":"https://doi.org/10.15273/dmj.vol46no2.10147","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":293977,"journal":{"name":"Dalhousie Medical Journal","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128343708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-19DOI: 10.15273/dmj.vol46no2.10140
Mélanie Bourassa Forcier, L. Khoury, Nathalie Vézina
This paper explores Canadian liability concerns flowing from the integration of artificial intelligence (AI) as a tool assisting physicians in their medical decision-making. It argues that the current Canadian legal framework is sufficient, in most cases, to allow developers and users of AI technology to assess each stakeholder's responsibility should the technology cause harm.
{"title":"Liability issues for the use of artificial intelligence in health care in Canada: AI and medical decision-making","authors":"Mélanie Bourassa Forcier, L. Khoury, Nathalie Vézina","doi":"10.15273/dmj.vol46no2.10140","DOIUrl":"https://doi.org/10.15273/dmj.vol46no2.10140","url":null,"abstract":"This paper explores Canadian liability concerns flowing from the integration of artificial intelligence (AI) as a tool assisting physicians in their medical decision-making. It argues that the current Canadian legal framework is sufficient, in most cases, to allow developers and users of AI technology to assess each stakeholder's responsibility should the technology cause harm.","PeriodicalId":293977,"journal":{"name":"Dalhousie Medical Journal","volume":"115 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117147742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-19DOI: 10.15273/dmj.vol46no2.10142
J. Kiberd, G. Kephart, I. Bata, A. Quraishi
Background: Primary percutaneous coronary intervention (PPCI) remains the treatment of choice for patients presenting with ST-elevation myocardial infarction (STEMI). With STEMI, total ischemic time is an important predictor of myocardial injury and other short and long-term adverse events including mortality. Several studies have examined ‘Door to Balloon’ times, but few studies have examined pre-hospital and in hospital component times as individual pieces that make up total ischemic time. Methods: Total ischemic and component times for patients who received PPCI from 2012- 2015 in the Queen Elizabeth-II Halifax Infirmary were described. Median total ischemic times and component times were calculated and compared. Regression modeling was performed to identify which component times and component variables explained the most variation in total ischemic times. Results: 551 patients who had successful PPCI and complete component times were identified. Most were male (76%) with a median age of 59.2 years (IQR: 52.7-68.0 years). The longest component time was ‘Symptom Onset to First Medical Contact’ (Median: 61 min, IQR: 32-138 min). ‘Symptom Onset to First Medical Contact’ was found to account for most of the variation seen in total ischemic time (R2= 61%). Conclusions: We determined that most time in the component of receiving PPCI lies in the pre-hospital setting and that component variables including EHS use and pre-activation of the cardiac catheter lab reduce total ischemic time. More research needs to be devoted to reducing patient delay, as there appears to be little room for improvement in hospital component times.
{"title":"Prehospital times in primary percutaneous coronary intervention: The new frontier for improvement","authors":"J. Kiberd, G. Kephart, I. Bata, A. Quraishi","doi":"10.15273/dmj.vol46no2.10142","DOIUrl":"https://doi.org/10.15273/dmj.vol46no2.10142","url":null,"abstract":"Background: Primary percutaneous coronary intervention (PPCI) remains the treatment of choice for patients presenting with ST-elevation myocardial infarction (STEMI). With STEMI, total ischemic time is an important predictor of myocardial injury and other short and long-term adverse events including mortality. Several studies have examined ‘Door to Balloon’ times, but few studies have examined pre-hospital and in hospital component times as individual pieces that make up total ischemic time. Methods: Total ischemic and component times for patients who received PPCI from 2012- 2015 in the Queen Elizabeth-II Halifax Infirmary were described. Median total ischemic times and component times were calculated and compared. Regression modeling was performed to identify which component times and component variables explained the most variation in total ischemic times. Results: 551 patients who had successful PPCI and complete component times were identified. Most were male (76%) with a median age of 59.2 years (IQR: 52.7-68.0 years). The longest component time was ‘Symptom Onset to First Medical Contact’ (Median: 61 min, IQR: 32-138 min). ‘Symptom Onset to First Medical Contact’ was found to account for most of the variation seen in total ischemic time (R2= 61%). Conclusions: We determined that most time in the component of receiving PPCI lies in the pre-hospital setting and that component variables including EHS use and pre-activation of the cardiac catheter lab reduce total ischemic time. More research needs to be devoted to reducing patient delay, as there appears to be little room for improvement in hospital component times.","PeriodicalId":293977,"journal":{"name":"Dalhousie Medical Journal","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129920378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-19DOI: 10.15273/dmj.vol46no2.10148
Aleksandra K. Kajetanowicz, P. Holland, Carley Bekkers, Deji Ologbenla, A. Stueck, T. Arnason
A new half-year longitudinal rotating pathology elective was offered to second-year Dalhousie medical students. The elective ran from January 2018 to April 2018 and again from January 2019 to April 2019. From both the student and preceptor perspective, the rotating elective provided a well-rounded experience in pathology, and is an excellent student introduction to residency programs and career options.
{"title":"Longitudinal rotating pathology elective: Reflections on a pilot project in pathology at Dalhousie","authors":"Aleksandra K. Kajetanowicz, P. Holland, Carley Bekkers, Deji Ologbenla, A. Stueck, T. Arnason","doi":"10.15273/dmj.vol46no2.10148","DOIUrl":"https://doi.org/10.15273/dmj.vol46no2.10148","url":null,"abstract":"A new half-year longitudinal rotating pathology elective was offered to second-year Dalhousie medical students. The elective ran from January 2018 to April 2018 and again from January 2019 to April 2019. From both the student and preceptor perspective, the rotating elective provided a well-rounded experience in pathology, and is an excellent student introduction to residency programs and career options.","PeriodicalId":293977,"journal":{"name":"Dalhousie Medical Journal","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123881867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-19DOI: 10.15273/dmj.vol46no2.10138
Sonja Macdonald, K. Blake
.
．
{"title":"Working with interpreters: An important skill for medical students","authors":"Sonja Macdonald, K. Blake","doi":"10.15273/dmj.vol46no2.10138","DOIUrl":"https://doi.org/10.15273/dmj.vol46no2.10138","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":293977,"journal":{"name":"Dalhousie Medical Journal","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126224575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-19DOI: 10.15273/dmj.vol46no2.10146
Michael Wong
.
．
{"title":"Where no child knocks in vain: A History of the Izaak Walton Killam Hospital for Children","authors":"Michael Wong","doi":"10.15273/dmj.vol46no2.10146","DOIUrl":"https://doi.org/10.15273/dmj.vol46no2.10146","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":293977,"journal":{"name":"Dalhousie Medical Journal","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123526604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：