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Administrative data accurately identified intensive care unit admissions in Ontario.

https://arctichealth.org/en/permalink/ahliterature168382
Source
J Clin Epidemiol. 2006 Aug;59(8):802-7
Publication Type
Article
Date
Aug-2006
Author
Damon C Scales
Jun Guan
Claudio M Martin
Donald A Redelmeier
Author Affiliation
Department of Critical Care, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, G1 06, 2075 Bayview Avenue, Toronto, Ontario, Canada. damon.scales@utoronto.ca
Source
J Clin Epidemiol. 2006 Aug;59(8):802-7
Date
Aug-2006
Language
English
Publication Type
Article
Keywords
Databases as Topic
Health Services Research
Hospitalization - statistics & numerical data
Humans
Insurance Claim Reporting
Intensive Care Units - utilization
Medical Record Linkage
Ontario
Outcome Assessment (Health Care) - methods
Predictive value of tests
Sensitivity and specificity
Abstract
To evaluate the accuracy of Ontario administrative health data for identifying intensive care unit (ICU) patients.
Records from the Critical Care Research Network patient registry (CCR-Net) were linked to the Ontario Health Insurance Program (OHIP) database and the Canadian Institute for Health Information (CIHI) database. The CCR-Net was considered the criterion standard for assessing the accuracy of different OHIP or CIHI codes for identifying ICU admission.
The highest positive predictive value (PPV) for ICU admission (91%) was obtained using a CIHI special care unit (SCU) code, but its sensitivity was poor (26%). A strategy based on a combination of CIHI SCU codes yielded a lower PPV (84%) but a higher sensitivity (92%). A strategy based purely on OHIP claims yielded further reductions in PPV (73%), gains in specificity (99%), and moderate sensitivity (56%). The highest sensitivity (100%) was obtained using a combination of CIHI and OHIP codes in exchange for poor PPV (32%).
Administrative databases can be used to identify ICU patients, but no single strategy simultaneously provided high sensitivity, specificity, and PPV. Researchers should consider the study purpose when selecting a strategy for health services research on ICU patients.
PubMed ID
16828673 View in PubMed
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Aerial photogrammetry and tag-derived tissue density reveal patterns of lipid-store body condition of humpback whales on their feeding grounds.

https://arctichealth.org/en/permalink/ahliterature312186
Source
Proc Biol Sci. 2021 01 27; 288(1943):20202307
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Date
01-27-2021
Author
Kagari Aoki
Saana Isojunno
Charlotte Bellot
Takashi Iwata
Joanna Kershaw
Yu Akiyama
Lucía M Martín López
Christian Ramp
Martin Biuw
René Swift
Paul J Wensveen
Patrick Pomeroy
Tomoko Narazaki
Ailsa Hall
Katsufumi Sato
Patrick J O Miller
Author Affiliation
Atmosphere and Ocean Research Institute, The University of Tokyo, Kashiwa, Chiba 2778564, Japan.
Source
Proc Biol Sci. 2021 01 27; 288(1943):20202307
Date
01-27-2021
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Keywords
Animals
Bayes Theorem
Canada
Female
Humpback Whale
Lactation
Lipids
Male
Norway
Photogrammetry
Pregnancy
Abstract
Monitoring the body condition of free-ranging marine mammals at different life-history stages is essential to understand their ecology as they must accumulate sufficient energy reserves for survival and reproduction. However, assessing body condition in free-ranging marine mammals is challenging. We cross-validated two independent approaches to estimate the body condition of humpback whales (Megaptera novaeangliae) at two feeding grounds in Canada and Norway: animal-borne tags (n = 59) and aerial photogrammetry (n = 55). Whales that had a large length-standardized projected area in overhead images (i.e. whales looked fatter) had lower estimated tissue body density (TBD) (greater lipid stores) from tag data. Linking both measurements in a Bayesian hierarchical model to estimate the true underlying (hidden) tissue body density (uTBD), we found uTBD was lower (-3.5 kg m-3) in pregnant females compared to adult males and resting females, while in lactating females it was higher (+6.0 kg m-3). Whales were more negatively buoyant (+5.0 kg m-3) in Norway than Canada during the early feeding season, possibly owing to a longer migration from breeding areas. While uTBD decreased over the feeding season across life-history traits, whale tissues remained negatively buoyant (1035.3 ± 3.8 kg m-3) in the late feeding season. This study adds confidence to the effectiveness of these independent methods to estimate the body condition of free-ranging whales.
PubMed ID
33499785 View in PubMed
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"A future not of riches but of comfort": the emigration of pauper children from Bristol to Canada, 1870-1915.

https://arctichealth.org/en/permalink/ahliterature162686
Source
Immigr Minor. 2000;19(1):25-52
Publication Type
Article
Date
2000
Author
M. Martin
Author Affiliation
University of the West of England, Bristol.
Source
Immigr Minor. 2000;19(1):25-52
Date
2000
Language
English
Publication Type
Article
Keywords
Adolescent
Canada - ethnology
Child
Child Care - economics - ethics - history - legislation & jurisprudence - methods - supply & distribution - trends
Child, Preschool
Colonialism - classification - history
Emigration and Immigration - classification - history - legislation & jurisprudence - statistics & numerical data - trends
England
History, 19th Century
History, 20th Century
Humans
Infant
Infant, Newborn
Legislation as Topic - classification - ethics - history - trends
Orphanages - economics - ethics - history - legislation & jurisprudence - manpower - methods - statistics & numerical data - supply & distribution - trends
Politics
Poverty - economics - ethics - history - legislation & jurisprudence - statistics & numerical data - trends
Social Welfare - classification - ethics - history - statistics & numerical data - trends
Women - history
Abstract
This article examines the emigration of orphan and deserted children from Bristol to Canada in the late nineteenth and early twentieth centuries. This emigration was organised and financed by the local Boards of Guardians and, as such, raises important questions about the way in which state agencies cared for dependent children. The emigration of Poor Law children is explored in relation to debates about childcare, poverty, racial degeneration and imperialism. Of particular interest is the role played by women in promoting child emigration and the article considers the women's contribution to discourse and practice, both locally and nationally. The dynamics of emigration are analysed by using both British and Canadian sources and the tensions associated with pauper emigration are examined in some detail.
PubMed ID
17607864 View in PubMed
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Association of an X-chromosome dodecamer insertional variant allele with mental retardation.

https://arctichealth.org/en/permalink/ahliterature204843
Source
Mol Psychiatry. 1998 Jul;3(4):303-9
Publication Type
Article
Date
Jul-1998
Author
R A Philibert
B H King
S. Winfield
E H Cook
Y H Lee
B. Stubblefield
P. Damschroder-Williams
C. Dea
A. Palotie
C. Tengstrom
B M Martin
E I Ginns
Author Affiliation
Clinical Neuroscience Branch, National Institute of Mental Health, Bethesda, MD 20892, USA. philiber@irp.nimh.nih.gov
Source
Mol Psychiatry. 1998 Jul;3(4):303-9
Date
Jul-1998
Language
English
Publication Type
Article
Keywords
Alleles
Amino Acid Sequence
Animals
Base Sequence
California - epidemiology
Chromosome Mapping
Conserved Sequence
Cosmids
DNA Transposable Elements
Europe - epidemiology
Exons
Female
Finland - epidemiology
Fragile X Syndrome - genetics
Gene Library
Genetic Variation
Humans
Hypothyroidism - epidemiology - genetics
In Situ Hybridization, Fluorescence
Intellectual Disability - genetics
Male
Mice
Molecular Sequence Data
Polymorphism, Genetic
Prevalence
Sequence Alignment
Sequence Homology, Amino Acid
Trinucleotide Repeats
X Chromosome
Abstract
Mental retardation is a prominent feature of many neurodevelopmental syndromes. In an attempt to identify genetic components of these illnesses, we isolated and sequenced a large number of human genomic cosmid inserts containing large trinucleotide repeats. One of these cosmids, Cos-4, maps to the X-chromosome and contains the sequence of a 7.3-kb mRNA. Initial polymorphism analysis across a region of repetitive DNA in this gene revealed a rare 12-bp exonic variation (
Notes
Erratum In: Mol Psychiatry 1999 Mar;4(2):197
PubMed ID
9702738 View in PubMed
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Bilevel noninvasive positive pressure ventilation for acute respiratory failure: survey of Ontario practice.

https://arctichealth.org/en/permalink/ahliterature173956
Source
Crit Care Med. 2005 Jul;33(7):1477-83
Publication Type
Article
Date
Jul-2005
Author
Karen E A Burns
Tasnim Sinuff
Neill K J Adhikari
Maureen O Meade
Diane Heels-Ansdell
Claudio M Martin
Deborah J Cook
Author Affiliation
Division of Critical Care Medicine, University of Western Ontario, London, Ontario, Canada.
Source
Crit Care Med. 2005 Jul;33(7):1477-83
Date
Jul-2005
Language
English
Publication Type
Article
Keywords
Acute Disease
Cross-Sectional Studies
Hospitals - statistics & numerical data
Humans
Medicine - statistics & numerical data
Ontario
Physician's Practice Patterns
Positive-Pressure Respiration - utilization
Practice Guidelines as Topic
Randomized Controlled Trials as Topic
Regression Analysis
Respiratory Insufficiency - therapy
Specialization
Abstract
To determine physicians' stated practices regarding the use of bilevel noninvasive ventilation (NIV) for acute respiratory failure and the predictors of practice variation.
Cross-sectional postal survey.
Province of Ontario, Canada.
Attending physicians and residents in four specialties at 15 teaching hospitals.
We used literature searches and focus groups to design questions related to NIV utilization with respect to frequency, location of and indications for use, awareness of supporting literature, and perceived efficacy. We assessed the survey's clinical sensibility and reliability. We used regression analyses to evaluate practice variation among hospitals and specialties and to determine predictors of more frequent NIV use, initiation of and continued use in nonmonitored settings, and use for specific indications.
Three hundred eighty-five (48%) of 808 physicians responded; 242 used NIV. The two most common indications for NIV use were chronic obstructive pulmonary disease and congestive heart failure. NIV guidelines, protocols, or policies were available in 12 of 15 hospitals. We found variation in NIV utilization among specialties but not hospitals. Specialty (critical care and respirology versus internal and emergency medicine), fewer years of postgraduate experience, and a greater number of noninvasive ventilators were predictors of more frequent NIV use (all p
Notes
Comment In: Crit Care Med. 2005 Jul;33(7):1642-316003076
PubMed ID
16003051 View in PubMed
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Burden of illness in venous thromboembolism in critical care: a multicenter observational study.

https://arctichealth.org/en/permalink/ahliterature171809
Source
J Crit Care. 2005 Dec;20(4):341-7
Publication Type
Article
Date
Dec-2005
Author
Rakesh Patel
Deborah J Cook
Maureen O Meade
Lauren E Griffith
Geeta Mehta
Graeme M Rocker
John C Marshall
Rick Hodder
Claudio M Martin
Daren K Heyland
Sharon Peters
John Muscedere
Mark Soth
Nicole Campbell
Gordon H Guyatt
Author Affiliation
Department of Medicine, University of Ottawa, Canada K1Y 4E9.
Source
J Crit Care. 2005 Dec;20(4):341-7
Date
Dec-2005
Language
English
Publication Type
Article
Keywords
Anticoagulants - therapeutic use
Canada - epidemiology
Female
Humans
Incidence
Intensive Care Units
Male
Middle Aged
Prevalence
Pulmonary Embolism - epidemiology - prevention & control - therapy
Retrospective Studies
Venous Thrombosis - epidemiology - prevention & control - therapy
Abstract
The frequency of clinically diagnosed venous thromboembolism (VTE) including deep venous thrombosis (DVT) and pulmonary embolism (PE) in medical-surgical critically ill patients is unclear. The objectives of this study were to estimate the prevalence and incidence of radiologically confirmed DVT and PE in medical-surgical intensive care unit (ICU) patients and to determine the impact of prophylaxis on the frequency of these events.
In a retrospective observational cohort study in 12 adult ICUs, we identified prevalent cases (diagnosed in the 24 hours preceding ICU admission up to 48 hours post-ICU admission) and incident cases (diagnosed 48 hours or more after ICU admission and up to 8 weeks after ICU discharge) of upper or lower limb DVT or PE. Deep venous thrombosis was diagnosed by compression ultrasound or venogram. Each DVT was classified as clinically suspected or not clinically suspected in that the latter was diagnosed by scheduled screening ultrasonography. Pulmonary embolism was diagnosed by ventilation-perfusion lung scan, computed tomography pulmonary angiography, echocardiography, electrocardiography, or autopsy.
Among 12,338 patients, 252 (2.0%) patients had radiologically confirmed DVT or PE and another 47 (0.4%) had possible DVT or PE. Prevalent DVTs were diagnosed in 0.4% (95% confidence interval [CI], 0.3%-0.5%) of patients and prevalent PEs were diagnosed in 0.4% (95% CI, 0.3%-0.6%). Incident DVTs were diagnosed in 1.0% (95% CI, 0.8%-1.2%) of patients, and incident PEs were diagnosed in 0.5% (95% CI, 0.4%-0.6%). Of patients with incident VTE, 65.8% of cases occurred despite receipt of thromboprophylaxis for at least 80% of their days in ICU. The median (interquartile range) ICU length of stay was similar for patients with DVT (7 [3-17]) and PE (5 [2-8]). For all patients with VTE, ICU mortality was 16.7% (95% CI, 12.0%-21.3%) and hospital mortality was 28.5% (95% CI, 22.8%-34.1%).
Venous thromboembolism appears to be an apparently infrequent, but likely underdiagnosed problem, occurring among patients receiving prophylaxis. Findings suggest the need for increased suspicion among clinicians, renewed efforts at thromboprophylaxis, and evaluation of superior prevention strategies.
PubMed ID
16310605 View in PubMed
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Chronic disease and illness care: adding principles of family medicine to address ongoing health system redesign.

https://arctichealth.org/en/permalink/ahliterature159829
Source
Can Fam Physician. 2007 Dec;53(12):2086-91
Publication Type
Article
Date
Dec-2007
Author
Carmel M Martin
Author Affiliation
Northern Ontario School of Medicine, Clinical Sciences Division, 238 Bruyère St, Ottawa, ON, Canada. carmel.martin@NorMed.ca
Source
Can Fam Physician. 2007 Dec;53(12):2086-91
Date
Dec-2007
Language
English
Publication Type
Article
Keywords
Chronic Disease - therapy
Disease Management
Family Practice - organization & administration
Guidelines as Topic
Health Care Reform - organization & administration
Humans
Models, organizational
Ontario
Notes
Cites: Aust Health Rev. 2001;24(2):207-1411496465
Cites: BMJ. 2007 Jan 6;334(7583):3117107984
Cites: Eff Clin Pract. 1998 Aug-Sep;1(1):2-410345255
Cites: Health Aff (Millwood). 2001 Nov-Dec;20(6):64-7811816692
PubMed ID
18077734 View in PubMed
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Concordance between results of optic disc tomography and high-pass resolution perimetry in glaucoma.

https://arctichealth.org/en/permalink/ahliterature50892
Source
J Glaucoma. 2000 Feb;9(1):28-33
Publication Type
Article
Date
Feb-2000
Author
L M Martin
B. Lindblom
U K Gedda
Author Affiliation
Department of Clinical Science, Karolinska Institutet, Stockholm, Sweden.
Source
J Glaucoma. 2000 Feb;9(1):28-33
Date
Feb-2000
Language
English
Publication Type
Article
Keywords
Aged
Comparative Study
Diagnosis, Differential
Female
Glaucoma - diagnosis
Humans
Image Processing, Computer-Assisted
Male
Ocular Hypertension - diagnosis
Optic Disk - pathology
Perimetry - methods
Reproducibility of Results
Tomography - methods
Visual Fields
Abstract
PURPOSE: To evaluate concordance between results obtained with the Heidelberg Retina Tomograph (HRT) (Heidelberg Engineering GmbH, Heidelberg, Germany) and those obtained with the high-pass resolution perimeter (HRP) in glaucoma diagnosis. METHODS: A total of 217 patients from the glaucoma services at St. Erik Eye Hospital, Stockholm, Sweden (n = 107) and Sahlgrenska University Hospital, Göteborg, Sweden (n = 110) were included in the study. All patients were examined because of known or suspected glaucoma in at least one eye. The conventional indices presented by the instruments were used, i.e., glaucoma index from the HRT (negative values = abnormal, positive = normal) and combined deviation (upper normal limit 2.1 dB) from the HRP. RESULTS: The concordance regarding the classification of normal or glaucomatous by the two instruments was 71% (153/217 eyes). The HRT indicated glaucoma but HRP findings were normal in 47 patients, and the reverse occurred in 17 patients. There was a significant difference in optic disc area between patients with abnormal HRT findings and normal HRP findings and in patients with normal HRT findings and abnormal HRP findings. The concordance could not be improved by adjusting for disc size. The correlation between combined deviation on HRP and the HRT glaucoma index was r = -0.53. CONCLUSION: A significant correlation was found between the combined index given by HRP and the HRT glaucoma index in 217 patients examined for known or suspected glaucoma. Discordant findings were observed in 64 patients; in 22 this discordance was explained by the influence of disc size. No other reasons for differences in examination results could be detected.
PubMed ID
10708228 View in PubMed
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Critical care services in Ontario: a survey-based assessment of current and future resource needs.

https://arctichealth.org/en/permalink/ahliterature151993
Source
Can J Anaesth. 2009 Apr;56(4):291-7
Publication Type
Article
Date
Apr-2009
Author
Andrea D Hill
Eddy Fan
Thomas E Stewart
William J Sibbald
Eric Nauenberg
Bernard Lawless
Jocelyn Bennett
Claudio M Martin
Author Affiliation
University Health Network, Toronto General Hospital, and Department of Health Policy Management and Evaluation, University of Toronto, 200 Elizabeth Street, 11C-1165, Toronto, ON, Canada, M5G 2C4. andrea.hill@uhn.on.ca
Source
Can J Anaesth. 2009 Apr;56(4):291-7
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Bed Occupancy - trends
Critical Care - organization & administration - trends
Health Services Needs and Demand - statistics & numerical data - trends
Hospital Bed Capacity - statistics & numerical data
Humans
Intensive Care Units - statistics & numerical data - supply & distribution - trends
Middle Aged
Needs Assessment
Ontario
Questionnaires
Respiration, Artificial - statistics & numerical data - trends
Young Adult
Abstract
In response to the challenges of an aging population and decreasing workforce, the provision of critical care services has been a target for quality and efficiency improvement efforts. Reliable data on available critical care resources is a necessary first step in informing these efforts. We sought to describe the availability of critical care resources, forecast the future requirement for the highest-level critical care beds and to determine the physician management models in critical care units in Ontario, Canada.
In June 2006, self-administered questionnaires were mailed to the Chief Executive Officers of all acute care hospitals, identified through the Ontario government's hospital database. The questionnaire solicited information on the number and type of critical care units, number of beds, technological resources and management of each unit.
Responses were obtained from 174 (100%) hospitals, with 126 (73%) reporting one or more critical care units. We identified 213 critical care units in the province, representing 1789 critical care beds. Over half (59%) of these beds provided mechanical ventilation on a regular basis, representing a capacity of 14.9 critical care and 8.7 mechanically ventilated beds per 100,000 population. Sixty-three percent of units with capacity for mechanical ventilation involved an intensivist in admission and coordination of care. Based on current utilization, the demand for mechanically ventilated beds by 2026 is forecast to increase by 57% over levels available in 2006. Assuming 80% bed utilization, it is estimated that an additional 810 ventilated beds will be needed by 2026.
Current utilization suggests a substantial increase in the need for the highest-level critical care beds over the next two decades. Our findings also indicate that non-intensivists direct care decisions in a large number of responding units. Unless major investments are made, significant improvements in efficiency will be required to maintain future access to these services.
PubMed ID
19296190 View in PubMed
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Cross-reactivity of IgE-binding components between boiled Atlantic shrimp and German cockroach.

https://arctichealth.org/en/permalink/ahliterature15889
Source
Allergy. 1995 Nov;50(11):918-24
Publication Type
Article
Date
Nov-1995
Author
J F Crespo
C. Pascual
R. Helm
S. Sanchez-Pastor
I. Ojeda
L. Romualdo
M. Martin-Esteban
J A Ojeda
Author Affiliation
Allergy Division, La Paz Children's Hospital, Madrid, Spain.
Source
Allergy. 1995 Nov;50(11):918-24
Date
Nov-1995
Language
English
Publication Type
Article
Keywords
Adolescent
Allergens - immunology
Animals
Child
Child, Preschool
Cockroaches - immunology
Cross Reactions - immunology
Decapoda (Crustacea) - immunology
Electrophoresis, Polyacrylamide Gel
Food Hypersensitivity - immunology
Humans
Immunoblotting
Immunoenzyme Techniques
Immunoglobulin E - immunology
Infant
Infant, Newborn
Molecular Weight
Research Support, Non-U.S. Gov't
Abstract
IgE-antibody reactivity to boiled Atlantic shrimp (Pandalus borealis) and German cockroach (Blattella germanica) of sera from 89 patients, sensitive to one or the other, was investigated with an enzymatic immunoassay for specific IgE detection (CAP-FEIA System, Pharmacia, Sweden). IgE serum levels to both antishrimp and anticockroach allergens were found to be positive in 76 of the 89 (85.4%) tested sera. A positive anticockroach IgE was very rare in the absence of detectable antishrimp IgE (five of 89 sera). Linear regression analysis on antishrimp and anti-German cockroach IgE levels-log plot revealed a correlation coefficient (r) of 0.73. Inhibition experiments showed that boiled Atlantic shrimp extract inhibited CAP with German cockroach, and vice versa. Immunoblotting showed the strongest IgE binding for both allergenic extracts between 30 and 43 kDa. By blot inhibition, the binding capacity of German cockroach was totally abolished by Atlantic shrimp extract, while German cockroach extract only partially IgE binding to Atlantic shrimp. Cross-reactivity exists between shrimp, an important food allergen, and German cockroach, which has an increasing role in allergic asthma. It could be important to determine the clinical significance of cross-allergy to both allergens, in which exposures occur in different ways.
PubMed ID
8748725 View in PubMed
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48 records – page 1 of 5.