809 research outputs found
Supplemental Material Case mix-based changes in health status: A prospective study of elective surgery patients in Vancouver, Canada
No full textSupplemental Material for Case mix-based changes in health status: A prospective study of elective surgery patients in Vancouver, Canada by Jason M Sutherland, R Trafford Crump, Ahmer A Karimuddin, Guiping Liu, Kevin Wing, Arif Janjua and Kathryn Isaac in Journal of Health Services Research & Policy</p
MSJ908163_supplemental_material – Supplemental material for Fatigue, sleep disorders, anaemia and pain in the multiple sclerosis prodrome
No full textSupplemental material, MSJ908163_supplemental_material for Fatigue, sleep disorders, anaemia and pain in the multiple sclerosis prodrome by Fardowsa LA Yusuf, José MA Wijnands, Elaine Kingwell, Feng Zhu, Charity Evans, John D Fisk, Yinshan Zhao, Jason M Sutherland, David M Patrick, Ruth Ann Marrie and Helen Tremlett in Multiple Sclerosis Journal</p
the Eloquence of Mary Astell
No full textThe Eloquence of Mary Astell makes an important contribution to the knowledge and understanding of the important role that women, and one woman in particular, played in the history of rhetoric. Mary Astell (1666-1731) was an unusually perceptive thinker and writer during the time of the Enlightenment. Here, author Christine Sutherland explores her importance as a rhetorician, an area that has, until recently, received little attention. Astell was widely known and respected during her own time, but her influence and reputation receded in the years after her death. Her importance as an Enlightenment thinker is becoming more and more recognized, however. As a skilled theorist and practitioner of rhetoric, Astell wrote extensively on education, philosophy, politics, religion, and the status of women. She showed that it was possible for a woman to move from the semi-private form of rhetoric represented by conversation and letters into full public participation in philosophical and political debate
the Eloquence of Mary Astell
No full textThe Eloquence of Mary Astell makes an important contribution to the knowledge and understanding of the important role that women, and one woman in particular, played in the history of rhetoric. Mary Astell (1666-1731) was an unusually perceptive thinker and writer during the time of the Enlightenment. Here, author Christine Sutherland explores her importance as a rhetorician, an area that has, until recently, received little attention. Astell was widely known and respected during her own time, but her influence and reputation receded in the years after her death. Her importance as an Enlightenment thinker is becoming more and more recognized, however. As a skilled theorist and practitioner of rhetoric, Astell wrote extensively on education, philosophy, politics, religion, and the status of women. She showed that it was possible for a woman to move from the semi-private form of rhetoric represented by conversation and letters into full public participation in philosophical and political debate
the Eloquence of Mary Astell
No full textThe Eloquence of Mary Astell makes an important contribution to the knowledge and understanding of the important role that women, and one woman in particular, played in the history of rhetoric. Mary Astell (1666-1731) was an unusually perceptive thinker and writer during the time of the Enlightenment. Here, author Christine Sutherland explores her importance as a rhetorician, an area that has, until recently, received little attention. Astell was widely known and respected during her own time, but her influence and reputation receded in the years after her death. Her importance as an Enlightenment thinker is becoming more and more recognized, however. As a skilled theorist and practitioner of rhetoric, Astell wrote extensively on education, philosophy, politics, religion, and the status of women. She showed that it was possible for a woman to move from the semi-private form of rhetoric represented by conversation and letters into full public participation in philosophical and political debate
Factors associated with health outcomes in patients receiving hysterectomy for benign conditions
No full textHysterectomy is one of the most common surgical procedures among patients. Despite the high volume of this surgery, it is not well understood what patient and clinical factors are associated with a patient’s health-related quality of life before and after surgery. This thesis used a prospectively recruited cohort of patients scheduled for, or who had received, a hysterectomy for non-cancerous conditions to investigate: 1) the health of patients awaiting hysterectomy and factors associated with self-reported health, 2) patient and clinical factors associated with postoperative health, and 3) perceptions of shared decision-making and its association with postoperative health. These investigations were divided into three sub-studies. Patient-reported outcomes were used to measure pelvic floor health, sexual function, depression, and pain. Multi-variable regression analyses measured the association of age, comorbidities, socioeconomic factors, surgical approach, surgical indication, and shared decision-making with self-reported health. The first investigation found that participants that were younger, had more comorbidities, or had worse symptoms of pelvic health were more likely to report depression and pain before their surgery. The second investigation found that most participants reported improvements in health after their hysterectomy, however, those with lower socioeconomic status were more likely to report more pain. Participants that received a hysterectomy for their endometriosis or had received a hysterectomy through the abdominal approach, were more likely to report postoperative depressive symptoms. The last investigation found that almost half of hysterectomy patients reported less than optimal scores on their shared decision-making process with their surgeon before their hysterectomy. Those with lower scores were more likely to report poor pelvic health postoperatively.Medicine, Faculty ofPopulation and Public Health (SPPH), School ofGraduat
Application of physician claims and hospital discharge data to the classification of carotid endarterectomy symptomatic status and to the analysis of the symptom to surgery process
No full textBackground and purpose. The discipline of quality improvement emphasizes the use of data to improve specific and measurable attributes of performance. Using the example of carotid artery endarterectomy (CEA) for carotid artery stenosis, this thesis examined the use of hospital discharge and physician claims data for two quality improvement use cases. In Study 1, claims data were used to assemble patient cohorts based on symptomatic status at time of CEA. In Study 2, claims data were used to identify process-related causes of delayed symptomatic CEA.
Methods. A single hospital’s administrative database was used to assemble a retrospective cohort of participants who had undergone CEA. Chart review data were linked with physician claims and hospital discharge data. In Study 1, a standard method of classification by hospital discharge diagnosis was compared to classification using physician claims and hospital discharge data. In Study 2, delays related to the selection of medical care activities, such as physician visits and diagnostic tests, were investigated using linear regression models of waiting time for surgery and K-means clustering for patterns of activity co-occurrence.
Results. We identified 971 participants undergoing CEA at the Vancouver General Hospital (Vancouver, Canada) between January 1, 2008, and December 31, 2016. For Study 1, 729 people met inclusion/exclusion criteria and were included in diagnostic classification models (615 training, 114 test). Classification of symptomatic status using hospital discharge diagnosis codes was 32.8% (95% CI 29% – 37%) sensitive and 98.6% specific (96% – 100%). At matched 98.6% specificity, models that incorporated physician claims data were significantly more sensitive: elastic net 69.4% (59% – 82%) and random forest 78.8% (69% – 88%). In Study 2, K means clustering and linear regression analyses of process delay yielded similar results: early evaluation by emergency physicians or neurologists was associated with reduced delay, whereas carotid ultrasonography and post-imaging follow up with general practitioners or eye specialists was associated with greater delay.
Conclusion. Physician claims data can be used within quality improvement projects for cohort definition and process analysis use cases.Medicine, Faculty ofPopulation and Public Health (SPPH), School ofGraduat
Facial image manipulation:a tool for investigating social perception
No full textThe author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by the Australian Research Council (ARC) Centre of Excellence in Cognition and its Disorders (CE110001021), an ARC Discovery Outstanding Researcher Award to Rhodes (DP130102300), and an ARC Discovery grant to Rhodes, Sutherland, and Young (DP170104602).Peer reviewe
LeConte Bay Seafloor Elevation Data
No full text<p>Multibeam data of LeConte Bay seafloor from the inner fjord.</p>
<p>These are processed multibeam sonar data from LeConte Bay, southeast Alaska. The data come from five cruises grouped into five files:<br>
1) Aug 1999 and Sep 2000 (20-m resolution) - 1 file;<br>
2) August 2016 (20-m and 4-m resolution) - 2 files;<br>
3) May 2017 (2-m resolution) - 1 file;<br>
4) Sep 2018 (2-m resolution) - 1 file.</p>
<p>The datasets collected in 2016-2018 originally included ice-face data, as reported in Sutherland et al., 2019 (DOI 10.1126/science.aax3528). The data presented here include only the seafloor data, exclusive of the ice face. They are referenced to WGS84, UTM zone 8 (meters easting/northing), and mean sea level.</p>
<p>Reference and more details: Eidam, E.F., Sutherland, D.A., Duncan, D., Kienholz, C., Amundson, J.M., Motyka, R.J. Morainal bank evolution and fjord infilling during a tidewater glacier stillstand, on seasonal to decadal timescales. In prep for JGR-Earth Surface, September 2019.</p>
Atypical antipsychotic treatment among immigrant and non-immigrant pediatric patients with attention deficit/hyperactivity disorder in British Columbia
No full textThis thesis is focused on characterizing differences in pharmacological treatment among immigrant and non-immigrant children with Attention-Deficit/Hyperactivity Disorder (ADHD). Multimodal approaches combining psychosocial and pharmacological interventions are recommended for the treatment of ADHD. Among pharmacological treatments, stimulant medications are among the most common and efficacious drug therapy used to manage ADHD symptoms. However, there are concerns around increasing use of medications, such as atypical antipsychotics, that lack substantive evidence and are not currently approved by Health Canada for the treatment of ADHD.
This thesis has two main studies: First, scoping review methodology was used to examine longitudinal trends, prevalence, tolerability, and safety of atypical antipsychotics among children with ADHD. No studies were identified relating to atypical antipsychotic use specific to immigrant children with ADHD, even though this review found that many children with ADHD still receive atypical antipsychotics. Atypical antipsychotic medications are often used to manage psychiatric comorbidity and/or aggressive and impulsive symptoms associated with ADHD. However, there is little evidence regarding the safety and tolerability of atypical antipsychotics to support the use of these medications as a first-line intervention among children diagnosed with ADHD.
Second, differences in first-line stimulant and atypical antipsychotic prescribing practices were examined among newly diagnosed immigrant and non-immigrant children with ADHD, living in British Columbia, Canada. Immigrant children were less likely than non-immigrant children to be dispensed a stimulant medication prescription in the 30-days following an incident diagnosis of ADHD. Among children, being older, male, and receiving treatment from a psychiatrist was associated with being dispensed an atypical antipsychotic prescription as a first-line intervention within 30-days of diagnosis. A latent class analysis (LCA) was conducted to account for sources of variability that may be associated with ADHD treatment. A high proportion of children with ADHD were not dispensed any prescription medications. Non-migrant boys had a 68% increased likelihood of being treated with atypical antipsychotics compared to their migrant counterparts. Together, the studies incorporated in this thesis underline the importance of examining relationships between structural determinants of health, health equity, and ADHD-related prescribing practices.Medicine, Faculty ofPopulation and Public Health (SPPH), School ofGraduat
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