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Winnipeg, Canada

Benson E.E.,Seven Oaks General Hospital | McMillan D.E.,University of Manitoba | Ong B.,University of Manitoba
American Journal of Nursing

Background: Total knee arthroplasty (TKA) is a procedure with associated risks of inadvertent perioperative hypothermia and significant postoperative pain. Hypothermia may affect patients' experience of postoperative pain, although the link is not well understood. Objective: The aim of this prospective, randomized controlled trial was to determine the efficacy of a patient-controlled active warming gown in optimizing patients' perioperative body temperature and in diminishing postoperative pain after TKA. Methods: Thirty patients who would be undergoing TKA received either a standard hospital gown and prewarmed standard cotton blanket (n = 15) or a patient-controlled, forced-air warming gown (n = 15). Results: Although pain scores were not significantly different in the two groups (P = 0.08), patients who received warming gowns had higher temperatures (P < 0.001) in the postanesthesia care unit, used less opioid (P = 0.05) after surgery, and reported more satisfaction (P = 0.004) with their thermal comfort than did patients who received standard blankets. These findings indicate that patient-controlled, forced-air warming gowns can enhance perioperative body temperature and improve patient satisfaction. Patients who use warming gowns may also need less opioid to manage their postoperative pain. Conclusions: Nurses should ensure that effective patient warming methods are employed in all patients, particularly in patients with compromised thermoregulatory systems (such as older adults), and in surgeries considered to be exceptionally painful (such as TKA). Source

Manyanga T.,University of Manitoba | Froese M.,Seven Oaks General Hospital | Zarychanski R.,University of Manitoba | Abou-Setta A.,University of Manitoba | And 3 more authors.
BMC Complementary and Alternative Medicine

Background: The utility of acupuncture in managing osteoarthritis symptoms is uncertain. Trial results are conflicting and previous systematic reviews may have overestimated the benefits of acupuncture.Methods: Two reviewers independently identified randomized controlled trials (up to May 2014) from multiple electronic sources (including PubMed/Medline, EMBASE, and CENTRAL) and reference lists of relevant articles, extracted data and assessed risk of bias (Cochrane's Risk of Bias tool). Pooled data are expressed as mean differences (MD), with 95% confidence intervals (CI) (random-effects model).Results: We included 12 trials (1763 participants) comparing acupuncture to sham acupuncture, no treatment or usual care. We adjudicated most trials to be unclear (64%) or high (9%) risk of bias. Acupuncture use was associated with significant reductions in pain intensity (MD -0.29, 95% CI -0.55 to -0.02, I2 0%, 10 trials, 1699 participants), functional mobility (standardized MD -0.34, 95% CI -0.55 to -0.14, I2 70%, 9 trials, 1543 participants), health-related quality of life (standardized MD -0.36, 95% CI -0.58 to -0.14, I2 50%, 3 trials, 958 participants). Subgroup analysis of pain intensity by intervention duration suggested greater pain intensity reduction with intervention periods greater than 4 weeks (MD -0.38, 95% CI -0.69 to -0.06, I2 0%, 6 trials, 1239 participants).Conclusions: The use of acupuncture is associated with significant reductions in pain intensity, improvement in functional mobility and quality of life. While the differences are not as great as shown by other reviews, current evidence supports the use of acupuncture as an alternative for traditional analgesics in patients with osteoarthritis.Systematic review registration: CRD42013005405. © 2014 Manyanga et al.; licensee BioMed Central Ltd. Source

Rigatto C.,Seven Oaks General Hospital | Sood M.M.,University of Manitoba | Tangri N.,Seven Oaks General Hospital
Current Opinion in Nephrology and Hypertension

Purpose of Review: This review aims to describe the challenges and highlight recent advances in the field of risk prediction for patients with chronic kidney disease (CKD). We first focus on methods of model development and metrics of model performance in general, and then highlight important risk prediction tools for patients with CKD, for prediction of kidney failure and all-cause mortality. Recent Findings: Investigators have used data from patients with CKD stages 1-5 and developed models for predicting the progression to kidney failure and all-cause mortality. Models for kidney failure have included estimated glomerular filtration rate, albuminuria, demographic and laboratory variables, and have achieved excellent discrimination. In contrast, model performance for prediction of all-cause mortality has been relatively modest. No validated models exist for predicting the risk of cardiovascular events in patients with CKD. Summary: Models for predicting kidney failure in patients with CKD are highly accurate and clinically usable. The kidney failure risk equation includes routinely collected laboratory data and can predict the progression of CKD to kidney failure with accuracy. Additional validation of the risk equation and development of new models for all-cause mortality and cardiovascular events in patients with CKD are needed. © 2012 Wolters Kluwer Health | Lippincott Williams and Wilkins. Source

Yi C.,University of Manitoba | Zhao Z.,University of Manitoba | Cai J.,University of Manitoba | Lobato De Faria R.,Seven Oaks General Hospital | Zhang G.,Seven Oaks General Hospital
Computer Networks

In this paper, a radio resource allocation scheme for wireless body area networks (WBANs) is proposed. Unlike existing works in the literature, we focus on the communications in beyond-WBANs, and study the transmission scheduling under a scenario that there are a large number of gateways associating with one base station of medical centers. Motivated by the distinctions and requirements of beyond-WBAN communications, we introduce a priority-aware pricing-based capacity sharing scheme by taking into account the quality of service (QoS) requirements for different gateways. In the designed scheme, each gateway is intelligent to select transmission priorities and data rates according to its signal importance, and is charged by a price with regard to its transmission request. The capacity allocation is proceeded with guarantee of the absolute priority rule. In order to maximize the individual utility, gateways will compete with each other by choosing the optimal transmission strategies. Such decision process is formulated as a non-atomic game. Theoretical analyses show that our proposed pricing-based scheme can lead to an efficient Wardrop equilibrium. Through numerical results, we examine the convergence of strategy decisions, and demonstrate the effectiveness of our proposed mechanism in improving the utilities of gateways. © 2016 Elsevier B.V. Source

Macdonald K.,University of Manitoba | Bass J.,University of Manitoba | Maloney T.,Seven Oaks General Hospital
Medical Reference Services Quarterly

There is limited literature on hospital archives projects. Hospitals understandably have a strong focus on patient care, but there is still a critical need to keep institutional archives. Among their many uses, institutional archives preserve corporate memory, provide evidence of interactions with community, and assist in contemporary decision making. This column describes a university-hospital partnership to undertake a one-year project to preserve, detail, and digitize ten boxes, or approximately 3.8 meters, of materials dating from 1980 to 2006. This project serves as a model for other hospital or health care facilities wanting to preserve and more actively engage with their archival collections. © 2016, Published with license by Taylor & Francis. Source

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