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32 records – page 1 of 4.

A 4-year review of pediatric mental health emergencies in Alberta.

https://arctichealth.org/en/permalink/ahliterature148300
Source
CJEM. 2009 Sep;11(5):447-54
Publication Type
Article
Date
Sep-2009
Author
Amanda S Newton
Samina Ali
David W Johnson
Christina Haines
Rhonda J Rosychuk
Rachel A Keaschuk
Philip Jacobs
Terry P Klassen
Author Affiliation
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta. mandi.newton@ualberta.ca
Source
CJEM. 2009 Sep;11(5):447-54
Date
Sep-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Alberta - epidemiology
Analysis of Variance
Child
Child, Preschool
Emergencies
Emergency Service, Hospital - utilization
Humans
Infant
Mental Disorders - epidemiology
Risk factors
Abstract
We sought to determine and compare rates of pediatric mental health presentations and associated costs in emergency departments (EDs) in Alberta.
We examined 16 154 presentations by 12 589 patients (patient age
PubMed ID
19788789 View in PubMed
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Adaptations for finding irregularly shaped disease clusters.

https://arctichealth.org/en/permalink/ahliterature162615
Source
Int J Health Geogr. 2007;6:28
Publication Type
Article
Date
2007
Author
Nikolaos Yiannakoulias
Rhonda J Rosychuk
John Hodgson
Author Affiliation
School of Geography and Earth Sciences, McMaster University, Hamilton, Canada. niwiyi@gmail.com
Source
Int J Health Geogr. 2007;6:28
Date
2007
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Cluster analysis
Data Interpretation, Statistical
Disease Outbreaks
Female
Humans
Male
Models, Statistical
Sensitivity and specificity
Abstract
Recent adaptations of the spatial scan approach to detecting disease clusters have addressed the problem of finding clusters that occur in non-compact and non-circular shapes--such as along roads or river networks. Some of these approaches may have difficulty defining cluster boundaries precisely, and tend to over-fit data with very irregular (and implausible) clusters shapes.
We describe two simple adaptations to these approaches that can be used to improve the effectiveness of irregular disease cluster detection. The first adaptation penalizes very irregular cluster shapes based on a measure of connectivity (non-connectivity penalty). The second adaptation prevents searches from combining smaller clusters into large super-clusters (depth limit). We conduct experiments with simulated data in order to observe the performance of these adaptations on a number of synthetic cluster shapes.
Our results suggest that the combination of these two adaptations may increase the ability of a cluster detection method to find irregular shapes without affecting its ability to find more regular (i.e., compact) shapes. The depth limit in particular is effective when it is deemed important to distinguish nearby clusters from each other. We suggest that these adaptations of adjacency-constrained spatial scans are particularly well suited to chronic disease and injury surveillance.
Notes
Cites: Lancet. 1988 Feb 6;1(8580):272-32893085
Cites: Stat Med. 2006 Mar 15;25(5):723-4216453376
Cites: Stat Med. 1996 Apr 15-May 15;15(7-9):717-269132899
Cites: Am J Epidemiol. 1990 Jul;132(1 Suppl):S136-432356825
PubMed ID
17615077 View in PubMed
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An exact test to detect geographic aggregations of events.

https://arctichealth.org/en/permalink/ahliterature143029
Source
Int J Health Geogr. 2010;9:28
Publication Type
Article
Date
2010
Author
Rhonda J Rosychuk
Jason L Stuber
Author Affiliation
Department of Pediatrics, 11402 University Avenue NW, Edmonton, Alberta, Canada. rhonda.rosychuk@ualberta.ca
Source
Int J Health Geogr. 2010;9:28
Date
2010
Language
English
Publication Type
Article
Keywords
Adolescent
Age Distribution
Alberta - epidemiology
Cluster analysis
Databases, Factual
Demography
Emergency Service, Hospital - utilization
Female
Humans
Incidence
Male
Poisson Distribution
Risk assessment
Sampling Studies
Self-Injurious Behavior - diagnosis - epidemiology
Sensitivity and specificity
Sex Distribution
Abstract
Traditional approaches to statistical disease cluster detection focus on the identification of geographic areas with high numbers of incident or prevalent cases of disease. Events related to disease may be more appropriate for analysis than disease cases in some contexts. Multiple events related to disease may be possible for each disease case and the repeated nature of events needs to be incorporated in cluster detection tests.
We provide a new approach for the detection of aggregations of events by testing individual administrative areas that may be combined with their nearest neighbours. This approach is based on the exact probabilities for the numbers of events in a tested geographic area. The test is analogous to the cluster detection test given by Besag and Newell and does not require the distributional assumptions of a similar test proposed by Rosychuk et al. Our method incorporates diverse population sizes and population distributions that can differ by important strata. Monte Carlo simulations help assess the overall number of clusters identified. The population and events for each area as well as a nearest neighbour spatial relationship are required. We also provide an alternative test applicable to situations when only the aggregate number of events, and not the number of events per individual, are known. The methodology is illustrated on administrative data of presentations to emergency departments.
We provide a new method for the detection of aggregations of events that does not rely on distributional assumptions and performs well.
Notes
Cites: Lancet. 1988 Feb 6;1(8580):272-32893085
Cites: Stat Med. 1995 Apr 30;14(8):799-8107644860
Cites: Am J Epidemiol. 1990 Jul;132(1 Suppl):S136-432356825
Cites: Stat Med. 1996 Apr 15-May 15;15(7-9):727-409132900
Cites: Biometrics. 2006 Jun;62(2):465-7016918910
Cites: Stat Med. 1995 Nov 15-30;14(21-22):2323-348711272
PubMed ID
20529286 View in PubMed
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The association between iron deficiency and febrile seizures in childhood.

https://arctichealth.org/en/permalink/ahliterature152515
Source
Clin Pediatr (Phila). 2009 May;48(4):420-6
Publication Type
Article
Date
May-2009
Author
Dawn S Hartfield
Jonathan Tan
Jerome Y Yager
Rhonda J Rosychuk
Don Spady
Christina Haines
William R Craig
Author Affiliation
Department of Pediatrics, University of Alberta, Edmonton, Canada. dawn.hartfield@capitalhealth.ca
Source
Clin Pediatr (Phila). 2009 May;48(4):420-6
Date
May-2009
Language
English
Publication Type
Article
Keywords
Alberta - epidemiology
Anemia, Iron-Deficiency - blood - diagnosis - epidemiology
Child, Preschool
Cohort Studies
Comorbidity
Emergency Service, Hospital - statistics & numerical data
Erythrocyte Indices
Female
Humans
Infant
Iron - blood - deficiency
Male
Odds Ratio
Retrospective Studies
Seizures, Febrile - blood - diagnosis - epidemiology
Abstract
The purpose of this study was to determine the association between iron deficiency and febrile seizures in a large cohort of children aged 6 to 36 months.
A retrospective case control study with 361 patients who presented with febrile seizures to the emergency department and 390 otherwise healthy controls who presented with a febrile illness to the emergency department were reviewed to determine iron status using the MCV, RDW, and hemoglobin.
A total of 9% of cases had iron deficiency (ID) and 6% had iron deficiency anemia (IDA), compared to 5% and 4% of controls respectively. The conditional logistic regression odds ratio for ID in patients with febrile seizures was 1.84 (95% CI, 1.02-3.31).
Children with febrile seizures were almost twice as likely to be iron deficient as those with febrile illness alone. The results suggest that screening for ID should be considered in children presenting with febrile seizure.
PubMed ID
19229063 View in PubMed
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Asthma presentations by adults to emergency departments in Alberta, Canada: a large population-based study.

https://arctichealth.org/en/permalink/ahliterature155763
Source
Chest. 2009 Jan;135(1):57-65
Publication Type
Article
Date
Jan-2009
Author
Brian H Rowe
Donald C Voaklander
Dongsu Wang
Ambikaipakan Senthilselvan
Terry P Klassen
Thomas J Marrie
Rhonda J Rosychuk
Author Affiliation
Department of Emergency Medicine, University of Alberta, Edmonton, AB, Canada.
Source
Chest. 2009 Jan;135(1):57-65
Date
Jan-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Alberta - epidemiology
Asthma - epidemiology - therapy
Databases, Factual
Emergency Service, Hospital - utilization
Female
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Outcome Assessment (Health Care)
Retrospective Studies
Sex Distribution
Socioeconomic Factors
Young Adult
Abstract
Asthma is a widespread disease with a prevalence of approximately 7 to 10% in adults. Exacerbations are common in the emergency department (ED) setting. The objective of this study was to describe the epidemiology of asthma presentations to EDs made by adults in the province of Alberta, Canada.
The Ambulatory Care Classification System of Alberta and provincial administrative databases were used to obtain all ED encounters for asthma during 6 fiscal years (April 1999 to March 2005). Information extracted included demographics, ED visit timing, and subsequent visits to non-ED settings. Data analysis included descriptive summaries and directly standardized visit rates.
There were 105,813 ED visits for asthma made by 48,942 distinct adults, with an average of 2.2 visits per individual. Most patients (66%) had only one asthma-related ED visit. Female patients (61.2%) presented more commonly than male patients. The gender- and age-standardized visit rates declined from 9.7/1,000 in 1999/2000 to 6.8/1,000 in 2004/2005. The welfare and Aboriginal subsidy groups had larger age-specific ED visits rates than other populations. Important daily, weekly, and monthly trends were observed. Hospital admission occurred in 9.8% of the cases; 6.4% had a repeat ED visit within 7 days. Overall, 67.4% of individuals had yet to have a non-ED follow-up visit by 1 week. The estimated median time to the first follow-up visit was 19 days (95% confidence interval, 18 to 21).
Asthma is a common presenting problem in Alberta EDs, and further study of these trends is required to understand the factors associated with the variation in presentations. The important findings include an overall decrease in the rates of presentation over the study period, disparities based on age, gender, and socioeconomic/cultural status, and the low rate of early follow-up. Targeted interventions could be implemented to address specific groups and reduce asthma-related visits to Alberta EDs.
PubMed ID
18689586 View in PubMed
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Asthma presentations by children to emergency departments in a Canadian province: a population-based study.

https://arctichealth.org/en/permalink/ahliterature142145
Source
Pediatr Pulmonol. 2010 Oct;45(10):985-92
Publication Type
Article
Date
Oct-2010
Author
Rhonda J Rosychuk
Donald C Voaklander
Terry P Klassen
Ambikaipakan Senthilselvan
Thomas J Marrie
Brian H Rowe
Author Affiliation
Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada. rhonda.rosychuk@ualberta.ca
Source
Pediatr Pulmonol. 2010 Oct;45(10):985-92
Date
Oct-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Alberta - epidemiology
Asthma - epidemiology
Child
Child, Preschool
Emergency Service, Hospital - utilization
Female
Hospitalization - statistics & numerical data
Humans
Infant
Male
Severity of Illness Index
Sex Distribution
Socioeconomic Factors
Abstract
Asthma has a high prevalence in North American children and exacerbations presenting to the emergency department (ED) setting are common.
Describe the epidemiology of asthma presentations to EDs by children residing in a large geographic area (Alberta, Canada).
Data were extracted from provincial administrative databases for children
PubMed ID
20632409 View in PubMed
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Central nervous system (CNS) tumor trends in children in a western Canadian province: a population-based 22-year retrospective study.

https://arctichealth.org/en/permalink/ahliterature129426
Source
J Neurol. 2012 Jun;259(6):1131-6
Publication Type
Article
Date
Jun-2012
Author
Rhonda J Rosychuk
Adrienne Witol
Bev Wilson
Kent Stobart
Author Affiliation
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 3rd Floor, Edmonton Clinic Health Academy, 11405 87 Avenue NW, Edmonton, AB, Canada. rhonda.rosychuk@ualberta.ca
Source
J Neurol. 2012 Jun;259(6):1131-6
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Alberta - epidemiology
Brain Neoplasms - diagnosis - epidemiology
Central Nervous System Neoplasms - diagnosis - epidemiology
Child
Child, Preschool
Female
Humans
Infant
Male
Population Surveillance - methods
Registries
Retrospective Studies
Spinal Cord Neoplasms - diagnosis - epidemiology
Young Adult
Abstract
In Canada, CNS tumors accounted for nearly 22% of the new childhood cancer diagnoses during 1995-2000 in the = 15 year age group. The study's objective was to describe children and youth (age
PubMed ID
22109636 View in PubMed
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Characteristics of patients who leave emergency departments without being seen.

https://arctichealth.org/en/permalink/ahliterature169464
Source
Acad Emerg Med. 2006 Aug;13(8):848-52
Publication Type
Article
Date
Aug-2006
Author
Brian H Rowe
Peter Channan
Michael Bullard
Sandra Blitz
L Duncan Saunders
Rhonda J Rosychuk
Harris Lari
William R Craig
Brian R Holroyd
Author Affiliation
Department of Emergency Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. brian.rowe@ualberta.ca
Source
Acad Emerg Med. 2006 Aug;13(8):848-52
Date
Aug-2006
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Alberta
Child
Child, Preschool
Emergency Service, Hospital - utilization
Female
Follow-Up Studies
Hospitals, Pediatric - utilization
Humans
Length of Stay
Male
Middle Aged
Patient Acceptance of Health Care - statistics & numerical data
Patient Admission - statistics & numerical data
Primary Health Care - utilization
Prospective Studies
Sex Distribution
Treatment Refusal - statistics & numerical data
Waiting Lists
Abstract
Patients leaving the emergency department (ED) without being seen (LWBS) by a physician have become a growing concern in overcrowded EDs. The purpose of this study was to determine the acuity level, reasons, and outcomes of LWBS cases.
LWBS patients (or their guardians) from two linked Canadian EDs (one adult, one pediatric), identified during 11 sampling periods of seven days' duration each, were contacted by telephone. Descriptive statistics are provided.
A total of 711 (4.5%) of 15,660 registered emergency patients left without being seen (50% male; median age, 33 years). Triage-matched controls waited a median of 87 minutes before seeing a physician. Of the 711 LWBS cases, 512 (72%) were contacted and 498 agreed to participate. The most common major reason for leaving was "fed up with waiting" (44.8%). Overall, 60% of LWBS cases sought medical attention within one week; 14 patients were hospitalized, and one required urgent surgery. Triage level was not associated with the probability of subsequently seeking medical attention (61%, 61%, and 60% in triage levels 3, 4, and 5, respectively). Of the 198 (39%) who did not subsequently seek medical attention, 50 patients (26%) had been triaged as urgent and one patient died six days after ED registration.
The most common reason for LWBS is impatience during peak ED periods. Many of these patients seek medical care within one week. Complications occurred rarely; however, "high-risk" patients who leave without being seen do experience adverse health outcomes. Further research is required to examine ways to reduce LWBS cases.
PubMed ID
16670258 View in PubMed
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Childhood cancer trends in a western Canadian province: a population-based 22-year retrospective study.

https://arctichealth.org/en/permalink/ahliterature140909
Source
Pediatr Blood Cancer. 2010 Dec 15;55(7):1348-55
Publication Type
Article
Date
Dec-15-2010
Author
Rhonda J Rosychuk
Adrienne Witol
Kent Stobart
Author Affiliation
Faculty of Medicine & Dentistry, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada. rhonda.rosychuk@ualberta.ca
Source
Pediatr Blood Cancer. 2010 Dec 15;55(7):1348-55
Date
Dec-15-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Alberta - epidemiology
Child
Child, Preschool
Female
Humans
Infant
Male
Neoplasms - epidemiology
Registries
Young Adult
Abstract
The objective of this study was to describe children and youth
PubMed ID
20830776 View in PubMed
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Circumstances surrounding end of life in a pediatric intensive care unit.

https://arctichealth.org/en/permalink/ahliterature183026
Source
Pediatrics. 2003 Nov;112(5):e371
Publication Type
Article
Date
Nov-2003
Author
Daniel Garros
Rhonda J Rosychuk
Peter N Cox
Author Affiliation
Department of Critical Care Medicine, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Source
Pediatrics. 2003 Nov;112(5):e371
Date
Nov-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Analgesia
Attitude to Death
Cause of Death
Child
Child, Preschool
Decision Making
Female
Humans
Infant
Infant, Newborn
Intensive Care Units, Pediatric
Male
Ontario
Parent-Child Relations
Parents - psychology
Patient care team
Physicians - psychology
Resuscitation Orders
Terminal Care - psychology
Treatment Failure
Withholding Treatment
Abstract
Approximately 60% of deaths in pediatric intensive care units follow limitation or withdrawal of life-sustaining treatment (LST). We aimed to describe the circumstances surrounding decision making and end-of-life care in this setting.
We conducted a prospective, descriptive study based on a survey with the intensivist after every consecutive death during an 8-month period in a single multidisciplinary pediatric intensive care unit. Summary statistics are presented as percentage, mean +/- standard deviation, or median and range; data are compared using the Mantel-Haenszel test and shown as survival curves.
Of the 99 observed deaths, 27 involved failed cardiopulmonary resuscitation; of the remaining 72, 39 followed withdrawal/limitation (W/LT) of LST, 20 were do not resuscitate (DNR), and 13 were brain deaths (BDs). Families initiated discussions about forgoing LST in 24% (17 of 72) of cases. Consensus between caregivers and staff about forgoing LST as the best approach was reached after the first meeting with 51% (35 of 68) of families; 46% (31 of 68) required >or=2 meetings (4 not reported). In the DNR group, the median time to death after consensus was 24 hours and for W/LT was 3 hours. LST was later withdrawn in 11 of 20 DNR cases. The family was present in 76% (45 of 59) of cases when LST was forgone. The dying patient was held by the family in 78% (35 of 45) of these occasions.
More than 1 formal meeting was required to reach consensus with families about forgoing LST in almost half of the patients. Families often held their child at the time of death. The majority of children died quickly after the end-of-life decision was made.
PubMed ID
14595079 View in PubMed
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32 records – page 1 of 4.