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Conestoga, Canada

Heckman G.A.,University of Waterloo | Boscart V.M.,Conestoga College | Mckelvie R.S.,Hamilton Health Sciences
Future Cardiology | Year: 2014

Heart failure, a condition that affects up to 20% of older persons residing in long-term care facilities, is an important cause of morbidity, health service utilization and death. Effective and interprofessional heart failure care processes could potentially improve care, outcomes and quality of life and delay decline or hospital admission. This article reviews the clinical aspects of heart failure, and the challenges to the diagnosis and management of this condition in long-term care residents who are frail and are affected by multiple comorbidities. © 2014 Future Medicine Ltd.

St-Maurice J.,University of Victoria | St-Maurice J.,Conestoga College | Kuo M.H.,University of Victoria
Studies in Health Technology and Informatics | Year: 2012

Primary care data represents the complete biopsychosocial profile of the patient and has recently become available for secondary analysis in Ontario. This study involved extracting de-identified primary care data and analyzing it with natural language processing to extract UMLS codes. These codes were used to statistically relate inappropriate emergency room use to biopsychosocial concepts with logistic regression. The concepts of pain and mental health were statistically significant. This technique demonstrates a creative use of primary care data. It could be used to analyze system use in other health care settings. © 2012 European Federation for Medical Informatics and IOS Press. All rights reserved.

Dickinson J.K.,National Research Council Canada | Woodard P.,National Research Council Canada | Canas R.,National Research Council Canada | Ahamed S.,National Research Council Canada | Lockston D.,Conestoga College
Electronic Journal of Information Technology in Construction | Year: 2011

In collaboration with a college teaching construction trades, the authors engaged in developing and deploying a serious game focussed on teaching trench health and safety lessons as an initial investigation into applying edutainment in the construction trades. This paper reviews the background of using interactive technology in construction trades training and presents the observations taken from the developers, teachers and students involved and subsequent conclusions drawn based on these observations. The broad lessons learnt indicate that serious games offer an engaging and innovative medium for delivering training to students who are more comfortable with hands-on learning for a hands-on trade. Although studies are still underway in assessing the long term benefits in retention, the students and teachers involved found the use of gaming technology to be an overall positive experience with some immediately demonstrable benefits. Furthermore, the potential for adopting serious games in educational programs will only grow as interactive computer technology only becomes more and more ubiquitous in society. This said, challenges remain in measuring the long term impact, and costs associated with developing and delivering the interactive content to the students and subsequently finding ways to reduce those costs and maximise the positive benefits attained using such technology. © 2011 The authors.

Seifer D.B.,Oregon Health And Science University | Tal O.,Conestoga College | Wantman E.,Redshift Technologies | Edul P.,Redshift Technologies | Baker V.L.,Stanford University
Fertility and Sterility | Year: 2015

Objective: To assess cycle outcomes when antimüllerian hormone (AMH) is ultralow (≤0.16 ng/mL) and to determine which parameters contribute to the probability of cycle cancellation and/or outcome. Design: Retrospective analysis. Setting: Not applicable. Patient(s): 5,087 (7.3%) fresh and 243 (1.5%) thawed cycles with ultralow AMH values. Intervention(s): Linear and logistic regression, comparison with age-matched cycles with normal AMH concentrations. Main Outcome Measure(s): Cancellation rate; number of retrieved oocytes, embryos, transferred embryos, and cryopreserved embryos; clinical pregnancy, live-birth, and multiple birth rates. Result(s): The total cancellation rate per cycle start for fresh cycles was 54%. Of these, 38.6% of the cycles were canceled before retrieval, and 3.3% of cycles obtained no oocytes at time of retrieval. Of all retrieval attempts, 50.7% had three oocytes or fewer retrieved, and 25.1% had no embryo transfer. The live-birth rates were 9.5% per cycle start. Cycles with ultralow AMH levels compared with age-matched normal AMH cycles demonstrated more than a fivefold greater pre-retrieval cancellation rate, a twofold less live-birth rate per cycle and a 4.5-fold less embryo cryopreservation rate. Conclusion(s): Refusing treatment solely on the basis of ultralow AMH levels is not advisable, but patients should be counseled appropriately about the prognostic factors for cancellation and outcomes. © 2015 American Society for Reproductive Medicine.

Tal R.,Yale University | Tal O.,Conestoga College | Seifer B.J.,Yale University | Seifer D.B.,Oregon Health And Science University
Fertility and Sterility | Year: 2015

Objective: To assess whether antimüllerian hormone (AMH) is a predictor of implantation and/or clinical pregnancy in women undergoing assisted reproductive technology. Design: Systematic review and meta-analysis. Setting: Not applicable. Patient(s): Women undergoing IVF/intracytoplasmic sperm injection in nondonor cycles. Intervention(s): Measurement of serum AMH level. Main Outcome Measure(s): Diagnostic odds ratio (OR) and summary receiver operating characteristic curve (AUC) for AMH as a predictor of implantation and/or clinical pregnancy. Result(s): A total of 525 observational studies were identified, of which 19 were selected (comprising 5,373 women). Studies reporting clinical pregnancy rates in women with unspecified ovarian reserve (n = 11), diminished ovarian reserve (DOR) (n = 4), and polycystic ovary syndrome (n = 4) were included, together with studies reporting implantation rates (n = 4). The OR for AMH as a predictor of implantation in women with unspecified ovarian reserve (n = 1,591) was 1.83 (95% confidence interval [CI] 1.49-2.25), whereas the AUC was 0.591 (95% CI 0.563-0.618). The OR for AMH as a predictor of clinical pregnancy in these women (n = 4,324) was 2.10 (95% CI 1.82-2.41), whereas the AUC was 0.634 (95% CI 0.618-0.650). The predictive ability of AMH for pregnancy was greatest in women with DOR (n = 615), with OR and AUC of 3.96 (95% CI 2.57-6.10) and 0.696 (95% CI 0.641-0.751), respectively. In contrast, AMH had no significant predictive ability in women with PCOS (n = 414), with OR and AUC of 1.18 (95% CI 0.53-2.62) and 0.600 (95% CI 0.547-0.653), respectively. Conclusion(s): Antimüllerian hormone has weak association with implantation and clinical pregnancy rates in assisted reproductive technology but may still have some clinical utility in counseling women undergoing fertility treatment regarding pregnancy rates, particularly those with DOR. © 2015 by American Society for Reproductive Medicine.

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