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Dojeiji L.,A+ Network | Taylor A.,A+ Network | Boland C.,Winchester District Memorial Hospital | Brennan C.,Queensway Carleton Hospital | Penney R.,Renfrew Victoria Hospital
Healthcare Management Forum | Year: 2017

Hospital leaders in Eastern Ontario, Canada, have acknowledged the critical role of food to health and the need for progressive change that goes beyond personal responsibility paradigms. The Healthy Foods in Champlain Hospitals program aims to create supportive, healthy nutrition environments in hospital retail food settings. Twenty independent hospital corporations have collectively initiated a plan to transition cafeteria, vending, franchise, and volunteer operations towards healthier offerings. Hospitals are actively implementing a set of progressively phased, evidence-based nutrition criteria, which cover food and beverage categories, preparation methods, product placement, and provision of nutrition information. Implementation strategies and successes, as well as challenges and limitations, are discussed. © 2017 The Canadian College of Health Leaders.


Nagaraju S.P.,Kasturba Medical College | Cohn A.,Queensway Carleton Hospital | Akbari A.,Ottawa Hospital Research Institute | Zimmerman D.L.,Ottawa Hospital Research Institute
BMC Nephrology | Year: 2013

Background: Anemia secondary to iron deficiency is common in patients with non-dialysis dependent chronic kidney disease (ND-CKD) but it is unclear if oral supplementation is as effective as intravenous (IV) supplementation in re-establishing iron stores. The purpose of this study was to determine if oral Heme Iron Polypeptide (HIP) is as effective as IV iron sucrose in the treatment of iron-deficiency anemia for patients with ND-CKD. Methods. Forty ND-CKD patients were randomized; 18 to HIP 11 mg orally 3 times per day and 22 to IV iron sucrose 200 mg monthly for 6 months. Baseline clinical and laboratory data were collected for all patients. The primary and secondary outcomes for the study were hemoglobin (Hgb) concentration and iron indices [ferritin and percentage transferrin saturation (TSAT)] at the end of 6 months respectively. Adverse events were also compared. Results: The baseline demographic characteristics and laboratory values were similar for the two groups. After 6 months of treatment, Hb in the HIP group was 117 g/L and 113 g/L in the IV sucrose group (p = 0.37). The TSAT at 6 months was not different between the two groups {p = 0.82}but the serum ferritin was significantly higher in the IV iron sucrose group {85.5 ug/L in HIP and 244 ug/L; p = 0.004}. Overall adverse events were not different between the groups. Conclusion: HIP is similar in efficacy to IV iron sucrose in maintaining hemoglobin in ND-CKD patients with no differences in adverse events over 6 months. It is unclear if the greater ferritin values in the IV iron sucrose group are clinically significant. Trial registration. ClinicalTrials.gov: NCT00318812. © 2013 Nagaraju et al.; licensee BioMed Central Ltd.


Fargo J.H.,U.S. National Cancer Institute | Fargo J.H.,Center for Cancer and Blood Disorders | Rochowski A.,Queensway Carleton Hospital | Giri N.,U.S. National Cancer Institute | And 3 more authors.
Cytogenetic and Genome Research | Year: 2014

Fanconi anemia (FA) is a rare inherited bone marrow failure syndrome (IBMFS). Affected individuals must be distinguished from relatives, patients with mosaicism must be identified, and patients with other IBMFS classified as non-FA. The diagnostic feature of FA is increased chromosomal breakage in blood lymphocytes cultured with diepoxybutane or mitomycin C. Here, we sought a method to uniquely identify patients with FA with mosaicism, using cells from participants in the National Cancer Institute IBMFS cohort. Lymphocytes were treated with diepoxybutane or mitomycin C, and metaphases scored for breaks and radials. Analyses included the percentage of cells with any aberration, breaks per cell, and breaks per aberrant cell. There were 26 patients with FA (4 mosaics), 46 FA relatives, and 62 patients with a non-FA IBMFS. By all analytic methods, patients with FA were abnormal compared with other groups. Those with FA mosaicism had more breakage than relatives or patients with non-FA IBMFS, but there was some individual overlap. The choices of clastogen are laboratory-dependent, but there was no method or analysis of lymphocytes that clearly distinguished all individuals mosaic for FA from relatives or patients with other IBMFS. Thus, genotyping remains the best method for providing absolute clarity. © 2014 S. Karger AG, Basel.


Webster A.,Queensway Carleton Hospital | Bowron C.,Queensway Carleton Hospital
Nursing standard (Royal College of Nursing (Great Britain) : 1987) | Year: 2014

University students Alanna Webster and Caitlin Bowron led a study examining the effects of role models in clinical placements. They share their findings.


Calder L.,University of Ottawa | Calder L.,Ottawa Hospital Research Institute | Pozgay A.,University of Ottawa | Riff S.,Queensway Carleton Hospital | And 5 more authors.
BMJ Quality and Safety | Year: 2015

Objectives: This study describes the proportion of emergency department (ED) returns within 7 days due to adverse events, defined as adverse outcomes related to healthcare received. Design: Prospective cohort study. Setting: We used an electronically triggered adverse event surveillance system at a tertiary care ED from May to June 2010 to examine ED returns within 7 days of index visit. Participants: One of three trained nurses determined whether the visit was related to index emergency care. For such records, one of three trained emergency physicians conducted adverse event determinations. Main outcome measure: We determined adverse event type and severity and analysed the data with descriptive statistics, χ2 tests and logistic regression. Results: Of 13 495 index ED visits, 923 (6.8%) were followed by ED returns within 7 days. The median age of all patients was 47 years and 52.8% were women. After nursing review, 211 cases required physician review. Of these, 53 visits were adverse events ( positive predictive value (PPV)=5.7%, 95% CI 4.4% to 7.4%) and 30 (56.6%) were preventable. Common adverse event types involved management, diagnostic or medication issues. We observed one potentially preventable death and 58.5% of adverse events resulting in transient disability. The PPV of a modified trigger with a cut-off of return within 72 h, resulting in admission was 11.9% (95% CI 6.8% to 18.9%). Conclusions: Our electronic trigger efficiently identified adverse events among 12% of patients with ED returns within 72 h, requiring hospital admission. Given the high degree of preventability of the identified adverse events, this trigger also holds promise as a performance measurement tool. © 2015, BMJ Publishing Group. All rights reserved.


Beiko D.,Queen's University | Pierre S.A.,Queensway Carleton Hospital | Leonard M.P.,University of Ottawa
Journal of Pediatric Urology | Year: 2011

Urethral hair and diverticula are well described long-term complications following urethroplasty or hypospadias repair. Endoscopic laser ablation is an uncommonly reported treatment option for a symptomatic hair-bearing urethra, and holmium laser hair epilation has not been previously reported in the literature. We report the first case of urethroscopic holmium laser ablation of urethral diverticular hair follicles and the outcome. © 2010 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.


Townshend D.,North Tyneside General Hospital | Di Silvestro M.,Queensway Carleton Hospital | Krause F.,University of Bern | Penner M.,University of British Columbia | And 3 more authors.
Journal of Bone and Joint Surgery - Series A | Year: 2013

Background: Ankle arthrodesis results in measurable improvements in terms of pain and function in patients with endstage ankle arthritis. Arthroscopic ankle arthrodesis has gained increasing popularity, with reports of shorter hospital stays, shorter time to solid fusion, and equivalent union rates when compared with open arthrodesis. However, there remains a lack of high-quality prospective data. Methods: We evaluated the results of open and arthroscopic ankle arthrodesis in a comparative case series of patients who were managed at two institutions and followed for two years. The primary outcome was the Ankle Osteoarthritis Scale score, and secondary outcomes included the Short Form-36 physical and mental component scores, the length of hospital stay, and radiographic alignment. There were thirty patients in each group. Results: Both groups showed significant improvement in the Ankle Osteoarthritis Scale score and the Short Form-36 physical component score at one and two years. There was significantly greater improvement in the Ankle Osteoarthritis Scale score at one year and two years and shorter hospital stay in the arthroscopic arthrodesis group. Complications, surgical time, and radiographic alignment were similar between the two groups. Conclusions: Open and arthroscopic ankle arthrodesis were associated with significant improvement in terms of pain and function as measured with the Ankle Osteoarthritis Scale score. Arthroscopic arthrodesis resulted in a shorter hospital stay and showed better outcomes at one and two years. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2013 by The Journal of Bone and Joint Surgery, Incorporated.


PubMed | Queensway Carleton Hospital and Queen's University
Type: Journal Article | Journal: Canadian Urological Association journal = Journal de l'Association des urologues du Canada | Year: 2014

Isolated anterior urethral metastases from prostate cancer are rare. The pathogenesis of this form of loco-regional recurrence may be related to spread by instrumentation-induced implantation and could potentially then be associated with a better prognosis than metastatic disease secondary to a more malignant phenotype. We report a case of a 68-year-old man with high-risk prostate cancer, diagnosed at transurethral resection of prostate, who was originally treated with combination external beam radiotherapy and hormonal therapy. He re-presented 4 years after his original diagnosis with recurrent gross hematuria and cystourethroscopic biopsies of anterior urethral polyps revealing isolated recurrent prostatic adenocarcinoma. We present our this case and review the literature.


PubMed | Queensway Carleton Hospital, Ottawa Hospital Research Institute and University of Ottawa
Type: Journal Article | Journal: BMJ quality & safety | Year: 2015

This study describes the proportion of emergency department (ED) returns within 7days due to adverse events, defined as adverse outcomes related to healthcare received.Prospective cohort study.We used an electronically triggered adverse event surveillance system at a tertiary care ED from May to June 2010 to examine ED returns within 7days of index visit.One of three trained nurses determined whether the visit was related to index emergency care. For such records, one of three trained emergency physicians conducted adverse event determinations.We determined adverse event type and severity and analysed the data with descriptive statistics, (2) tests and logistic regression.Of 13,495 index ED visits, 923 (6.8%) were followed by ED returns within 7days. The median age of all patients was 47years and 52.8% were women. After nursing review, 211 cases required physician review. Of these, 53 visits were adverse events (positive predictive value (PPV)=5.7%, 95% CI 4.4% to 7.4%) and 30 (56.6%) were preventable. Common adverse event types involved management, diagnostic or medication issues. We observed one potentially preventable death and 58.5% of adverse events resulting in transient disability. The PPV of a modified trigger with a cut-off of return within 72h, resulting in admission was 11.9% (95% CI 6.8% to 18.9%).Our electronic trigger efficiently identified adverse events among 12% of patients with ED returns within 72h, requiring hospital admission. Given the high degree of preventability of the identified adverse events, this trigger also holds promise as a performance measurement tool.


PubMed | Queensway Carleton Hospital
Type: Journal Article | Journal: Nursing standard (Royal College of Nursing (Great Britain) : 1987) | Year: 2014

University students Alanna Webster and Caitlin Bowron led a study examining the effects of role models in clinical placements. They share their findings.

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