Open Access Journals University of Manitoba
Not a member yet
139 research outputs found
Sort by
7 Steps to start a research project
No full textResearch is an important platform whereby leaders in any profession share their knowledge and expertise. Just like any growing profession, conducting and publishing research work is essential for Physician Assistants (PAs). Through research, PAs can highlight their vital roles in the Canadian Healthcare system in various clinical settings. PA research is important and very much needed yet challenging. It\u27s often difficult to carryout meaningul studies especially when one lacks research background. This infographic aims to guide PAs interested in conducting research, in a stepwise fashion, from an idea to publication.Â
Optimizing Adult Ambulatory Care in Inflammatory Bowel Disease
Get PDFIntro: Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, is a chronic, complex and unpredictable disease affecting an increasing number of patients from a young age, worldwide. The purpose of this article is to review the literature on outpatient care models used to treat adults with IBD, and to gain insight on how to improve quality of care and reduce costs. Method: A comprehensive review of recent literature on PubMed, Scopus, and Google Scholar databases about care models used to treat IBD was performed. Key terms included “inflammatory bowel diseaseâ€, “organizational modelsâ€, “patient care teamâ€, “quality improvementâ€, and “physician assistantsâ€.Results: Studies showed that an integrated care model decreases hospital admissions, IBD-related surgeries, and comorbidities of IBD, ultimately decreasing direct and indirect costs of IBD compared to a more traditional patient-physician model. A gastroenterologist-led multidisciplinary team (MDT), involving comprehensive care by IBD nurses, a surgeon, psychologist, dietician, pharmacist, and other members as needed is recommended. No research was found on the use of physician assistant (PAs) in IBD care.Conclusions: A holistic approach to IBD care delivered by a MDT with structured monitoring, active follow-up, patient education, and prompt access to care improves outcomes for IBD patients. More research is needed on the cost-effectiveness of integrated care models to demonstrate long-term value and secure funding for implementation. Future research should examine how the use of PAs in IBD care influences patient outcomes, healthcare costs, as well as patient and physician satisfaction
The Failure to Provide Equitable Public Health Services in British Columbia and the Case Study of Physician Assistants
Get PDFThis paper presents a picture of an impoverished philosophy of health care in Canada. Our system features weakly designed legal protections which cannot help manifest necessary public health interventions beyond the narrowest confines of ‘medical necessity’. The case study used to illustrate this will be British Columbia’s crisis in healthcare provision, coupled with the province’s failure to regulate physician assistants despite persistent lobbying
Evidence-based Resources for Clinical Practice
Get PDFA key clinical skill in evidence-based practice is the ability to obtain accurate, quality clinical information quickly. Also crucial are empathy and communication skills to enable shared decision-making with the patient, toward formulation of practical treatment decisions. How do clinicians find and use the most current evidence-based resources to answer clinical questions? This article draws from Thomas Agoritsas et al’s chapter “Finding Current Best Evidenceâ€, and explores the search for and utilization of evidence-based resources, using Clostridioides (formerly Clostridium) difficile infection as an example.Â
The role of physician assistants in rural emergency departments of Manitoba
Get PDFWait times in Winnipeg emergency departments (EDs) are currently amongst the longest in Canada. With the goal of improving wait times and lower costs, the Winnipeg Regional Health Authority plans to consolidate services by closing one ED and one urgent care centre, while converting two EDs to urgent care centres. With the conversion of EDs in Winnipeg to urgent care centres, an analysis of new and cost-effective models of managing the less acute, but urgent medical conditions typically seen at urgent care centres, is needed.The objective of this study was to identify the Canadian Triage and Acuity Scale (CTAS) classification of illness severity that Physician Assistants (PAs) are currently treating in rural EDs in Manitoba. Patient charts were reviewed from the emergency departments of Beausejour District Hospital and Selkirk Regional Health Centre between January and May 20017. The majority of patients treated by PAs in these rural EDs were of CTAS levels 3 and 4. This study highlights that PAs are experienced in treating CTAS level 3 presentations and are utilized to help increase patient flow in these rural emergency departments. Furthermore, with the increased need to find cost-effective and innovative ways of reducing wait times in Winnipeg EDs and urgent care centers, it may be suggested that PAs could be beneficial in this process
Impacts on declining moose populations in southeastern Manitoba
Get PDFMoose (Alces alces) populations in eastern and central North America have declined in many parts of their southern range. Many potential impacts on moose have been suggested as contributing to moose declines, including changing habitat disturbance regimes and enhanced disease transmission through increasing deer populations. We examined factors affecting moose in Game Hunting Area (GHA) 26 in southeastern Manitoba, where moose populations have declined substantially, by comparing provincial aerial survey data with features of the landscape. Moose were more likely to be found in areas with high logging (>25%) and recent forest fires (within the past 30 years), indicating that moose respond favorably to habitat disturbances. The presence of roads did not affect the likelihood of moose presence. Moose were negatively impacted by white-tailed deer (Odocoileus virginianus). We used model selection to determine the variables most important for predicting the presence of moose in GHA 26. The best model included the presence of deer, logging, and forest fires. Among the variables considered, deer presence had the highest relative importance. This study suggests that to increase moose numbers, controlled burns and potential logging areas should be considered as ways to produce new habitat and plant growth for moose in the area. Managing the deer population also could control the effect of the deer brain worm (Parelaphostrongylus tenuis) on the moose population in GHA 26
Developing a Genotyping Scheme for Mycobacterium abscessus Complex Using Whole Genome Sequencing Data
Get PDFMycobacterium abscessus complex is a rapid growing non-tuberculous mycobacteria (NTM) and a clinically significant pathogen capable of causing varying infections in humans. It is notoriously difficult to treat due to its inducible resistant state to clarithromycin and intrinsic resistant states to other drugs including rifampicin. Typing schemes for bacterial pathogens provide numerous applications including sourcing an outbreak, identifying cross contamination, chain of transmission and surveillance. However, they either lack or are limited for many NTMs including M. abscessus complex. The current publically available scheme on PubMLST has not been updated in several years and was only able to apply a sequence type to less than half of tested isolates. This project was aimed at creating a workflow for the development of a multi-locus sequence typing (MLST) scheme using whole genome data. A total of 104 genomes and 14 loci were used to build the scheme (including 3 type strains of each of the 3 subspecies). All 7 genes from the PubMLST scheme were incorporated namely, argH, cya, gnd, murC, pta, purH, and rpoB and were expanded by 6, 9, 12, 8, 12, 10, and 8 alleles, respectively. Another 7 novel genes were added including hsp65, erm(41), arr, rrs, rrl, gyrA, and gyrB with 9, 14, 20, 7, 25, 24, 22 alleles, respectively with 62 unique sequence types were identified among all isolates. This scheme can also differentiate M. abscessus complex to the subspecies level on the basis of 3 discriminatory genes and includes 6 genes related to antimicrobial resistance. Supplementary information available online at: http://ojs.lib.umanitoba.ca/index.php/pmuser/article/view/682/699Â
E-cadherin, catenin, cytoskeletal interactions and induced pluripotency
Get PDFPluripotency is defined as the capability of cells to differentiate into cell types derived from each of the three embryonic germ layers (Kelly et al., 2011). Induced pluripotency defines a process of epigenetic reprogramming in which epigenetic changes implemented during differentiation are reversed to generate cells with a stem-like phenotype. Fibroblasts (Takahashi and Yamanaka, 2006; Sommer et al., 2009), human keratinocytes (Aasen et al., 2008) and nasal mucosal cells (Ono et al., 2012) can be reprogrammed to stem-like cells with introduction of four stem cell transcription factors Oct4, KLF4, Sox2 and c-Myc (OKSM). Previous studies have provided evidence that the adhesion and cellular signaling provided by a glycoprotein, known as E-cadherin, has essential functions in pluripotency. Induced pluripotency has potential medical application which the induced pluripotent stem cells (iPSCs) apply as clinical tools for modeling diseases, drug development, and to deliver cell-replacement therapy to support regenerative medicine (Goldthwaite, 2011).The present review summarizes our current knowledge on the role of E-cadherin, its cellular signaling and cytoskeletal interactions in the induction and maintenance of pluripotent cells
