A5032010271- Radiation Dose and Imaging
- Emergency and Acute Care Studies
- Health Systems, Economic Evaluations, Quality of Life
- Cardiac Imaging and Diagnostics
- Healthcare cost, quality, practices
- Clinical Reasoning and Diagnostic Skills
- Innovations in Medical Education
- Advanced X-ray and CT Imaging
- Ultrasound in Clinical Applications
- Trauma and Emergency Care Studies
- Healthcare Policy and Management
- Meta-analysis and systematic reviews
- Disaster Response and Management
- Health Sciences Research and Education
- Primary Care and Health Outcomes
- Clinical practice guidelines implementation
- Acute Myocardial Infarction Research
- Radiology practices and education
- Venous Thromboembolism Diagnosis and Management
- Healthcare professionals’ stress and burnout
- Global Health Workforce Issues
- Cardiac, Anesthesia and Surgical Outcomes
- Traumatic Brain Injury and Neurovascular Disturbances
- Patient-Provider Communication in Healthcare
- Ethics in medical practice
Public Health Ontario
2020-2024
University of Toronto
2017-2024
University of Johannesburg
2017-2024
McMaster University
2014-2024
Queen's University
2017-2024
Ottawa Hospital
2023-2024
University of Ottawa
2014-2024
Hamilton Health Sciences
2009-2024
Ottawa University
2021-2024
Hamilton General Hospital
2016-2024
AimsTo characterize patient radiation doses from nuclear myocardial perfusion imaging (MPI) and the use of radiation-optimizing ‘best practices’ worldwide, to evaluate relationship between laboratory best practices dose.
Combination therapy is recommended for the treatment of KPC-producing Klebsiella pneumoniae (KPC-Kp), but optimal regimen colistin-resistant strains unknown. We compared synergistic activity and post-antibiotic effect (PAE) colistin in combination with other antimicrobials against colistin-susceptible -resistant KPC-Kp bloodstream isolates. The genotypes nine eight isolates were analysed using PCR amplicon sequencing. Combinations colistin, meropenem, tigecycline, rifampicin teicoplanin then...
The aim of this study was to report burnout time trends and describe the psychological effects working as a Canadian emergency physician during first weeks coronavirus disease 2019 (COVID-19) pandemic.This mixed-methods study. Emergency physicians completed weekly online survey. primary outcome measured by emotional exhaustion depersonalization items, from Maslach Burnout Inventory. We captured data on work patterns, aerosolizing procedures, testing diagnosis COVID-19. Each week participants...
<p>Problem: As patient volumes increase, it is becoming increasingly important to find novel ways teach junior medical learners about the intricacies of managing multiple patients simultaneously and working in a resource-limited environment.</p> <p>Approach: Serious games (i.e., not intended purely for fun) are teaching modality that have been gaining momentum as tools education. From May 2016 August 2017, authors designed tested serious game, called GridlockED, provide...
Purpose This study examines the influence of patient social context on physicians' adherence to clinical practice guidelines (CPGs). Method Expert emergency medicine (EM) physicians and novice (EM residents) were surveyed using an Internet-based program between January July 2013. Participants presented cases asked indicate if they would order or prescribe a specified test treatment. Cases chosen from four domains where CPGs exist, constructed include exclude "context variable" (CV). Both...
The evidence based medicine movement has championed the need for objective and transparent methods of clinical guideline development. Grades Recommendation, Assessment, Development, Evaluation (GRADE) framework was developed that purpose. Central to this is criteria assessing quality from studies impact body should have on our confidence in effectiveness a therapy under examination. been adopted by number professional medical societies organizations as means orienting development guidelines....
The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) framework has undergone several modifications since it was first presented as a method for developing clinical practice recommendations. In the previous two articles this series, we showed that absent, in three versions GRADE, is justification (theoretical and/or empirical) why criteria determining quality evidence components strength recommendation were included (and others not included) framework. Furthermore,...
<h3>Background:</h3> Ground-level falls are common among older adults and the most frequent cause of traumatic intracranial bleeding. The aim this study was to derive a clinical decision rule that safely excludes clinically important bleeding in who present emergency department after fall, without need for computed tomography (CT) scan head. <h3>Methods:</h3> This prospective cohort 11 departments Canada United States enrolled patients aged 65 years or presented falling from standing on...
As patient volumes increase, it is becoming increasingly important to find novel ways teach junior medical learners about the intricacies of managing multiple patients simultaneously and working in a resource-limited environment.Serious games (i.e., not intended purely for fun) are teaching modality that have been gaining momentum as tools education. From May 2016 August 2017, authors designed tested serious game, called GridlockED, provide focused educational experience trainees learn...
Peter Drucker pointed out an important distinction between 'doing things right' and the right thing', which recognised that all problems are embedded in a context thus can only be understood within their unique contextual setting. Contemporary research practices clinical medicine often regards factors as potential confounders will bias effect estimates must avoided. However rigorous, devoid of ultimately deprives users understanding support make transferable to policy decisions or managing...
This study estimates current rates of stress-only imaging in cardiology patients the United States and worldwide, as well potential effect changes this rate on radiation burden to US population.
Implementing evidence-based practice guidelines is challenging. We used a multifaceted, continuous educational approach to disseminate an up-to-date internal guideline adapted from published for management of intra-abdominal infections (IAI).The intervention consisted continuing sessions, pocket cards and posters with collaboration among all key stakeholders starting in December 2010. emphasized risk stratification the use ceftriaxone/metronidazole treatment low-risk IAI, discouraged...
ABSTRACT Background Competency-based medical education requires frequent assessment to tailor learning experiences the needs of trainees. In 2012, we implemented McMaster Modular Assessment Program, which captures shift-based assessments resident global performance. Objective We described patterns (ie, trends and sources variance) in aggregated workplace-based data. Methods Emergency medicine residents faculty members from 3 Canadian university-affiliated, urban, tertiary care teaching...
Purpose Physicians are often asked to integrate clinical decision rules (CDRs) with their own cognitive processes reach a diagnosis. Clinicians, researchers, and educators must understand these evaluate improve the diagnostic process. The authors sought explore emergency physicians’ examine how they integrated CDRs into reasoning using simulated cases (with chest pain or leg pain). Method From August 2015 July 2016, 16 practicing physicians from 3 teaching hospitals associated McMaster...
Nuclear cardiology is widely used to diagnose coronary artery disease and guide patient management, but data on current practices, radiation dose-related best doses are scarce. To address these issues, the IAEA conducted a worldwide study of nuclear practice. We present European subanalysis. In March 2013, invited laboratories across world document all SPECT PET studies performed in one week. The included age, gender, weight, radiopharmaceuticals, injected activities, camera type,...
OBJECTIVES Emergency department (ED) visits among older adults are frequently instigated by a fall at home. Some of these patients develop intracranial bleeding. The aim this study was to identify the incidence bleeding and associated clinical features in who present ED after falling. DESIGN Prospective cohort study. SETTING Three Canadian EDs. PARTICIPANTS A total 2 176 age 65 years or presented with were assessed, 1753 included. Inclusion criteria on level ground, off bed, chair, toilet,...
<h3>Importance</h3> Although the heart team approach is recommended in revascularization guidelines, frequency with which decisions differ from those of original treating interventional cardiologist unknown. <h3>Objective</h3> To examine difference between and for treatment patients multivessel coronary artery disease. <h3>Design, Setting, Participants</h3> In this cross-sectional study, 245 consecutive disease were recruited 1 high-volume tertiary care referral center (185 enrolled through...
<h3>BACKGROUND:</h3> Evidence-based guidelines advise excluding pulmonary embolism (PE) diagnosis using d-dimer in patients with a lower probability of PE. Emergency physicians frequently order computed tomography (CT) angiography without testing or when is negative, which exposes to more risk than benefit. Our objective was develop conceptual framework explaining emergency physicians’ test choices for <h3>METHODS:</h3> We conducted qualitative study in-depth interviews Canada. A nonmedical...
Whilst policymaking will always remain a highly political process, especially amidst crises, evidence-based pandemic management can benefit from adopting socioecological perspective that integrates multi- and trans-disciplinary insights: biology, biomedicine, mathematics, statistics, social behavioural sciences, as well the perspectives experiences of non-scientific stakeholders. We make case for an "integrated inter- transdisciplinarity" overcomes typical additive nature current...