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Challenges to the surveillance of meningococcal disease in an era of declining incidence in montréal, Québec.

https://arctichealth.org/en/permalink/ahliterature107170
Source
Can J Public Health. 2013 Jul-Aug;104(4):e335-9
Publication Type
Article
Author
Ruwan Ratnayake
Robert Allard
Author Affiliation
1. Canadian Field Epidemiology Program, Public Health Agency of Canada, Ottawa, Ontario, Canada 2. Public Health Department, Montréal Health and Social Services Agency, Montréal, Québec, Canada. ruwan.ratnayake@rescue.org.
Source
Can J Public Health. 2013 Jul-Aug;104(4):e335-9
Language
English
Publication Type
Article
Keywords
Cluster analysis
Databases, Factual
Disease Notification - statistics & numerical data
Humans
Incidence
Laboratories
Meningococcal Infections - epidemiology
Physician's Practice Patterns - statistics & numerical data
Population Surveillance - methods
Quebec - epidemiology
Time Factors
Abstract
Though rare in Montréal, meningococcal disease continues to cause serious morbidity and mortality. In an era of declining incidence, our objective was to evaluate the sensitivity and the timeliness of case reporting and the capacity to statistically detect disease clusters.
We used the public health department's reportable disease database (RDD) to calculate the timeliness of reporting by physicians and laboratories for the period 1995 to 2008. The sensitivity of case reporting was evaluated through capture-recapture estimation using the RDD and the hospitalization discharge database (MED-ECHO). To evaluate the detection of cases clustered by time and proximity, we applied scan statistics to the RDD with cases coded by time and geographic location for the period 1992 to 2008.
While the system sensitivity was judged to be high at 94%, physicians reported only 54% of cases. A total of 92.3% of cases were notified by physicians or laboratories within seven days, meaning that in theory, 13 cases were not notified in time to conduct thorough contact tracing and offer chemoprophylaxis to close contacts. In high-incidence years, scan statistics detected two statistically-significant clusters one to two weeks earlier than traditional detection through the manual monitoring of cumulative cases.
To improve system performance, we recommended increasing the emphasis of laboratory reporting, reinforcing early reporting by physicians and if incidence increases, using scan statistics to identify clusters that can add to a public health practitioner's initial "hunch" of an emerging outbreak.
PubMed ID
24044476 View in PubMed
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Ciprofloxacin-resistant Shigella sonnei among men who have sex with men, Canada, 2010.

https://arctichealth.org/en/permalink/ahliterature131670
Source
Emerg Infect Dis. 2011 Sep;17(9):1747-50
Publication Type
Article
Date
Sep-2011
Author
Christiane Gaudreau
Ruwan Ratnayake
Pierre A Pilon
Simon Gagnon
Michel Roger
Simon Lévesque
Author Affiliation
Centre Hospitalier de l'Université de Montréal-Hôpital Saint-Luc, Montreal, Québec, Canada. christiane.gaudreau.chum@ssss.gouv.qc.ca
Source
Emerg Infect Dis. 2011 Sep;17(9):1747-50
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Anti-Bacterial Agents - therapeutic use
Canada - epidemiology
Ciprofloxacin - therapeutic use
Disease Outbreaks
Drug Resistance, Bacterial
Dysentery, Bacillary - drug therapy - epidemiology - transmission
Electrophoresis, Gel, Pulsed-Field
Female
Homosexuality, Male
Humans
Male
Microbial Sensitivity Tests
Middle Aged
Molecular Typing
Sexual Behavior
Shigella sonnei - classification - drug effects - isolation & purification
Young Adult
Abstract
In 2010, we observed isolates with matching pulsed-field gel electrophoresis patterns from 13 cases of ciprofloxacin-resistant Shigella sonnei in Montréal. We report on the emergence of this resistance type and a study of resistance mechanisms. The investigation suggested local transmission among men who have sex with men associated with sex venues.
Notes
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Cites: J Clin Microbiol. 1995 Sep;33(9):2233-97494007
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Cites: MMWR Morb Mortal Wkly Rep. 2010 Dec 17;59(49):161921160457
Cites: Foodborne Pathog Dis. 2006 Spring;3(1):59-6716602980
Cites: Emerg Infect Dis. 2006 Sep;12(9):1458-6017073105
Cites: J Med Microbiol. 2008 Jul;57(Pt 7):856-6318566144
Cites: Microb Drug Resist. 2010 Jun;16(2):155-6120438349
Cites: Can Commun Dis Rep. 2005 Apr 15;31(8):85-9015875326
PubMed ID
21888811 View in PubMed
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Rehabilitation challenges for Aboriginal clients recovering from brain injury: a qualitative study engaging health care practitioners.

https://arctichealth.org/en/permalink/ahliterature152713
Source
Brain Inj. 2009 Mar;23(3):250-61
Publication Type
Article
Date
Mar-2009
Author
Michelle L Keightley
Ruwan Ratnayake
Bruce Minore
Mae Katt
Anita Cameron
Randy White
Alice Bellavance
Claudine Longboat-White
Angela Colantonio
Author Affiliation
Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada. michelle.keightley@utoronto.ca
Source
Brain Inj. 2009 Mar;23(3):250-61
Date
Mar-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Attitude of Health Personnel - ethnology
Brain Injuries - epidemiology - ethnology - rehabilitation
Continuity of Patient Care
Cultural Diversity
Female
Health Services, Indigenous - standards
Humans
Male
Middle Aged
Patient compliance
Qualitative Research
Young Adult
Abstract
To explore the experiences of health care practitioners working with Aboriginal clients recovering from acquired brain injury (ABI).
Participatory research design using qualitative methods.
Fourteen in-depth, semi-structured interviews were conducted. The Framework Method of analysis was used to uncover emerging themes.
Five main categories emerged: practitioners' experience with brain injury, practitioners' experience with Aboriginal clients, specialized needs of Aboriginal clients recovering from brain injury, culturally sensitive care and traditional healing methods. These categories were then further divided into emergent themes and sub-themes where applicable, with particular emphasis on the specialized needs of Aboriginal clients.
Each emergent theme highlighted key challenges experienced by Aboriginal peoples recovering from ABI. A key challenge was that protocols for rehabilitation and discharge planning are often lacking for clients living on reserves or in remote communities. Other challenges included lack of social support; difficulty of travel and socio-cultural factors associated with post-acute care; and concurrent disorders.
Results suggest that developing reasonable protocols for discharge planning of Aboriginal clients living on reserves and/or remote communities should be considered a priority.
PubMed ID
19205962 View in PubMed
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