Canadian Journal of Rural Medicine最新文献_第4页

La réforme des soins primaires dans un contexte rural. 农村地区的初级保健改革。

IF 1.1

Canadian Journal of Rural Medicine Pub Date : 2024-01-01 Epub Date: 2024-02-20 DOI: 10.4103/cjrm.cjrm_8_24

Peter Hutten-Czapski

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Food security. 粮食安全。

IF 1.1

Canadian Journal of Rural Medicine Pub Date : 2024-01-01 Epub Date: 2024-02-20 DOI: 10.4103/cjrm.cjrm_55_23

Peter Hutten-Czapski

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La réforme des soins primaires dans un contexte rural. 农村地区的初级保健改革。

IF 1.1

Canadian Journal of Rural Medicine Pub Date : 2024-01-01 Epub Date: 2024-02-20 DOI: 10.4103/cjrm.cjrm_7_24

Sarah Lespérance

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A Case Study of Eliminating Urinary Tract Infections for an Elderly Woman with Frequent Recurring UTIs 老年妇女尿路感染频繁复发的个案研究

Canadian Journal of Rural Medicine Pub Date : 2023-10-15 DOI: 10.33844/cjm.2023.6031

Richard Burns

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Message de la présidente. Renforcer les partenariats. 主席的致辞。加强伙伴关系。

IF 1.1

Canadian Journal of Rural Medicine Pub Date : 2023-10-01 DOI: 10.4103/1203-7796.387888

Sarah Lespérance

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Rendezvous procedure, a simultaneous endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy for choledocholithiasis, in a rural surgical program in Northwest Ontario. 在安大略省西北部的一个农村手术项目中，同时进行内镜逆行胰胆管造影和腹腔镜胆囊切除术治疗胆总管结石。

IF 1.1

Canadian Journal of Rural Medicine Pub Date : 2023-10-01 DOI: 10.4103/cjrm.cjrm_8_23

Matt Parkinson, Jenna Poirier, Erin Belmore, Len Kelly

{"title":"Rendezvous procedure, a simultaneous endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy for choledocholithiasis, in a rural surgical program in Northwest Ontario.","authors":"Matt Parkinson, Jenna Poirier, Erin Belmore, Len Kelly","doi":"10.4103/cjrm.cjrm_8_23","DOIUrl":"10.4103/cjrm.cjrm_8_23","url":null,"abstract":"Introduction: Northwest Ontario has a high prevalence of cholelithiasis, at 1.6 times the provincial norm. There is a concomitant 14% rate of choledocholithiasis. Accessing surgical services in the region often requires extensive travel by air. Choledocholithiasis management is typically with a 2-staged approach, an endoscopic retrograde cholangiopancreatography (ERCP) followed several days or weeks later by laparoscopic cholecystectomy (LC). Regional surgeons were concerned about the patient burden of travel and the loss to follow-up inherent in scheduling two independent procedures at separate hospital admissions. They adopted a 1-stage management, called the rendezvous procedure, which describes the simultaneous performance of an ERCP and LC.Methods: We accessed Sioux Lookout Meno Ya Win Health Centre hospital data for all patients receiving an ERCP and LC between 1 June 2019 and 1 December 2022. We documented patient demographics, operative outcomes, length of stay and transfer to other facilities.Results: There were 29 rendezvous procedures performed, with successful cannulation of the ampulla of Vater in 27 (93%) cases and stone removal in 23 (79%), with a complication rate of 7%. The operating time averaged 136 min, and two patients required transfer to a tertiary care centre and four were stented locally and required a return trip to Sioux Lookout for repeat ERCP and successful stone removal. The average length of stay was 2.1 ± 1.3 days. Patients who could not access a rendezvous procedure averaged 46.1 ± 78.1 days between procedures.Conclusion: Managing choledocholithiasis with a 1-stage approach was safe and effective and reduced patient travel, time to definitive care and hospital admissions.","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"28 4","pages":"190-194"},"PeriodicalIF":1.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Utilisation and barriers of PoCUS in a rural emergency department - A quality improvement project. 农村急诊科PoCUS的使用和障碍——一个质量改进项目。

IF 1.1

Canadian Journal of Rural Medicine Pub Date : 2023-10-01 DOI: 10.4103/cjrm.cjrm_90_22

Jamie E C Vander Ende, Ryan A Labossiere, Joshua Lawson

{"title":"Utilisation and barriers of PoCUS in a rural emergency department - A quality improvement project.","authors":"Jamie E C Vander Ende, Ryan A Labossiere, Joshua Lawson","doi":"10.4103/cjrm.cjrm_90_22","DOIUrl":"10.4103/cjrm.cjrm_90_22","url":null,"abstract":"Introduction: Point-of-care ultrasound (PoCUS) has been recognised as a tool that leads to more definitive diagnoses and enhances clinical decision-making in rural emergency departments (EDs) where diagnostic imaging is limited. We aimed to determine the current utilisation, barriers and solutions to using PoCUS in this rural Saskatchewan ED.Methods: Physicians working in the ED participated in a semi-structured interview. An online survey, administered via SurveyMonkey post-interview to provide further context, was used to support qualitative approaches. Interviews were recorded, transcribed and then analysed using inductive interpretation.Results: Seven physicians completed the quantitative survey with a response rate of 70%. Ten physicians were interviewed with a response rate of 100%. Themes identified were that physicians in this community's ED perceived their skill level as determining whether a scan was diagnostic or not, rather than the specific PoCUS application itself. In addition, they performed scans primarily for the purpose of triage. Inadequate training, Core IP certification certification requirement and intradepartmental logistics were barriers to PoCUS utilisation.Conclusion: This study showed that ED physicians in this community perceived PoCUS as a clinical adjunct and as a tool to triage patients for further imaging. Results highlight the need to have accessible training for rural physicians to increase PoCUS utilisation, awareness of current Saskatchewan PoCUS guidelines and education on diagnostic applications of PoCUS. Increased use of PoCUS for specific scans could decrease the need for formal imaging and the associated healthcare system resources.","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"28 4","pages":"170-178"},"PeriodicalIF":1.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

President's Message - Strengthening partnerships. 总统致辞-加强伙伴关系。

IF 1.1

Canadian Journal of Rural Medicine Pub Date : 2023-10-01 DOI: 10.4103/cjrm.cjrm_34_23

Sarah Lesp Rance

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A resident physician's reflection on rural medicine. 一位住院医师对乡村医学的思考。

IF 1.1

Canadian Journal of Rural Medicine Pub Date : 2023-10-01 DOI: 10.4103/cjrm.cjrm_26_23

Evelyne Guay

引用次数: 0

Enhanced recovery after surgery reduces length of stay after colorectal surgery in a small rural hospital in Ontario. 在安大略省的一家小型农村医院，术后恢复能力的增强缩短了结直肠手术后的住院时间。

IF 1.1

Canadian Journal of Rural Medicine Pub Date : 2023-10-01 DOI: 10.4103/cjrm.cjrm_71_22

Hector A Roldan, Andrew Robert Brown, Jane Radey, John C Hogenbirk, Lisa Rosalie Allen

{"title":"Enhanced recovery after surgery reduces length of stay after colorectal surgery in a small rural hospital in Ontario.","authors":"Hector A Roldan, Andrew Robert Brown, Jane Radey, John C Hogenbirk, Lisa Rosalie Allen","doi":"10.4103/cjrm.cjrm_71_22","DOIUrl":"10.4103/cjrm.cjrm_71_22","url":null,"abstract":"Introduction: Enhanced recovery after surgery (ERAS) programmes include pre-operative, intraoperative and post-operative clinical pathways to improve quality of patient care while reducing length of stay (LOS) and readmission. This study assessed the feasibility and outcomes of an ERAS protocol for colorectal surgery implemented over 2 years in a small, resource-challenged rural hospital.Methods: A prospective cohort study used retrospectively matched controls to assess the effect of ERAS on LOS in patients undergoing colorectal surgery in a small rural hospital in northern Ontario, Canada. ERAS patients were matched to two patients in the control group based on diagnosis, age and gender. Patients had open or laparoscopic colorectal surgeries, with those in the intervention group treated per ERAS protocol and given instructions on pre- and post-operative self-care.Results: Most of the 47 ERAS patients recruited to the study reported adherence to ERAS protocols before surgery. Adherence to protocol was strongest for chewing gum in the days after surgery. Most patients were sitting in a chair for their afternoon meal by the 1st day and most were walking down the hallway by the 2nd day. The control group had significantly higher (P < 0.001) malignant neoplasm of the colon (C18, 69% vs. 35%) and significantly lower malignant neoplasm of the rectum (C20, 0% vs. 5%). The control group had an average ln-transformed LOS that was significantly longer (exponentiated as 1.7 days) than ERAS patients (t-test, P < 0.001).Conclusion: This study found that ERAS could be implemented in a small rural hospital and provided evidence for a reduced LOS of approximately 2 days.","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"28 4","pages":"179-189"},"PeriodicalIF":1.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0