A5052674144- Intensive Care Unit Cognitive Disorders
- Palliative Care and End-of-Life Issues
- Family and Patient Care in Intensive Care Units
- Respiratory Support and Mechanisms
- Ethics in medical practice
- Healthcare Decision-Making and Restraints
- Cystic Fibrosis Research Advances
- Cardiac Arrest and Resuscitation
- Health Systems, Economic Evaluations, Quality of Life
- Ethics in Clinical Research
- Frailty in Older Adults
- Viral Infections and Outbreaks Research
- Pneumonia and Respiratory Infections
- Alcoholism and Thiamine Deficiency
- Influenza Virus Research Studies
- Insect symbiosis and bacterial influences
- Evolution and Genetic Dynamics
- Nosocomial Infections in ICU
- Sinusitis and nasal conditions
- Patient-Provider Communication in Healthcare
- Inhalation and Respiratory Drug Delivery
- Nutrition and Health in Aging
- Neonatal Respiratory Health Research
- Disaster Response and Management
- Freshwater macroinvertebrate diversity and ecology
St. Michael's Hospital
2013-2024
Unity Health Toronto
2023
University of Toronto
2009-2019
<h3>Importance</h3> Although most critically ill patients receive invasive mechanical ventilation (IMV), few studies have characterized how IMV is discontinued in practice. <h3>Objective</h3> To describe practice variation discontinuation internationally, associations between initial events and outcomes, factors associated with the use of select strategies failed spontaneous breathing trials (SBTs). <h3>Design, Setting, Participants</h3> Prospective, multinational, observational study adults...
Although women at all career stages are more likely to leave academia than men, early-career a particularly high-risk group. Research supports that less men receive research funding; however, whether funding success rates vary based on content is unknown. We addressed gender differences in for applications directed one or of 13 institutes, representing communities, over 15-year period.We retrospectively reviewed 55,700 grant and 4,087 personnel award submitted the Canadian Institutes Health...
Rationale: Randomized trials and meta-analyses have informed several aspects of weaning. Results are rarely replicated in practice, as evidence is applied intensive care units that differ from the settings which it was generated.Objectives: We aimed to: 1) describe weaning practice variation (identifying candidates, conducting spontaneous breathing trials, using ventilator modes, other during weaning); 2) characterize regional differences practices; 3) identify factors associated with...
Stakeholder engagement in research is expected to provide unique insights, make investments more accountable and transparent, ensure that future applicable patients family members.To inform the design of a trial strategies for weaning from mechanical ventilation, we sought identify preferences patient visitors regarding outcome treatment measures.We conducted an interviewer-administered questionnaire critically ill two waiting rooms serving three intensive care units (ICUs) Toronto, Canada....
It is unknown whether more frequent screening of invasively ventilated patients, identifies patients earlier for a spontaneous breathing trial, and shortens the duration ventilation. We assessed feasibility conducting large trial to evaluate frequency in critically ill adults North American context.We conducted two contemporaneous, multicenter, pilot, randomized controlled trials (the LibeRation from MEchanicaL VEntilAtion ScrEening Frequency [RELEASE] Screening Elderly PatieNts For...
Little information exists to identify barriers participation in pandemic research involving critically ill patients. We sought characterize clinical activity during the recent influenza A and understand experiences, beliefs, practices of key stakeholders involved implementation.Cross-sectional, provincial postal questionnaire.Level III ICUs.ICU administrators coordinators.We used rigorous survey methodology potential respondents develop, test, administer two-related questionnaires.We...
Engagement promotes and supports the active participation of patients families in health care research to strengthen their influence on decision-making. We sought characterize how citizens wish be engaged intensive unit (ICU).Interviewers administered questionnaires visitors 3 adult ICUs 1 pediatric ICU.We surveyed 202 (adult [n = 130] 72]) visitors. Adults prioritized patient topics (family involvement rounds, improving communication between family members health-care providers, information...
Abstract Rationale In critically ill patients receiving invasive mechanical ventilation (MV), research supports the use of daily screening to identify who are ready undergo a spontaneous breathing trial (SBT) followed by conduct an SBT. However, once (OD) is poorly aligned with continuous care provided in most intensive units (ICUs) and best SBT technique for clinicians remains controversial. Objectives To optimal frequency wean adults ICU. Methods We aim multicenter, factorial design...
Objective To examine the effects of extent endoscopic sinus surgery (ESS) on pulmonary health, including exacerbations and lung function in patients with cystic fibrosis (CF). Study Design Retrospective cohort study. Setting Tertiary health care center. Subjects Methods A retrospective review CF who underwent ESS at St. Michael’s Hospital between 1999 2016 was performed. Two groups were identified based surgical extent: (1) complete (maxillary antrostomy, ethmoidectomy, sphenoidotomy,...
Introduction Research supports the use of specific strategies to discontinue mechanical ventilation (MV) in critically ill patients. Little is known about how clinicians actually wean and MV practice or association between different discontinuation outcomes. The primary objective this study describe international practices (1) daily screening for readiness MV, (2) modes used before initial attempts, (3) weaning spontaneous breathing trial (SBT) protocols, (4) SBT techniques (5) sedation...
Background: Most critically ill patients are unable to comprehend or communicate and Substitute Decision Makers (SDMs) typically provide proxy consent for research. Ontario legislation requires individuals within the ‘circle of care’ introduce research personnel SDMs with some Research Ethics Boards (REBs) mandating physician involvement. We aim conduct mixed methods, pilot Randomized Controlled Trial (RCT) comparing two strategies introducing a fully nested qualitative study evaluating...
Benzodiazepines are considered first-line treatment for patients experiencing severe acute alcohol withdrawal syndrome (sAAWS). Although several medications have been evaluated as potential adjuvant treatments sAAWS, barbiturates show particular promise. In the PHENOMANAL trial, we will assess feasibility of conducting an allocation-concealed, quadruple-blinded, randomized controlled trial (RCT) comparing symptom-triggered benzodiazepine therapy with either a single dose intravenous (IV)...
Abstract Eleven polymorphic microsatellite loci were isolated and developed from the black fly, Simulium negativum , a member of arcticum sibling species complex. The observed heterozygosity 11 ranged 0.03 to 0.83. number alleles per locus 8 19. Significant linkage disequilibria encountered only for primer pairs BF7‐1 with BF7‐5 BF6‐32 BF7‐16. Presumably, these can be used study genetic structure within entire S.
Rationale: Research supports the use of screening protocols to identify patients who are candidates for weaning from mechanical ventilation, and spontaneous breathing trials (SBTs) predict ability breathe spontaneously. However, once daily is poorly aligned with 24-hour continuous care in intensive unit (ICU) environment most effective SBT technique not known. The optimal strategy liberate our sickest ventilators remains be determined. Objectives: To assess recruit critically ill adults...
Abstract Purpose: To characterize differences in directives to limit treatments and discontinue invasive mechanical ventilation (IMV) elderly (65 - 80 years) very (> intensive care unit (ICU) patients. Measurements: We prospectively described new orders treatments, IMV discontinuation strategies [direct extubation, direct tracheostomy, spontaneous breathing trial (SBT), NIV use], associations between initial failed SBT outcomes 142 ICUs from 6 regions (Canada, India, United Kingdom,...