A5002809439- Chronic Obstructive Pulmonary Disease (COPD) Research
- Asthma and respiratory diseases
- Chronic Disease Management Strategies
- Respiratory and Cough-Related Research
- Respiratory Support and Mechanisms
- Health Policy Implementation Science
- Atomic and Subatomic Physics Research
- Mobile Health and mHealth Applications
- COVID-19 and healthcare impacts
- Nursing Diagnosis and Documentation
- Climate Change and Health Impacts
- Primary Care and Health Outcomes
- Digital Mental Health Interventions
- Air Quality and Health Impacts
- Health Literacy and Information Accessibility
- Inhalation and Respiratory Drug Delivery
- Interprofessional Education and Collaboration
- Health Systems, Economic Evaluations, Quality of Life
- School Health and Nursing Education
- Delphi Technique in Research
- Eosinophilic Esophagitis
- Advanced NMR Techniques and Applications
- Mental Health and Patient Involvement
- Congenital Diaphragmatic Hernia Studies
- COVID-19 Impact on Reproduction
Western University
2015-2024
London Health Sciences Centre
2019-2024
St. Michael's Hospital
2024
University of British Columbia
2024
University of Ottawa
2024
McGill University
2024
University of Calgary
2024
University of Toronto
2024
University of Saskatchewan
2024
Université Laval
2024
Many persons with chronic obstructive pulmonary disease (COPD) or asthma have not received a diagnosis, so their respiratory symptoms remain largely untreated.
Individuals with asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS), have more rapid decline in lung function, frequent exacerbations, and poorer quality of life than those asthma or COPD alone. Air pollution exposure is a known risk factor for COPD; however, its role ACOS not as well understood.To determine if individuals exposed to higher levels air an increased ACOS.Individuals who resided Ontario, Canada, aged 18 years older 1996 incident between 2009...
BackgroundWe previously showed in patients with poorly controlled eosinophilic asthma that a single dose of benralizumab resulted significantly improved Asthma Control Questionnaire (ACQ-6) score and 129Xe MRI ventilation defect percent (VDP) 28 days postinjection, VDP CT airway mucus occlusions were shown to independently predict this early ACQ-6 response benralizumab.Research QuestionDo responses at persist, do FEV1, fractional exhaled nitric oxide, plug improve during 2.5 year treatment...
Exposure to air pollution has been linked the exacerbation of respiratory diseases. The Air Quality Health Index (AQHI), developed in Canada, is a new health risk scale for reporting quality and advising reduction actions.
BACKGROUND: Collaborative self‐management is a core recommendation of national asthma guidelines; the written action plan knowledge tool that supports this objective. Mobile health technologies have potential to enhance effectiveness as translation tool. OBJECTIVE: To design, develop and pilot mobile system support self‐management. METHODS: The present study was prospective, single‐centre, nonrandomized, preintervention‐postintervention analysis. System design development were guided by an...
Background: Uncontrolled asthma poses substantial negative personal and health system impacts. Web-based technologies, including smartphones, are novel means to enable evidence-based care improve patient outcomes. Objective: The aim of this study was design, develop, assess the utilization an collaborative self-management (CSM) platform (breathe) using content based on international clinical guidelines. Methods: We designed developed breathe as a mobile (mHealth) accessible tablets, or...
Rationale: In patients with asthma, X-ray computed tomography (CT) has provided evidence of thickened airway walls and occlusions, but the total number CT-visible airways its relationship disease severity is unknown.Objectives: To measure CT count (TAC) in asthma evaluate relationships severity, morphology, pulmonary function, magnetic resonance imaging (MRI) ventilation.Methods: Participants underwent post-bronchodilator inspiratory CT, prebronchodilator spirometry hyperpolarized 3He MRI....
Rationale: A significant proportion of individuals with chronic obstructive pulmonary disease (COPD) and asthma remain undiagnosed. Objectives: The objective this study was to evaluate symptoms, quality life, healthcare use, work productivity in subjects undiagnosed COPD or compared those previously diagnosed, as well healthy control subjects. Methods: This multicenter population-based case-finding randomly recruited adults respiratory symptoms who had no previous history diagnosed lung from...
Individuals with asthma are more likely to die from chronic conditions than the general population. Measuring only mortality listed as primary cause of death may lead an underestimation total mortality.To examine patterns in population over 10 years, including (asthma-specific mortality) and a secondary, contributing (asthma-contributing mortality).Health administrative data Ontario, Canada were used identify rates subjects 0 99 years age. Mortality calculated 1999 2008. Total was estimated...
Abstract Patients with chronic obstructive pulmonary disease (COPD) have a reduced quality of life (QoL) and exacerbations that drive health service utilization (HSU). A majority patients COPD are managed in primary care. Our objective was to evaluate an integrated management, self-management, structured follow-up intervention (IDM) for high-risk This one-year multi-center randomized controlled trial. High-risk, exacerbation-prone were IDM provided by certified respiratory educator...
Background ∼5–10% of adults may have undiagnosed airflow obstruction. The objective this study was to develop a population-based case-finding strategy assess the prevalence obstruction (asthma or COPD) amongst with respiratory symptoms in Canada. Methods Adults without previous history asthma, COPD lung disease were recruited using random digit-dialling and asked if they had dyspnoea, cough, sputum wheeze within past 6 months. Those who answered affirmatively completed Asthma Screening...
Severe exacerbation of chronic obstructive pulmonary disease (COPD) is a trajectory-changing life event for patients and major contributor to health system costs. This study evaluates the real-world impact primary care, integrated management (IDM) programme on acute service utilisation (HSU) in Canadian system.
There is lack of clarity on whether pregnancies during COVID-19 resulted in poorer mode delivery and birth outcomes Ontario, Canada. We aimed to compare (C-section), (low birthweight, preterm birth, NICU admission), health services use (HSU, hospitalizations, ED visits, physician visits) pregnant Ontario women before (pandemic periods). further stratified for pre-existing chronic diseases (asthma, eczema, allergic rhinitis, diabetes, hypertension). Deliveries (Jun 2018–Feb 2020) (Jul...
Objectives The objective of this study was to use health administrative and environmental data quantify the effects ambient air pollution on service among those with chronic diseases. We hypothesised that would be higher more exposure as measured by Air Quality Health Index (AQHI). Setting used at primary (physician office visits) secondary (emergency department visits, hospitalisations) level care in Ontario, Canada. Participants included individuals who resided Canada, from 2003 2010, were...
Quality problem International guidelines establish evidence-based standards for asthma care; however, recommendations are often not implemented and many patients do meet control targets. Initial assessment Regional pilot data demonstrated a knowledge-to-practice gap. Choice of solutions We engineered health system change in multi-step approach described by the Canadian Institutes Health Research knowledge translation framework. Implementation Knowledge occurred at multiple levels: patient,...
BACKGROUND: Primary care office spirometry can improve access to testing and concordance between clinical practice asthma guidelines. Compliance with test quality standards is essential implementation. OBJECTIVE: To evaluate the of performed onsite in a regional primary program (RAP) by health professionals limited training. METHODS: Asthma educators were trained perform during two 2 h workshops supervised up six patient encounters. Quality was analyzed using American Thoracic Society (ATS)...
Background Many people with asthma and COPD remain undiagnosed. We developed validated a new case-finding questionnaire to identify symptomatic adults undiagnosed obstructive lung disease. Methods Adults in the community no prior history of physician-diagnosed disease who self-reported respiratory symptoms were contacted via random-digit dialling. Pre- post-bronchodilator spirometry was used confirm or COPD. Predictive questions selected using multinomial logistic regression backward...
Background Longitudinal progression to irreversible airflow limitation occurs in approximately 10% of patients with asthma, but it is difficult identify who are at risk for this transition. Purpose To investigate 6-year longitudinal changes hyperpolarized helium 3 (3He) MRI ventilation defects study participants mild-to-moderate asthma and predictors postbronchodilator forced expiratory volume 1 second (FEV1) reversibility Materials Methods Spirometry 3He were evaluated two prospectively...
Women with asthma are at a high risk of developing chronic obstructive pulmonary disease (COPD) or and COPD overlap syndrome (ACOS) as they age, which is condition associated mortality rate, low quality life, healthcare costs. However, factors influencing the development ACOS remain unclear.To quantify in women Ontario identify that increased risk.Data for who participated Canadian National Breast Screening Study from 1980 to 1985 were linked health administrative databases, participants...
This position statement aims to provide rapid guidance for Canadian physicians treating patients with asthma during the COVID-19 pandemic. The recommendations are informed by a very limited body of...
In Canada, there is widespread agreement about the need for integrated models of team-based care. However, less on how to support scale-up and spread successful models, limited empirical evidence this process in chronic disease management. We studied supporting mitigating factors required successfully implement an model care primary care.We conducted a collective case study using multiple methods data collection including interviews, document analysis, living documents, focus group. Our...